CHAPTER 13
ETHNOBOTANY OF ORAL AND DENTAL PROBLEMS IN INDIA
CONTENTS
13.4 Toothpastes and Tooth Powders
13.5 Oral Diseases and Problems
ABSTRACT
Plants have been used by human beings since time immemorial. Plants are significant and perennial sources of food and medicines that are used for the treatment of various human diseases. Traditional drugs derived from herbal plants are used by about 60% of the world’s population, especially in Asia and Africa. The present review focuses on herbal drugs and antidiabetic plants as traditional practice of Indian people in the treatment of diabetes mellitus. Diabetes mellitus is a major health problem especially in the rural and urban population not only of India but throughout the world. There are several remedies for the treatment of diabetes and its associated secondary complications. Herbal drug formulations are correctly preferred due to low toxicity and no side effects. A list of medicinal plants with proven antidiabetic activity and related beneficial effects has been compiled in this review with their botanical names, common name, family, plant/parts used for the diabetic treatment. We hope that this review would initiate an action plan that would lead to the discovery/development of indigenous antidiabetic plant drugs.
13.1 INTRODUCTION
Oral hygiene involves the keeping the oral cavity, gingival and the teeth clean and in healthy condition so as to prevent gingival, periodontal and dental problems due to bacteria (mostly commonly, gingivitis, periodontitis and caries) and halitosis (bad breath). Poor dental health can also adversely affect speech and self-esteem (Bairwa et al., 2012) as well as impose financial and social burdens (Jenkinson and Lamont, 2005). Oral and dental problems form one of the most common health hazards among the people of the world and many children and adults are affected by them (Peterson et al., 2005; Muhammad and Lawal, 2010; Szyszkowska et al., 2010). These problems are also prevalent in India in the last 50 to 100 years since there was a major shift among people from the traditional methods of maintaining oral hygiene to more westernized methods. People have almost forgotten the traditional methods of keeping away the oral and dental problems. People losing their teeth at an earlier age (around 40 to 45 years of age) have substantially increased in number in the last four to five decades and more and more people are subjecting themselves to rootcanal treatment, bridges and implants.
In addition, western culture has led to improper brushing habits leading to dental caries, gingivitis and periodontitis. This is also partly due to the drastic change in the type of food taken and due to change in dietary habits mostly western. More people now suffer from plaque-forming bacteria and yeasts such as species of Actinomyces, Actinobacillus and Candida (Van Ooster et al., 1987). Dental treatment has also become very expensive and out of reach for the common man, moreover, various chemical agents have been introduced to maintain oral hygiene, which include bisgranide antiseptics, quaternary ammonium antiseptics, phenolic antiseptics, a number of oxygenating agents and even metal ions (Bairwa et al., 2012), which produce many side-effects such as vomiting, diarrhea and discoloration of teeth.
Many antibiotics are being used to treat or prevent gingivitis, periodontitis and infections due to dental caries and this has also have resulted in antibiotic-resistance microbial strains. It is therefore, very essential now to review the traditional methods of oral and dental care that are in existence among the ancient ethnic communities of India. These are not only preventive but are also curative and inexpensive. Many plants have been reported in the various pharmacopoeias of the world that have efficacy to treat oral problems (Cowan, 1999; Kalemba and Kunicka, 2003; Lewis, 1990; Bairwa et al., 2012). India is very rich in traditional medical knowledge, both codified and non-codified, as there are several ancient ethnic tribes living in various parts of India and exploiting the very rich flora around them. This review summarizes the available information on the ethnobotany of oral and dental problems in India.
13.2 TEETH CLEANING
Teeth cleaning refer to the removal of dental plaque formed by microbes and calculus (tartar) so as to prevent the formation of caries, gingivitis and periodontitis. Gingivitis, periodontitis and dental caries causes tooth loss. Caries invariably are formed inside pits and fissures on occlusal surfaces where the toothbrush normally does not easily reach to remove food particles. Sticky film that forms on teeth is well-evident at gingival margins. The bacteria present in the plaque converts the carbohydrate component of the food into organic acids which in turn demineralize the teeth and form caries. Brushing and flossing are used to remove plaque and prevent calculus formation. Good oral hygiene results in preventing plaque and calculus formation and its associated problems.
Flossing removes food particles and plaque at and below the gingival margin and in-between the teeth and the actual method of flossing is described in Bairwa et al. (2012). Gums and resins obtained from some plant species are used in forming chewing gums/resins for maintaining teeth cleanliness. These plants include Croton species, Ficus species, Acacia species, some species of Sapotaceae, etc. Although some of these are of bitter taste and unpleasant flavor they reduce, prevent dental caries and mask halitosis. The leaves of the following three plants are chewed to clean teeth: Anacardium occidentale, Mangfera indica and Pongamia pinnata (Jose et al., 2011); also used are the pericarps of coconut fruit or Areca nut fruit. Chewing sponges are used in Ghana and are made from Acacia pennata, Hibiscus rostellatus and Lasianthera africana. The stems or vines of these plants are collected from the forest, bark removed and beaten on rocks till they become fibrous. This is washed and made into sponges that are about five inches in diameter. To clean the teeth, a small portion of the sponge is placed in the mouth and vigorously chewed for 20-30 minutes.This activity produces foam and stimulates saliva flow. In addition, charcoal, burnt rice bran mixed with salt, soot formed by burning wood, etc. are used by tribes for cleaning their teeth.
13.3 PLANT-BASED TOOTHBRUSHES
Normally plant-based, toothbrushes are used to clean the teeth and the gingiva (Lewis, 1990). Usually one end of these toothbrushes are chewed by the teeth and the extracted juice is allowed to act on the teeth and gingiva where cleaning is needed. This chewing also makes the twig end to look like a brush. Normally tender to semi-mature stem twigs are used, although in some cases the root is also used (for example root of Senna). A list of plants of India whose twigs are used as toothbrushes are given in Table 13.1. The juice emanating from these brushes are often antimicrobial, antiseptic and aromatic/flavor so that dental caries, halitosis, etc. are prevented and controlled. Chewed toothbrush sticks impart different tastes such as sweet, bitter, sour, peppery, etc. The twigs used must be smooth, easily chewable, and should not harm. Toothbrush is that there is no need to use toothpaste or tooth powder under normal circumstances. A list of ethnobotanically important toothbrushes is given in Table 13.1
TABLE 13.1 Stem Twigs Used As Toothbrush
13.4 TOOTHPASTES AND TOOTH POWDERS
Traditionally a number of plants were used to prepare toothpastes, powders and gels. A list of plants from which toothpastes and powders are made is given in Table 13.2. Even in artificially made toothpastes and powders many plant extracts/essences are often mixed, e.g., Oils of Eucalyptus, tea, clove, cinnamon, cardamom, betel leaf, etc. A number of chemicals found in these plant materials such as tannins and other phenolics, alkaloids, terpenoids, glycosides, etc., are important not only to clean the teeth and oral cavity but also to prevent/cure oral and dental problems which are mainly caused by different microbes.
13.5 ORAL DISEASES AND PROBLEMS
Ayurveda recognizes the following oral and dental diseases (rogas): Diseases of lips, gums, teeth, tongue, palate and throat (Amruthesh, 2015) with each one labeled differently. Siddha, another traditional codified Indian medical system, recognizes the same diseases although naming them in a different way. However, as per allopathy dental caries and periodontal diseases are the two most common dental pathologies of the humans. Both caries and gingivitis emerge at an early stage, i.e., even in childhood. Caries is due to excess use of sweets and chocolates and is almost non-reversible and sometimes difficult to treat. On the contrary, gingivitis at an early stage is curable if teeth brushing are done regularly and effectively. The oral diseases in adults are invariably the result of diseases not properly treated or cured in the childhood and are due to age changes in gingiva. Susceptibility to dental carries varies between individuals and between different teeth in the same individual. The configuration of jaw and oral cavity, tooth structure and quantity and quality of saliva produced are all equally important. The other important factor is the type and number of caries-causing bacteria present in the mouth. All these bacteria convert carbohydrates into acids but some species are very powerful acid-producers; the latter’s presence in plaque increases the risk of tooth decay. Eating habits and composition of food eaten also play a vital role in dental caries, especially sweets and confectionary carbohydrates, pasta, rice, potato, fruits and bread. On the other hand, milk and milk products especially cheese induce less caries.
TABLE 13.2 Plants Used As Tooth Powders and Toothpaste Formulation
Traditional codified and non-codified Indian medical systems employ wide variety of plant materials to prevent and cure the different types of oral/dental diseases and these are mentioned in Table 13.3. A number of plants are also used as mouth fresheners for removing bad breath and to prevent/cure ulcers on lips, tongue and gingiva and these are listed in Table 13.4.
TABLE 13.3 Plants Used Against Tooth Ache and Decay and Gum Problems (Including Pyorrhea)
TABLE 13.4 Mouth Fresheners, Mouth Washes and Mouth Ulcers (Stomatitis)
13.6 DISCUSSION
It is sad to note that there is no baseline catalog available for listing and describing the plants used for the ethnomedical treatments of dental and oral diseases (Colvard et al., 2006). There is also a significant lack of published research work on the ethnography, ethnomedicine, ethnopharmacology and clinical application of plant-based medicines that are specifically used for dental and oral diseases. Most publications on hand merely describe anecdotal dental therapeutic applications of the current medical uses of ethnobotanicals. These papers at best provide various descriptive dental therapies attributed to traditional herbs (Yatsu, 1985; Boisyvon, 1986; Jacobsen and Cohan, 1998; Ocasio et al., 1999; see also Colvard et al., 2006; Szyszkowska et al., 2010). There are also research papers that deal with individual plants that are used for dental and oral healthcare (see detailed literature in Colvard et al., 2006). There are also reference books that describe the possible medical applications of ethnobotanicals (Johnson, 1999; Gage and Pickett, 2005). From the foregoing review it is evident that:
- There is the lack of proper recording/database of the ethnographic component within dental and oral and medicine.
- There is a lack of clinical documentation of the ethnomedical treatment for the dental/oral diseases experienced by ethnic people in their actual cultural and socio-ecological settings.
- There are no details on the phytochemical basis of why these plants are used against oral and dental diseases.
To conclude there is thus an urgent need to establish the chemical basis for all the ethnobotanical plants listed in this paper so as to prove the veracity of the claims made on them by various researchers.
KEYWORDS
- Antidiabetic activity
- Diabetes mellitus
- Ethnomedicinal plants
- Traditional medicine
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