Antibacterial efficacy of triphala against oral streptococci: an in vivo study

BACKGROUND

Triphala is a botanical preparation consisting of equal parts of three herbal fruits. Much revered in Ayurveda, triphala has been proven to have antibacterial, antiviral, antifungal actions.

AIMS AND OBJECTIVES

The objective of this study was to investigate the effect of 6% triphala in a mouthwash formulation on the salivary streptococci levels at the end of 48 h and 7 days, of twice a day usage, and to compare the same with 0.2% chlorhexidine.

MATERIALS AND METHODS

Sixty undergraduate student volunteers aged between 18 and 25 years were randomly allocated into three study groups. (a) 6% triphala mouthwash, 15 ml twice a day; (b) 0.2% chlorhexidine mouthwash, 15 ml twice a day (active control group); (c) passive control group asked to rinse with plain water, twice a day. The oral streptococci colony forming units/ml (CFUs/ml) was assessed by inoculating blood agar with saliva samples at the end of 48 h and at 7 days.

RESULTS

The triphala group showed a 17% and 44% reduction, while the chlorhexidine group showed 16% and 45% reduction at the end of 48 h and 7 days (P < 0.001). The reduction in CFUs/ml seen in triphala group closely paralleled that of chlorhexidine group.

CONCLUSION

Triphala has been used in Ayurveda from time immemorial and has many potential systemic benefits. The promising results shown by Triphala call for further investigations of its antimicrobial effects against the numerous oral microorganisms.

Perceived sources of stress amongst final year dental under graduate students in a dental teaching institution at Bangalore, India: a cross sectional study

BACKGROUND

Dental schools are known to be highly demanding and stressful learning environments. Dentistry involves an acquisition of required academic, clinical and interpersonal skills during the course of learning. Practicing dentistry requires clinical skills and patient management skills, which also add to the stress perceived by the students. Identifying sources of stress represents the crucial first step towards advocating policy changes and strategies to alleviate the stressors and enhance students' stress coping skills. The aim of this study was to identify self-reported sources of the stress among the final year [4 th year] dental undergraduate students in a Dental Teaching Institution in Bangalore, India.

MATERIALS AND METHODS

A 38 items, 4-point Likert Scale item modified Dental Environmental Stress (DES) questionnaire, addressing 5 stressor domains (living accommodation, interpersonal relationships, academics, clinical skills and miscellaneous) was administered to all final year undergraduate dental students of the Institution. Items and domains were considered to be perceived as "stressful", when students classified them as 'slightly', 'moderately' or 'severely stressful'. Descriptive and bivariate analyzes based on chi square tests were performed.

RESULTS

Out of the 38 items, 19 items were reported to be "stressful" by >70% of the students. Of these, examinations, difficulty in managing difficult cases, lack of patient co-operation, difficulty and amount of course work and completing clinical requirements were reported to be "stressful" by >85% of the students. Personal physical health, difficulty in making friends, staying with roommates, narcotic substance dependencies were least commonly reported to be "stressful".

DISCUSSION AND CONCLUSION

The stress provoking factors among >70% of the students are quite similar to those reported by the researchers' worldwide. Curricular changes, student support mechanisms at departmental/institutional level with appropriate policy changes need to be considered to assist the students in coping with identified stressors.

Assessment of antibacterial efficacy of triphala against mutans streptococci: a randomised control trial

PURPOSE

Triphala is an ayurvedic preparation with known antimicrobial action. This study was carried out to assess the antibacterial efficacy of triphala against salivary mutans streptococci in comparison with the 'gold standard' chlorhexidine.

MATERIALS AND METHODS

A double blind randomised control trial was conducted among 57 volunteers who were assessed to be in the high caries risk category. They were randomly allocated into three study groups: 1) 15 ml of 6% triphala mouthwash; 2) 15 ml of 0.2% chlorhexidine (active control); 3) no mouthwash (passive control). Mouthwashes were given twice a day for 15 days. Unstimulated saliva samples were collected at baseline and at 15 and 45 days. Mutans streptococci (MS) were cultured on MSB agar and colony counts obtained. The α error was fixed at 5%. ANOVA and post-hoc LSD tests were performed using SPSS version 14.

RESULTS

After using mouthwash for 15 days, an 83% and 80% reduction and at 45 days a 67% and 65% reduction in salivary MS colony count was observed in the triphala and chlorhexidine groups, respectively (P = 0.0001). The control group showed an increase of 3% in MS colony count at 15 days and a reduction of 7% at 45 days. (P = 0.116).

CONCLUSION

The antimicrobial action of triphala against mutans streptococci closely parallels that of chlorhexidine. It does not have the side effects commonly associated with chlorhexidine and is cost effective.