natural compounds in the field of community dentistry

Usage of various natural compounds in clinical dentistry

1. “Exploring Herbal Compounds : Enhancing Dentistry Naturally” Dr. sreeja Junior resident Public health dentistry 1

2. CONTENTS What kind of JC is this ? Why was this topic chosen ? Source of article About the journal Introduction Materials and Methods Results Discussion Conclusion References 2

3. What kind of JC is this? 1. JOURNAL CLUB AIMED AT UPDATING KNOWLEDGE RELATED TO A FIELD OF INTEREST. 2. JOURNAL CLUB AIMED AT UPDATING CLINICAL PRACTICE. 3. JOURNAL CLUB WHICH AIM AT TEACHING AND LEARNING CRITICAL APPRAISAL TECHNIQUES WITH EVIDENCE BASED MEDICINE AND DENTISTRY. 4. PROBLEM BASED JOURNAL CLUB- CENTERED ON A PROBLEM. 5. ALTERNATIVE JOURNAL CLUB- VIDEO, BOOK, REVIEW AND STORYTELLING 6. INNOVATIVE JOURNAL CLUBS 3

4. WHY was this topic CHOSEN? Many people are becoming increasingly interested in natural and holistic approaches to healthcare, including dentistry. Some individuals may have concerns about the safety or potential side effects of synthetic ingredients commonly used in dental products. There is ongoing research into the therapeutic properties of natural compounds for oral health. Exploring the relevance of these traditional remedies in modern dentistry can bridge the gap between traditional knowledge and contemporary dental practices. 4

5. ARTICLE-1 5

6. Source of article Dental Research Journal Year : 2023 | Volume : 20 Page No : 1 - 6 Published on : 27-Jun-2023 PMID: 37483902 PMCID:  PMC10361262   DOI:  10.4103/1735-3327.379627 6

7. About the Journal 7

8. About the Journal The aim of Dental Research Journal (DRJ) is to keep its readers informed of research, clinical developments, clinical opinions and treatments as well as other key issues of relevance to dentistry. The journal is visible in  Thomson Reuters ISI Web of Knowledge   and is indexed by PubMed, PubMed Central, Chemical Abstract Services (CAS), Scopus, CINAHL, etc. Impact factor : 2.7 8

9. Important Features: Immediate Open access articles. Manuscripts online submission system. Fast reviewing system of manuscripts. Free access to the full-texts for all authors and reviewers. Publication of different types of articles. Publication of Basic and Clinical papers in the fields of dentistry from all over the world Publishing Company: Wolter Kluwers-Medknow 9

10. Article processing charge: The journal charges following fee on acceptance Case Report : US $ 350 (for overseas authors), and 6000000 Rials (for Iranian authors). Original Article , Review Article: US $700 (for overseas authors), and 10000000 Rials (for Iranian authors). 10

11. INTRODUCTION Untreated gingivitis can progress to periodontitis, causing damage to the structures supporting the teeth. Although mechanical methods like toothbrushing and flossing are crucial for controlling dental plaque, gingival inflammation remains common due to ineffective implementation. Therefore, chemical methods like toothpaste and mouthwashes with anti-plaque properties should use along with mechanical methods for optimal oral hygiene. 11

12. Among all available mouthwashes, CHX has a high capacity in reducing dental plaque and pathogenic microorganisms like S. mutans. Aloe vera is a member of Aloaceae family that is increasingly being used as an herbal drug for dental problems. Anthraquinones or phenolic compounds, saponin, tannin, sterol, and organic acids are active agents in A. vera gel. Flavonoids such as catechin are bioactive compounds in the leaves of green tea 12

13. The green tea catechin has bactericidal effects on black pigment bacteria and Gram-negative anaerobic rods , and a combination of mechanical methods and green tea catechin is effective in improving the periodontal condition. Chamomile belongs to the Asteraceae family and its pharmaceutical properties are owing to the flavonoid compounds and breakdown of volatile oils. Abdelmonem et al, observed that the number of bacterial colonies of Porphyromonas gingivalis and Prevotella intermedia significantly decreased in the group receiving A. vera mouthwash. 13

14. Considering the above mentioned studies, the current study was conducted to determine and compare the antimicrobial effects of chamomile (Matrika), A. vera-green tea, and CHX mouthwashes on S. sanguis, S. oralis, S. mutans, P. gingivalis, and Eikenella corrodens bacterial species . 14

15. MATERIALS AND METHODS This prospective single-blind in vitro study investigated the antibacterial effects of Matrika, A. vera-green tea, and CHX 0.2% as well as distilled water as control on five bacterial species, including S. oralis, S. sanguis, and S. mutans as primary colonizers and P. gingivalis and E. corrodens as secondary colonizers at the Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences. First, some of the suspension containing each bacterium was cultured on the specific culture medium of each species. After incubation, several colonies of each species were separately dissolved in the Trypticase Soy Broth , and a suspension with specific McFarland turbidity was prepared. 15

16. The study involved various methods to analyze the effectiveness of mouthwashes against bacterial growth: 1. Colony-forming unit method : Mouthwash and distilled water were mixed with bacterial suspension and cultured on a specific medium. Colonies were counted before and after incubation. 2. Disc diffusion method : Bacterial suspension was cultured, and paper discs soaked in mouthwash were placed on the plate. The zone of inhibition around each disc was measured after incubation. 16

17. 3. Well diffusion method : Bacterial suspension was cultured, wells were created on the plate, and mouthwash was added. The zone of inhibition around each well was measured after incubation. Anaerobic conditions were maintained for P. gingivalis. Multiple tests were conducted for accuracy, and statistical analysis was performed using SPSS. 17

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19. Results The study found that there were significantly fewer bacterial colonies in both Aloe vera-green tea and chamomile mouthwashes compared to the control group. Additionally, there were no colonies found in the bacteria when using CHX mouthwash. In both the well diffusion and disc diffusion methods, there was a significant difference in the size of the zone of inhibition among the four groups. The size of the inhibition zone also varied significantly among different bacteria in all three mouthwashes. However, in the control group, there was no inhibition zone observed for any bacterial species. Overall, the results indicate that all three mouthwashes were effective in reducing bacterial growth, with CHX mouthwash showing the highest efficacy. 19

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22. Discussion The results of this study showed that CHX had a significantly higher effect on all five bacterial species than the other two mouthwashes. Regarding the comparison of zone of inhibition by disc diffusion and well diffusion methods, the finding indicated no significant difference for the effect of CHX in both methods for each bacterial species except E. corrodens . The diameter of the zone of inhibition induced by the herbal mouthwashes was higher in well diffusion method than disc diffusion method. It seems that the herbal mouthwashes have not been able to diffuse well from the disc to the culture medium after impregnation of discs in disc diffusion method. 22

23. In well diffusion method , considering the absence of disc and higher amount of the mouthwash used, the zone of inhibition was formed in a greater number of bacterial species. The present study showed that CHX mouthwash had the lowest effect on S. mutans in both disc diffusion and well diffusion methods. In this study, the effect of A. vera-green tea mouthwash on S. mutans, P. gingivalis, and E. corrodens was higher than that of Matrika mouthwash in all three methods, but , its effect on S. sanguis was lower than that of Matrika. 23

24. Araghizadeh et al . reported a higher inhibitory effect of green tea on S. mutans than periopathogenic bacteria. It was confirmed that the sensitivity of Gram-positive bacteria might be due to the difference in the cell wall and bacterial polysaccharide charge. Bertolini et al . also found no significant difference between the antimicrobial effects of A. vera-beeswax and CHX gluconate 0.12% mouthwashes on S. mutans in colony-forming unit. However, our study showed that CHX had a significantly higher effect on the studied bacterial species than A. vera-green tea mouthwash in all methods. 24

25. Limitations A limitation of this study was lack of access to other species. The mouthwashes used in this study were made before hand and it was not possible to change their concentration. In addition, given the different growth conditions of oral bacterial species compared to in vitro conditions, further clinical studies are suggested to explore the effect of herbal mouthwashes. 25

26. CONCLUSION The findings of the present study showed that A. vera-green tea and Matrika mouthwashes had potentially antibacterial effects , but these effect were lower than that of CHX mouthwash. Within the limitations of this study, it seems that these herbal mouthwashes cannot be an appropriate substitute to CHX mouthwash. However, more clinical studies are needed to prove the present finding. 26

27. Financial support and sponsorship This study has been supported by the Isfahan University of Medical Sciences . 27

28. Article - 2 28

29. Source of article Journal of Indian Society of Pedodontics and Preventive Dentistry Year : 2018 | Volume :36 Page No : 357-63. PMID: 30324925 DOI: 10.4103/JISPPD.JISPPD_65_18 29

30. About the Journal 30

31. Introduction A wide range of mouth rinses containing chlorhexidine (CHX) and/or sodium fluoride, and essential oils are available commercially. The American Dental Association recommends that mouth rinses should be effective to modify the oral microbiota selectively eliminating pathogens without affecting the normal commensals of the oral cavity. In recent years, extracts of active ingredients from medicinal herbs have gained attention of researchers all over the world in an attempt to find an alternative to chemotherapeutic agents. 31

32. Trachyspermum ammi , that is, ajowan or ajwain is one of the similar herbal plants seen in Southern Asia including India, seeds of which are used as a spice. Essential oil of ajwain contains about 50% thymol , a major phenolic compound has been reported to have germicidal, antispasmodic, antifungal, insecticidal, bronchodilator, and analgesic effect. Despite the traditional use, in many areas of allopathic and ayurvedic medicine, its exact mode of action in the field of dentistry is yet to explored. Keeping these factors in consideration , they conducted an in vitro study to evaluate antimicrobial efficacy of pure extract of T. ammi oil against five oral bacteria. 32

33. Materials and Methods They carried out this in vitro study at the Department of Pedodontics and Department of Microbiology after gaining clearance from the institutional ethical committee. Material used for the microbiological experiment were: Commercially available T. ammi (Ajwain oil) 100%. Commercially available CHX gluconate 2%. 33

34. Bacterial strains tested S. mutans S. oralis Lactobacillus acidophilus Lactobacillus fermentum C. albicans All the bacterial strains were procured from IM-TECH, Chandigarh. 34

35. Preparation of microbial inocula A direct colony suspension of each bacterial isolate was prepared in brain–heart infusion broth and turbidity was adjusted to 0.5 McFarland Standard for all the bacteria. Determination of minimum inhibitory concentration of antimicrobial agents by serial dilution method. Determination of minimum bactericidal concentration using agar disc diffusion method. 35

36. Statistical analysis The data obtained were subjected to statistical analysis with SPSS version 22.0 Statistical Package for the MS Windows. Intragroup mean and standard deviation was analyzed using paired t-test . Intergroup mean and standard deviations were analyzed using one-way ANOVA and statistical significance was analyzed using Tukey’s post hoc HSD test (P < 0.05). 36

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41. Discussion They prepared a stock solution of 0.1 mg/ml concentration of T. ammi oil as well as CHX gluconate solution that contains 12.5 mg of total concentration of active ingredient in both solutions, respectively, and through double dilution method, ten concentration ranging from 1000 µg/ml to 1.95 µg/ml. Inhibitory effect against L. acidophilus, L. fermentum, and C. albicans when compared against comparing with positive control group T. ammi oil showed higher. The possible explanation for antimicrobial activity of T. ammi oil might be because of major ingredients thymol and carvacrol . 41

42. Khan et al . reported that antibacterial action of T. ammi extract on S. mutans is due to 5,8 di-1-propyl-octahydronaphthalen a novel compound. S. oralis showed least zone of inhibition against both the antibacterial agents. The presence of adhesins along with layer of acquired pellicle , intracellular polysaccharides, or sailadase might be responsible for enhancing resistance of S. oralis against chemical insults for extended period of time. 42

43. Conclusion In this experimental study, we found that T. ammi oil has comparable antibacterial activity against oral bacteria than CHX. It has shown significantly higher bacteriostatic and bactericidal efficacy at the same concentration of CHX. T. ammi oil is available naturally and abundantly. It is nonirritating and nontoxic to the human body. It is cheaper than artificially formulated CHX. They propose that T. ammi oil can also be used in the future as an effective antiplaque agent due to its antimicrobial profile against oral plaque-forming bacteria after exploring its biological and chemical profile in detail. 43

44. Article -3 44

45. Introduction Herbal therapy has been used to treat oral health issues for thousands of years, with the oldest accounts coming from India and China. Hippocrates recommended rinsing your mouth with a mixture of alum, salt, and vinegar. Talmud, a combination of “dough water” and olive oil to maintain good mouth hygiene. The Arak tree , from which comes “Miswak”, has been used for dental hygiene for millennia and is still being utilized today in many Asian and African civilizations 45

46. Herbal Remedies and Periodontal Health The presence of bacteria triggers immune system activation, which leads to the generation of pro-inflammatory cytokines and, ultimately, reactive oxygen species (ROS ). Dentifrices and therapeutic chips are only two examples of useful products that herbal medicine has helped bring to market. One study found that S. persica-containing dentifrice was more effective than a regular toothpaste at reducing the sulcular bleeding inde x in patients with gingivitis after three weeks of use. This study was conducted by Azaripour A. et al c linical trials of an herbal dentifrice containing Carica papaya produced encouraging results. 46

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49. Emerging Trends and Patterns Several novel pharmaceuticals lead chemicals have their origins in the natural products extracted from medicinal plants. Just around one percent of the world’s plant species have been studied phytochemically, so there is a lot of room for new bioactive substances to be found. The efficacy, safety, cost-effectiveness, and characterization of these natural chemicals are all crucial areas that need immediate attention and more financing from the scientific community. 49

50. References Naghsh N, Moghareabed A, Nematnejad M, Yaghini J, Sadeghi SM. A comparative evaluation of the antimicrobial effect of chamomile, Aloe vera ‑green tea, and chlorhexidine mouthwashes on some oral bacterial species. Dent Res J 2023;20:70 . Dadpe MV, Dhore SV, Dahake PT, Kale YJ, Kendre SB, Siddiqui AG. Evaluation of antimicrobial efficacy of Trachyspermum ammi (Ajwain) oil and chlorhexidine against oral bacteria: An in vitro study. J Indian Soc Pedod Prev Dent 2018;36:357-63. Budala, D.G.; Martu, M.-A.; Maftei, G.-A.; Diaconu-Popa, D.A.; Danila, V.; Luchian, I. The Role of Natural Compounds in Optimizing Contemporary Dental Treatment—Current Status and Future Trends. J. Funct. Biomater. 2023 , 14, 273. 50

51. THANK YOU 51