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Received : 14-08-2021

Accepted : 01-09-2021

Available online : 22-10-2021



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Kataria, Singh, and Shergill: Herbal mouthwashes for oral health care-A paradigm shift


Introduction

Gingival and periodontal infections have afflicted humans since a very long time. Paleopathological studies have directed that critical periodontal diseases, as indicated by bone loss, have affected early humans in varied cultures. The ancient Greeks, Hippocrates of Cos (460- 377 B.C.) thought that inflammation of gum could be caused by buildup of “pituita” or calculus with gingival haemorrhage.1, 2 These periodontal diseases occur when bacteria in the plaque infect gums and bones that support the teeth.3 The mild to moderate forms of these periodontal diseases are treatable by non-surgical periodontal therapy, while the more severe cases require surgical intervention.3 Anti-microbial agents and antibiotics are used as an adjunct to both surgical and non-surgical periodontal therapy.4, 5

It has been seen in the past that continued use of antimicrobial agents and antibiotics can cause antibiotic resistance.6 It has also been seen that emergence of previously rare infections is on a rise, possibly due to incorrect and prevalent overuse of antimicrobials. As a result, there has been a continual search for alternatives of conventional antibiotics.

Herbal medicine is a popular form of Complementary and Alternative Medicine (CAM).7 Herb, by definition, is a plant or plant part valued for its medicinal, savory, or aromatic qualities. Medicinal herbs are an effective method of treating various diseases.8 Over the recent years, herbal products are being preferred over conventional drugs because of substantial natural activity, advanced safety margins, and inferior cost.3 One of the most accepted method of delivering herbal extracts for their antimicrobial properties is mouthwashes. Mouthrinses are antiseptic solutions used to decrease microbial burden in the oral cavity. They have the capacity to provide therapeutic effect on all tooth surfaces, including the interproximal areas.9 This review aims at evaluating some commonly available herbal mouthwashes in India.

Medicinal properties of some popular herbal extracts

Some of the commonly used herbs for preparation of mouthwashes are Aloe vera, Syzigiumaromaticum, Azadirachta indica, Mentha piperita extract, Elettaria cardamomum oil, Ricinus communis, and Melaleuca alternifolia oil. Other than these, Eucalyptuses, Calendula officinalis, Trachyspermumammi, Cinnamomum camphora, and Ocimumtenuiflorum are also widely used.

Aloe barbadensis

Aloe vera is a medicinal plant that has been used since many years for treatment of sunburns, digestive tract disorders and wounds. The active compounds include aloesin, aloin, aloeride, naftoquinones, methylchromones, flavonoids, saponin, sterols, etc.10 It is antibacterial, anti-inflammatory, antiulcer, and antioxidant in action.11 Aloe vera mouthwashes have become increasingly popular because of its safety, easy availability, and its effectiveness against plaque causing bacteria.

Syzigiumaromaticum

Popular as Clove oil, Syzigiumaromaticum is another commonly used herbal extract used as an ingredient in herbal mouthrinses. It is a frequent find in Indian kitchens as flavor enhancer.12 Studies done by Gijzen M et al.13 and Gislene GF et al.14 have shown that clove oil extracts have the potential to combat many gram positive and gram negative bacteria, thus establishing its antimicrobial properties.

Azadirachta indica

Azadirachta indica (Neem) has been used in India for decades for various dental problems. A large percentage of people still rely on neem, rather than on commercially available chemical toothpastes, for their daily dental hygiene. Neem has been proven to possess excellent antifungal and antibacterial properties.15 Studies also suggest that it has anti-inflammatory action, as it possibly inhibits prostaglandin E and 5HT.16

Melaleuca alternifolia oil

Popular worldwide for its antiseptic and anti-inflammatory properties, Melaleuca alternifolia (Tea tree) oil is a volatile essential oil originating in Australia. It has been used since almost 100 years. The antimicrobial activity of tea tree oil is mainly because of presence of terpinen-4-ol, a major component of the oil.17 It also has antibacterial properties. Tea tree oil is mostly bactericidal, while being bacteriostatic at lower concentrations.17

Mentha piperita

M piperita (peppermint) concentrates have been observed to be better than synthetic chlorhexidine mouthwash in suppressing Streptococcus mutans, bacteria commonly associated with dental caries.18 Leaves of peppermint are powdered to be used for brightening of teeth.19 It also helps get rid of bad breath, giving freshness.20 Peppermint is well known for its antimicrobial, antioxidant, anticarcinogenic, antiviral, and antiseptic properties.18

Elettaria cardamomum

A popular flavoring and food preservative agent, Cardamom is well known for its medicinal benefits. It is commonly used as breath freshener. Studies have proven that cardamom is a potent antimicrobial agent.21 Other than that; E cardamomum exhibits hypocholesterolemic, hypoglycemic, anti-inflammatory, and antimutagenic properties.22

Ricinus communis

Ricinoleic acid, synthesised from fatty acid molecules of Ricinus communis (Castor oil), has antimicrobial activity against a number of gram positive bacteria and yeast.23, 24 A study by Panghal et al.25, 26 also concluded that Castor oil has antimicrobial activity against clinical isolates of oral cancer.

Commercially available herbal mouthwashes for periodontal health

Many herbal mouthwashes are currently available in the market

  1. IMC Aloe Mouthwash

  2. Hiora-K

  3. Closeup Natural Boost Mouthwash

  4. Dr Organic Aloe Vera Mouthwash

  5. Purexa Antioxidant Mouthrinse

  6. Herbostra Oil Pulling Mouthwash

Summary

Due to lesser side effects, low cost, and ease of availability, use of herbal medicine continues to expand rapidly across the globe. Herbal extracts have been used in dentistry for their anti-inflammatory, antibacterial, antifungal, and antioxidant properties. They are also effective in controlling microbial plaque, thus preventing gingivitis and periodontitis. Despite being highly useful, there have been fewer researches regarding the standardization and product development in this field. It is critical that steps be taken in this regard as soon as possible, while also bolstering the current efforts already in place.

Source of Funding

None.

Conflict of Interest

None.

References

1 

R Anarthe A Mani P Kale S Maniyar S Anuraga Herbal approaches in periodonticsGal Int J Heal Sci Res2017211825

2 

B Anand Herbal therapy in periodontics: a reviewJ Res Pharm Sci20173517

3 

H Abdelmagyd S R Shetty A A Mmm Herbal medicine as adjunct in periodontal therapies- A review of clinical trials in past decadeJ Oral Biol Craniofac Res2019932127

4 

E Barca E Cifcibai S Cintan Adjunctive use of antibiotics in periodontal therapyJ Istanb Univ Fac Dent2015493556210.17096/jiufd.90144

5 

J Keestra I Grosjean W Coucke M Quirynen W Teughels Non-surgical periodontal therapy with systemic antibiotics in patients with untreated chronic periodontitis: a systematic review and meta-analysisJ Periodontal Res201550329431410.1111/jre.12221

6 

B K English A H Gaur The use and abuse of antibiotics and the development of antibiotic resistanceAdv Exp Med Biol2010659738210.1007/978-1-4419-0981-7_6

7 

Ministry Health NZ Food: NZ People. Key Results of the 1997 National Nutrition Survey. Wellington: Ministry of Health1999https://www.health.govt.nz/nz-health-statistics/national-collections-and-surveys/surveys/past-surveys/nutrition-survey

8 

J A Duke CRC Handbook of Medicinal Herbs19854245

9 

G Biswas N Anup S Acharya H Kumawat Evaluation of the efficacy of 0.2% chlorhexidine versus herbal oral rinse on plaque induced gingivitis - A randomized clinical trial J Nurs Health Sci201432586310.9790/1959-03255863

10 

D M A Alnouri C Kouchaji A H Nattouf M M A Hasan Effect of aloe vera mouthwash on dental plaque and gingivitis indices in children: A randomized controlled clinical trialPediatr Dent J20203011810.1016/j.pdj.2020.01.001

11 

S K Yeturu S Acharya A S Urala K C Pentapati Effect of Aloe vera, chlorine dioxide, and chlorhexidine mouth rinses on plaque and gingivitis: a randomized controlled trialJ Oral BiolCraniofac Res201661546210.1016/j.jobcr.2015.08.008

12 

B C Nzeako Z Al-Kharousi Z Al-Mahrooqui Antimicrobial Activities of Clove and Thyme ExtractsSultan Qaboos Univ Med J200661339

13 

Bioactive Volatile Compounds from Plants. In: Teranishi R, Buttery RG, Sugisawa H, editors. Conifer Monoterpenes: Biochemistry and Bark Beetle Chemistry Ecology. Ch. 2 ed. Washington DC: American Chemistry Society; 1991.

14 

G F Gislene C Paulo L Giuliana Antibacterial Activity of Plant Extracts and Phytochemicals on Antibiotic Resistant BacteriaBraz J Microbiol20003143142510.1590/S1517-83822000000400003

15 

H Singh M Kaur J S Dhillon M Batra J Khurana Neem: A magical herb in EndodonticsStomatological Dis Sci2017150410.20517/2573-0002.2016.10

16 

A Chatterjee M Saluja N Singh A Kandwal To evaluate the antigingivitis and antipalque effect of an Azadirachta indica (neem) mouthrinse on plaque induced gingivitis: A double-blind, randomized, controlled trialJ Indian Soc Periodontol201115439840110.4103/0972-124X.92578

17 

C F Carson K A Hammer T V Riley Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal PropertiesClin Microbiol Rev20061915062

18 

N Shabeer Peppermint Oil, its Useful, and Adverse Effects on Human Health: A Review2020861410.22159/ijas.2020.v8i6.39189

19 

I Rasooli S Shayegh M Taghizadeh S D Astaneh Phytotherapeutic prevention of dental biofilm formationPhytother Res20082211621169

20 

S Shayegh I Rasooli M Taghizadeh S D Astaneh Phytotherapeutic inhibition of supragingival dental plaqueNat Prod Res20082254286710.1080/14786410701591739

21 

K Aneja J Radhika Antimicrobial activity of Amomum subulatum and Elettaria cardamomum against dental caries causing microorganismsEthnobotanLeafl13849

22 

I P S Kapoor B Singh G Singh V Isidorov L Szczepaniak Chemistry, antifungal and antioxidant activities of cardamom (Amomum subulatum) essential oil and oleoresinsInt J Essent Oil Ther22940

23 

I Y Ito I C Froner H Mian G O Chierici Castor oil: antimicrobial activity of detergent derived from ricinoleic acidJ Dent Res199978344

24 

C M Ferreira K C Bonifacio I C Froner I Y Ito Evaluation of the antimicrobial activity of three irrigating solutions in teeth with pulpal necrosisBraz Dent J19991011521

25 

M Panghal V Kaushal J P Yadav In vitro antimicrobial activity of ten medicinal plants against clinical isolates of oral cancer casesAnn Clin Microbiol Antimicrob2011102110.1186/1476-0711-10-21

26 

K Ananthathavam J Ramamurthy Treating periodontitis with the use of essential oil and herbsJ Pharm2014412250301310.9790/3013-0411-39-42



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