Phytodentistry: use of medicinal plants

Herbal remedies for oral and dental health: a comprehensive review of their multifaceted mechanisms including antimicrobial, anti-inflammatory, and antioxidant pathways

Across diverse cultures, herbal remedies have been used to alleviate oral discomfort and maintain dental hygiene. This review presents studies on herbal remedies with remarkable antimicrobial, anti-inflammatory, antioxidant, anticancer, anticaries, analgesic, and healing properties. The manuscripts demonstrate the depth of scientific inquiry into herbal remedies used for the management of various oral and dental health conditions. These include gingivitis, oral ulcers, mucositis, periodontitis, oral pathogens, carcinoma, xerostomia, and dental caries. Researchers have investigated the phytochemical and pharmacological properties of plant-derived compounds and their extracts evaluated their interactions with oral pathogens and inflammatory processes. The convergence of traditional knowledge and rigorous scientific investigation offers a compelling narrative, fostering a deeper understanding of herbal remedies as viable alternatives to conventional dental interventions. This work has the potential to provide patients with access to gentle, yet effective solutions, and simultaneously offer dental health professionals the opportunity to enrich their knowledge, and ability to provide personalized, holistic care. This review highlights the symbiotic relationship between herbal medicine and scientific understanding, emphasizing the importance of disseminating this knowledge to benefit both practitioners and patients, enabling evidence-based decision-making in dental care. The exploration of herbal remedies offers a promising alternative, potentially mitigating some of these side effects while promoting oral health in a more natural and holistic manner.

Unleashing nature's defense: potent antimicrobial power of plant extracts against oral pathogens and Streptococcus mutans biofilms

Objectives

The increasing demand for alternatives to antibiotics against resistant bacteria has led to research on natural products. The aim of this study was to analyze the antimicrobial and antibiofilm activity of 16 Mediterranean herb extracts.

Materials and methods

The extracts were analyzed using High Performance Thin Layer Chromatography. The minimum inhibitory concentration and minimum bactericidal concentration of the extracts from Achillea taygetea, Cistus creticus ssp. creticus, Cistus monspeliensis, Lavandula stoechas, Mentha aquatica, Mentha longifolia, Origanum vulgare, Phlomis cretica, Rosmarinus officinalis, Salvia sclarea, Satureja parnassica, Satureja thymbra, Sideritis euboea, Sideritis syriaca, Stachys spinosa, and Thymus longicaulis were determined against eight oral bacteria and fungus Candida albicans. Microtiter plate test was conducted to evaluate the antibiofilm activity against Streptococcus mutans.

Results

Overall, all tested extracts efficiently suppressed the growth of obligate anaerobic bacteria. When applied at concentrations ≥0.15 mg/ml, the extracts exhibited moderate to high antibiofilm activity comparable to that of chlorhexidine (CHX) against S. mutans. Interestingly, R. officinalis (MIC: 0.01-0.06 mg/ml) and O. vulgare (MIC: 0.04-1.25 mg/ml) demonstrated the highest antibacterial activity against oral bacteria. Additionally, R. officinalis and L. stoechas significantly inhibited S. mutans biofilm formation at 0.15 mg/ml.

Conclusions

The tested plant extracts can be considered as alternative natural antimicrobial and antibiofilm agents.

Clinical relevance

Mediterranean herb extracts show promise as natural alternatives to combat oral bacteria and biofilm formation, offering potential new therapies for infectious oral diseases in the context of antibiotic resistance.

Dentistry in the centuries: a historical overview

The began of the dentistry as medicine's concept has a long history dating back to 7000 BCE, making it one of the earliest medical specialties. In its early days, dental diseases were often attributed to supernatural causes like "evil spirits" and "tooth worms." However, today, dentistry leverages cutting-edge technologies, including artificial intelligence, for diagnosis and treatment. This journey reflects the remarkable progress made in the field. Despite these advancements, there is still room for improvement in integrating dental knowledge and skills with medical science and engineering backgrounds. Bridging these disciplines could lead to even greater advancements in the diagnosis and maintenance of oral health. Thus, over time, it has transformed from a primitive form of medicine into a modern field that emphasizes preventative dental care, advanced diagnostics, and state-of-the-art treatment.

Assessing the effect of Artemisia sieberi extracts on surface roughness and candida growth of digitally processed denture acrylic materials

BACKGROUND

Denture stomatitis, frequently encountered, is generally addressed symptomatically, with limited exploration of preventive approaches involving antifungal medicinal plants.

OBJECTIVE

This study assessed the impact of Artemisia sieberi extracts on the candida growth of conventional and digitally processed acrylic materials.

METHOD

Thirty acrylic resin discs (3 mm thickness × 10 mm diameter) were prepared by conventional or CAD/CAM technology (milling and 3D printing). The resin discs were exposed to simulated brushing, thermocycling, and immersion in Artemisia sieberi extract for 8 hours. The surface roughness of the discs was assessed at baseline and after immersion in Artemisia sieberi extract. Candida growth was quantified through colony-forming units (CFU/mL). Data was analyzed using SPSS v.22 (α⩽ 0.05).

RESULTS

Irrespective of the material type, the post-immersion surface roughness was significantly higher compared to pre-immersion values (p< 0.05). Candida growth was significantly higher in conventional acrylic materials than digitally fabricated acrylics (p< 0.05). At × 3, Ra and CFU were found to be moderately positive and non-significantly correlated (R= 0.664, p= 0.149). At × 4, Ra and CFU were found to be weak positive and non-significantly correlated (R= 0.344, p= 0.503).

CONCLUSION

Artemisia sieberi extracts had a notable impact on digitally fabricated denture acrylics, reducing candida albicans growth compared to conventional heat-cured acrylic. This suggests a potential role for these extracts in improving denture hygiene and preventing denture stomatitis, particularly in the context of digitally fabricated dentures.

The Potential of Cochlospermum tinctorium, Flueggea virosa, and Waltheria indica Traditional Plants From Burkina Faso in Treating Periodontitis: A Systematic Review

Periodontitis is a chronic, infectious, and inflammatory oral disease with a high prevalence in developing countries, where limited access to modern dental care curtails its treatment. This review is dedicated to examining three indigenous botanical species frequently recommended by traditional therapists for the treatment of periodontal disease, namely, Cochlospermum tinctorium, Flueggea virosa, and Waltheria indica, with the aim of elucidating their chemical constituents and pharmacological properties that may support their empirical use. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines extension for scoping reviews. An electronic search was conducted in three databases (PubMed, Science Direct, and Google Scholar) up to July 2022. Out of 700 articles initially identified, only 11 were deemed eligible for inclusion; a substantial majority (80%) of these comprised in vitro studies. Among the trio of botanicals considered, Waltheria indica emerged as the most extensively investigated (65% of the studies). The administration of these plants was predominantly in the form of decoctions or macerations, with extraction methods employing alcoholic agents (ethanolic and methanolic), hydroalcoholic solutions, or aqueous solvents. The selected plants exhibited notable richness in polyphenolic compounds, particularly flavonoids, and demonstrated anti-inflammatory effects, as indicated in 60% of the studies, along with antibacterial properties (against Streptococcus aureus and Helicobacter pylori). None of the studies reported antibacterial activity against periodontal pathogens. The pharmacological properties of these plants may hold promise for the management of oral inflammatory and infectious conditions. Nevertheless, further comprehensive investigations are imperative to establish their safety and efficacy for periodontitis treatment before conclusive recommendations can be formulated.

Insight of Ethnomedicines in Dentistry: A Brief Review

Ethnomedicines in the literature compare the therapeutic efficacy of various herbs based on active ingredients of plants and animals. The application of phytomedicines in the field of dentistry is uncommon. The main objective of this article is to access the efficacy of ethnomedicines and newly evolving treatment modalities in reducing post-op complications following dentoalveolar surgeries. Inclusion criteria were selected according to the population, intervention, control, and outcomes (PICO) format. Case reports, case series, retrospective studies, and studies with inappropriate reporting of outcomes were all excluded. An electronic search of English literature in PubMed was performed using the keywords Ethnomedicine, Anti-inflammatory, Analgesics, Therapeutic herbs, Herbal mouthwashes, Third molar surgery. A total of 25 articles were selected, of which three were on herbal mouthwashes and 22 were on anti-inflammatory effect. All the articles were regarding the therapeutic effect of the herbs. The present paper studies various traditionally used therapeutic herbs, their benefits, and shortcomings with their application in dentistry. This study has shown the different herbal alternatives to conventionally used drugs in relation to third molar.

Evaluation of In Vitro Antiprotease Activity of Selected Traditional Medicinal Herbs in Dentistry and Its In Silico PASS Prediction

Background

Dental/oral diseases are one of the significant public health problems globally. Herbal medicines for managing oral diseases are considered an effective alternative to synthetic compounds due to their lower side effect. Azadirachta indica, Terminalia chebula, Camellia sinensis, and Piper nigrum are used to control and prevent oral inflammations in dentistry. In this study, we have evaluated the protease inhibition activity of these plant extracts, and further, the binding mode of the active ingredient of these plants with trypsin was studied using molecular docking.

Methods

In this study, protease inhibition activity was carried out using aqueous extracts of the plant parts such as Azadirachta indica (neem) twig, Terminalia chebula (Haritaki) fruit, Camellia sinensis (green tea) powder, and Piper nigrum (kali miri) seed. Next, to explore the binding mode of active ingredients azadirachtin, chebuligenic acid, catechin, and piperine with trypsin, we employed a molecular docking study using AutoDock4.2.

Results

The results revealed that the Azadirachta indica plant extract showed an IC50 value of 96.19 μg mL⁻¹, Camellia sinensis IC50 value of 188.50 μg mL⁻¹, Piper nigrum IC50 value of 371.20 μg mL⁻¹, and Terminalia chebula IC50 value of 639.48 μg mL⁻¹, when compared with standard drug diclofenac sodium, had IC50 value 93.00 μg mL⁻¹. Further, the docking result reveals that all the main active ingredients of these plants have significant binding affinity and prefer the same binding pocket of trypsin.

Conclusion

Hence, our results show the importance of traditional plants Azadirachta indica, Terminalia chebula, green tea, and Piper nigrum to control oral disease conditions. As they show significant protease inhibition activity, hence, the active ingredient could act as a potential anti-inflammatory agent and further help to prevent or control oral disease conditions such as gingivitis and periodontitis.

Antioxidant-Rich Natural Raw Materials in the Prevention and Treatment of Selected Oral Cavity and Periodontal Diseases

Antioxidant-rich natural raw materials have been used for thousands of years in traditional medicine. In the past decade, there has been increasing interest in naturotherapy, which is a practice of using products with a natural origin. Natural products can be effective in the treatment and prevention of oral and dental diseases, among others. Such raw materials used in dentistry are characterized by antioxidant, anti-inflammatory, antibacterial, antiviral, antiedematous, astringent, anticoagulant, dehydrating, vitaminizing, and-above all-regenerative properties. Reports have shown that a relationship exists between oral diseases and the qualitative and quantitative composition of the microbiota colonizing the oral cavity. This review aimed to analyze the studies focusing on the microbiome colonizing the oral cavity in the context of using natural raw materials especially herbs, plant extracts, and isolated biologically active compounds as agents in the prevention and treatment of oral and periodontal diseases such as dental caries as well as mucosal changes associated with salivary secretion disorder. The present work discusses selected plant ingredients exhibiting an antioxidant activity with potential for the treatment of selected oral cavity and periodontal diseases.

Homeopathic consideration for resistant endodontic bacteria Enterococcus faecalis: An in vitro comparative disc diffusion study

Background:

Homeopathy is one of the commonly used systems of complementary or alternative medicine. The present study was conducted with an aim to compare the antibacterial efficacy of two commonly used homeopathic medicaments acid benzoicum 30C (SBL Pvt Ltd) and silicea 6C (SBL Pvt Ltd) with that of calcium hydroxide (Deepti Ltd) as intracanal medicament against Enterococcus faecalis (ATCC-29212).

Materials and Methods:

The test organism used for the study was E. faecalis. Petri plates with 20 ml of sheep blood agar were inoculated with 0.1 ml of the microbial suspensions. The medicaments to be tested for antimicrobial efficacy against E. faecalis were divided into three groups: Group A (acid benzoicum), Group B (silicea), and Group C (calcium hydroxide). The antimicrobial activity of each medicament was measured and expressed in terms of the mean of the diameter of zone of inhibition (in mm) produced by each extract at the end of the incubation period. ANOVA and Tukey's honestly-significant difference posthoc test were used for the intergroup comparison. P < 0.05 was considered statistically significant.

Results:

Group A (acid benzoicum) showed the maximum zone of inhibition against Gram-positive E. faecalis (17.2 ± 0.65), and the difference between the groups related to the antibacterial activity was highly significant (P < 0.001). A statistically significant difference was observed between the three groups on the intergroup comparison (P < 0.001).

Conclusion:

In the present in vitro study, antimicrobial activity of the acid benzoicum extract was the highest followed by silicea extract and then calcium hydroxide.

Potential effect of Allium sativum bulb for the treatment of biofilm forming clinical pathogens recovered from periodontal and dental caries

Biofilm producing clinical bacterial isolates were isolated from periodontal and dental caries samples and identified as, Lactobacillus acidophilus, Streptococcus sanguis, S. salivarius, S. mutansand Staphylococcus aureus. Among the identified bacterial species, S. aureus and S. mutansshowed strong biofilm producing capacity. The other isolated bacteria, Streptococcus sanguis, S. salivarius showed moderate biofilm formation. These pathogens were subjected for the production of extracellular polysaccharides (EPS) in nutrient broth medium and the strain S. aureus synthesized more amounts of EPS (610 ± 11.2 µg/ml) than S. sanguis (480 ± 5.8 µg/ml).EPS production was found to be less in S. salivarius (52 ± 3.8 µg/ml).The solvent extract of A. sativum bulb showed the phytochemicals such as, carbohydrate, total protein, alkaloids, saponins, flavonoids, tannins and sterioids. The solvent extract of A. sativum bulb showed wide ranges of activity against the selected dental pathogens. The difference in antibacterial activity of the solvent extract revealed differences in solubility of phytochemicals in organic solvents. Ethanol extract was highly active againstS. aureus (25 ± 2 mm). The Minimum Inhibitory Concentration (MIC) of crude garlic bulb varied widely and this clearly showed that bacteria exhibits different level of susceptibility to secondary metabolites. MIC value ranged between 20 ± 2 mg/ml and 120 ± 6 mg/ml and Minimum Bactericidal Concentration (MBC) value ranged from 60 ± 5 mg/l to 215 ± 7 mg/ml. To conclude, A. sativum bulb can be effectively used to treat periodontal and dental caries infections.

The Use of Medicinal Plants for the Treatment of Toothache in Ethiopia

This paper presents a review of relevant medicinal plants used for toothache treatment in Ethiopia. This finding is based on a review of the literature published in scientific journals. A total of 130 medicinal plants, distributed in 117 genera and 62 families, are reported in the reviewed literature. Of the 130 species of medicinal plants reported in the literature, ninety-two (70.7%) were obtained from the wild whereas twelve (9.2%) were from home gardens. Shrubs (34.6%) were the primary source of medicinal plants, followed by herbs (30%). The Asteraceae came out as a leading family with 12 medicinal species while the Fabaceae followed with nine. Some findings include the predominance of root material used (31%), followed by leaves (29%). This study demonstrates the importance of traditional medicines in the treatment of toothache in Ethiopia. It is essential for the health of users to phytochemically demonstrate the effects of medicinal plants for their possible therapeutic applications. Hence, future phytochemical and pharmaceutical studies should give due consideration on frequently reported medicinal plants in order to produce natural drugs that could be effective in toothache treatment and without side effects.

Mediterranean herb extracts inhibit microbial growth of representative oral microorganisms and biofilm formation of Streptococcus mutans

In light of the growing antibiotic resistance, the usage of plant-derived antimicrobial agents could serve as an effective alternative treatment against oral infections. The aim of this study was to investigate the antimicrobial and antibiofilm activity of Mediterranean herb extracts against representative oral microorganisms. The extraction procedures and the analysis of the obtained extracts were performed under established experimental conditions. The minimum inhibitory (MIC) and bactericidal (MBC) concentrations of the methanol extracts of Cistus creticus ssp. creticus, Cistus monspeliensis, Origanum vulgare, Rosmarinus officinalis, Salvia sclarea and Thymus longicaulis against eight typical oral bacteria and the fungus Candida albicans were determined. The antibiofilm activity against Streptococcus mutans was also quantified using the microtiter plate test. Overall, all tested extracts inhibited effectively the screened obligate anaerobic microorganisms and in concentrations ≥0.3 mg ml-1 had moderate to high antibiofilm activity comparable to that of chlorhexidine (CHX) against S. mutans. In particular, R. officinalis (MIC: 0.08-5.00 mg ml-1) and S. sclarea (MIC: 0.08-2.50 mg ml-1) showed the highest antibacterial activity, while Cistus spp., R. officinalis and S. sclarea significantly inhibited S. mutans biofilm formation at 0.60, 1.25 and 2.50 mg ml-1, respectively. Porphyromonas gingivalis and Parvimonas micra were high susceptible to O. vulgare (MIC = 0.30 mg ml-1), whereas T. longicaulis eradicated all oral bacteria (MBC: 0.15-2.50 mg ml-1). Nevertheless, C. albicans showed no sensitivity to the tested extracts. In conclusion, the tested plant extracts could serve as alternative natural antibacterial and antibiofilm components against oral infections.

Discovering the Health Promoting Potential of Fermented Papaya Preparation—Its Future Perspectives for the Dietary Management of Oxidative Stress During Diabetes

The simplistic morphological characteristics of Carica papaya fruit or “pawpaw” should not be the cause for underestimating its potential as a nutraceutical. The market for papaya has been expanding at a staggering rate, partly due to its applicability as a biofortified product, but also due to its phytochemical properties and traditional health benefits. Papaya or formulations of fermented papaya promotion (FPP) display effective free radical scavenging abilities thought to be influenced by its phenolic, carotenoid, flavonoid, or amino acid profile. The antioxidant properties of FPP have been extensively reported in literature to potently target a broad spectrum of free radical-induced diseases ranging from neurological impairments, such as senile dementia, to systemic diseases, to its interference at the cellular level and the support of normal biological ageing processes. FPP has thus been extensively investigated for its ability to exert cellular protective effects and reduce oxidative stress via the mitigation of genetic damage, reduction of lipid peroxidation, and enzymatic inactivation in specific diseases. The focus of this review is to appraise the potential of oxidative stress reduction strategies of FPP and discuss its holistic approach in disease prevention and management, with a particular focus on diabetes and cancer. However, with the current lack of information surrounding its mechanism of action, this review wishes to set the stage and aspire researchers to more profoundly investigate molecular pathways related to how FPP can unequivocally contribute to wellness in an aging population.

Natural Products for Drug Discovery in the 21st Century: Innovations for Novel Drug Discovery

The therapeutic properties of plants have been recognised since time immemorial. Many pathological conditions have been treated using plant-derived medicines. These medicines are used as concoctions or concentrated plant extracts without isolation of active compounds. Modern medicine however, requires the isolation and purification of one or two active compounds. There are however a lot of global health challenges with diseases such as cancer, degenerative diseases, HIV/AIDS and diabetes, of which modern medicine is struggling to provide cures. Many times the isolation of "active compound" has made the compound ineffective. Drug discovery is a multidimensional problem requiring several parameters of both natural and synthetic compounds such as safety, pharmacokinetics and efficacy to be evaluated during drug candidate selection. The advent of latest technologies that enhance drug design hypotheses such as Artificial Intelligence, the use of 'organ-on chip' and microfluidics technologies, means that automation has become part of drug discovery. This has resulted in increased speed in drug discovery and evaluation of the safety, pharmacokinetics and efficacy of candidate compounds whilst allowing novel ways of drug design and synthesis based on natural compounds. Recent advances in analytical and computational techniques have opened new avenues to process complex natural products and to use their structures to derive new and innovative drugs. Indeed, we are in the era of computational molecular design, as applied to natural products. Predictive computational softwares have contributed to the discovery of molecular targets of natural products and their derivatives. In future the use of quantum computing, computational softwares and databases in modelling molecular interactions and predicting features and parameters needed for drug development, such as pharmacokinetic and pharmacodynamics, will result in few false positive leads in drug development. This review discusses plant-based natural product drug discovery and how innovative technologies play a role in next-generation drug discovery.

Members of the Oral Microbiota Are Associated with IL-8 Release by Gingival Epithelial Cells in Healthy Individuals

The triggers for the onset of oral diseases are still poorly understood. The aim of this study was to characterize the oral bacterial community in healthy humans and its association with nutrition, oral hygiene habits, and the release of the inflammatory marker IL-8 from gingival epithelial cells (GECs) with and without stimulation by bacterial endotoxins to identify possible indicator operational taxonomic units (OTUs) associated with inflammatory marker status. GECs from 21 healthy participants (13 females, 8 males) were incubated with or without addition of bacterial lipopolysaccharides (LPSs), and the oral microbiota was profiled using 16S rRNA gene-targeted sequencing. The basal IL-8 release after 6 h was between 9.9 and 98.2 pg/ml, and bacterial communities were characteristic for healthy oral microbiota. The composition of the oral microbiota was associated with basal IL-8 levels, the intake of meat, tea, white wine, sweets and the use of chewing gum, as well as flossing habits, allergies, gender and body mass index. Additionally, eight OTUs were associated with high basal levels of IL-8 and GEC response to LPS, with high basal levels of IL-8, and 1 with low basal levels of IL8. The identification of indicator bacteria in healthy subjects with high levels of IL-8 release is of importance as they may be promising early warning indicators for the possible onset of oral diseases.

Antimicrobial effects of Citrus sinensis peel extracts against dental caries bacteria: An in vitro study

Background

Ethnomedicine is gaining admiration since years but still there is abundant medicinal flora which is unrevealed through research. The study was conducted to assess the in vitro antimicrobial potential and also determine the minimum inhibitory concentration (MIC) of Citrus sinensis peel extracts with a view of searching a novel extract as a remedy for dental caries pathogens.

Material and Methods

Aqueous and ethanol (cold and hot) extracts prepared from peel of Citrus sinensis were screened for in vitro antimicrobial activity against Streptococcus mutans and Lactobacillus acidophilus, using agar well diffusion method. The lowest concentration of every extract considered as the minimal inhibitory concentration (MIC) values were determined for both test organisms. One way ANOVA with Post Hoc Bonferroni test was applied for statistical analysis. Confidence level and level of significance were set at 95% and 5% respectively.

Results

Dental caries pathogens were inhibited most by hot ethanolic extract of Citrus sinensispeel followed by cold ethanolic extract. Aqueous extracts were effective at very high concentrations. Minimum inhibitory concentration of hot and cold ethanolic extracts of Citrus sinensis peel ranged between 12-15 mg/ml against both the dental caries pathogens.

Conclusions

Citrus sinensispeels extract was found to be effective against dental caries pathogens and contain compounds with therapeutic potential. Nevertheless, clinical trials on the effect of these plants are essential before advocating large-scale therapy.

Key words:Agar well diffusion, antimicrobial activity, dental caries, Streptococcus mutans, Lactobacillus acidophilus.