|Year : 2015 | Volume
| Issue : 1 | Page : 8-10
Herbal dentistry: A boon
Neeraj Grover, Sandeep Sharma, Sanjeet Singh, Jyoti Sharma
Department of Oral Pathology, D. J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
|Date of Web Publication||30-Jul-2015|
Dr. Neeraj Grover
Department of Oral and Maxillofacial Pathology and Microbiology, D. J. College of Dental Sciences and Research, Modinagar - 201 204, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Oral health influences the general quality of life and poor oral health is linked to chronic conditions and systemic diseases. Inter-relationship of oral diseases and the oral microbiota is well established. A number of species of bacteria that are inhabitant of the oral cavity are also implicated in oral diseases. Various plant species like Garlic, lemon, walnut and their extracts are now a days used in place of allopathic drug regimen because of near to minimum side effects. The advent and progression of dental caries involves acid producing gram-positive and gram negative bacteria and these bacterial strains have also been seen as the cause of periodontal diseases. Keeping in view the adverse effects of the various medications used in dentistry such as vomiting, diarrhoea and tooth staining and financial considerations in developing countries, there is a need for a safe and effective alternative and treatment options. Natural medicinal extracts isolated from plants come as good alternatives as they inhibit the growth of oral pathogens thereby reducing the development of biofilm on the tooth thus reducing the symptoms of oral diseases thereby enhancing the immunity.
Keywords: Dental diseases, medicinal plants, herbal toxicity
|How to cite this article:|
Grover N, Sharma S, Singh S, Sharma J. Herbal dentistry: A boon. Saint Int Dent J 2015;1:8-10
One of the burning problems throughout the world is the rising oral diseases. Among all the oral diseases prevalent, dental caries and periodontal diseases are the most important oral health problems as they are concerned with the health of a person.  Good oral health signifies a good quality life thereby indicating the direct relationship between oral health and general body functions. Tooth brushing although is the basic process in oral care but still a lot of people, throughout the world prefer natural toothbrushes also called as "twigs" which are made from healing plants. The twigs contain volatile oils which have the potential to stimulate the blood circulation whereas tannins make the gingival tissue smooth, resilient, flexible, and Vitamin C helps in maintaining healthy gums. 
| Discussion|| |
The inter-relationship of microbial flora of oral cavity and oral diseases is well known. About 500 species of microbial flora reside in the oral cavity and an appreciable number of these microbes are involved in number of oral diseases.  Throughout the world need for a safe, effective and economical method of oral health care is felt because of the known side effects such as tooth discoloration and GIT disturbances of the chemotherapeutic drugs used for treating them.  The nature harbors a lot of plants of medicinal importance such as amla, tulsi, nimbu, aloe vera, neem, lahsun, etc., which are a potent source of biologically active compounds required for good oral and general health.  As the organisms which are seen in the oral cavity are becoming resistant to the therapeutic agents like antimicrobial drugs a resurging interest has developed for search of novel anti-infective compounds.
Only a handful of plant species (1%) of more than 5 lakh plant species found worldwide have been investigated for procuring novel bioactive compounds. Investigating studies concerned with observing the activity of traditional medicinal plants against harmful oral microbes have been limited to evaluation of organic solvent extracts or crude (raw) aqueous extracts.  Mostly the investigators have simply sought to validate the traditional medicinal use of the plant. Novak in his study on 27 medicinal and different other plant extracts identified that there are a number of medicinal plant species that can inhibit the growth of oral streptococci. Extracts were obtained from plant species like Albizia julibrissin (Fabaceae), Chelidonium majus (Papaveraceae), Abies canadensis (Pinaceae), Pinus virginiana (Pinaceae), Rosmarinus officinalis (Lamiaceae), Sassafras albidum (Lauraceae), Thuja plicata (Cupressaceae) and Juniperus virginiana (Cupressaceae).  Extracts of Coptidis rhizome of Ranunculaceae family and Garlic (Allium sativum) of Liliaceae family have shown bactericidal activity against periodontal pathogens along with wide range of antimicrobial properties against Gram-negative and Gram-positive pathogens. Allicin present in garlic extract is more active against Gram-negative rather than Gram-positive bacteria. Garlic is implicated in periodontal diseases as it has shown to exhibit inhibition of trypsin-like protease activity thereby suggesting of their therapeutic implications. Many of the African plants like Harungana madagascariensis exhibit antimicrobial properties. Ethanolic extracts of powdered flowering tops of Piper cubeba shown to exhibit good antimicrobial properties against Streptococcus mutans and Streptococcus sanguis. Resinous extract obtained from propolis plant has shown to exhibit good antimicrobial activity against oral bacteria by preventing adherence of S. mutans and Streptococcus sobrinus to the tooth surface. Number of studies has been done to testify the activity of propolis against a number of microorganisms, including S. mutans and S. sobrinus one done by Uzel et al. These studies have shown that antimicrobial activity of Propolis was similar to chlorhexidine but was greater than clove extracts. 
There are certain purified phytochemicals like flavonoids, polyphenols that exhibit antibacterial activity against oral pathogens and have shown to inhibit growth of numerous cariogenic and oral bacteria, including S. mutans and other oral streptococci, lactobacilli and Actinomyces. Of the phytochemicals isolated till date Flavonone phytoalexins obtained from Sophora exigua has exhibited maximum growth inhibition potential of numerous cariogenic bacteria. Number of plants like Erythrina variegata is used as a normal medicinal aid in tropical and sub-tropical regions and show number of biological properties, including antibacterial activity. Root bark of plants such as Morus alba have shown to exhibit medicinal significance and can be effectively used in cases of food poisoning. Certain tea varieties like Camelia sinensis possess certain components that render it with anti-cariogenic property and apart from being anti-cariogenic it also exerts bactericidal effects on oral bacteria, inhibits adherence of bacteria to tooth surfaces and also inhibits glucan production.  Polyphenols such as epicatechin gallate, epicatechin are thought to be the cause of these biological effects. Plants like Psidium guajava has been used traditionally to maintain oral hygiene. This plant reduces the adherence of plaque forming microorganisms like Streptococcus mitis, Streptococcus Sanguinis, and Actinomyces over the tooth surfaces. A concentration dependent study involving treatment of S. mutans with aqueous extract of Psidium cattleianum resulted in dysfunction of genes involved in lactic acid production, general metabolism and glycolysis (at low concentration) but on the other hand at higher concentrations there was inhibition of S. mutans biofilms. A polymethoxylated flavonoid Naringin content of citrus fruit shows inhibition of the growth of periodontal pathogens like A. Actinomycetemcomitans and Porphyromonas gingivalis other common oral pathogens.  Bakuchiol, a terpenes derivative, obtained from medicinal plant Psoralea corylifolia is highly active against Gram-positive and Gram-negative oral pathogens. When this terpenes derivative was tested in the oral cavity, there was evident inhibition of the growth of S. mutans on the tooth surface.  Terminalia chebula yield a herbal product, Triphala, which possess a free radical scavenging effect and therefore is an effective antiplaque and antimicrobial agent.  As it possess anti-oxidant property therefore it is also an effective anti-carcinogenic agent.  A dental gel prepared from medicinal plant Berberis vulgaris is used in preventing gingivitis and plaque formation in children.  Juices of this plant are rich in Vitamin C and so it can be effectively used as an immune booster and can be used for treating scurvy.  Herbal extract prepared from German chamomile is used in mouthwashes and also as an irrigant to root canal disinfection with less toxic reactions. , [Table 1] showing common medicinal plants with their traditional use.
| Herbal Toxicity|| |
As the herbal medicines are relatively benign they do not cause severe toxicity but when used inadvertently can cause severe toxicity and even death.  Certain plants such as Nerium oleander, Aconitum napellus, Tripterygium wilfordii, Ginkgo bilbo, Piper mysticum, etc., cause number of toxic cardiopulmonary reactions as seizers, ventricular fibrillations, bradycardia, ventricular tachycardia, complete A-V Block, and shock. ,, There can be pulmonary manifestations also such as anaphylaxis, interstitial pneumonitis, and pulmonary edema. ,
| Conclusion|| |
The use of herbal medicines is expanding at a very rapid pace. People nowadays prefer herbal medicines or herbal products as they have a minimal side effect as compared to other treatment modalities. The use of herbal products in dentistry has seen a positive upsurge and these are nowadays are extensively use in treatment of gingival inflammation, as antiplaque agents and as antiseptics, antioxidant, antimicrobial, antifungals, and analgesics. Apart from this these natural products contribute to healing and in effective microbial plaque control as in gingivitis and periodontitis and thereby strengthening the immunity. Hence, it can be said that, when the oral cavity is healthy a person can eat and drink properly and remains healthy with sound immunity.
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Conflicts of interest
There are no conflicts of interest.
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