Herbal Alternatives for Oral Health:  Mechanistic Exploration with their Market Potential

Shradha Devi Dwivedi¹, Madhu Yadav¹, Deependra Singh¹, Manju Rawat Singh¹*

¹ University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur (C.G), India-492010

*Corresponding author: manjursu@gmail.com

The utilization of customary methods for oral cleanliness maintenance has a long-written history. Herbs are making a comeback all over the world. Herbal extracts have been used in dentistry to alleviate pain as antimicrobial plaque specialists, to delay receptor arrival, and as germicides, cancer prevention agents, antimicrobials, antifungals, antibacterial, antiviral, and analgesics. Current article gives an outline of different natural products used in oral care with their impacts on oral health, restorative actions, applications, and marketed products. This article also highlights mechanistic need of oral cleanliness and the different dental diseases associated with it. The regular phytochemicals could offer a successful anti-microbial and address ways to deal with avoidance and restorative systems for different dental infections. There are different herbal formulations available on the market for oral care such as paste, mouthwash, gargles, gels, etc. creating need for awareness of consumers towards the herbal products. In these review, we have also discussed the commercial aspect of the herbal dental products along with assessment of side effects and toxicity of these herbs. 

 Keywords: Herbs, Oral care, commercialization, dental diseases.

1.     Introduction

Oral problems are a significant health burden for many nations and impact people at all stages of life, resulting in pain, discomfort, deformity, and even death. According to WHO, 3.5 billion individuals are impacted by oral disorders signifying 3 out of 4 people affected in developing countries. Globally, it is estimated 2 billion individuals experience caries of permanent teeth as well as 514 million children suffer from caries of primary teeth(Salari et al. 2022). Oral and dental health is inextricably linked to overall wellness that affects day-to-day life. Speech, food selection, life quality, and well-being are all factors to consider. In light of the incidence of oral illnesses and their effects on people, dental care became very important.

 Disease associated with improper dental care and hygiene is one of the world’s most influencing diseases. Dental well-being is essential to general prosperity and connects with the norms of life that reach out past the elements of the craniofacial complex(Torwane et al. 2014). The most predominant and considerable oral illnesses all around the world are dental caries (tooth rot), periodontal sickness, tooth loss, herpangina, Thrush, and Canker sores (Janakiram et al. 2020). An oral cavity might be a limited, moderate rot of the teeth and one of the chief normal kinds of plaque‐related infection. WHO report claims that around 100% of adults and 60 to 90% of school children are suffering from cavities(“Oral Health” n.d.). Improper dental cares enhance the oral microbes that cause oral infections, such as gingivitis, periodontitis, oral candidiasis, and other oral infections. Gingivitis is the initial stage of gum disease, which is caused by a variety of bacterial species. These bacteria enter the crevices between a person's gums, where the toxins are produced leading to irritation and inflammation of the gum tissue nearby. While periodontitis is a serious bacterial infection in which the accumulation of bacteria over gums and teeth forms pus pockets underneath the gum lines, loss, and falling of teeth. On the other hand, candidiasis is a kind of fungal infection caused by Candida. It is also known as oropharyngeal candidiasis or thrush. In these, white patches have appeared in the inner lining of cheeks, tongues, the upper part of mouth, and throat; pain during swallowing and eating. The persistence of these oral disorders leads to chronic diseases like oral cavity arises to ulcers and cancer in the oral cavity; periodontitis leads to rheumatoid arthritis and ostio-arthritis; candidiasis leads to HIV/AIDS and cancer. Oral microorganisms required inside the circulatory system are connected to coronary corridor sickness, atherosclerosis, and stroke. This is how oral hygiene and dental care are interlinked with other chronic disease.

Figure 1. Relationship between dental health care and other diseases

There are many different ways to do oral care through various marketed products in the form of paste, jellies, creams, ointments, gel, and mouth rinses containing both synthetic components and natural herbs. Brushing, flossing teeth and the effective use of a toothbrush can help to prevent decay, but once a cavity has formed, a dentist must treat it to prevent further damage by filling it. Avoiding too many sweets is also a way to prevent your tooth from decaying. To prevent teeth from decaying further, the use of fluoride toothpaste may increase the risk of dental caries. There are many fluoride-containing gels, mouth rinses, and toothpaste that are also available as a marketed-products. Sodium hypochlorite it's aggravation to the peri-apical tissues as well as has weaknesses such as bursting of encompassing tissues, unwanted taste, high poisonousness, destructive to instruments, failure to dispose of the smear layer, decrease in coefficient of versatility and adaptable strength of dentin. As well as Antibiotics prefer antibiotic medication, penicillin, amoxicillin, metronidazole, and sterilizers like chlorhexidine which are usually utilized in dentistry, yet they make many side impacts. The utilization of natural medication in dentistry is useful in decreasing irritation and controlling plaque development. While natural medicine is so successful in oral sicknesses and makes fewer side impacts (Torwane et al. 2014).

2. Natural products over synthetic products

2.1. Synthetic dental components 

There are numerous chemical agents available who are effective against the metabolism of bacteria and the adherence of bacterial cells. Certain, chemical agents like chlorhexidine, triclosan, and delmopinol, have potent inhibitory actions against the maturation and development of microbes. The degradation of the serosa permeability barrier against bacterial cells is generally accepted to be the mechanism of chlorhexidine's bactericidal effect. High concentrations of this chemical result in cytoplasm condensation and denaturation, which leads to sterilization, whereas low quantities can produce partial cytoplasmic leakage. Apart from anti-microbial agents, non-herbal dental products consist of abrasives excipients (Sodium alginate and calcium carbonate), foaming agents (Sodium lauryl sulfate), anti-cavities fluoridation, anti-sensitivity agents (strontium chloride or potassium nitrate) flavoring agents and sweetening agents (sodium saccharin) (Chen et al. 2020). Fluorides, such as sodium fluoride, stannous fluoride, and amine fluoride are effective deterrents for tooth caries. Through bacterial cell walls free fluoride ions in sodium fluoride may disrupt bacterial metabolism. A cationic antibacterial agent with an unknown method of action is amine fluoride(Naumova et al. 2019). It is hypothesized that amine fluorides attach to bacterial cell surfaces and interfere with the stability of the bacterial membrane. Chemical agents, however, can have significant unintended consequences. Antimicrobial drugs that have low penetration may limit their ability to suppress cariogenic bacteria. Additionally, the time of exposure and agent concentration have an impact on the effectiveness and anti-caries activity. Overuse of chemicals causes certain conditions such as weakening of tooth enamel and heightened sensitivity. High chemical concentrations can upset the oral flora and cause side effects like vomiting, diarrhea, mucosal desquamation, and tooth discoloration. Utilizing alternative natural items as dental caries prevention strategies might thus be fruitful for dental care (Chen et al. 2020). In many non-herbal oral care products, there are warnings that ‘’Children under 6 years of age should have adult supervision and use only a pea-sized amount; Do not swallow.’’ These warnings are mentioned to prevent any side effects in the long-term use of those products. The utilization of natural medication in dentistry is useful in diminishing aggravation and controlling plaque development.

2.2. Herbal dental components 

Indian medicinal system comprises Allopathy, Homeopathy, Ayurveda, Unani, Siddha, Naturopathy, and Yoga. Ayurvedic is a medical system that has been practiced for about 5000 years in India and prescribes a mix of lifestyle management and therapy with particular herbs to address various conditions. Approximately 1,250 medicinal plants are employed in the formulation for oral treatments (M, Yashoda R, and Puranik P Manjunath 2015).

Herbal medicines differ from chemical products in two ways as they are employed in crude form with persistent usage. Long term treatment from medicinal plants show desired benefits with negligible side effects. It is widely recognized that medicinal herbs have significant antibacterial action against a variety of pathogens, including germs that cause tooth caries. There are phytochemicals for the prevention, treatment, and maintenance of periodontal disorders. Formulation of the herbal dental product has been illustrated in figure 2. They might be tannins, terpenoids, flavanoids, alkaloids, or other compounds. These antimicrobial actions have been demonstrated to be very beneficial for periodontal infections(K, Ansari, and Ali 2009). The greatest obstacle and concern is a lack of knowledge regarding herb effects on oral tissues, mechanisms of action, and side effects. The use of natural products in dentistry marks fewer side effects. The drawbacks of utilizing natural medication like Clove oil are intended to lead to major issues like pharyngitis, regurgitating, cytotoxicity, kidney disappointments, harm to the liver, seizures, trouble in breathing, and others if utilized in higher dosages only. Hence, the Preclinical and clinical preliminaries are expected to me

asure biocompatibility and security before natural medications are frequently suggested for oral consideration. Hence the present review has been undertaken to study the effect of various herbs that are useful in dentistry(M, Yashoda R, and Puranik P Manjunath 2015). Therapeutical applications of the various natural products are given in table 1.

Figure 2:- Formulation process of Herbal dental products

3. Natural sources with key potential in oral wellbeing

Traditional methods of maintaining oral hygiene have a long history and are still widely used in rural Africa, South America, and the Indian subcontinent. Although it may be tempting for oral healthcare professionals and the general public, particularly those living in urban areas, to outright dismiss them as ineffectual, the use of these natural products is based on tried-and-true scientific principles. Herbs have their own therapeutical potential such as anti-inflammatory, antimicrobial, analgesic and anesthetic and antioxidant which is implemented in treatment of various oral health problems. In this current section we have provide the therapeutical potential of natural agent in oral health care.

3.1 Clove

The key phenolic parts of clove unpredictable oil, eugenol, and eugenyl acetic acid derivation have been displayed to fluctuate a few actual properties of tar composite like the unfriendly impact on surface harshness, cross-over strength, and surface hardness. The oil extricated from the clove is known as eugenol. Contingent upon where the oil is extricated from the bud, leaf, or stem. The convergence of eugenol by and large ranges from 60 to 90%. Clove oil is for the most part utilized in dentistry to treat torment from a dry attachment, as well as utilized in several transitory helpful materials. Clove oil can be seen in most regular well-being stores and some supermarkets (Kumar et al. 2013).

3.1.1. Antimicrobial

Clove oil has an inhibitory activity against different organic entities like S. aureus, L. monocytogenes, and Aspergillus. Synergistic impacts of clove oil alongside different oils of cilantro, dill, coriander, and eucalyptus showed a more significant level of hindrance on gram-negative bacteria, in this way demonstrating that the synergism aggravates the counter microbial action of clove oil. Streptococcus mutants are the causative living being for dental caries Streptococcus mutants are the typical verdure present in each oral cavity. They are coccus-formed nonmotile microbes S. mutants are the predominant ones found in dental plaque, which utilizes the sugar contents present in our food particles and develops and secretes a tacky polysaccharide which then, at that point, prompts the plaque development in our teeth. It produces a compound that uses sugars and deliveries lactic acids as their results; the acids will gradually erode the veneer in this manner prompting dental caries. If these dental caries are left untreated they enter the mash chamber and annihilate it so the tooth becomes non-vital. The key constituent of refined clove-bud-oil (60‑90%) is eugenol (4‑allyl‑2‑meth-oxyphenol) (Aishwarya, Harini, and Karthikeyan 2014). The oil likewise contains around 10% acetyl eugenol and little amounts of gallic corrosive, sesquiterpenes, furfural and vanillin, and methyl‑n‑amyl ketone. Other constituents incorporate flavonoids, carbs, lipids, oleanolic corrosive, rhamnetin, and nutrients. Contrasted with any remaining oil extricates clove oil removal shows serious areas of strength for an exceptionally low focus(4‑allyl‑2‑meth-oxyphenol)(Aishwarya, Harini, and Karthikeyan 2014).

3.1.2. Clove oil as an analgesic and anesthetic

Individuals visit the dental specialist provided that there is an aggravation in their oral holes, which is caused due to dental caries. Be that as it may, they experience a throbbing torment just during evening times, as quickly as a home cure clove oil can be used.

Eugenol is used to lessen torment in the oral hole might be because of dental caries. Recent explores have been done on the utilization of clove oil as an all sedation in amphibians. Clove oil contains eugenol which assuages torment and fills in as a pain-relieving and eliminates every one of the microorganisms present in that area of the tooth. The entire clove additionally can be squashed and utilized however it has a sensitive taste so clove oil is generally an awesome and viable method for getting relief from tooth hurt. Using clove oil will reduce the pain and also helps in the removal of infection from the abscess. Benzocaine sometimes produces allergic reactions in some patients, so for these kinds of patients natural alternative should be used has to be. Clove oil has that anesthetic effect and so it can be used as an alternative, but if an excess amount is ingested this will cause respiratory and liver disorders also both clove oil and benzocaine have the same effects so the clove oil is used as an anesthetic.

3.1.3. Clove oil as an antioxidant

Our oral pit is presented continually to food, liquor, nicotine, dental materials and strategies, and tobacco item, since the oral hole is exceptionally fragile every one of these can cause harm to the tissues by delivering free revolutionaries. Antioxidants are the solution for the decrease in the levels of free revolutionaries. The cancer prevention agents act by hindering the oxidative cycle (Aishwarya, Harini, and Karthikeyan 2014). Clove oil has the cancer prevention agent property and thus can successfully decrease the levels of the free radicals present in the oral pit.

3.1.4. Clove oil to treat halitosis

Halitosis is far and wide and is accepted to influence one-fourth of the populace all over the planet and a great many people Halitosis (bad breath) is principal because of the microbes present in the oral hole, these microorganisms will proteolyze the amino corrosive and deliver unpredictable sulfur. Clove oil can be a transient solution for halitosis since it is against microbial, however, can't be utilized long haul since it misses the mark on favorable to biotic activity (Nivetha et al. 2014). The Chinese utilized cloves to dispose of bad breath a while back.

3.2 Neem

Neem has been broadly utilized in Ayurveda, Unani, and Homeopathic medication and has turned into a miracle tree of present-day medicine. It has been utilized customarily for the treatment of aggravation, contaminations, fever, skin infections, and dental issues. It is compelling in a few epidermal dysfunctions like skin break out, psoriasis, and dermatitis(Gupta et al. 2016). Neem has likewise been generally utilized as a skin moisturizer. Neem dental consideration items contain Neem leaf or bark extricate. Neem leaf is wealthy in cancer prevention agents and assists with helping the resistant reaction in gum and tissues of the mouth (Lakshmi et al. 2015). Neem offers a great solution for relieving mouth ulcers, and tooth rot and goes about as a pain killer in toothache issues.

3.2.1. Antibacterial action

Neem is a characteristic antibacterial specialist. Different logical investigations have uncovered its antibacterial activity. The antimicrobial impacts of Neem have been accounted for against S. mutants and S. faecalis (Kapoor and Saraf 2010). Ethanolic concentrate of Neem leaves and sticks and bark displayed huge antibacterial activity. Dried biting sticks of Neem showed the most extreme antibacterial action against S. mutans contrasted with other dental caries‑causing living beings, S. salivarius, S. mitis, and S. sanguis (Siswomihardjo et al. 2007).

3.2.2. Anti-candidial action

Ethanolic and watery concentrate of Neem leaf showed a huge anticandidal impact against C. albicans(Chava et al. 2012). A clinical report had shown the impacts of the leaf fluid concentrate from Azadirachta indica (Neem) on bond, cell surface hydrophobicity also, and biofilm arrangement, which might influence the colonization by Candida albicans. The outcomes recommend that Neem leaves have a potential anti‑adhesive impact on the example concentrated in vitro.

3.2.3. Anti‑cariogenic action

Mango and Neem extricate showed antimicrobial action against S. mutans, S. salivarius, S. sanguis, and S. mitis. A blend of biting sticks is viewed as useful in annihilating the dental caries‑causing organism. Chloroform concentrates of Neem leaf hindered Streptococcus mutans and Streptococcus salivarius and give a guide to treating dental caries. The antimicrobial action of economically accessible Himalaya natural dental cream (Marketed-formulation) containing neem and fluoride‑containing Cheerio gel toothpaste has been surveyed in younger students. The review detailed both the toothpaste showed a decent antimicrobial impact on caries creating salivary streptococcus mutants(Mistry et al. 2014). The toothpaste containing Neem as well as fluoridated toothpaste was similarly useful against caries‑producing microscopic organisms. (CH3)2CO remove from the bark of Neem is bactericidal against S. sobrinus consequently demonstrating its anti‑cariogenic activity.

The profoundly unadulterated supercritical O2 Neem leaf separate forestalls the inception and movement of Oral epithelial cell carcinoma through the downregulation of intra-cancer professional fiery pathways, which advance tumorigenesis (Packia Lekshmi et al. 2012).

3.2.4. Anti‑plaque action

The watery concentrate of Neem stick and the gall tannin‑enriched removal from Melaphis Chinensis hindered insoluble glucan combination also, brings about bacterial accumulation (Patil et al. 2018). It decreases the capacity of streptococci to colonize tooth surfaces. Neem oil shows huge antibacterial action and has been proposed for use in treating dental plaque. Mucoadhesive dental gel marketed formulation containing Azadirachta indica is viewed as valuable in diminishing the plaque record and salivary bacterial count relatively better compared to chlorhexidine gluconate mouthwash.

3.3 Turmeric

The benefits of turmeric include pain-relieving antibacterial, hostile to inflammation against growth, hostile to unfavorably susceptible, cancer prevention agent, disinfectant, antispasmodic, astringent, carminative, and stomach related.

3.3.1. Dental-plaque discovery framework

Caries or periodontal sicknesses are believed to be irresistible illnesses brought about by microscopic organisms present in dental plaques and it is realized that the expulsion of dental plaques is exceptionally significant for the soundness of oral depressions. In any case, dental plaques are difficult to recognize by the unaided eye and it is difficult to confirm their connection site and degree exactly. Appropriately, dental plaques are by and large stained with dental-plaque staining specialists, which contain colors, to uncover their areas to reveal the connected dental plaques(Zheng et al. 2015).

3.4 Tulsi

Tulsi is viewed as the most sacrosanct plant and is frequently alluded to as the "HolyBasil" in the Indian subcontinent. There is recorded proof in regards to the utilization of Ocimum sanctum (Tulsi) as a fragrant plant in Ayurveda. Having a place with the family Labiatae, it fills in tropical and sub-tropical belts including India also, which are ordinarily found in the Indian fields. "Tulsi" in Sanskrit signifies "the unique one" also, in this way known as the sovereign of the herbs plant. This plant has been analyzed pharmacologically for antimicrobial, immunomodulatory, calming, hypoglycemic, chemoprotective, and pain-relieving exercises(Patil et al. 2018).

3.4.1. Toothache

Tulsi contains a critical measure of Eugenol (1-hydroxy-2-methoxy-4 allylbenzene) henceforth it goes about as COX-2 inhibitors like present-day analgesics. Ocimum sanctum leaves contain 0.7% unstable oil comprising around 71% eugenol and 20% methyl eugenol (Patil et al. 2018).

3.4.2. Oral diseases

Tulsi leaves are very compelling in treating normal oral diseases. When bitten, tulsi leaves help in keeping up with oral cleanliness. Antibacterial specialists to be specific carvacrol and terpene are available in this plant. Anti-carcinogenic agent Streptococcus mutans is a causative microorganism significantly contributing to tooth decay. In an in-vitro study, the various concentrations of the Tulsi extracts have been evaluated against Streptococcus mutants.

3.4.3. Tulsi in periodontal illnesses

Tulsi leaves dried in sun and powdered can be utilized for cleaning teeth. It can likewise be blended in with mustard oil to make glue and utilized as toothpaste. Tulsi has additionally been demonstrated to be extremely powerful in forestalling halitosis. Its calming property makes it an appropriate solution for gum disease and periodontitis, and it tends to be utilized for kneading the gingiva in these circumstances with maximum antimicrobial potential (Mistry et al. 2014).

3.5. Other Natural agents

3.5.1. Kikar (Acacia arabica) and Arak (Salvadora persica)

Different plants are utilized as biting sticks in various areas of the planet.  A few investigations have provided details regarding the antimicrobial impacts of biting sticks on oral microbes and it was tracked down that a half focus of Kikar (Acacia arabica) and Arak (Salvadora persica) delivered an antimicrobial impact on Streptococcus fecalis. The herbs containing mouthwashes are a marketed formulation thought about well, especially in repressing the development of Actinomyces species, the periodontal microorganisms, E. nodatum, and Prevotella intermedia. The viability of the herbaceous mouth flush, in all likelihood, was because of its antimicrobial impact. Goldenseal had antimicrobial properties against oral microorganisms like S. mutans furthermore, Fusobacterium nucleatum (Bansod and Rai 2008).

3.5.2. Aloe vera

An audit proposed the capability of utilizing aloe vera with its antibacterial, antifungal, and antiviral properties. The antimicrobial impacts of aloe vera have been ascribed to the plant's normal anthraquinones: aloe-emodin, aloetic corrosive, aloin, anthracene, ethanol, barbaloin, chrysophanic corrosive, ethereal oil, ester of cinnamonic corrosive, isobarbaloin, and resistant.  In moderately little fixations, along with the gel division, these anthraquinones give pain-relieving, antibacterial, antifungal, and antiviral exercises, in high fixations, they could be poisonous. The aloe vera tooth gel and the kinds of toothpaste easily available on the market were similarly viable against Candida albicans, Streptococcus mutants, Lactobacillus acidophilus, Enterococcus faecalis, Prevotella intermedia, and Peptostreptococcus anaerobius(Saquib et al. 2019). Aloe vera tooth gel additionally has an improved antibacterial impact against S. mitis.

3.5.3. Barberry

The barberry (Berberisvulgari) dental gel has been displayed to control gum disease furthermore, microbial plaque arrangement in youngsters. Barberry juice contains a lot of Vitamin C thus it builds the movement of a safe framework, animates to retain iron, and stays away from scurvy. A concentrate that was produced using the leaves of the tree, Newbouldia laevis (a medium-measured angiosperm of the Bignoniaceae family) was tried as a bactericide for the microbes which were implicated in dental caries and it was found that Newbouldia laevis had bactericidal activity against Streptococci mutants and Lactobacilli. Natural concentrates involve logical interest in endeavors that are being made to restrain plaque amassing on teeth. The capacity of the natural concentrate, German chamomile, in mouthwashes to diminish gingival aggravation and plaque arrangement and for use as an irritant to clean the root waterway with less poisonousness, has been well reported.

3.5.4. Cinnamon zeylanicum

 Cinnamon remove irrigant shows a better decrease in E. faecalis when contrasted with three percent of sodium hypochlorite and neem remove irrigant. The sugar-sweetened cinnamon-biting gum might help halitosis by lessening unpredictable sulfur compounds creating anaerobes inside the mouth. The Ethanolic separates which are ready from Toothbrush tree (Miswak) and Cinnamomum zeylanicum (Ceylon cinnamon), by the soxhlet strategy showed variable antibacterial movement against periodontal pathobionts (Saquib et al. 2019). Both Cinnamomum furthermore, chlorhexidine utilized as an irrigant through Dental Unit Water lines (DUWL) successfully helped the decrease bacterial include in dental sprayers during Ultrasonic scaling (Nimbulkar et al. 2020).

Table 1:- Therapeutic applications of the herbs in dental care

4. Commercialization of natural oral care products

The worldwide oral care market was worth USD 33.7 billion in 2021, and it is predicted to increase at a compound annual growth rate (CAGR) of 6.4% between 2022 and 2030. The rising frequency of dental caries in both adults and children is likely to drive market expansion. According to the World Health Organization (WHO), about 530 million children suffer from primary tooth decay. Major firms such as Colgate-Palmolive Company and Procter & Gamble have implemented a variety of campaigns to raise awareness about oral hygiene among both children and adults, resulting in a rise in demand for oral care products (“Colgate-Palmolive – Global Household & Consumer Products” n.d.). The global markets of herbal dental products are segmented into regions, types, and sales channels. Depending upon the region, the market is studied across Europe (Europe, Germany, Italy, Spain, Rest of Europe), North America (US, Canada, Mexico), and Asia – Pacific (China, India, Japan, Asians, other regions of Asia) and LAME (Latin America, Middle East, Africa). In terms of consumption, Asia – pacific is at the highest rank while during this forecast period, the LAME has the highest CAGR growth. The sales channels, the market is categorized into hypermarkets or supermarkets, Independent stores, specialty stores, and online sales channels. Depending upon the type, it is toothpaste, toothpowder, and mouthwash. Toothpaste leads in the consumption rate; however, herbal mouthwash is estimated to grow with maximum CAGR during the conjecture periods. Initially, the supply chain of dental oral care items was also impacted. The epidemic has created widespread disruption in the medical device industry's supply chain. However, this is expected to be a transient impact, and demand for dental care is expected to rise throughout the projection period. The market is being driven by an increase in dental care awareness and shifting demographics. As consumer awareness of hygiene grows, leading personal care companies such as Johnson & Johnson Services, Colgate-Palmolive Company, Inc., Procter & Gamble, GlaxoSmithKline PLC (GSK), and Amway Corporation, etc. have seen an increase in sales from the oral care area (“Herbal Toothcare Market Size, Share & Trends | Analysis Forecast, 2026” n.d.).  Further commercialization of the herbal product both in national and international market has been described in table 2.

As awareness of herbal products is enhanced, the consumer gets more attracted to natural products. Different formulations of natural/herbal products are available in the market which are used in oral care or as oral cosmetics. These are toothpaste of many different herbs like clove, neem, babul, miswak, Triphala, etc. Toothpaste named Complete Care of Himalaya is also available as a marketed product containing the natural products neem, miswak, and Triphala.

Not only international companies but also Indian companies are leading in herbal dental care. Natural dental products ranked 5th growing market in the country that includes Patanjali, Dabur and Colgate, and Himalaya Hindustan Unilever (HUL). According to Nielsen number from industrial official the Patanjali get around 350 basis points in the markets with the 7000 core share in Indian oral segments.  These shares may be expanded as HUL and Colgate over the former two quarters, launched a specialized natural oral product to compete with the Patanjali.  In this context, Dabur has also launched India’s first Ayurvedic toothpaste gel under the Dabur Red franchisees.  There is a growing demand for product that has natural ingredients and more and more companies are crashing on them. The Indian units of Coalgate Corporation have launched the sensitive Clove toothpaste and Salt Neem. Moreover, they also add Cibaca Vedshaskti, which is the first ever indigenous brand in herbal segments for getting 16 billion dollars and control half of the dental care market in India.

Some formulations of clove are there as clove oil to reduce pain and swelling of the gum. Glister herbals, NEEMAYU, and Herbodent are also some toothpaste containing different herbs and are used for brushing instead of synthetic toothpaste. The different formulation includes mouthwash, toothpaste, gel, dental cream, etc. In terms of lowering plaque accumulation, gingival irritation, and bleeding, Triphala mouthwash was just as effective as chlorhexidine mouthwash [26In this regard, we can deduce that many herbal remedies have a wide range of applications in dental therapy and oral hygiene. Anti-inflammation, antimicrobial plaque agents, antiseptics, antioxidants, antimicrobials, antifungals, antibacterials, antivirals, and analgesics are all found in herbal medicines used in dentistry. Turmeric is the key ingredient in many gels, and it helps to reduce erythematous halo, ulcer size, and pain severity. Aloe vera tooth gel additionally has an improved antibacterial impact against S. mitis. The all-herbal marketed products used are having different therapeutic activities like anti-bacterial, anti-cariogenic, anti-oxidant, astringent, and anti-inflammatory activities and some are also having cosmetic activities. (Singh et al. 2019).

Herbal ‘’shotgun" or "synergistic multitarget impacts" are the terms utilized for the methodology of joining various concentrates. Here, the herb concentrates and medications are joined to offer a multitargeted approach through their synergistic activity. This system might offer the greatest advantages with an additional advantage of dialing back the pace of advancement of bacterial obstruction to synergistic medication combinations.

Table 2: Commercial herbal products

5. Toxicity and side effects of Oral herbal products

There are many side effects of using natural herbs when it is taken in high doses except the average dose, for example utilizing clove oil as a dental pain killer isn't suggested for everybody. When undiluted clove oil is consumed in enormous portions it very well may be risky. It might cause sore throat, retching, trouble in breathing, seizures, liquid in the lungs, draining problems and in outrageous cases, kidney and liver harm. Individuals with draining problems shouldn't utilize clove oil, as causing expanded bleeding is known. Likewise, the oil of cloves is known to diminish blood glucose levels, so diabetics ought to utilize alert while considering the utilization of clove oil for dental torment. For certain individuals, clove oil could be unfavorably susceptible and can cause an anaphylactic response that incorporates tingling, windedness, and rashes. Clove oil is confined to pregnant ladies and youngsters under two years since even little amounts cause genuine secondary effects. If we see neems then neem supplements are for the most part alright for use in grown-ups when taken by mouth for a brief timeframe(Aishwarya, Harini, and Karthikeyan 2014). Portions of up to 60 milligrams (mg) each day have been utilized securely. Little is had some significant awareness of the drawn-out wellbeing of neem supplements. There is some worry that neem might make harm the kidneys and liver, especially whenever abused. Neem enhancements ought not to be utilized in kids or individuals who are pregnant or breastfeeding because of the absence of well-being research in those gatherings. A few early investigations proposed that taking high-fixation extricates in pregnancy might prompt work, albeit this has not been demonstrated. All things considered, it is ideal to keep away from neem simply. Neem creams are viewed as safe for use on the skin. Neem oil can likewise be utilized however should be weakened with an impartial transporter oil, similar to almond oil, to stay away from bothering. Neem oil ought not to be taken internally(Morris et al. 2019).  By and large, thought to be protected, however, may cause a gastric disturbance, stomach upset, sickness, loose bowels, unfavorably susceptible skin response, and antithrombosis action slowing down blood-clump arrangement.  Turmeric is generally considered to be safe. It can produce nausea and diarrhea, especially when used in large dosages or over an extended period. In excessive doses, it may potentially increase the risk of ulcers. It can irritate the skin when used as a topical therapy (Rivera et al. 2017).

6. Conclusion

Herbal medicine is becoming increasingly popular around the world. In various national healthcare contexts, many people increasingly use herbal medicines or herbal products for their health care. Antiseptics, antioxidants, antimicrobials, antifungals, antibacterials, antivirals, and analgesics have all been used in dentistry to reduce inflammation, as antimicrobial plaque agents, to prevent histamine release. They also help with healing and managing microbial plaque in gingivitis and periodontitis, increasing immunity. It is very well may be inferred based on this current article that herbal dentifrice has expected benefits in plaque and irritation control as enhancements to the day-to-day oral cleanliness of patients with gum disease. The fundamental benefits of utilizing herbal medication are simple accessibility, cost-viability, expanded period, and low harmfulness. The weaknesses of utilizing herbal medication like Clove oil is intended to cause difficult issues like pharyngitis, kidney disappointments, harm to the liver, seizures, trouble in breathing, and others whenever utilized in higher dosages. Hence, the Preclinical and clinical preliminaries are expected to check biocompatibility and security before Herbal medication is frequently suggested indisputably for oral consideration.

Declarations of interest: none

Conflict of Interest: The authors declare that they have no Conflict of interests.

Availability of Data: I have not used any personal data that require being available for the reader

Acknowledgement:

I would like to acknowledge University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur (C.G), for providing support.

Funding source: - None

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Aishwarya, J, N Harini, and M Karthikeyan. 2014. “Clove Oil and Its Role in Oral Health-A Review.” International Journal of Pharmaceutical Science and Health Care 3 (4): 155–68.

Altemimi, Ammar, Naoufal Lakhssassi, Azam Baharlouei, Dennis G. Watson, and David A. Lightfoot. 2017. “Phytochemicals: Extraction, Isolation, and Identification of Bioactive Compounds from Plant Extracts.” Plants 6 (4). https://doi.org/10.3390/plants6040042.

Bansod, Sunita, and Mahendra Rai. 2008. “Antifungal Activity of Essential Oils from Indian Medicinal Plants Against Human Pathogenic Aspergillus Fumigatus and A. Niger.” World Journal of Medical Sciences 3 (2): 81–88.

Catalfamo, Luciano Maria, Giulia Marrone, Michele Basilicata, Ilaria Vivarini, Vincenza Paolino, David Della-Morte, Francesco Saverio De Ponte, et al. 2022. “The Utility of Capsicum Annuum L. in Internal Medicine and In Dentistry: A Comprehensive Review.” International Journal of Environmental Research and Public Health 19 (18): 1–20. https://doi.org/10.3390/ijerph191811187.

Chava, Venkateswara Rao, S. M. Manjunath, A. V. Rajanikanth, and N. Sridevi. 2012. “The Efficacy of Neem Extract on Four Microorganisms Responsible for Causing Dental Caries Viz Streptococcus Mutans, Streptococcus Salivarius, Streptococcus Mitis and Streptococcus Sanguis: An in Vitro Study.” Journal of Contemporary Dental Practice 13 (6): 769–72. https://doi.org/10.5005/jp-journals-10024-122.

Chen, Xiuqin, EBM Daliri, Namhyeon Kim, Jong Rae Kim, Daesang Yoo, and Deong-Hwan Oh. 2020. “Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms.” Pathogens 9 (7): 569.

“Colgate-Palmolive – Global Household & Consumer Products.” n.d. Accessed March 27, 2023. https://www.colgatepalmolive.co.in/.

Gupta, Arun, Rahul Bhowate, Ruchi Srivastava, Sunil Kumar, S. V. Devasthale, and J. L.N. Sastry. 2016. “Clinical Evaluation of Babool Neem Toothpaste in Oral Hygiene and Dental Care.” International Journal of Pharmaceutical Research 8 (2): 57–64.

Gutiérrez, Rosa Martha Pérez, and Alethia Muñiz Ramirez. 2016. “Hypoglycemic Effects of Sesquiterpene Lactones from Byrsonima Crassifolia.” Food Science and Biotechnology 25 (4): 1135–45. https://doi.org/10.1007/s10068-016-0182-8.

“Herbal Toothcare Market Size, Share & Trends | Analysis Forecast, 2026.” n.d. Accessed March 27, 2023. https://www.alliedmarketresearch.com/herbal-toothcare-market-A06037.

Hernández, Ivones, Yeny Lemus, Sylvia Prieto, Jorge Molina-Torres, and Gabino Garrido. 2009. “Anti-Inflammatory Effect of an Ethanolic Root Extract of Heliopsis Longipes in Vitro.” Boletin Latinoamericano y Del Caribe de Plantas Medicinales y Aromaticas 8 (3): 160–64.

Janakiram, Chandrashekar, Ramanarayanan Venkitachalam, Paul Fontelo, Timothy J. Iafolla, and Bruce A. Dye. 2020. “Effectiveness of Herbal Oral Care Products in Reducing Dental Plaque & Gingivitis - a Systematic Review and Meta-Analysis.” BMC Complementary Medicine and Therapies 20 (1): 43. https://doi.org/10.1186/s12906-020-2812-1.

K, Pramod, Shahid Ansari, and Javed Ali. 2009. “Herbal Remedies for the Treatment of Periodontal Disease - A Patent Review.” Recent Patents on Drug Delivery & Formulation 3 (3): 221–28. https://doi.org/10.2174/187221109789105603.

Kapoor, Shweta, and Swarnlata Saraf. 2010. “Assessment of Viscoelasticity and Hydration Effect of Herbal Moisturizers Using Bioengineering Techniques.” Pharmacognosy Magazine 6 (24): 298–304. https://doi.org/10.4103/0973-1296.71797.

Kumar, Gunjan, Md Jalaluddin, Purnendu Rout, Rajat Mohanty, and C. L. Dileep. 2013. “Emerging Trends of Herbal Care in Dentistry.” Journal of Clinical and Diagnostic Research 7 (8): 1827–29. https://doi.org/10.7860/JCDR/2013/6339.3282.

Lakshmi, T., Vidya Krishnan, R. Rajendran, and N. Madhusudhanan. 2015. “Azadirachta Indica: A Herbal Panacea in Dentistry - An Update.” Pharmacognosy Reviews 9 (17): 41–44. https://doi.org/10.4103/0973-7847.156337.

Lolo, Bertha, Sarworini Bagio, and Berna Elya. 2019. “Original Article Evaluation of the Antimicrobial Activity of Caesalpinia Pulcherrima ( L ) Swartz Extract against Microbes That Cause Dental and Oral Infections and Determination of the Total Flavonoid and Total Phenolic Contents of the Plant Bacteria Por” 15 (4): 1–10.

M, Anushri, Yashoda R, and Puranik P Manjunath. 2015. “Herbs: A Good Alternatives to Oral Health Problems.” International Journal of Advances Health Sciences 1 (12): 26–32.

Méndez, J, and U Villasanti. 2020. “Carica Papaya Mouthwash for Reducing Dental Plaque.” International Journal of Oral and Dental Health 6 (3): 6–7. https://doi.org/10.23937/2469-5734/1510117.

Mistry, Kunjal S., Zarna Sanghvi, Girish Parmar, and Samir Shah. 2014. “The Antimicrobial Activity of Azadirachta Indica, Mimusops Elengi, Tinospora Cardifolia, Ocimum Sanctum and 2% Chlorhexidine Gluconate on Common Endodontic Pathogens: An in Vitro Study.” European Journal of Dentistry 8 (2): 172–77. https://doi.org/10.4103/1305-7456.130591.

Morris, Jay, Cara B. Gonzales, Jorge J. De La Chapa, April B. Cabang, Christos Fountzilas, Mandakini Patel, Stephanie Orozco, and Michael J. Wargovich. 2019. “The Highly Pure Neem Leaf Extract, SCNE, Inhibits Tumorigenesis in Oral Squamous Cell Carcinoma via Disruption of Pro-Tumor Inflammatory Cytokines and Cell Signaling.” Frontiers in Oncology 9 (September): 1–14. https://doi.org/10.3389/fonc.2019.00890.

Naumova, E. A., L. Weber, V. Pankratz, V. Czenskowski, and W. H. Arnold. 2019. “Bacterial Viability in Oral Biofilm after Tooth Brushing with Amine Fluoride or Sodium Fluoride.” Archives of Oral Biology 97 (January): 91–96. https://doi.org/10.1016/J.ARCHORALBIO.2018.10.013.

Nimbulkar, Gargi, Vikram Garacha, Vittaldas Shetty, Ketaki Bhor, Kumar Chandan Srivastava, Deepti Shrivastava, and Mohammed G. Sghaireen. 2020. “Microbiological and Clinical Evaluation of Neem Gel and Chlorhexidine Gel on Dental Plaque and Gingivitis in 20-30 Years Old Adults: A Randomized Parallel-Armed, Double-Blinded Controlled Trial.” Journal of Pharmacy & Bioallied Sciences 12 (Suppl 1): S345. https://doi.org/10.4103/JPBS.JPBS_101_20.

Nivetha, Raja, Karthikeyan Murthykumar, K. S. Ashwin, Nirmal Kumar, and R. Priyadharshini. 2014. “Effects of Natural Products on Oral Health: A Review.” Asian Journal of Pharmaceutical and Clinical Research 7 (5): 279–82.

Olmedo-Juárez, A., M. A. Zarza-Albarran, R. Rojo-Rubio, A. Zamilpa, M. González-Cortazar, J. Mondragón-Ancelmo, N. Rivero-Pérez, and P. Mendoza-de Gives. 2020. “Acacia Farnesiana Pods (Plant: Fabaceae) Possesses Anti-Parasitic Compounds against Haemonchus Contortus in Female Lambs.” Experimental Parasitology 218 (June). https://doi.org/10.1016/j.exppara.2020.107980.

“Oral Health.” n.d. Accessed April 9, 2023. https://www.who.int/health-topics/oral-health#tab=tab_1.

Packia Lekshmi, N C J, N Sowmia, S Viveka, J Raja Brindha, and S Jeeva. 2012. “The Inhibiting Effect of Azadirachta Indica against Dental Pathogens.” Asian Journal of Plant Science and Research 2 (1): 6–10.

Patil, Amola, Sumit Gunjal, Ansari Adnan, and Abdul Latif. 2018. “Tulsi : A Medicinal Herb for Oral Health.” Galore International Journal of Health Sciences and Research 3 (4): 37–39.

Rivera, Mariela, Yanilda Ramos, Madeline Rodríguez-Valentín, Sheila López-Acevedo, Luis A. Cubano, Jin Zou, Qiang Zhang, Guangdi Wang, and Nawal M. Boukli. 2017. “Targeting Multiple Pro-Apoptotic Signaling Pathways with Curcumin in Prostate Cancer Cells.” PLoS ONE 12 (6): 1–25. https://doi.org/10.1371/journal.pone.0179587.

Rodriguez-Garcia, A., I. T.A. Peixoto, M. J. Verde-Star, S. De La Torre-Zavala, H. Aviles-Arnaut, and A. L.T.G. Ruiz. 2015. “In Vitro Antimicrobial and Antiproliferative Activity of Amphipterygium Adstringens.” Evidence-Based Complementary and Alternative Medicine 2015. https://doi.org/10.1155/2015/175497.

Salari, Nader, Niloofar Darvishi, Mohammadbagher Heydari, Shadi Bokaee, Fateme Darvishi, and Masoud Mohammadi. 2022. “Global Prevalence of Cleft Palate, Cleft Lip and Cleft Palate and Lip: A Comprehensive Systematic Review and Meta-Analysis.” Journal of Stomatology, Oral and Maxillofacial Surgery 123 (2): 110–20. https://doi.org/10.1016/J.JORMAS.2021.05.008.

Saquib, Shahabe Abullais, Nabeeh Abdullah Alqahtani, Irfan Ahmad, Mohammed Abdul Kader, Sami Saeed Al Shahrani, and Elyas Ali Asiri. 2019. “Evaluation and Comparison of Antibacterial Efficacy of Herbal Extracts in Combination with Antibiotics on Periodontal Pathobionts: An in Vitro Microbiological Study.” Antibiotics 8 (3): 1–12. https://doi.org/10.3390/antibiotics8030089.

Silva, Diego Romário da, Sabrina Avelar de Macedo Ferreira, Tainá Souza Silva, Pedro Henrique Sette-de-Souza, and Andréa Cristina Barbosa da Silva. 2018. “Atividade Antimicrobiana Do Extrato de Chenopodium Ambrosioides e Ruta Graveolens Sobre Streptococcus Mutans.” Archives of Health Investigation 7 (4). https://doi.org/10.21270/archi.v7i4.2821.

Silva, Jeferson da, Cláudio Daniel Cerdeira, Juliana Moscardini Chavasco, Ana Beatriz Pugina Cintra, Carla Brigagão Pacheco da Silva, Andreia Natan de Mendonça, Tati Ishikawa, Marcelo Fabiano Gomes Boriollo, and Jorge Kleber Chavasco. 2014. “Triagem in Vitro Da Atividade Antibacteriana de Bidens Pilosa Linné e Annona Crassiflora Mart. Contra Staphylococcus Aureus Resistente à Oxacilina (ORSA) Provenientes Do Ambiente Aéreo Na Clínica Odontológica.” Revista Do Instituto de Medicina Tropical de Sao Paulo 56 (4): 333–40. https://doi.org/10.1590/S0036-46652014000400011.

Singh, Surabhi, Sadiya Anjum, Jincy Joy, and Bhuvanesh Gupta. 2019. “Polysaccharide-Aloe Vera Bioactive Hydrogels as Wound Care System,” 1473–90. https://doi.org/10.1007/978-3-319-77830-3_48.

Siswomihardjo, Widowati, Siti Sunarintyas Badawi, Masahiro Nishimura, and Taizo Hamada. 2007. “The Difference of Antibacterial Effect of Neem Leaves and Stick Extracts.” Int Chin J Dent 7: 27–29.

Torwane, Nilesh, Sudhir Hongal, Pankaj Goel, and B. Chandrashekar. 2014. “Role of Ayurveda in Management of Oral Health.” Pharmacognosy Reviews 8 (15): 16–21. https://doi.org/10.4103/0973-7847.125518.

Velázquez, Claudia, José Correa-Basurto, Normand Garcia-Hernandez, Elizabeth Barbosa, Emiliano Tesoro-Cruz, Samuel Calzada, and Fernando Calzada. 2012. “Anti-Diarrheal Activity of (-)-Epicatechin from Chiranthodendron Pentadactylon Larreat: Experimental and Computational Studies.” Journal of Ethnopharmacology 143 (2): 716–19. https://doi.org/10.1016/j.jep.2012.07.039.

Xuan, Tran Dang, and Tran Dang Khanh. 2016. “Chemistry and Pharmacology of Bidens Pilosa: An Overview.” Journal of Pharmaceutical Investigation 46 (2): 91–132. https://doi.org/10.1007/s40005-016-0231-6.

Zheng, Zhaoling, Yanhua Sun, Ziliang Liu, Mingqin Zhang, Chunqing Li, and Hui Cai. 2015. “The Effect of Curcumin and Its Nanoformulation on Adjuvant-Induced Arthritis in Rats.” Drug Design, Development and Therapy 9 (August): 4931–42. https://doi.org/10.2147/DDDT.S90147.

Zulkarnain, Hamzah Sahag. 2019. “Penurunan Jumlah Koloni Bakteri Porphyromonas Gingivalis Setelah Pemberian Nano Gel Ekstrak Akar Sidaguri (Sida Rhombifolia L.),” July.

Aishwarya, J, N Harini, and M Karthikeyan. 2014. “Clove Oil and Its Role in Oral Health-A Review.” International Journal of Pharmaceutical Science and Health Care 3 (4): 155–68.

Altemimi, Ammar, Naoufal Lakhssassi, Azam Baharlouei, Dennis G. Watson, and David A. Lightfoot. 2017. “Phytochemicals: Extraction, Isolation, and Identification of Bioactive Compounds from Plant Extracts.” Plants 6 (4). https://doi.org/10.3390/plants6040042.

Bansod, Sunita, and Mahendra Rai. 2008. “Antifungal Activity of Essential Oils from Indian Medicinal Plants Against Human Pathogenic Aspergillus Fumigatus and A. Niger.” World Journal of Medical Sciences 3 (2): 81–88.

Catalfamo, Luciano Maria, Giulia Marrone, Michele Basilicata, Ilaria Vivarini, Vincenza Paolino, David Della-Morte, Francesco Saverio De Ponte, et al. 2022. “The Utility of Capsicum Annuum L. in Internal Medicine and In Dentistry: A Comprehensive Review.” International Journal of Environmental Research and Public Health 19 (18): 1–20. https://doi.org/10.3390/ijerph191811187.

Chava, Venkateswara Rao, S. M. Manjunath, A. V. Rajanikanth, and N. Sridevi. 2012. “The Efficacy of Neem Extract on Four Microorganisms Responsible for Causing Dental Caries Viz Streptococcus Mutans, Streptococcus Salivarius, Streptococcus Mitis and Streptococcus Sanguis: An in Vitro Study.” Journal of Contemporary Dental Practice 13 (6): 769–72. https://doi.org/10.5005/jp-journals-10024-122.

Chen, Xiuqin, EBM Daliri, Namhyeon Kim, Jong Rae Kim, Daesang Yoo, and Deong-Hwan Oh. 2020. “Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms.” Pathogens 9 (7): 569.

“Colgate-Palmolive – Global Household & Consumer Products.” n.d. Accessed March 27, 2023. https://www.colgatepalmolive.co.in/.

Gupta, Arun, Rahul Bhowate, Ruchi Srivastava, Sunil Kumar, S. V. Devasthale, and J. L.N. Sastry. 2016. “Clinical Evaluation of Babool Neem Toothpaste in Oral Hygiene and Dental Care.” International Journal of Pharmaceutical Research 8 (2): 57–64.

Gutiérrez, Rosa Martha Pérez, and Alethia Muñiz Ramirez. 2016. “Hypoglycemic Effects of Sesquiterpene Lactones from Byrsonima Crassifolia.” Food Science and Biotechnology 25 (4): 1135–45. https://doi.org/10.1007/s10068-016-0182-8.

“Herbal Toothcare Market Size, Share & Trends | Analysis Forecast, 2026.” n.d. Accessed March 27, 2023. https://www.alliedmarketresearch.com/herbal-toothcare-market-A06037.

Hernández, Ivones, Yeny Lemus, Sylvia Prieto, Jorge Molina-Torres, and Gabino Garrido. 2009. “Anti-Inflammatory Effect of an Ethanolic Root Extract of Heliopsis Longipes in Vitro.” Boletin Latinoamericano y Del Caribe de Plantas Medicinales y Aromaticas 8 (3): 160–64.

Janakiram, Chandrashekar, Ramanarayanan Venkitachalam, Paul Fontelo, Timothy J. Iafolla, and Bruce A. Dye. 2020. “Effectiveness of Herbal Oral Care Products in Reducing Dental Plaque & Gingivitis - a Systematic Review and Meta-Analysis.” BMC Complementary Medicine and Therapies 20 (1): 43. https://doi.org/10.1186/s12906-020-2812-1.

K, Pramod, Shahid Ansari, and Javed Ali. 2009. “Herbal Remedies for the Treatment of Periodontal Disease - A Patent Review.” Recent Patents on Drug Delivery & Formulation 3 (3): 221–28. https://doi.org/10.2174/187221109789105603.

Kapoor, Shweta, and Swarnlata Saraf. 2010. “Assessment of Viscoelasticity and Hydration Effect of Herbal Moisturizers Using Bioengineering Techniques.” Pharmacognosy Magazine 6 (24): 298–304. https://doi.org/10.4103/0973-1296.71797.

Kumar, Gunjan, Md Jalaluddin, Purnendu Rout, Rajat Mohanty, and C. L. Dileep. 2013. “Emerging Trends of Herbal Care in Dentistry.” Journal of Clinical and Diagnostic Research 7 (8): 1827–29. https://doi.org/10.7860/JCDR/2013/6339.3282.

Lakshmi, T., Vidya Krishnan, R. Rajendran, and N. Madhusudhanan. 2015. “Azadirachta Indica: A Herbal Panacea in Dentistry - An Update.” Pharmacognosy Reviews 9 (17): 41–44. https://doi.org/10.4103/0973-7847.156337.

Lolo, Bertha, Sarworini Bagio, and Berna Elya. 2019. “Original Article Evaluation of the Antimicrobial Activity of Caesalpinia Pulcherrima ( L ) Swartz Extract against Microbes That Cause Dental and Oral Infections and Determination of the Total Flavonoid and Total Phenolic Contents of the Plant Bacteria Por” 15 (4): 1–10.

M, Anushri, Yashoda R, and Puranik P Manjunath. 2015. “Herbs: A Good Alternatives to Oral Health Problems.” International Journal of Advances Health Sciences 1 (12): 26–32.

Méndez, J, and U Villasanti. 2020. “Carica Papaya Mouthwash for Reducing Dental Plaque.” International Journal of Oral and Dental Health 6 (3): 6–7. https://doi.org/10.23937/2469-5734/1510117.

Mistry, Kunjal S., Zarna Sanghvi, Girish Parmar, and Samir Shah. 2014. “The Antimicrobial Activity of Azadirachta Indica, Mimusops Elengi, Tinospora Cardifolia, Ocimum Sanctum and 2% Chlorhexidine Gluconate on Common Endodontic Pathogens: An in Vitro Study.” European Journal of Dentistry 8 (2): 172–77. https://doi.org/10.4103/1305-7456.130591.

Morris, Jay, Cara B. Gonzales, Jorge J. De La Chapa, April B. Cabang, Christos Fountzilas, Mandakini Patel, Stephanie Orozco, and Michael J. Wargovich. 2019. “The Highly Pure Neem Leaf Extract, SCNE, Inhibits Tumorigenesis in Oral Squamous Cell Carcinoma via Disruption of Pro-Tumor Inflammatory Cytokines and Cell Signaling.” Frontiers in Oncology 9 (September): 1–14. https://doi.org/10.3389/fonc.2019.00890.

Naumova, E. A., L. Weber, V. Pankratz, V. Czenskowski, and W. H. Arnold. 2019. “Bacterial Viability in Oral Biofilm after Tooth Brushing with Amine Fluoride or Sodium Fluoride.” Archives of Oral Biology 97 (January): 91–96. https://doi.org/10.1016/J.ARCHORALBIO.2018.10.013.

Nimbulkar, Gargi, Vikram Garacha, Vittaldas Shetty, Ketaki Bhor, Kumar Chandan Srivastava, Deepti Shrivastava, and Mohammed G. Sghaireen. 2020. “Microbiological and Clinical Evaluation of Neem Gel and Chlorhexidine Gel on Dental Plaque and Gingivitis in 20-30 Years Old Adults: A Randomized Parallel-Armed, Double-Blinded Controlled Trial.” Journal of Pharmacy & Bioallied Sciences 12 (Suppl 1): S345. https://doi.org/10.4103/JPBS.JPBS_101_20.

Nivetha, Raja, Karthikeyan Murthykumar, K. S. Ashwin, Nirmal Kumar, and R. Priyadharshini. 2014. “Effects of Natural Products on Oral Health: A Review.” Asian Journal of Pharmaceutical and Clinical Research 7 (5): 279–82.

Olmedo-Juárez, A., M. A. Zarza-Albarran, R. Rojo-Rubio, A. Zamilpa, M. González-Cortazar, J. Mondragón-Ancelmo, N. Rivero-Pérez, and P. Mendoza-de Gives. 2020. “Acacia Farnesiana Pods (Plant: Fabaceae) Possesses Anti-Parasitic Compounds against Haemonchus Contortus in Female Lambs.” Experimental Parasitology 218 (June). https://doi.org/10.1016/j.exppara.2020.107980.

“Oral Health.” n.d. Accessed April 9, 2023. https://www.who.int/health-topics/oral-health#tab=tab_1.

Packia Lekshmi, N C J, N Sowmia, S Viveka, J Raja Brindha, and S Jeeva. 2012. “The Inhibiting Effect of Azadirachta Indica against Dental Pathogens.” Asian Journal of Plant Science and Research 2 (1): 6–10.

Patil, Amola, Sumit Gunjal, Ansari Adnan, and Abdul Latif. 2018. “Tulsi : A Medicinal Herb for Oral Health.” Galore International Journal of Health Sciences and Research 3 (4): 37–39.

Rivera, Mariela, Yanilda Ramos, Madeline Rodríguez-Valentín, Sheila López-Acevedo, Luis A. Cubano, Jin Zou, Qiang Zhang, Guangdi Wang, and Nawal M. Boukli. 2017. “Targeting Multiple Pro-Apoptotic Signaling Pathways with Curcumin in Prostate Cancer Cells.” PLoS ONE 12 (6): 1–25. https://doi.org/10.1371/journal.pone.0179587.

Rodriguez-Garcia, A., I. T.A. Peixoto, M. J. Verde-Star, S. De La Torre-Zavala, H. Aviles-Arnaut, and A. L.T.G. Ruiz. 2015. “In Vitro Antimicrobial and Antiproliferative Activity of Amphipterygium Adstringens.” Evidence-Based Complementary and Alternative Medicine 2015. https://doi.org/10.1155/2015/175497.

Salari, Nader, Niloofar Darvishi, Mohammadbagher Heydari, Shadi Bokaee, Fateme Darvishi, and Masoud Mohammadi. 2022. “Global Prevalence of Cleft Palate, Cleft Lip and Cleft Palate and Lip: A Comprehensive Systematic Review and Meta-Analysis.” Journal of Stomatology, Oral and Maxillofacial Surgery 123 (2): 110–20. https://doi.org/10.1016/J.JORMAS.2021.05.008.

Saquib, Shahabe Abullais, Nabeeh Abdullah Alqahtani, Irfan Ahmad, Mohammed Abdul Kader, Sami Saeed Al Shahrani, and Elyas Ali Asiri. 2019. “Evaluation and Comparison of Antibacterial Efficacy of Herbal Extracts in Combination with Antibiotics on Periodontal Pathobionts: An in Vitro Microbiological Study.” Antibiotics 8 (3): 1–12. https://doi.org/10.3390/antibiotics8030089.

Silva, Diego Romário da, Sabrina Avelar de Macedo Ferreira, Tainá Souza Silva, Pedro Henrique Sette-de-Souza, and Andréa Cristina Barbosa da Silva. 2018. “Atividade Antimicrobiana Do Extrato de Chenopodium Ambrosioides e Ruta Graveolens Sobre Streptococcus Mutans.” Archives of Health Investigation 7 (4). https://doi.org/10.21270/archi.v7i4.2821.

Silva, Jeferson da, Cláudio Daniel Cerdeira, Juliana Moscardini Chavasco, Ana Beatriz Pugina Cintra, Carla Brigagão Pacheco da Silva, Andreia Natan de Mendonça, Tati Ishikawa, Marcelo Fabiano Gomes Boriollo, and Jorge Kleber Chavasco. 2014. “Triagem in Vitro Da Atividade Antibacteriana de Bidens Pilosa Linné e Annona Crassiflora Mart. Contra Staphylococcus Aureus Resistente à Oxacilina (ORSA) Provenientes Do Ambiente Aéreo Na Clínica Odontológica.” Revista Do Instituto de Medicina Tropical de Sao Paulo 56 (4): 333–40. https://doi.org/10.1590/S0036-46652014000400011.

Singh, Surabhi, Sadiya Anjum, Jincy Joy, and Bhuvanesh Gupta. 2019. “Polysaccharide-Aloe Vera Bioactive Hydrogels as Wound Care System,” 1473–90. https://doi.org/10.1007/978-3-319-77830-3_48.

Siswomihardjo, Widowati, Siti Sunarintyas Badawi, Masahiro Nishimura, and Taizo Hamada. 2007. “The Difference of Antibacterial Effect of Neem Leaves and Stick Extracts.” Int Chin J Dent 7: 27–29.

Torwane, Nilesh, Sudhir Hongal, Pankaj Goel, and B. Chandrashekar. 2014. “Role of Ayurveda in Management of Oral Health.” Pharmacognosy Reviews 8 (15): 16–21. https://doi.org/10.4103/0973-7847.125518.

Velázquez, Claudia, José Correa-Basurto, Normand Garcia-Hernandez, Elizabeth Barbosa, Emiliano Tesoro-Cruz, Samuel Calzada, and Fernando Calzada. 2012. “Anti-Diarrheal Activity of (-)-Epicatechin from Chiranthodendron Pentadactylon Larreat: Experimental and Computational Studies.” Journal of Ethnopharmacology 143 (2): 716–19. https://doi.org/10.1016/j.jep.2012.07.039.

Xuan, Tran Dang, and Tran Dang Khanh. 2016. “Chemistry and Pharmacology of Bidens Pilosa: An Overview.” Journal of Pharmaceutical Investigation 46 (2): 91–132. https://doi.org/10.1007/s40005-016-0231-6.

Zheng, Zhaoling, Yanhua Sun, Ziliang Liu, Mingqin Zhang, Chunqing Li, and Hui Cai. 2015. “The Effect of Curcumin and Its Nanoformulation on Adjuvant-Induced Arthritis in Rats.” Drug Design, Development and Therapy 9 (August): 4931–42. https://doi.org/10.2147/DDDT.S90147.

Zulkarnain, Hamzah Sahag. 2019. “Penurunan Jumlah Koloni Bakteri Porphyromonas Gingivalis Setelah Pemberian Nano Gel Ekstrak Akar Sidaguri (Sida Rhombifolia L.),” July.