Natural Oral Care in Dental Therapy

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Natural Oral Care in Dental Therapy

Edited byDurgesh Nandini Chauhan, Prabhu Raj Singh,

Kamal Shah and Nagendra Singh Chauhan

This edition first published 2020 by John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA and Scrivener Publishing LLC, 100 Cummings Center, Suite 541J, Beverly, MA 01915, USA© 2020 Scrivener Publishing LLCFor more information about Scrivener publications please visit www.scrivenerpublishing.com.

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Library of Congress Cataloging-in-Publication Data

Names: Chauhan, Durgesh Nandini, editor. | Singh, Prabhu Raj, editor. | Shah, Kamal, editor. | Chauhan, Nagendra Singh, editor. Title: Natural oral care in dental therapy / edited by Durgesh Nandini Chauhan, Prabhu Raj Singh, Kamal Shah and Nagendra Singh Chauhan. Description: Hoboken, New Jersey : Wiley-Scrivener, [2020] | Includes bibliographical references and index. Identifiers: LCCN 2019050429 (print) | LCCN 2019050430 (ebook) | ISBN 9781119614227 (cloth) | ISBN 9781119618935 (adobe pdf) | ISBN 9781119618904 (epub) Subjects: MESH: Mouth Diseases--drug therapy | Plants, Medicinal | Mouth Diseases--prevention & control | Dental Care | Medicine, Traditional Classification: LCC RK305 (print) | LCC RK305 (ebook) | NLM WU 166 | DDC 617.6/306--dc23 LC record available at https://lccn.loc.gov/2019050429LC ebook record available at https://lccn.loc.gov/2019050430

ISBN 978-1-119-61422-7

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10 9 8 7 6 5 4 3 2 1

v

Contents

Preface xix

Foreword xxiii

Part I: Natural Oral Care 11 Natural Oral Care in Dental Therapy: Current and Future Prospects 3

Durgesh Nandini Chauhan, Prabhu Raj Singh, Kamal Shah and Nagendra Singh Chauhan1.1 Introduction 31.2 Safety of Natural Oral Care 151.3 Advantage of Natural Oral Care 151.4 Limitations of Natural Oral Care 161.5 Future Prospects of Natural Oral Care 16 References 17

2 Herbal Products for Oral Hygiene: An Overview of Their Biological Activities 31Ummuhan Sebnem Harput2.1 Introduction 312.2 Oral Hygiene and Current Treatments 332.3 Plants Traditionally Used in Oral Hygiene 332.4 Clinically Studied Plant Product for Oral Hygiene 352.5 In Vitro Studied Herbal Product for Oral Hygiene 372.6 Discussion 402.7 Conclusion 41 References 41

3 Go Green—Periodontal Care in the Natural Way 45Siddhartha Varma and Sameer Anil Zope3.1 Introduction 453.2 Plaque Control 463.3 Dant Dhavani (Brushing) 463.4 Jivha Lekhana (Tongue Scrapping) 473.5 Gandusha (Gargling) or Oil Pulling 483.6 Oxidative Stress in Periodontitis 483.7 Green Tea 48

vi Contents

3.7.1 Components 483.7.2 Beneficial Effects of Various Tea Components 49

3.7.2.1 Antioxidative Effect 493.7.3 Role in Managing Periodontitis 49

3.8 Turmeric (Curcumin longa, Haldi) 493.8.1 Applications of Turmeric in Dentistry 49

3.9 Amala (Emblica officinalis, Amalaki, Phyllanthus emblica, Indian Gooseberry, Dhatriphala) 50

3.10 Anar/Dalima (Punica granatum) 503.11 Launga/Clove (Syzygium aromaticum) 503.12 Gotu Kola (Centella asiatica) 513.13 Amra/Mango (Magnifera indica) 513.14 Neem (Azadirachta indica) 513.15 Tulsi (Ocimum sanctum) 513.16 Nilgiri (Eucalyptus globulus) 523.17 Tila/Sesame (Sesamum indicum) 523.18 Triphala 523.19 Tea Tree Oil (Melaleuca Oil) 523.20 Rumi Mastagi/Mastic Gum (Pistacia lentiscus) 533.21 Wheat Grass 533.22 Goldenseal (Hydrastis canadensis) 533.23 Licorice Root 533.24 Myrrh (Commiphora glileadenis) 543.25 Psidium guajava 543.26 Ginkbo Biloba 543.27 Honey 543.28 Other Herbs Which Can Be Potentially Used for Treating Periodontitis 553.29 Conclusion 55 References 56

4 Role of Herbal and Natural Products in the Management of Potentially Malignant Oral Disorders 61P. Kalyana Chakravarthy, Komal Smriti and Sravan Kumar Yeturu4.1 Introduction 614.2 Oral Submucous Fibrosis (OSMF) 62

4.2.1 Background 624.2.2 Beta-Carotene 634.2.3 Lycopene 644.2.4 Aloe Vera 654.2.5 Colchicine 664.2.6 Tea Pigments 664.2.7 Spirulina 664.2.8 Chinese Herbal Medicines 674.2.9 Turmeric and Derivatives, Nigella sativa, Ocimum 684.2.10 Polyherbal Formulations 684.2.11 Ayurvedic Formulations 694.2.12 Conclusion 69

Contents vii

4.3 Oral Leukoplakia (OL) 704.3.1 Background 704.3.2 Green Tea and Extracts 704.3.3 Beta-Carotene (βC) 714.3.4 Lycopene 724.3.5 Curcumin 724.3.6 Miscellaneous 73

4.3.6.1 Alpha-Tocopherol 734.3.6.2 Chinese Herbs 734.3.6.3 Bowman–Birk Inhibitor Concentrate (BBIC) 73

4.3.7 Conclusion 734.4 Oral Lichen Planus (OLP) 74

4.4.1 Conclusion 75 References 75

Part II: Studies of Plants Used in Dental Disease 815 Studies on the Anticariogenic Potential of Medicinal Plant Seed

and Fruit Extracts 83Disha M. Patel, Jenabhai B. Chauhan and Kalpesh B. Ishnava5.1 Introduction 835.2 Materials and Methods 85

5.2.1 Plant Materials 855.2.2 Preparation of Plant Seed and Fruit Extracts 855.2.3 Cariogenic Bacterial Strains 855.2.4 Preparation of Inoculums 865.2.5 Anticariogenic Activity Screening of Plant Extracts 87

5.2.5.1 Agar Well Diffusion Assay 875.2.5.2 Determination of Minimum Inhibitory Concentration (MIC) 87

5.2.6 Preliminary Phytochemical Analysis 875.2.7 Analytical Thin Layer Chromatography 875.2.8 TLC—Bioautography 88

5.3 Result and Discussion 885.3.1 MIC Value of Effective Plant Extracts 915.3.2 Phytochemical Screening and Bioautography 92

5.4 Conclusion 94 Acknowledgments 95 References 95

6 Cytotoxic and Anti-Inflammatory Effect of Turmeric and Aloe Vera in a Gingivitis Model 97Karen Esperanza Almanza-Aranda, Miguel Aranda-Fonseca, Gabriela Velazquez-Plascencia and Rene Garcia-Contreras6.1 Introduction 976.2 Gingivitis and Periodontitis 986.3 Aloe Vera 99

6.3.1 Aloe Vera for Gingivitis and Periodontitis 1006.3.2 Aloe Vera: Other Oral Applications 100

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6.4 Turmeric 1006.4.1 Turmeric for Gingivitis and Periodontitis 1016.4.2 Turmeric: Other Oral Applications 101

6.5 Methodology 1026.5.1 Materials and Methods 102

6.5.1.1 Authorization 1026.5.1.2 Cell Culture 1026.5.1.3 Cell Subculture 1026.5.1.4 Cytotoxicity Test 1036.5.1.5 Anti-Inflammatory Activity in a Gingivitis Model 1036.5.1.6 Statistical Analysis 104

6.5.2 Results 1046.5.2.1 Cytotoxicity 1046.5.2.2 Anti-Inflammatory Activity in a Gingivitis Model 105

6.5.3 Discussion 1056.5.3.1 Cytotoxicity 1056.5.3.2 Anti-Inflammatory Activity 106

6.6 Perspectives for the Future 1076.7 Conclusions 107 References 107

7 Effects of Bauhinia forficata Link in Reducing Streptococcus mutans Biofilm on Teeth 111Julio Cesar C. Ferreira-Filho, Mariana Leonel Martins, Andressa Temperini de Oliveira Marre, Juliana Soares de Sá Almeida, Leandro de Araújo Lobo, Adriano Gomes Cruz, Marlon Máximo de Andrade, Thiago Isidro Vieira, Maria Teresa Villela Romanos, Lucianne Cople Maia, Ana Maria Gondim Valença and Andréa Fonseca-Gonçalves7.1 Introduction 1127.2 Materials and Methods 112

7.2.1 Recognition, Production, and Chemical Characterization of Ethanolic Tincture From B. forficata L. Leaves 112

7.2.2 Microbial Strains and Preparation of Inoculum 1137.2.3 Minimum Inhibitory Concentration and Minimum Bactericidal

Concentration (MBC) 1137.2.4 Kill-Kinetic Assay 1137.2.5 Cytotoxic Potential 1147.2.6 Tooth Selection and Preparation for Microbiologic Assay Using

an S. mutans Biofilm 1147.2.7 Statistical Analysis 115

7.3 Results and Discussion 1157.4 Final Considerations 118 Acknowledgments 118 References 119

Contents ix

8 Antimicrobial Effect of a Cardamom Ethanolic Extract on Oral Biofilm: An Ex Vivo Study 121Marina Fernandes Binimeliz, Mariana Leonel Martins, Julio Cesar Campos Ferreira Filho, Lucio Mendes Cabral, Adriano Gomes da Cruz, Lucianne Cople Maia and Andréa Fonseca-Gonçalves8.1 Introduction 1218.2 Materials and Methods 122

8.2.1 Cardamom Extract Production 1228.2.2 Physical Analyses 1238.2.3 Bacterial Strains and Determination of Minimum Inhibitory

Concentration and Minimum Bactericidal Concentration 1238.2.4 Salivary Collection for Biofilm Formation (Ex Vivo Experiment) 1248.2.5 Biofilm Formation and Treatment 1248.2.6 Statistical Analyses 127

8.3 Results and Discussion 1278.4 Final Considerations 129 Acknowledgment 129 References 129

9 Effect of Punica granatum Peel Extract on Growth of Candida albicans in Oral Mucosa of Diabetic Male Rats 133Maryam Eidi and Fatemeh Noorbakhsh9.1 Introduction 1339.2 Materials and Methods 134

9.2.1 Hydro-Methanolic Extract 1349.2.2 Candida albicans Inoculation 1349.2.3 Animal 1349.2.4 Statistical Analysis 135

9.3 Results and Discussion 1359.4 Conclusion 136 Acknowledgment 136 References 137

Part III: Applications of Natural Products in Oral Care 13910 Effect of Oil Pulling on Oral Health 141

Sameer Anil Zope and Siddhartha Varma10.1 Introduction 14110.2 What Is Oil Pulling (Snaihik Gandoosh)? 14210.3 How Does Oil Pulling Work? 14310.4 Composition and Various Activities of Most Commonly Used Oils

for Oil Pulling 14310.4.1 Sesame Oil 143

10.4.1.1 Antioxidant Activity 14310.4.1.2 Antimicrobial Activity 144

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10.4.2 Coconut Oil 14510.4.2.1 Antibacterial, Antifungal, and Antiviral Activity 14510.4.2.2 Antinociceptive, Anti-Inflammatory, Antioxidant,

and Anti-Ulcer Activity 14510.5 Procedure of Oil Pulling 14610.6 Effects of Oil Pulling on Oral Health 146

10.6.1 Dental Caries 14610.6.2 Plaque-Induced Gingivitis 14710.6.3 Halitosis 14810.6.4 Oral Thrush 14910.6.5 Xerostomia and Burning Mouth Syndrome 149

10.7 Drawbacks of Oil Pulling 150 References 150

11 Role of Proteolytic Enzymes in Dental Care 153P. Kalyana Chakravarthy and Sravan Kumar Yeturu11.1 Introduction 15311.2 Role of Proteolytic Enzymes in Oral Surgery 154

11.2.1 Post-Extraction Management 15411.2.2 Post-Surgical Facial Ecchymosis and or Edema 15511.2.3 Enhanced the Action of Antibiotics 15611.2.4 Effect of Bromelain on Blood Coagulation and Fibrinolysis 156

11.3 Role of Proteolytic Enzymes in Cancer and Oral Mucositis 15611.3.1 Cancer 15611.3.2 Management in Oral Mucositis 157

11.4 Osteoarthritis 15711.5 Anti-Microbial Action 15811.6 Treatment of Dental Carious Lesions 159

11.6.1 Laboratory Studies 15911.6.2 Clinical Studies 160

11.7 Improvement in Bonding of Orthodontics Brackets 16111.8 Role on Biofilm Control (Plaque, Gingivitis, and Oral Malodor) 16311.9 Extrinsic Stain Removal on the Teeth 16411.10 Role in Replantation of the Avulsed Tooth 16511.11 Effect of Bromelain on Immunogenicity 16511.12 Other Possible Applications and Scope for Future Research 165 References 165

12 The Effect of Probiotic on Oral Health 171Patricia Nadelman, Marcela Baraúna Magno, Mariana Farias da Cruz,

Adriano Gomes da Cruz, Matheus Melo Pithon, Andréa Fonseca-Gonçalves and Lucianne Cople Maia12.1 Introduction 17112.2 Overview of Oral Communities and Probiotic-Based Therapy

to Oral Dysbiosis 17212.3 Probiotics Mechanisms of Action 17512.4 Dental Caries 176

Contents xi

12.4.1 Definition and Etiopathology 17612.4.2 Probiotics and Dental Caries 17912.4.3 Probiotic-Contained Dairy Products and Dental Caries 17912.4.4 Probiotic Powder and Dental Caries 18012.4.5 Probiotic Tablets and Lozenges and Dental Caries 18012.4.6 Probiotic Mouthwashes and Dental Caries 181

12.5 Periodontal Disease 18112.5.1 Definition and Etiopathology 18112.5.2 Probiotics and Periodontal Diseases 182

12.6 Oral Candidiasis 18312.6.1 Definition and Etiopathology 18312.6.2 Probiotics and Oral Candidiasis 184

12.7 Halitosis 18512.7.1 Definition and Etiopathology 18512.7.2 Probiotics and Halitosis 185

12.8 Conclusion 186 Acknowledgments 186 References 186

13 Charcoal in Dentistry 197Abhilasha Thakur, Aditya Ganeshpurkar and Anupam Jaiswal13.1 Introduction 19713.2 Charcoal Production Methods 199

13.2.1 The Traditional Method 19913.2.2 The Modern Methods 199

13.3 Uses of Charcoal 20013.3.1 Medicinal Uses 20013.3.2 Non-Medicinal Uses 201

13.4 Charcoal Containing Oral and Dental Care Products 20113.5 Benefits of Using Charcoal Containing Oral

and Dental Care Products 20413.5.1 Removes Stains and Whitens Teeth 20413.5.2 Removes Acidic Plaque 20413.5.3 Gives Fresh Breath and Improves Halitosis 20413.5.4 Remineralize Teeth 20513.5.5 Helps Overall Dental Health 20513.5.6 Protects From Infection 20513.5.7 Cost Effective for Regular Basis Use 205

13.6 Precautions to be Taken While Using Charcoal Containing Oral and Dental Care Products 206

13.7 Conclusion 207 References 207

xii Contents

14 Propolis Benefits in Oral Health 211Mariana Leonel Martins, Karla Lorene de França Leite, Yuri Wanderley Cavalcanti, Lucianne Cople Maia and Andréa Fonseca-Gonçalves14.1 Introduction 21114.2 Types of Propolis 213

14.2.1 Brown Propolis 21314.2.2 Green Propolis 21414.2.3 Red Propolis 214

14.3 Biological Properties of Propolis 21514.3.1 Oral Antibacterial Activity 21614.3.2 Oral Antifungal Activity 219

14.4 Other Biological Properties of Propolis 22014.4.1 Anti-Inflammatory Activity 22014.4.2 Antioxidant Activity 22114.4.3 Anticancer Activity 221

14.5 Benefits for Oral Health and Applications in Dentistry 22114.6 Final Considerations 222 Acknowledgment 223 References 223

15 Grape Seed Extract in Dental Therapy 229Anusuya V, Ashok Kumar Jena and Jitendra Sharan15.1 Introduction 22915.2 Part I: Basics About Grape Seed Extracts 230

15.2.1 Components of Grape Seed Extracts 23015.2.2 Chemical Structure 23115.2.3 Types of GSEs 23215.2.4 Methods of Separation 23215.2.5 Factors Influencing the Quality and Quantity of Polyphenols

in the GSEs 23415.2.6 Physical Properties of Polyphenols 23515.2.7 Biochemical Properties (Biological and Pharmacological) 236

15.3 Part II: Biological Applications in Dentistry 24015.3.1 GSEs in Dental Caries 24015.3.2 Anti-Erosive Agent (Prevention of Enamel erosion) 24215.3.3 Antiplaque Effect 24315.3.4 Antibacterial Agent 24415.3.5 Biomodifier 24515.3.6 GSEs as a Remineralizing Agent—Existing Dilemma 247

15.4 GSEs in Restorative Dentistry 24815.4.1 GSE as Cross-Linking Agent 24815.4.2 GSE in Bonding 249

15.5 GSEs in Endodontic Treatment 25015.5.1 Endodontic Irrigants 25015.5.2 Post Endodontic Restorations 251

15.6 GSEs in Periodontics 251

Contents xiii

15.6.1 Anti-Inflammatory Action in Periodontitis 25215.6.2 Anti-Oxidative Action in Periodontitis 25215.6.3 Antibacterial Action Against Periodontal Pathogens 25315.6.4 Antimicrobial Activity in Peri-Implantitis 253

15.7 GSEs in Oral Cancer 25415.8 Conclusion 254 References 255

16 Ocimum Sanctum L: Promising Agent for Oral Health Care Management 259Trinette Fernandes, Anisha D’souza and Sujata P. Sawarkar16.1 Introduction 25916.2 History of Ocimum sanctum 26016.3 Chemical Constituents of Ocimum sanctum 26016.4 Therapeutic Significance of Ocimum in Dental Health and Preventive

Care Management 26216.5 Novel Drug Delivery Formulations and Its Application in Dentistry 264

16.5.1 Nanofibers 26416.5.2 β-Cyclodextrin Complexes 26416.5.3 Nanoparticles of Biocompatible Ocimum sanctum-Coated

Silver Nanoparticles 26416.6 Conclusion 265 References 266

17 Coconut Palm (Cocos nucifera L.): A Natural Gift to Humans for Dental Ministrations 271Navneet Kishore and Akhilesh Kumar Verma17.1 Introduction 27117.2 Traditional Usage and Ethnopharmacological Relevance 27217.3 Pharmacological Properties of Coconut 27317.4 Role of Coconut Tree in Dental Ministrations 27417.5 Exemplary Potential of Coconut Water in Dentistry 27517.6 Other Significance of Coconut 276

17.6.1 Economic Value of Coconut Leaves 27617.6.2 Use of Coconut Heart 27717.6.3 Significance of Spathe and Inflorescence 27717.6.4 Potential of Coconut Fruits 27717.6.5 Usage of Coconut Milk 27717.6.6 Importance of Coconut Shell 27717.6.7 Commercial Usage of Husk Fibers 27817.6.8 Economic Importance of Coconut Stems 27817.6.9 Convention of Coconut Roots 278

17.7 Active Constituent Identified from Coconut 27817.8 Future Prospective 27917.9 Conclusions 280 Acknowledgments 280 References 281

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18 Salvadora persica L. (Miswak): An Effective Folklore Toothbrush 285Sujata P. Sawarkar, Anisha D’souza and Trinette Fernandes18.1 Introduction 28518.2 History 28618.3 Chemical Constituents 28618.4 Extraction, Isolation, Identification of Chemical Constituents 28718.5 Pharmacology—Therapeutic Activity of Salvadora persica L. 287

18.5.1 Theories for Miswak Activities 28718.5.2 Antibacterial and Antifungal 28818.5.3 Anti-Viral Effect 29018.5.4 Anti-Cariogenic Effect 29018.5.5 Antiplaque Effect 29018.5.6 Antiperiodontitis Effect 29018.5.7 Whitening Effect 291

18.6 Conclusion 292 References 292

19 Triphala and Oral Health 297Kamal Shigli, Sushma S Nayak, Mrinal Shete, Vasanti Lagali Jirge and Veerendra Nanjwade19.1 Introduction 29719.2 Taxonomical Classification 29819.3 Chief Phytoconstituents 29819.4 Role of Triphala in Dentistry 300

19.4.1 Anti-Caries Activity 30019.4.2 Triphala as a Root Canal Irrigant 30019.4.3 Anti-Microbial and Anti-Oxidant Effect of Triphala 30619.4.4 Role of Triphala in Periodontal Diseases 30619.4.5 Triphala as a Mouth Rinse 30619.4.6 Anti-Candida Activity of Triphala 30619.4.7 Anti-Collagenase Activity of Triphala 306

19.5 Pharmacological Activities of Triphala and Future Research 30719.5.1 Anticancer and Antioxidant Activity of Triphala 30719.5.2 Wound Healing Properties 30719.5.3 Antibacterial Activity of Triphala 30719.5.4 Anti-Diabetic Effect 30719.5.5 Anti-Inflammatory, Analgesic, and Antipyretic Effect 30719.5.6 Immunomodulatory Effect 308

19.6 Public Health Importance 30819.7 Formulation Using Triphala 30819.6 Conclusion 308 References 309

Contents xv

20 Azadirachta indica (Neem): An Ancient Indian Boon to the Contemporary World of Dentistry 313Sri Chandana Tanguturi, Sumanth Gunupati and Sreenivas Nagarakanti20.1 Introduction 31320.2 Vital Bioactive Compounds of Neem 314

20.2.1 Nimbidin 31420.2.2 Azadirachtin 31520.2.3 Nimbolide 31520.2.4 Gedunin 31520.2.5 Mahmoodin 31520.2.6 Tannins 31520.2.7 Diterpenoids 315

20.3 How to Distinguish Azadirachta Indica (Neem) from its Common Adulterant Melia Azedarach 316

20.4 Therapeutic Applications of Neem 31620.4.1 Neem as an Anti-Inflammatory, Analgesic Agent 31720.4.2 Antioxidant Activity 31720.4.3 Anticancerous Activity 31720.4.4 Antimicrobial Activity 318

20.4.4.1 Antibacterial Activity 31820.4.4.2 Antiviral Activity 31820.4.4.3 Antifungal Activity 31820.4.4.4 Antimalarial Activity 318

20.4.5 Wound Healing Effect 31820.5 Applications of Neem in Dentistry 318

20.5.1 Neem in Treatment of Periodontal Diseases 31920.5.2 Role of Neem in Endodontics 31920.5.3 Potent Role of Neem in Preventive Dentistry 320

20.5.3.1 Application in Dental Erosion Therapy 32020.5.3.2 Anti-Microbial Activity 32020.5.3.3 Anticaries Activity of Neem 32020.5.3.4 Anti-Candidiasis Property 32120.5.3.5 Anti-Cancer Property 321

20.6 Literature Supporting the Use of Neem in Dentistry 32120.7 Toxicity and Safety 32220.8 Contamination and Adulteration 32220.9 Drug Interactions 32220.10 Neem’s Prospects in Dentistry 32320.11 Action Points and Recommendations for Health Care Professionals 32320.12 Conclusion 323 References 324

21 Ginger in Oral Care 329Aditya Ganeshpurkar, Abhilasha Thakur and Anupam Jaiswal21.1 Introduction 32921.2 Description 330

xvi Contents

21.3 Macroscopic Characteristics 33021.4 Pharmacognostic Standards 33021.5 Nutrient Composition 33121.6 Pharmacological and Medicinal Effects 331

21.6.1 Oral Analgesic Effect 33121.6.2 Antimicrobial Effect 33221.6.3 Anti-Carries Activity 33321.6.4 Anti-Decay Effect 33321.6.5 Healing Effect in Root Canal Therapy 33421.6.6 Anti-Xerostomia Effect 33421.6.7 Anti-Pyorrhea Effect 33521.6.8 Anti-Thrush Effect 33521.6.9 Anti-Herpes Effect 33621.6.10 Tooth Polishing 33621.6.11 Mouth Deodorizing Effect 33621.6.12 Anticancer Effect 33821.6.13 Protection Against Aphthous Stomatitis 33821.6.14 Effect on Dentin Hardness 338

21.7 Pharmacokinetics 33921.8 Toxicological Studies 33921.9 Conclusion 339 References 340

22 Effectiveness of Allium sativum on Bacterial Oral Infection 345Vesna Karic, Anupam Jaiswal, Heidi Abrahamse, Abhilasha Thakur and Aditya Ganeshpurkar22.1 Introduction 345

22.1.1 History and Origin of Garlic 34722.1.2 Medicinal Values of Garlic 348

22.2 Types of Allium sativum 34922.2.1 Allium sativum Ophisocorodon/Hard-Necked Garlic 34922.2.2 Allium sativum Sativum/Soft-Necked Garlic 349

22.3 Chemical Constituents 35122.3.1 Allicin 35122.3.2 Ajoenes 35122.3.3 Alliin 351

22.4 Dental Infections and Epidemiology 35222.5 Dental Infection and Antibiotic Resistance 35222.6 The Antibacterial Application of Garlic in Dentistry 354

22.6.1 The Use of Garlic to Treat Oral Infections 35422.6.1.1 Periodontitis 35422.6.1.2 Pediatric Endodontitis 35622.6.1.3 Dental Caries 35722.6.1.4 Denture Stomatitis 35822.6.1.5 Protection Against Fibrosis 35922.6.1.6 Garlic Chewing Gum 35922.6.1.7 Garlic Used as a Breath-Freshening Agent 359

Contents xvii

22.7 Additional Use of Garlic in Dentistry—Oral Cancer 36022.7.1 High Blood Pressure 36122.7.2 Skin Disorders 36222.7.3 Anti-Allergic 36222.7.4 Anti-Obesity 362

22.8 Garlic Mechanism of Action 36222.9 Conclusions and Recommendations 362 Acknowledgments 364 References 364

Part IV: Ethnobotany and Ethanopharmacology 37123 Curative Plants Worn in the Healing of Mouth Evils 373

P. Shivakumar Singh, Pindi Pavan Kumar and D. Srinivasulu23.1 Introduction 37323.2 Materials and Methods 37423.3 Results and Discussion 37523.4 Conclusion 381 Acknowledgment 381 References 381

24 Ethnopharmacological Applications of Chewing Sticks on Oral Health Care 383E. A. Akaji and U. Otakhoigbogie24.1 Introduction 383

24.1.1 Background 38324.1.2 Historical Perspectives 38424.1.3 Sources and Types of Chewing Sticks 384

24.2 Applications of Chewing Sticks in Oral Health Care 38424.2.1 Chewing Sticks for Oral Hygiene 38424.2.2 Ethnopharmacological Applications of Chewing Sticks

in Oral Health 38724.2.2.1 Dental Caries (Tooth Decay) 38724.2.2.2 Periodontal Disease 38924.2.2.3 Oral Candidiasis 38924.2.2.4 Oral Ulcers and Halitosis 39024.2.2.5 Other Oral Conditions 390

24.3 Conclusions 390 References 391

25 Ethnomedicine and Ethnopharmacology for Dental Diseases in Indochina 393Viroj Wiwanitkit25.1 Introduction 39325.2 Ethnomedicine and Ethnopharmacology in Indochina 39425.3 Locally Available Naturally Derived Dental Products in Indochina 39625.4 Ethnopharmacology for Dental Diseases in Indochina 39725.5 Ethnomedicine for Dental Diseases in Indochina 402

xviii Contents

25.6 Future Trend of Ethnomedicine and Ethnopharmacology for Dental Diseases in Indochina 403

25.7 Conclusion 404 References 404

26 Traditional Medicinal Plants Used in Anti-Halitosis 407P. Shivakumar Singh, Pindi Pavan Kumar and D. Srinivasulu26.1 Introduction 40726.2 Materials and Methods 40826.3 Results and Discussion 40926.4 Conclusion 412 Acknowledgment 413 References 413

Index 415

xix

Preface

For hundreds of years now the existence and utility of natural products have bolstered the idea that natural products are still the choice for therapy. Their structural diversity and exclusive pharmacological actions differentiate them from drugs of synthetic origin. Not only are they used in traditional ways but also in modern medicine for treating life- threatening diseases. The discovery and design of new drugs from natural products always remain a challenging task. Still, they remain a choice due to their safety profile and negli-gible side effects. This book focuses on perspectives of natural medicine in various den-tal diseases. Oral diseases continue to be a major health problem worldwide. Oral health is integral to general well-being and relates to the quality of life that extends beyond the functions of the craniofacial complex. Standard Western medicine has had only limited success in the prevention of periodontal disease and treatment of a variety of oral diseases. The dentist needs to be more informed regarding the use, safety, and effectiveness of the various traditional medicines and over-the-counter products. For example, herbal extracts have been used in dentistry for reducing inflammation, as antimicrobial plaque agents, for preventing the release of histamine and as antiseptics, antioxidants, antimicrobials, antifun-gals, antibacterials, antivirals, and analgesics. They also aid in healing and are effective in controlling microbial plaque in gingivitis and periodontitis, thereby improving immunity.

The 26 chapters of this book cover the chemistry, clinical and preclinical panorama of natural products used in oral care. In Chapter 1, Chauhan et al. provide an exhaustive list of natural oral care products used in oral diseases and classify them according to use and chemistry. Chapter 2, contributed by Harput, discusses the crucial role that oral hygiene plays in the prevention of oral diseases, including periodontitis, tooth decay, and oral candidiasis. In Chapter 3, Varma and Zope highlight the herbs and their extracts used as an adjuvant in periodontal disease treatment. Chapter 4, written by Chakravarthy et al., focuses on various modalities currently available and discusses the efficacy and safety of such herbal products and natural extracts in the management of potentially malignant oral disorders. In Chapter 5, Patel et al. discuss experimental studies that show the promising broad spectrum anticariogenic activity of ethyl acetate and methanolic extract of Quercus infectoria that may prove useful for the clinical evaluation and development of a formula-tion suitable for the treatment of dental caries. Chapter 6, by Almanza-Aranda et al., reports that turmeric and Aloe vera in culture with HGF show promising potential and have clin-ical use for patients with gingivitis and periodontitis. In a study reported in Chapter 7, Ferreira-Filho et al. evaluate the effects of a tincture made from Bauhinia forficata Link leaves (TBF) on Streptococcus mutans biofilm formed on teeth. In Chapter 8, Binimeliz et al. demonstrate the effect of an Elettaria cardamomum ethanolic extract (ECE) against oral biofilm bacteria through an in vitro study. Chapter 9, contributed by Eidi and Noorbakhsh,

xx Preface

reports on the effect of Punica granatum peel extract on the growth of Candida albicans in the oral mucosa of diabetic male rats. In Chapter 10, Zope and Varma give an overview of the evidence-based use of oil pulling therapy in the maintenance of oral health. The focus of Chapter 11 by Chakravarthy and Yeturu is plant-based proteolytic enzymes, including papain, bromelain, actinidin, and ficin; as well as the application of these enzymes in pro-fessional as well as personal oral health care. The aim of Chapter 12 by Nadelman et al. is to present an updated viewpoint of the effect of probiotics on oral health by describing the relationship between the administration/consumption of these bacteria and the main oral dysbiosis, the oral microbiota parameters, and the immune salivary components. Chapter 13, written by Thakur, highlights the role of charcoal in dentistry and the development of charcoal-based dentifrices. In Chapter 14, Martins et al. present an updated review of the benefits of propolis in oral health, and the subject of Chapter 15 by Anusuya et al. is the role of grape seed extract in dentistry. In Chapter 16, Fernandes et al. discuss the use of Ocimum sanctum L for oral care and halitosis, which, because of its anticariogenic proper-ties, is also used in periodontal diseases such as periodontitis and gingivitis. This chapter not only discusses its conventional formulation but also O. sanctum L formulations loaded in a promising novel drug delivery system. Chapter 17, authored by Kishore and Verma, presents the latest information regarding traditional, ethnopharmacological, and bioactive phytochemicals and the significant use of coconut plant in oral cavity therapies. In Chapter 18, Sawarkar et al. discuss the use of miswak for maintaining oral health and its various commercial products. Shigli et al. write about triphala in Chapter 19 and demonstrate its traditional use and newer pharmacologic activities for use as an adjuvant mainstream drug in dentistry as well as in general medicine. The role that Azadirachta indica (neem) plays in dentistry is revealed by Tanguturi et al. in Chapter 20. In Chapter 21, Ganeshpurkar reveals the lethal effect ginger has on the growth of tooth-decaying bacteria since it is a good dental analgesic and promotes dentine remineralization. Moreover, the antiplaque and mouth- deodorizing effects of ginger are also well documented. The aim of Chapter 22 by Karic et al. is to raise awareness on the use of garlic formulations to reduce the risk of oral disease and dental caries. In Chapter 23, Singh and Rao discuss the traditional uses of plants in the treatment of mouth evils at Kosgimandal of Naryanapet District of Telangana State, India. Chapter 24 by Akaji and Otakhoigbogie reveals the healing power of plant materials, such as a chewing stick, primarily used for oral hygiene. In Chapter 25, Wiwanitkit discusses ethnomedicine and ethnopharmacology for dental diseases in Indochina, a tropical region in Asia, and Chapter 26 by Singh and Reddy enlists traditional medicinal plants with anti- halitosis efficacy.

This important new volume will be valuable to dentists, oral hygienists, pharmacognosy experts, and natural product formulation scientists alike, either as a textbook or a reference. It is a must-have addition to any dental or herbal industry library. The aim of this book is to be a reference for all those interested in the development of natural oral care as an alter-native treatment.

Preface xxi

Last, but not the least, we would like to express our sincere gratitude to all the authors who have taken time out from their busy schedules to be part of this project and have written wonderful chapters that add both to the depth and value of this book. We welcome suggestions and criticisms from our readers. We also acknowledge our mentor Prof. V.K. Dixit Sir for his valuable guidance. Special thanks to our families for their support and encouragement. We express our gratitude to the publishing and production team, especially Martin Scrivener, for their kind, proficient, and encouraging guidance.

Durgesh Nandini Chauhan Prabhu Raj Singh

Kamal Shah Nagendra Singh Chauhan

December 2019

xxiii

Foreword

Teeth are unique in the fact that, on one hand, they live for thousands of years and are often encountered in archeologic excavations, and on the other hand, we see rampant caries destroying almost all teeth in children. Dental and oral health remains a definitive part of one’s over-all health and wellbeing and helps one present oneself with confidence. The care of the oral cavity has been described as early as the Sushruta Samhita and in Hippocrates’ works. With evolution, there has been a constant change in the environmental factors, the food, oral hygiene

measures, as well as products used in dental care. As we look back in time, one can appre-ciate that the traditional methods of oral care and their incorporation in current measures may be the way forward to sustainable dental and oral health in the future. This book enti-tled Natural Oral Care in Dental Therapy by Chauhan et al. has come a long way in estab-lishing this connection.

Prevention is better than cure is a dictum that has repeatedly established itself. Modern dental science encourages oral hygiene measures based on mechanical and chemical cleans-ing, with continuous research on the chemical agents. Time and again, those agents and natural remedies described in history are proving to be fruitful. There are lots of research activities that have been started by academic institutions and research centers along with their industrial partners, for the development of natural product formulation in dental therapy. Thus, this book is a timely reference work for the scientific community.

Natural Oral Care in Dental Therapy is an applications-oriented book in the field of den-tal science. The book is a perfect resource for dentists, oral hygienists, herbal experts, phy-tochemists, research professionals, and technology investors. It is edited by an experienced and interdisciplinary group comprising a well-respected dentist, clinician, natural product, and pharmacology expert. I hope this book will inspire many current and future generations of academic and industrial researchers to expand the use of natural products in dentistry.

Dr. Santhosh Rao BDS, MDS, FIBOMS

Oral & Maxillofacial Surgeon Associate Professor

Department of Dentistry All India Institute of Medical Sciences,

Raipur, IndiaAugust 2019

Part INATURAL ORAL CARE

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Durgesh Nandini Chauhan, Prabhu Raj Singh, Kamal Shah, and Nagendra Singh Chauhan (eds.) Natural Oral Care in Dental Therapy, (3–30) © 2020 Scrivener Publishing LLC

1

Natural Oral Care in Dental Therapy: Current and Future Prospects

Durgesh Nandini Chauhan1*, Prabhu Raj Singh2, Kamal Shah3 and Nagendra Singh Chauhan4

1Columbia Institute of Pharmacy, Raipur, Chhattisgarh, India2MKD Muti Speciality Dental Clinic, Annupur, Madhy Pradesh, India

3Institute of Pharmaceutical Research, GLA University, Chaumuha, Mathura, (U.P.) India4Drugs Testing Laboratory Avam Anusandhan Kendra, Raipur Chhattisgarh, India

AbstractNowadays, natural medicines like honey, clove, miswak, and propolis are a part of dental treatment due to their reduced toxicity, wide availability, and cost effectiveness. This chapter gives an insight to the reader about the potential use of natural products in current dentistry. They are in many forms and include chewing sticks, oils, herbal extracts, minerals, animal products (e.g., honey), herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other plant materials as active ingredients. Natural medicines hold huge benefits as adjunctive ther-apeutic uses in dentistry. Use of these techniques with suitable dosage would benefit the general population by preventing various dental problems.

Keywords: Antiplaque, dentistry, antimicrobial, natural, oral health care, herbal, phytochemical, medicinal plants

1.1 Introduction

Oral health is a key indicator of overall health, well-being, and quality of life. The World Health Organization (WHO) defines oral health as “a state of being free from chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial well-being” [1].

There are seven major oral diseases and conditions reported for most of the oral disease burden.

1. Dental caries (tooth decay)2. Periodontal (gum) diseases3. Oral cancers

*Corresponding author: pharmanandini@gmail.com

4 Natural Oral Care in Dental Therapy

4. Oral manifestations of HIV5. Oro-dental trauma6. Cleft lip and palate7. Noma

Oral diseases affect at least 3.58 billion people worldwide, with caries of the per-manent teeth being the most common of all conditions assessed. Worldwide, it is esti-mated that 486 million children suffer from caries of primary teeth, and 2.4 billion people suffer from caries of permanent teeth as per study on the Global Burden of Disease Study 2016 [2].

Natural oral care rises to a growing trend in the increased use of “over-the-counter” dental product. Nowadays, there is a huge range of natural oral care products and tech-nology available that are self used without consulting an expert. The potential use of natural product in current dentistry is obtained from plants, animals, marine animals, and minerals sources (Figure 1.1). Minerals like alum, sodium bicarbonate, and sodium chloride are commonly used in dentistry. The use of an alum mouthrinse daily inhibited caries development in children with decay-prone teeth [3]. The saturated saline rinse and alum rinse showed statistically significant reductions in salivary S. mutans counts in children [4]. Intrinsic tooth stain was reduced using sodium chloride with vinegar [5]. Sodium bicarbonate acts as an antiadhering agent for bacteria [6]. Cheese and cow milk stimulates salivary secretion and increases plaque calcium concentration and protection from caries [7, 8].

Natural products have been used in dentistry as analgesic and local anesthetic, as antimicrobial plaque agents, as antiseptics, whitening agent, antibacterials, to prevent adhesion of bacteria, antianxiety, and anti-halitosis. Commonly used natural products are Azadirachta indica, Syzygium Aromaticum, Acacia catechu, Aloe vera, miswak, and propolis. Plants are also used in root canal irrigation, pulpal and dentin repair, solvents, sealer cements, natural antioxidants, and storage medium (Table 1.1). Morinda citrifolia, propolis, Triphala, and aloe vera, besides their oral care activity also act as additives in

PlantsEg.

Clove, Miswak, Neemetc

AnimalEg. Propolis, Honey

ProbioticsEg. Lactobacillus

MineralsEg. sodium

chloride, alum

Marine

Eg. alginate,carrageenan,

fucoidan

NaturalCare usedin Dental

Figure 1.1 Sources of natural care used in dental.