Tooth brushing, oil pulling and tissue regeneration: A review of holistic approaches to oral health

A systematic review of medicinal plants and herbal products' effectiveness in oral health and dental cure with health promotion approach

Medicinal plants and herbal drugs are being used increasingly as part of primary health care in most parts of the world. As important adjunctive and alternative treatments for oral health care, herbal products' use may continue to increase and become more widespread. The objective of this study is to present a comprehensive systematic review of the current published literature on the effectiveness of medicinal plants and herbal products employed to improve oral health in adolescents with a health promotion approach. The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The keywords "herbal medicine," "herbal extract," "herbal supplements," "plant extract," "natural drug," "pulpitis," "dental caries," "oral viral diseases," and "abscess" were used in combination with the Boolean operators OR and AND. PubMed, Embase, Scopus, and Web of Science were searched. Quality assessment of the included studies was performed using the Cochrane Handbook for Systematic Reviews of Interventions. The search yielded 49 original research studies. A total of 22 studies had low or unclear risk bias. The geographical distribution of included studies was primarily concentrated on western countries. Overall, studies reported herbal product users' age, ranging from young adults aged 18 years to elderly people aged 75 years or older. Most studies reported multiple compounds, including herbal drugs and herbal extracts. Chamomile and Aloe vera were the most frequently reported herbal compounds. The most commonly described herbal products to treat oral diseases were gels, mouth rinses, and pastes. The studies included a range of people with oral diseases, including periodontal and gingival diseases, recurrent aphthous stomatitis, oral lichen planus, and oral candidiasis. Herbal product interventions were found to be effective and safe alternatives for oral health care. One of the most important goals of the World Health Organization (until 2015) is the oral health index, so it is important that dental services be followed up more seriously. Considering the problems in reaching this goal of the World Health Organization in our country, herbal products have the ability to improve clinical oral health outcomes in adolescents. Limited adverse side effects indicate the overall safety of these treatments for a wide range of oral diseases. Therefore, the use of medicinal plants as well as alternative medicine is one of the useful methods in achieving this important goal of public health.

Effects of Ayurveda interventions on acute pain and quality of life of a trigeminal neuralgia patient - A case report

Classical trigeminal neuralgia (CTN) is a disease characterized by severe pain in the facial area related to the trigeminal nerve. CTN occurs due to neurovascular compression of the Trigeminal nerve presenting with recurrent pain episodes. This case reports the effect of Ayurveda interventions on CTN. Thirty-nine-year-old male patient with pain on the right side of the face for two years presented to the National Institute of Ayurveda, Hospital, Jaipur, Rajasthan, India. The pain was distributed on the right side of the upper lip, cheek, and chin. Paroxysms of pain appeared at the interval of 1-2 h and were lasting of 1-2 min. The case was diagnosed with the help of magnetic resonance imaging (MRI) as right-side classical trigeminal neuralgia due to indentation of the vascular loop of the right superior cerebellar artery. The patient had a treatment history of two years with allopathic medicine, and he sought Ayurveda treatment due to recurrence and excessive pain. The patient was given Ayurvedic interventions (oral medication, Nasya, Kavalagraha, and Gandusha) for three months. The improvement were observed on the visual analogue scale (VAS) for pain, hospital anxiety and depression scale (HADS), and Short Form -36 questionnaire (SF-36) for quality of life. After three months of the treatment, the VAS scale for pain and the HADS scale for anxiety and depression showed marked improvement. Improvement in all the domains of SF-36 was observed, with a total percentage improvement from 10.7% to 83.2%. Observations of this case highlight the usefulness of Ayurveda interventions, i.e., Oral medication, Nasya, Kavalagraha, and Gandusha, in reducing the acute paroxysms of pain in Classical TN and improving the quality of life of CTN patients.

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

Objectives

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

Materials and Methods

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

Results

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

Conclusion

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

Effect of Dextranase and Dextranase-and-Nisin-Containing Mouthwashes on Oral Microbial Community of Healthy Adults—A Pilot Study

This study analyzed the alteration of oral microbial composition in healthy subjects after using dextranase-containing mouthwash (DMW; Mouthwash formulation I) and dextranase-and-nisin-containing mouthwash (DNMW; Mouthwash formulation II). Eighteen participants were recruited and were randomly allocated to two groups: G1 (DMW user; n = 8) and G2 (DNMW user; n = 10). The subjects were instructed to use the provided mouthwash regularly twice a day for 30 days. The bleeding on probing (BOP), plaque index (PI), probing depth (PBD), and gingival index (GI) were analyzed, and saliva samples were collected before (day 0) and after (day 30) the use of mouthwashes. The saliva metagenomic DNA was extracted and sequenced (next-generation sequencing, Miseq paired-end Illumina 2 × 250 bp platform). The oral microbial community in the pre-and post-treated samples were annotated using QIIME 2™. The results showed the PI and PBD values were significantly reduced in G2 samples. The BOP and GI values of both groups were not significantly altered. The post-treated samples of both groups yielded a reduced amount of microbial DNA. The computed phylogenetic diversity, species richness, and evenness were reduced significantly in the post-treated samples of G2 compared to the post-treated G1 samples. The mouthwash formulations also supported some pathogens’ growth, which indicated that formulations required further improvement. The study needs further experiments to conclude the results. The study suggested that the improved DNMW could be an adjuvant product to improve oral hygiene.

Comparing the Effectiveness of Herbal and Conventional Dentifrices in Reducing Dental Plaque and Gingivitis: A Systematic Review

INTRODUCTION

The important cause of chronic gingivitis was proved to be dental plaque, which is a well-organized biofilm. However, self-care efforts or mechanical control of dental plaque by toothbrushing was important; these alone will not be enough to prevent gingivitis.

AIM

The aim of the present systematic review was to compare the effectiveness of herbal and conventional toothpastes on reduction of dental plaque and gingivitis.

MATERIALS AND METHODS

Data from original scientific papers published in PubMed, Cochrane, Lilacs, and Google Scholar were taken for review up to November 2020. Randomized controlled trials and clinical trials compare the effectiveness of herbal and non-herbal toothpastes on reduction of dental plaque and gingivitis. Articles published in English language only were included. References from the identified publications were manually searched to identify additional relevant articles. Seven publications fulfilled all the inclusion criteria and were finally selected for systematic review. Outcome measurements for gingivitis were gingival index and dental plaque index.

RESULTS

As all the studies were randomized controlled trials, level of evidence was II. Among all studies, green tea dentifrice toothpastes showed significant reduction when compared with conventional dentifrice, and ayurvedic toothpaste and Carica papaya leaf extract were also effective.

CONCLUSION

Herbal toothpaste seems to be powerful similar to non-herbal toothpaste; however, it is no longer extra superior to fluoride toothpaste. Further, long-term randomized studies of >6 months are needed to investigate the beneficial effects of intervention alone.

High-resolution taxonomic examination of the oral microbiome after oil pulling with standardized sunflower seed oil and healthy participants: a pilot study

OBJECTIVES

We aimed at the high-resolution examination of the oral microbiome depending on oil pulling, compared it with saline pulling, and analyzed whether the method is capable of reducing the overall microbial burden of the oral cavity.

MATERIALS AND METHODS

The study was a cohort study with three healthy subjects. Oil pulling samples, saline pulling samples, and saliva samples were microscoped and cultured under microaerophilic and anaerobic conditions; colony-forming units were counted; and cultivated bacteria were identified employing MALDI-TOF MS. The oral microbiomes (saliva) and the microbiota incorporated in oil and saline pulling samples were determined in toto by using 16S rDNA next-generation sequencing (NGS) and bioinformatics.

RESULTS

Microscopy revealed that oral epithelial cells are ensheathed with distinct oil droplets during oil pulling. Oil pulling induced a higher production of saliva and the oil/saliva emulsion contained more bacteria than saline pulling samples. Oil pulling resulted in a significant and transient reduction of the overall microbial burden in comparison to saliva examined prior to and after pulling. Both oil and saline pulling samples mirrored the individual oral microbiomes in saliva.

CONCLUSIONS

Within the limitations of this pilot study, it might be concluded that oil pulling is able to reduce the overall microbial burden of the oral cavity transiently and the microbiota in oil pulling samples are representative to the oral microbiome.

CLINICAL RELEVANCE

Within the limitations of this pilot study, it might be concluded that oil pulling can be considered as an enlargement of standard oral hygiene techniques since it has the characteristic of an oral massage, enwrapping epithelial cells carrying bacteria in oil vesicles and reaching almost all unique habitats in oral cavity.

An exploration of the oral health beliefs and behaviors of people living with HIV in Mangalore, India: a qualitative study

Introduction

People living with HIV (PLWHIV) have increased oral healthcare needs due to an increase in the prevalence of oral and dental diseases. Their oral health is influenced by psychosocial, behavioral and biologic factors. The aim of this study was to explore and obtain a deeper understanding of the oral health beliefs and behaviors of PLWHIV that could potentially affect their oral health.

Methods

We have used the Health Belief Model (HBM) and qualitative methods using in-depth interviews with 16 PLWHIV. Content analysis of the transcribed data was done. The data was grouped under the constructs of the HBM.

Findings

The perceived susceptibility to oral diseases and awareness on the importance of good oral health was low. Regular tooth brushing and traditional methods for oral hygiene maintenance were considered beneficial. Regular dental visits were not considered important. Psychosocial issues, time and financial constraints were the barriers. Participants believed that information on oral health should be provided by the health providers in hospitals and dental clinics. 

Conclusion

The findings on the oral health beliefs and behaviors support the need for education on oral health and preventive healthcare practices among PLWHIV. Oral health promotion should include behavioral change as one of its components.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01549-5.

Preventive aspect of ayurveda and yoga towards newly emerging disease COVID-19

The ongoing coronavirus pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and unique in various facets. The earlier experience from the past severe acute respiratory syndrome (SARS) epidemics seem to be insufficient and there is need for better strategies in public health and medical care. Ayurved & Yog are well known for their preventive and therapeutic aspect, but not getting utilized properly for prevention of Covid 19 crisis which may also be helpful as supportive therapy along with current line of management. This paper is aimed at unrevealing the role of Ayurved and Yoga guidelines established by Department of AYUSH for prevention from SARS-CoV-2 by providing help to improving the quality of supportive/prophylactic therapy in relation with their immunity.

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

OBJECTIVES

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Phytoperspective of Moringa oleifera for oral health care: An innovative ethnomedicinal approach

The present era accentuate the use of alternative medicines as drugs extracted from several plant parts. These herbal medicines otherwise called ethnomedicines are now the source of many imperative drugs in this contemporary world. Furthermore with ever rising oral problems by luxurious lifestyle in this modern society, there is a soaring need for use of potent medicinal plants like horse radish (Moringa oleifera Lam.) against various oral ailments. Therefore, use of herbal medicines in reducing the adverse effects of various conventional allopathic medicines and harmful side effects of conventional antibiotics has emerged as an evolved technique in pharmaceutical science. The present review emphasizes the antipathogenic potentiality of M. oleifera along with their known therapeutic properties through biologically active compounds (phytoconstituents) and ethnomedicinal uses. Various ethno-pharmacological studies of the plant parts with their nutritional value and multifarious medicinal uses including oral health care are being quoted in present review. This review will foster future research on phytoconstituent analysis, bioefficacy assessment for oral micro flora and ethno-pharmaceutical importance of M. oleifera in the field of medical science with special reference to dentistry. Consequently, this innovative ethnomedicinal approach for oral health care may supplement the modern medicine through its potent phytoconstituents.

Effect of St. John's wort oil and olive oil on the postoperative complications after third molar surgery: randomized, double-blind clinical trial

OBJECTIVES

This multicenter study aimed to evaluate the effects of St. John's wort oil and virgin olive oil on the postoperative complications and compare this with chlorhexidine gluconate plus benzydamine hydrochloride mouthwash after the removal of impacted third molar.

METHODS

A total of 90 patients in need of impacted third molar surgery were included in this study. All included patients were randomly divided into 3 groups. The patients in group 1 received St. John's wort oil; the patients in group 2 received virgin olive oil, and those in group 3 received mouthwash containing chlorhexidine gluconate plus benzydamine hydrochloride. The self-reported pain and difficulty during jaw function, trismus, facial swelling, number of analgesics used during first postoperative week, and postoperative periodontal condition including plaque accumulation, bleeding on probing, and periodontal pocket depth were compared between the groups.

RESULTS

No significant differences were found regarding the study variables.

CONCLUSIONS

The data of the present study supports that the use of essential oils provides efficient alternative to the gold standard chlorhexidine gluconate mouthwash in reducing postoperative complications and improving healing process without adverse effects after surgical removal of impacted third molars.

CLINICAL RELEVANCE

The use of essential oils showed similar results as the chlorhexidine gluconate mouthwash regarding swelling, mouth opening, pain, need for rescue medication, infectious complications (i.e., alveolar osteitis), and periodontal healing. Therefore, essential oils can be an alternative to routine mouthwashes to ensure oral hygiene after impacted third molar surgery.

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

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

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

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

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

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

Objectives

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

Data

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

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

Sources

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

Study selection

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

Conclusion

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

Clinical significance

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

Evaluation of dentifrices of complementary and alternative medicinal systems on plaque formation and gingivitis: A randomized controlled clinical trial

Background

Bio-film formation is a natural process in the oral environment, but needs to be controlled through regular brushing in order to prevent the development of caries and periodontal diseases.

Material and Methods

A wide variety of dentifrices of complementary and alternative medicinal systems are available in the market which claims superior plaque control. A randomized controlled double-blinded concurrent parallel clinical trial was conducted with the objective to evaluate and compare the clinical effectiveness of three commercially available dentifrices of complementary and alternative medicine systems with that of a placebo dentifrice on Gingival Index (GI) and Plaque Index (PI) scores after 15, 30, 45 and 60 days of usage among 80 adults aged 35-44 years.

Results

The mean GI scores reduced by 29.19 %, 22.28 %, 32.43 % and 10.33 % in the herbal dentifrice, homeopathic dentifrice, conventional dentifrice, and placebo dentifrice groups by the end of the study period. Highest reduction of 33.5% and 34.87 % in PI scores were seen in the herbal and conventional dentifrice. This reduction was statistically significant (p=0.001).

Conclusions

The herbal dentifrice tested in the present study has demonstrated anti-gingivitis and anti-plaque efficiency equivocal to the conventional dentifrice. The homeopathic dentifrice was as good as a placebo.

Key words:CAM dentifrices, Homeopathic dentifrice, plaque, gingivitis, tooth brushing.

Effect of Sudharshan Kriya Pranayama on Salivary Expression of Human Beta Defensin-2, Peroxisome Proliferator-Activated Receptor Gamma, and Nuclear Factor-Kappa B in Chronic Periodontitis

Introduction

Sudharshan kriya pranayama (SKP) is a form of yoga that reduces inflammation and contributes to general health. Very few prior studies have examined the role of pranayama on oral health. We evaluated the clinical status and inflammatory biomarkers in patients with chronic periodontitis before and after SKP.

Materials and methods

Ninety male subjects were considered for the study and divided into three groups: subjects with a healthy periodontium (Group1), subjects with chronic gingivitis (Group2), and subjects with chronic periodontitis (Group3). The clinical parameters included plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and salivary markers human beta-defensin-2(HBD-2), peroxisome proliferator-activated receptor gamma (PPAR-γ), and nuclear factor-kappa B (NF-κB). These parameters and markers were evaluated before and after 90 days of SKP. The data obtained were statistically evaluated by McNemar's test, paired sample t-test, and one-way analysis of variance.

Results

There was a significant improvement in PI in all three groups. GI showed an improvement in Groups 2 and 3. PPD and CAL also showed an improvement in Group 3. HBD-2 and NF-κB decreased with SKP, whereas PPAR-γ expression increased after the intervention. In Groups 2 and 3 with the decrease in GI, there was a corresponding decrease in HBD-2. In Group 3 with an improvement in PPD and CAL, there was an improvement in PPAR-γ expression.

Conclusions

The results show that SKP can significantly decrease periodontal inflammation and improve periodontal status. It also effectively improves the expression of PPAR-γ, thereby decreasing salivary levels of HBD-2 and NF-κB, respectively. Based on our results, pranayama can be an effective adjunct in maintaining oral health.

Effect of a Toothpaste/Mouthwash Containing Carica papaya Leaf Extract on Interdental Gingival Bleeding: A Randomized Controlled Trial

Clinical research on herbal-based dentifrice +/− mouth rinse products is very limited compared with the plethora of research on conventional oral care products under normal oral hygiene conditions. The aim of this study was to determine the anti-inflammatory effects of a novel plant Carica papaya leaf extract (CPLE) on interdental bleeding in healthy subjects. In this randomized, single-blind parallel-design study, the eligible subjects were generally healthy non-smokers, aged 18–26, who exhibited healthy periodontal conditions upon study entry. The participants were equally randomized into the following four groups: CPLE dentifrice, CPLE dentifrice and mouthwash, sodium lauryl sulfate (SLS)-free enzyme-containing dentifrice and SLS-free enzyme-containing dentifrice with essential oil (EO) mouthwash. Subjects were instructed to brush their teeth twice a day without changing their other brushing habits. Interdental bleeding (BOIP) was measured from inclusion (T₀) until the fourth week (T₄) of the study. Clinical efficacy was assessed after one, two, three and four weeks of home use. The analyses compared BOIP between groups and were then restricted to participants with ≥70% and then ≥80% bleeding sites at T₀. Pairwise comparisons between groups were performed at T₀ and T₄, and a logistic regression identified correlates of gingival bleeding (T₄). Among 100 subjects (2273 interdental sites), the median percentage of bleeding sites per participant at T₀ was 65%. The bleeding sites dramatically decreased in all groups between T₀ and T₄ (relative variations from −54% to −75%, p < 0.01 for all). Gingival bleeding did not significantly differ between the CPLE dentifrice and the SLS-free dentifrice +/− EO mouthwash groups (from p = 0.05 to p = 0.86), regardless of the baseline risk level. Among the CPLE dentifrice users, fewer bleeding sites were observed when toothpaste and mouthwash were combined compared to bleeding sites in those who used toothpaste alone (21% vs. 32%, p = 0.04). CPLE dentifrice/mouthwash provides an efficacious and natural alternative to SLS-free dentifrice +/−EO-containing mouthwash when used as an adjunct to mechanical oral care to reduce interdental gingival inflammation.

Parents' online discussions about children's dental caries: A critical content analysis

OBJECTIVES

Through an analysis of postings to an online parenting forum, we aimed to explore the many ways in which parents orient to (i.e., take up, challenge, re-articulate) information about child dental health in the context of their online interactions. Our analysis is anchored in Nettleton's theoretical work on dental authority and power, which we apply in a digital context.

METHODS

We examined discussion threads from the public online forums on BabyCenter Canada. We identified relevant threads using the site search function and keywords related to dental health, with a focus on dental caries (tooth decay), related care behaviours (e.g., toothbrushing), and the controversial issue of fluoride. Following descriptive content coding, we applied a critical lens to unpack themes related to expert knowledge, gender and parenting online cultures.

RESULTS

We analyzed 479 relevant threads. Our findings focus on two central themes: the tension between parents' views and those of dental health professionals; and, the gendered, cultural roles and expectations that position mothers as primarily responsible for the care of children's dental health. Though these themes are not new, our findings show that they persist in the digital context where social divisions (e.g., expert/non-expert) may be blurred.

CONCLUSIONS

Our analysis of online discussions provides an opportunity to think critically about ways in which parents engage with public health, in digital contexts. Although some mothers express disconnect when communicating with dental professionals, they are very engaged and concerned with dental health issues for their children. A challenge for dental public health is to find ways to shift perspective towards recognizing that the target population is empowered and already engaged in discussions of research evidence and clinical encounters on their own terms, facilitated by an online context.

Oil pulling and importance of traditional medicine in oral health maintenance

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

Oil pulling for maintaining oral hygiene - A review

Oil pulling is a traditional folk remedy practiced in ancient India. It is believed to cure more than thirty systemic diseases when practiced regularly and as directed. Due to occurrence of side effects to modern medicines and oral hygiene products, people are increasingly attracted towards complementary and traditional practices. Oil pulling in addition to offering several oral health benefits has also beneficial effects on overall health. The present article attempts to review and discuss this ancient practice.

Effect of oil pulling in promoting oro dental hygiene: A systematic review of randomized clinical trials

AIM

To critically appraise and evaluate the evidence from randomized clinical trials (RCTs) examining the effectiveness of oil pulling on oro dental hygiene.

METHODS

We conducted electronic searches in Medline, Embase, Amed, The Cochrane Library and Cinahl databases from inception to February 2015, and assessed reporting quality using the Cochrane risk of bias criteria. We included RCTs that compared oil pulling using conventional cooking oils with a control intervention. Our primary outcomes were measures of oro dental hygiene using validated scales.

RESULTS

Electronic searches yielded 26 eligible studies, of which five RCTs comprising a total of 160 participants were included. The studies varied in reporting quality, lasted between 10 and 45 days, and compared oil pulling with chlorhexidine, placebo or routine dental hygiene practice. Three studies reported no significant differences in post intervention plaque index scores between oil pulling and control groups (Chlorhexidine mouthwash +/- Placebo): p=0.28, 0.94, and 0.38, respectively. Two studies reported no significant difference in post-intervention modified gingival index score between oil pulling and Chlorhexidine mouthwash groups (p=0.32 and 0.64).

CONCLUSION

The limited evidence to date from clinical trials suggests that oil pulling may have beneficial effects on oro dental hygiene as seen for the short period of time investigated. Given that this is a potentially cost-effective intervention, this practice might be of particular benefit. Future clinical trials should be more rigorous and better reported.

Assessment of the Status of National Oral Health Policy in India

BACKGROUND

National oral health policy was conscripted by the Indian Dental Association (IDA) in 1986 and was accepted as an integral part of National Health Policy (NHP) by the Central Council of Health and Family Welfare in one of its conferences in the year 1995. Objectives of this paper were to find out the efforts made or going on towards its execution, its current status and recent oral health-related affairs or programs, if any.

METHODS

Literature search was done using the institutional library, web-based search engines like 'Google' and 'PubMed' and also by cross referencing. It yielded 108 articles, of which 50 were excluded as they were not pertinent to the topic. Twenty-four were of global perspective rather than Indian and hence were not taken into account and finally 34 articles were considered for analyses. Documents related to central and state governments of India were also considered.

RESULTS

All the articles considered for analysis were published within the past 10 years with gradual increase in number which depicts the researchers' increasing focus towards oral health policy. Criticisms, suggestions and recommendations regarding national oral health programs, dental manpower issues, geriatric dentistry, public health dentistry, dental insurance, oral health inequality, and public-private partnerships have taken major occupancies in the articles. Proposals like "model for infant and child oral health promotion" and "oral health policy phase 1 for Karnataka" were among the initiatives towards national oral health policy.

CONCLUSION

The need for implementation of the drafted oral health policy with modification that suits the rapidly changing oral health system of this country is inevitable.

Effect of oil gum massage therapy on common pathogenic oral microorganisms - A randomized controlled trial

Objectives:

(i) To assess reduction in Streptococcus mutans and Lactobacillus species count in saliva sample after ten minutes of oil gum massage therapy (massage of gingival tissues) per day for three weeks with sesame oil, olive oil, and coconut oil in three different groups of subjects. (ii) To compare the efficacy between three different oils and the “gold standard” chlorhexidine gel. (iii) To assess reduction in gingival scores and plaque scores of study subjects.

Materials and Methods:

Study design – Single center, parallel design, and triple blind randomized clinical study with four treatment groups. Participants: 32 of the 40 study subjects working as housekeeping personnel at Kasturba Hospital, Manipal; aged 18-55 years completed the three-week study period. Interventions: Subjects were randomly assigned to massage their gingiva everyday for three weeks with sesame oil, olive oil, coconut oil (tests), and Chlorhexidine gel (control). Oral health status and paraffin stimulated saliva samples were obtained at baseline and after three weeks of oil gum massage therapy. Outcome measures: Microbial culture, plaque index, and gingival index. Statistical analysis: Paired t test and Kruskal Wallis test.

Results:

There was a significant reduction in mean Streptococcus mutans count, Lactobacillus count, plaque scores, and gingival scores in all four groups after the study. However, there was no significant difference found in percentage reduction of these variables between the four groups.

Conclusion:

These oils can be used as valuable preventive agents in maintaining and improving oral health in low socioeconomic status population. However, it is recommended that further research should be conducted in other populations with a larger sample and longer duration of follow-up period.

Comparative effectiveness of chewing stick and toothbrush: a randomized clinical trial

BACKGROUND

With the increasing rate of oral diseases, the global necessity of effective and economical products for its prevention and treatment has intensified.

AIM

THIS STUDY WAS TO COMPARE THE EFFECTIVENESS OF TWO ORAL HYGIENE AIDS: Chewing stick and manual toothbrush, for plaque removal and gingival health after one month of a randomized clinical trial.

MATERIALS AND METHODS

Dental students (age 18-22 years) of a public sector dental hospital were recruited. Sample size was determined using the American Dental Association guidelines. Participants were randomized into two interventional groups and provided with either chewing sticks or toothbrushes. Pre- and post-intervention examinations were executed by two blind and calibrated examiners using plaque and gingival dental indices. Statistical analysis included descriptive statistics, paired t-test, and two sample independent t-tests.

RESULTS

Fifty subjects were recruited with mean age 20 ± 0.66 years (80% were females and 20% were males). Except for the mean plaque scores of toothbrush users (which increased at post-intervention examination), all other scores showed reduction. In contrast to the final mean gingival scores, a significant difference (P = < 0.0001) in the final mean plaque score was observed for the two respective interventional groups.

CONCLUSION

Chewing stick has revealed parallel and at times greater mechanical and chemical cleansing of oral tissues as compared to a toothbrush.

Role of Ayurveda in management of oral health

Oral diseases continue to be a major health problem world-wide. Oral health is integral to general well-being and relates to the quality-of-life that extends beyond the functions of the craniofacial complex. The standard Western medicine has had only limited success in the prevention of periodontal disease and in the treatment of a variety of oral diseases. Hence, the search for alternative products continues and natural phytochemicals isolated from plants used in traditional medicine are considered to be good alternatives to synthetic chemicals. The botanicals in the Ayurvedic material medica have been proven to be safe and effective, through several hundred to several thousand years of use. The exploration of botanicals used in traditional medicine may lead to the development of novel preventive or therapeutic strategies for oral health. The present scientific evidence based review is focused on the possible role of Ayurveda in the management of various orofacial disorders.