naturally occuring chemical plaque control agents
DESCRIPTION
Natural products to aid in dentistryTRANSCRIPT
NATURALLY OCCURING CHEMICAL PLAQUE CONTROL AGENTS
By: Yazhini.S
Guided by: Dr.Shivaram,MDS
CONTENTS
INTRODUCTION ADVANTAGES AGENTS AVAILABLE AS NATURAL
PRODUCTS METHODS OF DELIVERY OF NATURAL
PRODUCTS CONCLUSION
INTRODUCTION The oral microbiology includes many types of
organisms that accumulate on surface of teeth and at gum line. These bacteria and their products forms sticky residue known as plaque.
As organisms grow, they colonise and branch out to involve virtually on all surfaces of teeth extending below the gum line.
When allowed to grow, plaque causes two conditions, caries and gingivitis.
Plaque removal reverses gingivitis. When ignored, it proceeds to irreversible periodontitis with significant tooth mobility and loss of teeth.
Hence, it is necessary to control plaque.
ADVANTAGES Although number of chemical plaque control
agents are available, there is till a need for anti-plaque agents with minimal side effects.
Hence herbal formulations are used because they provide safe and long term use.
They inhibit the growth of oral pathogens. Reduce development of plaque. Influence adhesion of bacteria to surface and
decrease the occurence of oral disease. They are very effective in treating oral diseases
with minimal side effects.
AGENTS AVAILABLE AS NATURAL PRODUCTS 1) PLANT EXTRACT leaves roots stem barks
2)FRUIT EXTRACT
3)HONEY BEE EXTRACT
4)OTHER AYURVEDIC EXTRACT Turmeric Essential oils
PLANT EXTRACTS MISWAK: Source of origin: It is a teeth cleaning twig derived from the species salvadora persica. Ingredients: High chloride content, silica, resin, trimethylanine, vitamin C, sulphur compounds, isothiocyanate.
Clinical study in support: A 2003 scientific study comparing the use of miswak with ordinary toothbrushes concluded that the results clearly were in favor of the users who had been using the miswak, provided they had been given proper instruction in how to brush using it.
The World health organisation (WHO) recommended the use of the miswak in 1986.
Mainly used as chewing sticks and natural tooth brush, also available as paste.
SANGUINARINE: Source of origin: Derived from alcoholic extraction of powdered rhizomes of blood root plant, Sanguinacia lonadensis. Ingredients: BENZYLISOQUINOLONE, sanguinarine, chelerythrine, chelirubine, sanguirubine, cheilutine, protopine, sanguilutine, red resin & starch.
Mechanism of action: The proposed
antibacterial mechanism of action is sanguinarine's ability to react with nucleophiles.
Clinical study in support: There is particular interest in sanguinarium's effects on oral bacterial and fungal populations.
In a clinical split-mouth study, a seven day treatment with 5% sanguinarium led to significant microbiota changes, such as decreases in antibiotic-resistant bacteria and yeast in periodontal sites as
well as in the saliva.
The reduction in bacteria may be due to sanguinarine's inhibition of bacterial adherence and plaque formation, as it induces bacteria to aggregate and become morphologically irregular in vitro. Mainly used as mouth rinse in the concentration of 16 mg per ml.
PRODONTAX:
Source of origin: Derived from the plant sage and myrrh.
Ingredients: Fluorides, Extracts of herbs such as chamomile, echinacea, rhatany, peppermint, myrrh.
Mechanism of action: The extracts of these herbs decreases inflammation, stimulates immunity, lessens bleeding and kills plaque causing bacteria.Clinical study in support: A journal Brazilian Oral Research compared Prodontax and colgate total on 48 people with gingivitis. Both decreased plaque and gingivitis effectively. Hence, they concluded that herbal paste was as efficacious as colgate total.
AKUL:
Source of origin: From Alhagy camelorum, plant eaten by cael in deserts.
Ingredients: Tannin, Alkaloids, Flavenoid, Vitamin C.
Clinical study in support:
A study was conducted in which 88 patients were included. They were asked to rinse their mouth 4 times a day by the extract. The results were so encouraging for simple and acute gingivitis.
ROOT EXTRACT
LICORICE ROOTS:
Source of origin: Roots and stolons of glycyrrhiza species. Ingredients: Licoricidin, licorisoflavan A.
Clinical study in support: According to new study in journal of natural products, licorice root extracts can decrease the inflammation involved in periodontal disease and even inhibit bone loss that occurs in disease.
BERBERINE:
Source of origin: It is an alkaloid agent derived from root and stem of plant barberry.
Ingredients: Berberine hydrochloride, a main ingredient. It is available as various salts, berberine chloride, hemisulfate.
Clinical study in support: A study was performed to evaluate the efficacy of berrberine gel and it was concluded that barberry gel treated tissues showed reduced number of inflammatory cells.
LEAVES EXTRACT AZADIRACHTA INDICA:
Source of origin: Neem.
Ingredients: Three bitter compounds, nimbin, nimbidin, nimbinin.
Neem twigs contain antiseptic ingredients necessary for dental hygiene. Neem powder is also used to brush teeth and massage gums. Neem extracts prevent tooth decay and periodontal disease.
STREBLUS ASPER: Ingredients: Triterpenoids- Friedelin, Epifriedelinol, Taraxasteryl acetate.
Clinical study in support: A study by Khon Kaen was aimed to determine effect of subgingival irrigation of 80 mg per ml leaf extract as an adjunct to SRP in Chronic periodontitis. It was concluded that use of sterblus leaf extract was effective in control of gingival inflammation and plaque formation.
The other leaves extract are,
Ethanolic extracts of Walnut leaves.
Paste of tender leaves of Psidium guajava extract.
FLOWER EXTRACT
CALENDULA EXTRACT TOOTH PASTE:
Source of origin: Marie gold.
Ingredients: water, calcium carbonate, glycerin, calendula officinalis extract, commiphora myrrha resin extract, xanthan gum. Clinical study in support: According to Research Journal of Medicinal plants, brush with calendula tooth paste leads to significant reduction in plaque index and gingival index. This treatment could be recommended as an adjunctive procedure effective for the improvement of gingival inflammation.
FRUIT EXTRACTS
PUNICA GRANATUM It is nothing but the pomogranate fruit The extracts of this fruit is very effective
in treating the gum disease
Clinical study: A study conducted by bhadhad in 2011 tested mouthrinse against A.actinomycetemcomitans, P.gingivalis & P.intermedia strains in vivo.
Results: extracts of this was effective against organisms and used as anti plaque agents.
AMCHUR: It is the dried pulp of unripe mangifera
indica
Clinical study in support: A study was conducted in which amchur
extracts 50% ethanol was tested against 10 bacterial strains causing plaque by agar well diffusion method.
Results: Was found to be more effective than
chlorhexidine mouthwash.
Composition:
1) Moisture content:14.7%2) Total acidity(tartaric acid):15.2%3) Reducing sugar:3%4) Ash :5.4%
OTHER AYURVEDIC AGENTS
ESSENTIAL OIL: Tea tree oil(TTO)
Source of origin: taken from leaves of melaleaca alternifolia.Native of australia.
COMPOSITION:
Terpinen-4-ol -30-48% Gamma-terpinen-10-28% Alpha-terpinene-5-13% Alpha-terpinolene-1.5-5% Alpha-pinene-1-6% P –lymene-0.5-8%
Following herbs can also be added: Burdock-anti bacterial Horsetail-healing damaged gums Myrrh –disinfectant Neem – antibacterial herb
Clinical study in support:
A study was done to determine the in vitro suseptibility range of oral bacteria to TTO for use in oral cavity.
It was found that at a concentration of2% all bacterial isolates were inhibited &killed.
The data from this study suggest TTO can be used as oral product.
OTHER OILS:1)Ginger oil:extracted from plant
zingiberaceae officinale.Composition: apinene, campene, linalool, borneol, zingiberene.
2) Rosemary oil:it is antimicrobial against numerous bacteria.
Used topically-6-10%solution
3) Oil of thyme: derived from thymus vulgaris Contains 54% thymol which is
antimicrobial and antibacterial.
4)Peppermint oil: Most effective in killing anaerobic bacteria that cause gum disease.
Clinical study in support: A study named antimicrobial activity of essential oil and essential oil components towards oral bacteria found peppermint was strongest oil to kill disease causing bacteria.
TURMERIC It is a rhizome of curcuma
longa,flavourful yellow orange spice. Competents of turmeric are named
curcuminoids in which curcumin is active constituent of 0.3-5.4%of raw turmeric.
Clinical study in support: A study was conducted by waghmare et
al in which 100 subjects were randomly selected.
It was found that turmeric mouthwash prepared by dissolving 10mg of curcumin in 100ml of distilled water &0.005%flavouring agent peppermint oil with ph adjusted to 4 was found to be effective as chlorhexidine mouthwash.
HONEYBEE EXTRACT PROPOLIS:It is a resinous mixture that
honeybee collect from tree buds, sap flows or other botanical sources.
Composition:
It varies region to region along with vegetarian.
In northern temparate –balsams 50%,wax 30%,essntial oil 10%,pollen 5%.
In neotropical areas –bees gather resin from flower clusia dalechampia.
Clinical study in support:
Ozan et al conducted a study with the mouthrinse extract of propolis and compared with 0.2%chlorhexidine mouthwash.
It was concluded that this extract was not as effective as chlorhexidine but was less toxic.
