Oil pulling for maintaining oral hygiene - A review

Oral Microbiome: A Review of Its Impact on Oral and Systemic Health

PURPOSE OF REVIEW

This review investigates the oral microbiome's composition, functions, influencing factors, connections to oral and systemic diseases, and personalized oral care strategies.

RECENT FINDINGS

The oral microbiome is a complex ecosystem consisting of bacteria, fungi, archaea, and viruses that contribute to oral health. Various factors, such as diet, smoking, alcohol consumption, lifestyle choices, and medical conditions, can affect the balance of the oral microbiome and lead to dysbiosis, which can result in oral health issues like dental caries, gingivitis, periodontitis, oral candidiasis, and halitosis. Importantly, our review explores novel associations between the oral microbiome and systemic diseases including gastrointestinal, cardiovascular, endocrinal, and neurological conditions, autoimmune diseases, and cancer. We comprehensively review the efficacy of interventions like dental probiotics, xylitol, oral rinses, fluoride, essential oils, oil pulling, and peptides in promoting oral health by modulating the oral microbiome.

SUMMARY

This review emphasizes the critical functions of the oral microbiota in dental and overall health, providing insights into the effects of microbial imbalances on various diseases. It underlines the significant connection between the oral microbiota and general health. Furthermore, it explores the advantages of probiotics and other dental care ingredients in promoting oral health and addressing common oral issues, offering a comprehensive strategy for personalized oral care.

Effect of oil pulling on the Streptococcus mutans concentation in plaque around orthodontic brackets -A prospective clinical study

INTRODUCTION

Fixed orthodontic appliances create areas of plaque stagnation leading to an increase in the volume, structure, and composition of plaque. This increases the chances of decalcification and white spot lesions. Oil pulling, an ancient practice involving swishing oil in the mouth, has demonstrated a significant reduction in plaque scores after 45 days, and a reduction in salivary Streptococcus mutans concentration in few studies done in nonorthodontic subjects. The aim was to compare the concentration of S. mutans in plaque around orthodontic brackets in patients using oil pulling with sesame oil and those on routine oral hygiene.

SUBJECTS AND METHODS

Twenty subjects requiring fixed orthodontic treatment were divided into two equal groups: Group A-Oil pulling and Group B-Control. All subjects were instructed to follow common oral hygiene methods and in addition, Group A was instructed to perform oil pulling for 30 days starting 1 month after placement of fixed appliances. Plaque specimens were collected from labial surfaces of maxillary lateral incisors and quantification of S. mutans was done using real-time polymerase chain reaction. Mean and standard deviations for descriptive statistics, paired, and unpaired sample t-tests were analyzed.

RESULTS

Comparison of S. mutans concentration between T1 and T2 demonstrated a significant difference in both control and study groups. The experimental group showed significantly lesser S. mutans concentration compared to the control group.

CONCLUSIONS

Oil-pulling therapy with sesame oil resulted in a statistically significant reduction in the concentration of S. mutans in the plaque around orthodontic brackets.

Effect of coconut and sesame oils on gingivitis

The effectiveness of Oil Pulling Therapy (OPT) with coconut (CO) and sesame oil (SO) on gingivitis patients is of interest. Forty patients were randomly distributed into group A and B for CO and SO respectively. Participants of group A were explained in detail about the OPT with CO and group B with SO along with their routine oral hygiene practice for 30 days. The mean plaque index of CO and SO reduced from 1.5 to 1.32 and 1.65 to 1.36 (p<0.05) respectively after 30 days. The mean gingival index of CO and SO declined from 1.12 to 0.9 and 1.1 to 0.81 respectively after 30 days (p<0.05) compared to initial scores. The mean no. of colonies in the case of CO and SO declined from 35.8 x 103 to 32.4 x 103 and 6.8 x 103 to 34.6 x 103 after 30 days (p<0.05). OPT reduced plaque and gingivitis, according to the results of one month. Hence, we must increase awareness about oil pulling, as this home therapy can prevent gingival diseases in countries with limited resources like ours.

Effectiveness of Microneedling Technique Using Olive Oil on the Severity of Gingival Inflammation and Plaque Accumulation: A Randomised Controlled Trial

BACKGROUND

Gingival inflammation, a hallmark of periodontal diseases, serves as a critical focus in oral health research. Characterized by redness, swelling, and bleeding of the gingival tissues, it reflects the body's response to bacterial biofilms accumulating on the tooth surfaces. This inflammatory process, initiated by the interaction between oral bacteria and the host immune system, can lead to a spectrum of periodontal conditions ranging from mild gingivitis to severe periodontitis. Understanding the efficacy of various methods to treat gingival inflammation is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival inflammation.

AIM

The objective of the study was to evaluate the efficacy of employing the microneedling technique with olive oil on gingival inflammation and plaque accumulation in individuals with gingivitis.  Materials and methods:Twenty-four individuals diagnosed with plaque-induced gingivitis were selected from Saveetha Dental College, Chennai. Participants were randomly assigned to one of two groups: Group A, comprising 12 individuals who received mechanical periodontal treatment only and Group B, consisting of 12 individuals treated with dermapen and topical olive oil. This involved the creation of microholes in the gingival tissue to enhance the concentration and penetration of the oils through the gingival tissues. Post-intervention assessments of gingival and plaque status were conducted using a gingival index and a plaque index at baseline, one, two, and four weeks. Statistical analysis was done using IBM SPSS Statistics for Windows, version 23 (IBM Corp., Armonk, NY, USA). Intergroup analysis was done using Mann-Whitney test and intra-group analysis was done using Kruskal-Wallis test for all the study parameters. Statistical significance was set at a p-value of less than 0.05.

RESULTS

The mean plaque index scores were 2.02 ± 0.12 and 2.29 ± 0.21 in the subgingival scaling and microneedling with olive oil group respectively in baseline. The scores were 1.83 ± 0.29 and 0.57 ± 0.16 in the subgingival scaling and microneedling with olive oil group respectively at the end of four weeks. The results of plaque index scores were statistically significant between the control and the intervened groups at the end of four weeks with a p value of 0.01*. The mean gingival index scores were 2.09 ± 0.16 and 2.37 ± 0.17 in the subgingival scaling and microneedling with olive oil group in the baseline respectively. The scores were 1.88 ± 0.23 and 0.96 ± 0.21 in the subgingival scaling and microneedling with olive oil group respectively at the end of four weeks. The results of gingival index scores were statistically significant between the control and the intervened groups at the end of four weeks with a p value of 0.01*.

CONCLUSION

Our research showcased a novel and effective technique, unveiling a significant enhancement in gingival health accompanied by a reduction in both the average gingival index and plaque index.

Effects of Oil Pulling and Chlorhexidine Mouth Rinse on the Force Decay of Orthodontic Elastomeric Chains: A Comparative In Vitro Study

BACKGROUND AND OBJECTIVES

Oil pulling is a traditional Indian folk remedy for maintaining oral hygiene among orthodontic patients. This study aimed to assess the effects of oil pulling and compare them with those of chlorhexidine (CHX) and distilled water on the force decay of elastomeric chains.

METHODS

Twenty-one samples were tested in three groups. Each of these groups contained seven samples per group. The samples evaluated contained distilled water, 0.2% CHX, and sesame oil. The samples were dipped in various mouth rinses, and force degradation was measured using a dynamometer (dynamic universal testing machine, Instron 8801, Instron, Norwood, MA) during days 0, 1, 7, 14, 21, and 28. The significance level was considered at 1%.

RESULTS

Force degradation was observed more in distilled water, followed by sesame oil, and less in CHX at the end of 28 days. Significant differences in values (p < 0.01) were found among the three groups in all the timelines in the study except on days 14 and 21.

CONCLUSION

Chlorhexidine showed the least amount of force decay, followed by oil pulling and distilled water. However, if oil pulling is practiced daily as a household remedy along with regular oral hygiene practices, it can save time and money and enhance general health.

The effect of oil pulling in comparison with chlorhexidine and other mouthwash interventions in promoting oral health: A systematic review and meta-analysis

OBJECTIVES

A meta-analytic review was performed to critically synthesize the evidence of oil pulling on improving the parameters of gingival health, plaque control and bacteria counts against chlorhexidine and other mouthwash or oral hygiene practices.

METHODS

Databases including Medline, Embase and bibliographies were searched from inception to 1 April 2023. Randomized controlled trials (RCTs) with 7 days or longer duration of oil pulling with edible oils in comparison to chlorhexidine or other mouthwashes or oral hygiene practice concerning the parameters of plaque index scores (PI), gingival index scores (GI), modified gingival index scores (MGI) and bacteria counts were included. Cochrane's Risk of Bias (ROB) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework were employed to determine the quality of evidence. Two authors independently conducted study selection and data extraction. Meta-analyses of the effect of oil pulling on the parameters were conducted using an inverse-variance random-effects model.

RESULTS

Twenty-five trials involving 1184 participants were included. Twenty-one trials comparing oil pulling (n = 535) to chlorhexidine (n = 286) and non-chlorhexidine intervention (n = 205) were pooled for meta-analysis. More than half of the trials (n = 17) involved participants with no reported oral health issues. The duration of intervention ranged from 7 to 45 days, with half of the trials using sesame oil. When compared to non-chlorhexidine mouthwash interventions, oil pulling clinically and significantly improved MGI scores (Standardized mean difference, SMD = -1.14; 95% confidence interval [CI]: -1.31, -0.97). Chlorhexidine was more effective in reducing the PI scores compared to oil pulling, with an SMD of 0.33 (95% CI: 0.17, 0.49). The overall quality of the body of evidence was very low.

CONCLUSIONS

There was a probable benefit of oil pulling in improving gingival health. Chlorhexidine remained superior in reducing the amount of plaque, compared to oil pulling. However, there was very low certainty in the evidence albeit the clinically beneficial effect of oil pulling intervention.

Enzyme ChE, cholinergic therapy and molecular docking: Significant considerations and future perspectives

Enzyme Che plays an essential role in cholinergic and non-cholinergic functions. It is present in the fertilized/unfertilized eggs and sperm of different species. Inclusion criteria for data collection from electronic databases NCBI and Google Scholar are enzyme AChE/BChE, cholinergic therapy, genomic organization and gene transcription, enzyme structure, biogenesis, transport, processing and localization, molecular signaling and biological function, polymorphism and influencing factors. Enzyme Che acts as a signaling receptor during hematopoiesis, protein adhesion, amyloid fiber formation, neurite outgrowth, bone development, and maturation, explaining the activity out of synaptic neurotransmission. Polymorphism in the Che genes correlates to various diseases and diverse drug responses. In particular, change accompanies cancer, neurodegenerative, and cardiovascular disease. Literature knowledge indicates the importance of Che inhibitors that influence biochemical and molecular pathways in disease treatment, genomic organization, gene transcription, structure, biogenesis, transport, processing, and localization of Che enzyme. Enzyme Che polymorphism changes indicate the possibility of efficient and new inhibitor drug target mechanisms in diverse research areas.

Incorporation of bioactive glass-ceramic into coconut oil for remineralization of incipient carious lesions

This study evaluated the efficacy of incorporating different concentrations of bioactive glass-ceramic (Biosilicate) into coconut oil on the remineralizing potential and surface roughness of white spot lesions. Fragments (6 x 6 x 2mm) of bovine teeth were sectioned and initial microhardness (KHN) and surface roughness (Ra) readings were obtained. The samples were submitted to cariogenic challenge to form white spot lesions and were separated into six groups (n=13): 1) Artificial Saliva (AS); 2) Coconut Oil (CO); 3) CO+2% Biosilicate (CO+2%Bio); 4) CO+5% Biosilicate (CO+5%Bio); 5) 2% Biosilicate Suspension (2% Bio) and 6) 5% Biosilicate Suspension (5% Bio). The treatments for 1 cycle/day were: immersion into the treatments for 5 minutes, rinsing in distilled water, and storage in artificial saliva at 37ºC. After 14 days, KHN and Ra readings were taken. The surface roughness alteration ((Ra) was analyzed (Kruskal-Wallis, Dunn's post-test, p<0.05). CO+2%Bio had higher (p = 0.0013) (Ra followed by CO+5%Bio (p = 0.0244) than AS. The relative KHN and remineralization potential were analyzed (ANOVA, Tukey, p<0.05), and 5% Bio treatment presented a higher relative microhardness than all other groups (p>0.05). The remineralizing potential of all the treatments was similar (p > .05). When Biosilicate was added, the pH of the suspensions increased and the alkaline pH remained during the analysis. Biosilicate suspension is more efficient than the incorporation of particles into coconut oil at white spot lesion treatment. In addition to the benefits that coconut oil and Biosilicate present separately, their association can enhance the remineralizing potential of Biosilicate.

Mouthwashes: Alternatives and Future Directions

This narrative review summarises "alternative" or "natural" over-the-counter (OTC) mouthwashes not covered elsewhere in this supplement and newly emerging products, as potential mouthwashes of the future. The "natural" mouthwashes reviewed include saltwater, baking soda, coconut oil, charcoal, propolis, seaweeds, and probiotics. Other than essential oils, it is apparent that their clinical effectiveness is still under debate, but there is some evidence to suggest that propolis reduces plaque and gingivitis. This review also covers the host immune response, via novel anti-inmmunomodulant mouthwashes, such as erythropoietin to reduce inflammation with oral mucositis (OM) after radiotherapy. The emerging concept of nanoparticle-containing mouthwashes, such as iron oxide, is further discussed for OM, this agent having the potential for more targeted delivery of chemical antimicrobials. Unfortunately, there are impacts on the environment of widening mouthwash use with more new products, including increased use of packaging, antimicrobial resistance, and possible detrimental effects on marine life. Further, there are roadblocks, relating to regularly approvals and side effects, that still need to be overcome for any OTC deivered immunomodulant or nanoformulation mouthwashes. Despite these caveats, there are many new mouthwashes under development, which could help manage major oral diseases such as caries, gingivitis, and periodontal disease.

Nasal application of sesame oil-based Anu taila as 'biological mask' for respiratory health during COVID-19

This article narrates the potential role of sesame oil-based Anu taila for respiratory health and the prevention of COVID-19. Ayurveda recommends the use of sesame oil and A. taila as a part of daily routine (dinacharya) for oral gargling and transnasal application (Nasya) for preventing upper respiratory tract infections. Recent studies on COVID-19 have elucidated the activity of certain fatty acids in restricting viral binding. Based on the evidence gathered from in-silico, pre-clinical, and pharmacological studies as well as references from classical textbooks of Ayurveda, this article infers that the transnasal application of sesame oil and/or A. taila could provide resilience/protection to the respiratory system. It can act as a 'biological mask' to prevent respiratory infections like COVID-19. Detailed pharmacological study can give fuller confirmation of our informed "inference" that A. taila offers a cost-effective intervention for the prevention of COVID-19 like infections of the upper respiratory tract.

Oil Pulling and Polyphenols: Treatment of Gingivitis Patients with 'Itri Extra-Virgin Olive Oil'

OBJECTIVES

The aim of the study was to evaluate the effectiveness of extra virgin olive (EVO) oil and fruity oil for the treatment of gingivitis.

MATERIALS AND METHODS

A sample of 75 patients over 18 years of age with gingivitis induced by plaque bacteria was divided into three groups: study group A, with extra virgin olive oil; study group B, with fruity oil; and control group C. In the two study groups, EVO oil was administered as a mouthwash to patients with gingival inflammation. The protocol included a daily application of the product for 30 days, with three recalls 15 days apart. Clinical parameters of plaque formation and gingivitis, including plaque index (PI) and bleeding index (BI), were assessed at each recall and scored on a specific periodontal chart. The control group received no mouthwash treatment in addition to normal daily oral hygiene procedures, and the same clinical parameters as the study group were evaluated. Data were evaluated using SPSS 27.0 software for Windows (SPSS Inc., Chicago, IL, USA). Then, the pre- and post-treatment values of the groups were compared using Student's t-test, setting p < 0.05 as the significance level.

RESULTS

Comparison of the three groups showed that extra-virgin olive oil was an adjuvant in the treatment of gingival inflammation, improving PI and BI. In group A, the mean plaque index showed a 48% reduction, and the bleeding index showed a 64% reduction after 30 days. In group B, the mean plaque index showed a 35% reduction and a bleeding index reduction of 43% after 30 days.

CONCLUSIONS

The collected data showed significant improvements in the formation of bacterial plaque and gingivitis. The exact mechanism of such treatment is still to be elucidated. As a result of this, further studies with a different sample of patients than those used and a comparison with other products need to be addressed to verify and demonstrate the antibacterial and anti-inflammatory effects of the components of this natural product.

Disinfection of 3D-printed surgical guides using virgin coconut oil (in vitro study)

BACKGROUND/OBJECTIVE

Disinfection of a 3D-printed surgical guide is of utmost importance as it comes into contact with hard and soft tissue during implant placement so it poses a potential risk of pathogenic transmission. Methods used for disinfection in the surgical field should be reliable, practical, and safe for the instruments and the patients. The objectives of this study were to compare the antimicrobial potential of 100% Virgin Coconut Oil, 2% Glutaraldehyde, and 70% Ethyl Alcohol used to decontaminate 3D-printed surgical guides.

MATERIALS AND METHODS

Thirty identical surgical guides were printed and cut into two halves (N = 60). Both halves were then contaminated with a defined amount of human saliva samples (2 ml). The first half (n = 30) was sub-grouped into three study groups which were immersed in one of the three disinfectants for 20 min as follows; group VCO was immersed in 100% Virgin Coconut Oil, group GA was immersed in 2% Glutaraldehyde, and group EA was immersed in 70% Ethyl Alcohol. The second half (n* = 30) was sub-grouped into three control groups which were immersed in sterile distilled water as follows group VCO*, group GA*, and group EA*. The microbial count was expressed as colony-forming units per plate and the comparison of the antimicrobial potential of the three tested disinfectants between the three study and three control groups was done using the One-Way ANOVA test.

RESULTS

The culture results of three study groups revealed no bacterial growth with the highest % of reduction in the mean microbial count of the oral microorganisms (about100%) and an uncountable bacterial growth was shown between the three control groups (more than 100 CFU/plate) representing the baseline of the oral microorganisms. Therefore; statistically significant differences were found between the three control and three study groups (P < .001).

CONCLUSION

The antimicrobial potential of Virgin Coconut Oil was comparable and equivalent to Glutaraldehyde and Ethyl Alcohol with a significant inhibitory action against oral pathogens.

Effectiveness of Oil Pulling for Improving Oral Health: A Meta-Analysis

Objective: The effect of oil pulling on oral health has not yet been fully demonstrated. Therefore, we performed a meta-analysis to investigate the effect of oil pulling on oral health. Methods: We searched PubMed, the Cochrane Library, and the EMBASE database, limiting the search to human patients and articles written in English and published before 31 July 2022. We included randomized controlled trials (RCTs) comparing the effect of oil pulling on improving dental health and oral hygiene. The outcomes of this study were salivary bacteria count, plaque index, and gingival index. Results: In total, nine RCTs were included in this study. The study showed that salivary bacterial colony (BC) counts were significantly reduced in the oil pulling group compared to the control group [mean difference (MD): 17.55, 95% CI 2.56, 32.55]. There was no significant difference between the two groups (MD: -0.10, 95% CI -0.33, 0.14; -0.05, 95% CI -0.12, 0.02) in plaque index and gingival index score. Conclusions: Based on the results of this meta-analysis, the oil pulling may have a beneficial effect on reducing salivary BC count compared to the control group. There was no significant difference in the plaque index and gingival index score between the oil pulling and the control group. Therefore, future clinical trials should be more rigorous and better reported.

Evaluation of wiping edible sesame oils in the oral cavities of hospitalised older patients who resist oral hygiene management

Context

One of the causes of aspiration pneumonia is poor oral hygiene. We need care methods that caregivers can quickly, safely and inexpensively implement for convalescents with inadequate self-care. Edible sesame oil containing sesamin or sesaminol has already been shown to inhibit bacterial and fungal growth and have a vasodilating effect.

Aims

The aim of this study is to evaluate the usefulness of using edible sesame oils for oral hygiene management.

Settings and Design

This study evaluates an oral hygiene management method using two types of sesame oils in elderly hospitalised patients resistant to oral hygiene management.

Methods and Material

The inpatients received oral care for 90 days. In the intervention groups, nurses brushed and wiped the oral cavity with roasted sesame oil (RSO) or sesame salad oil, while in the control group, care with tap water alone and brushing were done. Bacteria and Candida counts from tongue swabs, water content from the tongue's surface and cheek mucosa, oral health assessment tool (OHAT) and cytology of the cheek mucosa were assessed every 30 days before and after the intervention.

Results

RSO showed a tendency to reduce the number of bacteria and Candida. There was an improvement in the OHAT scores with both oils. The water content or cytology was not changing.

Conclusions

Sesame oils may improve oral hygiene and maintain health in older patients.

The effectiveness of microneedling technique using coconut and sesame oils on the severity of gingival inflammation and plaque accumulation: A randomized clinical trial

Objectives

In our research, we evaluated the effect of coconut and sesame oils using the microneedling technique on gingival inflammation and plaque accumulation among patients with gingivitis by creating microholes in the gingiva to facilitate the concentration and entrance of the oils through gingival tissues.

Materials and Methods

Twenty‐four patients with clinically diagnosed plaque‐induced gingivitis were selected from Vision dental hospital, Riyadh, KSA, and assigned to one of three groups randomly; group A consisted of eight participants who were treated with dermapen and topical coconut oil, group B had eight participants who were treated with dermapen and topical sesame oil, and group C involved eight patients who received periodontal mechanical treatment only. Postintervention gingival status and plaque status for all participants were assessed using a modified average gingival index and a plaque index at Weeks 1, 2, and 4.

Results

Groups A and B experienced highly significant reductions in gingival indices, while group C showed reduced scores but was not significantly notable. On the contrary, the three studied groups exhibited no significant difference in the reduction of plaque indices when compared altogether.

Conclusion

Our study demonstrated an effective novel technique that revealed a noticeable improvement in gingival status and a reduction in the average gingival index and plaque index.

Effect of Different Mouthwashing Regimens on Adhesion of a Universal Adhesive:A Microshear Bond Strength and Scaning Electron Microscopy Evaluation

Objective: To evaluate the effect of probiotic or chlorhexidine-based mouthwashes and coconut oil pulling therapy on microshear bond strength of a universal adhesive, used with two application modes. Method: Ninety-six enamel specimens were prepared using bovine incisors and the surfaces were grounded. Then the specimens were randomly divided into 4groups and each group were subjected to a mouth washing regimen with one of three agents-chlorhexidine mouthwash, probiotic-based mouthwash, coconut oil pulling – or stored in artificial saliva(control) for 7 days(n=24). After the procedure, all groups were divided into 2 subgroups, and a universal adhesive was applied with etch-and-rinse or self-etch mode(n=12). Composite micro-cylinders were bonded to the enamel surfaces and micro-shear-bond strength was measured after 24hours water storage. Failure modes were determined using a stereomicroscope and SEM analysis was also performed. The data were analyzed using Mann-Whitney-U and Kruskal-Wallis tests. Results: No significant differences were observed between the different mouthwash groups, regardless of application modes(p> .05). There were no significant differences in microshear-bond strength, within the same mouthwash groups, between self-etch or etch-and-rinse modes, except for oil pulling group. Etch-and-rinse group showed higher bond strength than self-etch group in specimens subjected to oil pulling(p< .05). Conclusion: Etch-and-rinse mode might be preferable on patients who practice oil pulling.

Exploring the Potential of Natural Product-Based Nanomedicine for Maintaining Oral Health

Oral diseases pose a major threat to public health across the globe. Diseases such as dental caries, periodontitis, gingivitis, halitosis, and oral cancer affect people of all age groups. Moreover, unhealthy diet practices and the presence of comorbidities aggravate the problem even further. Traditional practices such as the use of miswak for oral hygiene and cloves for toothache have been used for a long time. The present review exhaustively explains the potential of natural products obtained from different sources for the prevention and treatment of dental diseases. Additionally, natural medicine has shown activity in preventing bacterial biofilm resistance and can be one of the major forerunners in the treatment of oral infections. However, in spite of the enormous potential, it is a less explored area due to many setbacks, such as unfavorable physicochemical and pharmacokinetic properties. Nanotechnology has led to many advances in the dental industry, with various applications ranging from maintenance to restoration. However, can nanotechnology help in enhancing the safety and efficacy of natural products? The present review discusses these issues in detail.

Analysis of Plant Origin Antibiotics against Oral Bacterial Infections Using In Vitro and In Silico Techniques and Characterization of Active Constituents

The pervasiveness of oral bacterial infections in diabetic patients is a serious health concern that may produce severe complications. We investigated 26 Ayurvedic medicinal plants traditionally used for treatment of the oral bacterial infections with the aim to look for new promising drug leads that can be further employed for herbal formulation design. The plants were grouped into three categories based on traditional usage. All plant extracts were examined for antibacterial, antibiofilm and antiquorum-sensing properties. The plants with significant activities including Juglans regia, Syzygium aromaticum, Eruca sativa, Myristica fragrans, Punica granatum and Azadirachta indica were further analyzed using HPLC-DAD-QToF and GC-MS. In silico and in vitro activity was evaluated for selected constituents. Finally, it could be concluded that eugenol and 2-phenylethylisothiocyanate are major contributors towards inhibition of bacterial biofilms and quorum sensing.

Role of Ayurveda and Yoga-Based lifestyle in the COVID-19 Pandemic - A Narrative Review

The COVID-19 pandemic has posed an immense challenge to health care systems around the globe in terms of limited health care facilities and proven medical therapeutics to address the symptoms of the infection. The current health care strategies have primarily focused on either the pathogen on the environmental factors. However, efforts towards strengthening the host immunity are important from public health perspective to prevent the spread of infection and downregulate the potency of the agent. While a vaccine can induce specific immunity in the host, non-specific ways of improving overall host immunity are the need. This scenario has paved the way for the use of traditional Indian therapies such as Ayurveda and Yoga. This review aims at collating available evidence on Ayurveda, Yoga and COVID-19. Further, it draws inferences from recent studies on Yoga and Ayurveda on immunity, respiratory health and mental health respectively to approximate its probable role in prophylaxis and as an add-on management option for the current pandemic.

Sesame Oil (Sesamum Indicum L.) as a New Challenge for Reinforcement of Conventional Glass Ionomer Cement, Could It Be?

Purpose

Despite the advantages of glass ionomer cement (GIC) including chemical bonding to the tooth structure and fluoride release, its low-grade mechanical properties make it a topic for research. Accordingly, this study was conducted to assess the ability of sesame oil as a natural bioactive additive to reinforce conventional glass ionomer cement.

Materials and Methods

Sesame oil was blended into the liquid component of the cement in ratios of 3 and 5 (v/v%). One control and two experimental groups were enrolled in the study; I: unmodified GIC (control), II: 3 (v/v%) sesame oil-modified GICs, and III: 5(v/v%) sesame oil-modified GICs. Compressive strength, shear bond strength, diametral tensile strength, surface microhardness, surface roughness, and color stability were the parameters assessed. A representative specimen of each group was analyzed for its chemical structure by Fourier transformation infrared spectroscopy. One-way ANOVA followed by Tukey test was used to analyze the collected data of all evaluated parameters except the color stability results, which were analyzed by Student t-test at p < 0.05.

Results

Three and 5 (v/v%) sesame oil-modified GICs exhibited significant increase in their compressive strength, shear bond strength, diametral strength, and surface microhardness. Concurrently, there was a significant decrease in surface roughness (p < 0.05) in both formulations of the modified cement. Both 3 and 5 (v/v%) sesame oil-modified GICs showed a clinically acceptable color change.

Conclusions

Sesame oil seems to be a promising natural bioactive product for reinforcement of conventional GIC with a clinically agreeable esthetic.

SARS CoV-2: Progression and treatment protocols - An overview

COVID-19 pandemic is a global health crisis which has affected citizens of all nations. With more than a million death cases, this outbreak has already had a significant impact on the physical and mental wellbeing of mankind. Considerable amount of research is going on worldwide to find out effective drugs against the virus. Chloroquine phosphate, an antimalarial drug is currently used for the treatment. Studies on the harmful effects of chloroquine is in progress. India is rich in traditional medical practicing such as Ayurveda, Siddha, Unani etc. Ministry of AYUSH is trying to implement an interdisciplinary treatment encompassing all traditional methodologies. It is proven that Ashwagandha rasayana (Withania sominefera L.Dunal) has better functions than hydroxychloroquine. The ayurvedic formulations such as Sudarshan Ghanvati and Sanshamanivati are also used. The combination of hydroxychloroquine (HCQ) and azithromycin is found to cure COVID-19 more effectively. Use of Tocilizumab is found to cure the respiratory disorders associated with COVID. Favilavir turns out to be yet another effective drug. The alternative medical system has effective prophylaxis and is considered better for the treatment of COVID-19. Ayurveda and yoga improve immunity thus maintaining good health. This review throws light on the mode of progression of the virus along with the various treatment protocols adopted to fight COVID-19.

Health effects of coconut oil: Summary of evidence from systematic reviews and meta-analysis of interventional studies

BACKGROUND AND AIMS

Systemic review (SR) and meta-analysis (MA) of interventional studies are considered as the highest level of evidence for clinical decision making. Therefore, we systematically summarized all high-quality evidence on the usage of coconut oil for health-related benefits from SRs and MA.

METHODS

PubMed®, Web of science®, SciVerse Scopus®, and EMBASE® databases were systematically searched to select SRs and SRs with MA of interventional studies reporting health-related clinical outcomes of coconut oil. Similar studies were grouped based on their respective clinical areas. A methodological quality appraisal was conducted for all included SRs and SRs with MA using the Critical Appraisal Checklist for Systematic Reviews.

RESULTS

A total of seven papers were selected for inclusion in this review, consisting of three MA and one SR on cardio-metabolic health, one SR on oral health, and one SR and one MA each on skin health. Coconut oil significantly increases serum total cholesterol, low-density- and high-density- lipoprotein cholesterol levels compared to poly- and mono-unsaturated oils. Limited studies showed that topical use of coconut oil helps in the prevention and treatment of atopic dermatitis and oil pulling for the prevention of dental caries. All four studies on cardiometabolic health and the SR on oral health had a high score in the quality assessment, SR with MA on skin health fulfilled high-quality scoring whereas the SR on the same topic had a low-quality scoring.

CONCLUSIONS

In summary, consistent and strong evidence shows that coconut oil has an adverse effect on the lipids parameters associated with cardio-metabolic health, with limited studies to conclude the effects of atopic dermatitis and oil pulling.

Oil pulling to relieve medication-induced xerostomia: A randomized, single-blind, crossover trial

OBJECTIVES

To determine the subjective effectiveness of oilpulling on medication-induced xerostomia with regard to symptom relief, quality of life, taste, mucosal moisture and oral parameters.

MATERIALS AND METHODS

In a randomized, single-blind, crossover trial in participants with medication-induced xerostomia (n = 26; mean age 64.71 (standard deviation (SD) 15.60) years), we investigated oilpulling efficacy (sunflower oil) versus mineral water after one-week use. Xerostomic burden (visual analogue scale, VAS), symptom relief and oral examinations (gingivitis index, plaque index, whole stimulated and unstimulated salivation rates) were investigated at baseline and the end of the follow-up.

RESULTS

Oilpulling reduced the xerostomic burden (baseline value 6.46 (SD 1.80), decreasing to 4.93 (SD 2.97)) (p = .003), without difference between oil versus water (p = .067). Baseline values for water were 6.08 (SD 2.17) decreasing to 5.72 (SD 2.17) (p = .124). Compared to water, oil made swallowing easier (p = .031), caused a pleasant mouthfeel (p = .031) and caused less waking up at night (p = .031). Effectiveness (p = .002) and duration (p = .007) of symptom relief showed differences between products in favour of oil.

CONCLUSIONS

Oil pulling alleviated the overall xerostomic burden. In the comparison between oil and water, no difference regarding symptom relief could be shown. Patients should be informed of possibilities and limitations of oilpulling as inexpensive and easy-to-obtain alternative to commercially available products for short-term symptom relief.

From Treatise to Test: Evaluating Traditional Remedies for Anti-Biofilm Potential

Traditional plant-based remedies hold vast potential as novel antimicrobial agents, particularly for recalcitrant infection states such as biofilms. To explore their potential, it is important to bring these remedies out of historical treatises, and into present-day scientific evaluation. Using an example of Indian traditional medicine (Ayurveda), we present a perspective toward evaluating historical remedies for anti-biofilm potential. Across compendia, we identified three plant-based remedies (of Kalanchoe pinnata, Cynodon dactylon, and Ocimum tenuiflorum) recommended for wounds. The remedies were reconstituted in accordance with historical practices, and tested for their effects on biofilm formation and eradication assays of wound pathogens, Pseudomonas aeruginosa and Staphylococcus aureus. Based on our approach and the results obtained, we provide insights into the considerations and challenges related to identifying potential remedies in historical texts, and testing them in the laboratory with standard biofilm assays. We believe this will be relevant for future studies exploring anti-biofilm approaches at the interface of historical medicine and present-day scientific practices.

The Role of Coconut Oil in Treating Patients Affected by Plaque-Induced Gingivitis: A Pilot Study

Objectives  The aim of the study was to evaluate the coconut oil pulling efficacy as adjuvant in reducing plaque formation and in treating plaque-induced gingivitis.

Materials and Methods  A sample of 20 patients was divided into two groups: a study and a control group. In the study group, coconut oil, in form of mouthwash, was administered to a sample of patients affected by gingivitis, aged between 18 and 35. The protocol established a daily application of the product for 30 days, where clinical parameters for plaque formation and gingivitis—plaque index (PI), bleeding index (BI)—will be evaluated during the recalls on a specific periodontal chart. The control group did not associate a coadjuvant to the normal daily oral health procedures and the same clinical parameters were evaluated at t0 and after 30 days (t1). The data were statistically analyzed using Student’s t -test, establishing the significance level as p < 0.05.

Results  PI and BI decreased in both groups, with a more relevant and significant drop in the study group, from a mean value of PI of 58.0 to 19.3 and a mean value of BI of 33.5 to 5.0. In the control group, the values decreased, respectively, from 53.9 to 29.1 for PI, and from 33.5 to 16.2. Furthermore, no significant side effect was reported during coconut oil pulling therapy.

Conclusions  The collected data showed significant and promising improvements in reducing plaque formation and gingivitis. However, further researches have to be performed to have more consistent and statistically significant data on larger samples and to fully understand the mechanisms of action and effectiveness.

The effect of oil pulling with coconut oil to improve dental hygiene and oral health: A systematic review

Objectives

Coconut oil is a cheap and accessible oil for many people around the world. There are numerous advocates for the practice of oil pulling to prevent common oral diseases. Therefore determining the effectiveness of oil pulling with coconut oil could potentially have monumental benefits. This review aimed to assess the effect of oil pulling with coconut oil in improving oral health and dental hygiene.

Data

We included randomized controlled trials comparing the effect of oil pulling with coconut oil on improving oral health and dental hygiene.

No meta-analysis was performed due to the clinical heterogeneity and differences in the reporting of data among the included studies.

Sources

Six electronic databases were screened: PubMed, Medline, EMBASE, AMED, CENTRAL and CINAHL.

Study selection

Electronic searches yielded 42 eligible studies, of which four RCTs including 182 participants were included. The studies lasted between 7 and 14 days. Significant differences were demonstrated for a reduction in salivary bacterial colony count (p = 0.03) and plaque index score (p=<0.001). One study also demonstrated a significant difference in staining compared to using Chlorhexidine (p = 0.0002). However, data was insufficient for conclusive findings, the quality of studies was mixed and risk of bias was high.

Conclusion

The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene. Future clinical trials are of merit considering the universal availability of the intervention. Prospective research should have a robust design with rigorous execution to provide a higher quality of evidence.

Clinical significance

Oil pulling with coconut oil could be used as a adjunct to normal preventative regimes to improve oral health and dental hygiene although further studies are needed to determine the level of effectiveness.

Oil pulling and importance of traditional medicine in oral health maintenance

Dental diseases have detrimental effects on the functionality and quality of life of individuals. In addition, a strong relationship has been established between various oral and systemic diseases. In fact, the prevention and treatment of dental caries and periodontal disease have been shown to reduce the risk of diabetes and heart disease significantly. This goes beyond the role of oral health as a means to identify early manifestations of systemic diseases in the oral cavity. It highlights the necessity of maintaining an optimal oral hygiene to significantly modify the risk factors for serious systemic diseases. The use of oil pulling can be frequently found in ancient medical text and is supported by recent studies for its efficacy and long-term use for maintaining and improving oral health. This article provides an overview on the concept of oil pulling or oil swishing, its mechanism of action and a summary of the evidence available, which highlights the role of oil pulling in specific oral diseases. The goal of this review is to highlight the ancient procedure that has the potential to be used as an adjunct to conventional chemical means of dental plaque control, such as mouth rinses. Incorporating oil swishing as a component of daily oral hygiene can significantly improve oral and general health, specifically in lower socioeconomic groups and rural communities that may have interrupted access to health-care services and dental products such as dentifrices and mouth washes due to various factors; availability and affordability being the most important.