Triphala effective as Mouthwash

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  • #10154
    Anonymous
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    According to researchers, a cost-effective mouthwash, prepared with the herb triphala, can be as effective as the commercially available chlorhexidine in preventing dental caries. The researchers conducted a study on 1,431 students in the age-group of 8-12 years having the same socio-economic status and oral hygiene practices.

    Dentist Neeti Bajaj from Haryana-based PDM Dental College and Research Institute and Dr. Shobha Tandon, from Manipal College of Dental Sciences, Karnataka had divided the students in three groups for the study purpose. One of the groups was given triphala mouthwash, the other one was instructed to rinse their mouth with chorohexidine while the third group was given distilled water for the purpose for nine months.

    On studying their oral health, the authors found that triphala and chlorhexidine had similar inhibitory effect on plaque, gingivitis, and growth of streptococcus mutans and lactobacillus. However as expected, distilled water did not help in significant reduction in the Streptococcus mutans counts, it was found.

    The authors concluded that Ayurveda-based regimens such as triphala mouthwash can replace chlorhexidine as cost-effective preventive strategies in the country particularly in rural areas where a large number of people suffer from dental caries which can be cured with mouth rinsing. However, the researchers note that more scientific work needs to be carried out to prove the efficacy of triphala which in Ayurveda is known as one of the best herbal remedy.

    #14857
    drsushant
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    Donal oMathuna, Ph.D., School of Nursing, Dublin City University has reported a research involving results from use of ‘Triphala’ as a mouthwash in school-children.
    Triphala has been extensively used for lowering blood cholesterol, and has many potential benefits on blood lipids, according to Donal OMathuna. The author also reports that ‘triphala’ contains Vitamin C, various anti-oxidants and number of other ingredients.
    “The antimicrobial effects of triphala have received some attention from researchers. Laboratory studies have shown that triphala is active against a broad spectrum of micro-organisms that are involved in microbial infections. A study published in 2010 found that triphala was active against microbes isolated from hospital patients, suggesting that the extract might be useful against microbes resistant to antibiotics. A group of tannins found in the extracts are believed to be the active ingredients. These are able to combine with microbial enzymes to prevent them from working properly.” reported the author.
    The research that has been published in 2010 was carried out in 1500-primary school children in India with the aim to examine the usefulness of triphala as a mouthwash to examine dental caries.
    “In this study, the children used a mouthwash which contained either triphala extract, chlorhexidine (a common component in popular mouthwashes) or distilled water. After nine months, those using distilled water had significantly increased scores on measures of dental caries. In contrast, those using triphala or chlorhexidine mouthwash had similar reductions in the incidence of caries.” he added.
    “The authors concluded that since the two mouthwashes were similarly effective, but triphala was much less expensive, that triphala could be recommended for dental hygiene.” wrote DonalO’mathuna

    #14856
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    Nearly 60-70% of the child Indian population suffers from dental caries. Mouth rinsing is the most cost effective method of preventing dental caries. ‘Triphala’ has been a classic Ayurveda remedy, probably the best known among all Ayurvedic compounds. This study was conducted on 1501 students in the age group of 8-12 years with the aim of determining the effect of Triphala mouthwash on prevention of dental caries (manifest caries) as well as incipient carious lesions, and also comparing the effect of Triphala and chlorhexidine mouthwashes. The incipient caries was recorded at 3, 6, 9 months intervals and manifest caries at 9 months interval. No significant increase in the DMFS scores was found at the end of 9 months. Also, there was no significant increase in the incipient caries score towards the conclusion of the study. It was concluded that there was no significant difference between the Triphala and the chlorhexidine mouthwashes.

    #14865
    drmithila
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    A new mouthwash may eradicate tooth decay.

    The mouthwash, which was created by a microbiologist from the UCLA School of Dentistry, targets Streptococcus mutans. That type of bacteria is one of the main causes for tooth decay and cavities.

    A recent study showed that 12 subjects had a mouth without any sign of S. mutans bacteria after just one rinse with this mouthwash. This study appears in the recent edition of Caries Research.

    Dental caries is one of the most common and expensive diseases in the United States. Billions of dollars are spent each year on treatment for the problem.

    This new mouthwash was developed by Wenyuan Shi, chair of the biology section at the UCLA School of Dentistry. It took about a decade to create and used a STAMP called C16G2 to be effective. The STAMP C16G2 can get rid of harmful bacteria and do so for long periods of time.

    The next step for the product to be put into practice is approval from the Food and Drug Administration. It’s conceivable it could be the first drug to prevent caries since fluoride was introduced about 60 years ago

    #15105
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     Unlike other commercial antiseptic rinses, G∙U∙M PerioShield Oral Health Rinse provides a unique, plaque-blocking technology that forms a shield to help prevent bacterial plaque from adhering to tooth and gum surfaces. This proc­ess of blocking the plaque from attaching and colonizing has been proven to help prevent and treat gingivitis. For more information, visitgumbrand.com orsunstaramericas.com

    #15511
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    The first historical mention of a mouth wash product is from Chinese medicine around the year 2700 BC, this was used in the treatment of gingivitus. During the Roman and Greek periods, the rinsing of the mouth after manual cleansing was commonly practiced by the upper classes with the famous physician Hippocrates recommending a mixture of salt, alum and vinegar. Modern mouthwashes as we know them first came to prominence in the late 1960’s when professor Hard Loe discovered that a compound made from chlorhexidine could help prevent plaque build up.

    Key Ingredients

    Commonly used ingredients in modern mouthwashes include eucalyptol, thymol, hexetidine, methyl salicyate, menthol, methylparaben, hydrogen peroxide and often fluoride. Many also include sweeteners like sorbitoal and sodium saccharine and xylitol. In some products alcohol may be added as it contributes to the antibacterial effect to carry the flavour. Commercial mouthwashes often contain preservatives like sodium benzoate which can help to ensure the product stays fresh after the bottle is opened. It’s important to note that if you suffer from heartburn, acid reflux or similar conditions, that many mouthwashes are high in acidity so you should opt for a neutral pH wash to avoid any unnecessary irritation.

     

    #15803
    Drsumitra
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    In a recent study, Dr. T. Blom and colleagues systematically reviewed the literature regarding the impact of mouthrinses on oral malodor, as well as current evidence for the treatment effects of mouthrinses on oral malodor. The authors searched PubMed-MEDLINE, the Cochrane-CENTRAL and EMBASE through February 10, 2012 to identify studies that met the review criteria. The outcome variables selected were: volatile sulphur compound measurements, organoleptic measurements, and tongue coating. The review independently screened 333 unique titles and paper abstracts, which resulted in 12 publications (12 experiments) that met the eligibility criteria. Means and standard deviations were extracted. The results were separated into short-term (< 3 weeks) and longer-term (≥ 3 weeks) studies. The review found that in both short- and longer-term studies, nearly all mouthwashes with active ingredients had beneficial effects in reducing oral malodor. The most compelling evidence was provided for chlorhexidine mouthwashes, and those that contained a combination of cetyl pyridinum chloride and zinc provided the best evidence profile on oral malodor. Little data with respect to tongue coating were available, and none of the studies showed a beneficial effect for this parameter.

     

    #15932
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    Do you apply the "80-20 rule" at work? The 80-20 rule, or Pareto principle,1 is the idea that a relatively small percentage of any cause (20%) creates most of the subsequent effects (80%). In a business context, this means that 80% of a company’s business stems from 20% of its customers.
    In dentistry, teeth make up only 20% of the surface area of the mouth, with the other 80% including interproximal spaces, the dorsum of the tongue and cheeks, and below the gumline; all reservoirs and niches for biofilm.2 There is a similar 80-20 situation happening with biofilm: 20% are pathogens and 80% is a slime layer composed of self-secreted glycoproteins and polysaccharides that is difficult to penetrate.3 Brushing and interproximal cleaning alone is not enough to disrupt biofilm. With a new-generation rinse now available, it’s time to revisit recommendations

     

    #16001
    drmithila
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    Listerine launched Advanced Defence Sensitive, a new mouthwash with new-patented technology
    In vitro, it blocks 92% of dentinal tubules in as little as six rinses, according to Listerine’s research by Johnson & Johnson.

    The formula includes potassium oxalate crystal technology.

    Crystals are deposited on the dentine and deep inside exposed open tubules. The crystals build with each rinse to provide a deep stable comprehensive tubule occlusion.

    Susie Sanderson OBE spoke at the launch. She is a wet-fingered health service dentist in Sheffield.

    She talked about the different types of patients who present and described typical sensitivity pain. She explained how she diagnoses by exclusion.

    Hygienist Sally Simpson talked about treating patients with sensitive teeth and treating patients with periodontal disease which is frequently teased out of the patient during ultrasonic debridement and mechanical debridement.

    She said: ‘For me, treatment of periodontal disease comes hand in hand with handling sensitivity.’

    Dr Roberto Labella from Johnson & Johnson launched this new product for the management of dentinal sensitivity. He explained that the potassium oxalate at 1.42% is the active ingredient in the mouthwash.

    Research shows the product is four times more effective at blocking tubules than leading other mouthwashes and 30% more effective than toothpaste after just six rinses.

    Research by J&J showed the product can withstand the typical daily challenges of mechanical and acid exposure. This was tested by measuring dentinal tubule occlusion.

    Research in clinical trials in vivo showed it to be 91% more effective at reducing sensitivity pain at two weeks than another leading potassium nitrate toothpaste.

    It is recommended for use twice daily for 60 seconds a time after brushing, fitting into the recommended typical daily oral hygiene routine.

     

    #16138
    Drsumitra
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    The 80-20 rule, or Pareto principle,1 is the idea that a relatively small percentage of any cause (20%) creates most of the subsequent effects (80%). In a business context, this means that 80% of a company’s business stems from 20% of its customers.
    In dentistry, teeth make up only 20% of the surface area of the mouth, with the other 80% including interproximal spaces, the dorsum of the tongue and cheeks, and below the gumline; all reservoirs and niches for biofilm.2 There is a similar 80-20 situation happening with biofilm: 20% are pathogens and 80% is a slime layer composed of self-secreted glycoproteins and polysaccharides that is difficult to penetrate.3 Brushing and interproximal cleaning alone is not enough to disrupt biofilm. Often in practice, periodontal disease is synonymous with periodontitis. This is incorrect. Periodontal disease is a continuum, a type of wound. Mealey and Rose4 discuss the periodontium as a unique ecological niche in the human body. Prior to the eruption of teeth, the tissue is intact, yet inhabited by bacterial communities that don’t challenge the individual’s health, similar to the bacteria that thrive harmlessly on your skin. When the teeth erupt, this surface can have as many as 32 objects violating this formerly intact mucosa.4 This creates the potential for biofilm and promoters of inflammation to reach the bloodstream.

    Often in practice, the words "biofilm" and "plaque" are used interchangeably. This too can be incorrect, or at least confusing. When talking about home care, we need to consider the makeup and location of biofilm, not plaque. Many of us completed our education at a time when bacteria were studied in a free-floating planktonic state. This led to the concept that certain pathologic pathogens were the reason for the breakdown. Dental professionals once thought that the thorough re­moval of supra- and subgingival plaque and deposits, and proper home care, would promote health. It is now known that biofilms are medically/dentally important. We also know that microbes living in a planktonic state that are nonadherent and free-floating cause few diseases. An oral biofilm environment is an accumulation of a mixed population of bacteria, fungi, or protozoa that produce large amounts of slime or matrix material around themselves.4 Using the terms "biofilm" and "plaque" interchangeably can confuse our understanding.

    Because of the work of Costerton,3 we know that biofilm is a complex community and it has a tremendous ability for self-preservation.3 Yet biofilm is not inherently bad. Biofilms are common in nature, yet damage can occur. Biofilm moving from a healthy to disease-inducing state can be prevented by routine home care. It is the routine disruption that keeps the biofilm in a healthy state.

    With this understanding of the 80-20 of bio­film, let’s look again at the 80-20 of common oral home care. Emphasizing brushing and interproximal cleaning to disrupt the biofilm is not enough. mouthrinse must be added to penetrate the 80% slime layer adhering to 80% of the oral cavity.

    Using Evidence-Based Dentistry in Product Selection
    How can professionals make a recommendation to Ashley? The answer lies in evidence-based dentistry (EBD). EBD is research. Clinical recommendations have 3 parts: (1) the evidence, (2) our professional experience and judgment, and (3) the patient’s clinical/social circumstances and preferences (Figure).5 Clinical recommendations are the overlap of these 3 areas.

    In the 21st century, EBD can now be ac­cessed easily via the Internet. Computers have become ubiquitous; most households have at least one or more of them. The reason for this is that we can do/learn/create differently with them. Using computers in healthcare, including the soon-to-be interoperable electronic health records, doesn’t just take what we have done traditionally and make it electronic. Rather, the use of computers opens options we didn’t have before, including finding research as part of the EBD process. The ADA has developed a website dedicated to EBD at ebd.ada.org.

    Although EBD is not a linear process, we will break down our journey into steps. EBD requires the judicious integration of systematic assessments of clinically relevant scientific evidence. We will begin step one in our EBD journey of mouthrinses by looking at 5 antimicrobial active ingredients in many of the over-the-counter (OTC)/prescription mouthrinse options.

    Evidence-Based Dentistry, Step 1—Science of the Options
    There are 5 main antimicrobial active ingredients in mouthrinses on the market today (Table).

    Essential oils have been around for thousands of years. They were first added to LISTERINE in 1879, but used as an antiseptic, not a mouthwash. In 1895, dentists started using it. In 1914, it became the first OTC mouthwash. LISTERINE is probably the most researched mouthwash on the market. The 4 essential oils used in the mouthwash are thymol, menthol, eucalyptol, and methyl salicylate. The oils disrupt the bacterial cell wall and kill biofilm and gingivitis organisms rapidly and nonselectively. Essential oils exhibit a broad spectrum of activity against Gram-positive and -negative bacteria, as well as fungi.

    As a result of reducing the number of pathogenic bacteria in the mouth, biofilm endotoxin levels are also reduced. This in turn decreases the pathogenicity of biofilm and the development of gingivitis.6,7 Essential oil rinses are available in both alcohol-containing and alcohol-free versions; however, the alcohol-free products might not meet the same efficacy standards. The alcohol in therapeutic mouth­rinses contains pharmaceutical-grade denatured alcohol to solubilize all the ingredients.

    As with essential oils, chlorhexidine (CHX) also ruptures the bacterial cell membrane, leading to rapid leakage of cell contents and cell death. Unlike essential oils, CHX binds salivary mucins, which reduces pellicle formation and in turn inhibits biofilm bacteria colonization. CHX also binds bacteria, further inhibiting their absorption onto tooth surfaces. CHX ex­hibits a broad spectrum of antimicrobial activity and is effective against both Gram-positive and -negative bacteria.8-9 CHX is available with and without alcohol. Due to its substantivity, CHX is often called the gold standard to which other rinses are compared.

    Cetylpyridinium chloride (CPC) is similar to CHX in that it too ruptures the bacterial cell membrane, leading to rapid leakage of cell contents and cell death. CPC may also alter bacterial metabolism and inhibit cell growth. CPC was first discussed in the scientific literature in the late 1930s and is included in many popular mouthrinses with varying concentrations, the most popular being Crest Pro-Health. It is important to recognize that the minimum recognized therapeutic concentration for CPC is 0.045%. Many cosmetic mouthrinses contain CPC at concentrations below 0.045%, and do not provide antiplaque/antigingivitis benefits. There are both alcohol-containing and alcohol-free products on the market.10,11

    Stabilized chlorine dioxide (CloSYS, Oxi­fresh) has been around for almost 200 years, but there are insufficient studies showing clinical efficacy against gingivitis. It also does not have the ADA seal. Manufacturers claim the products oxidize, causing chemicals to unite with oxygen and kill bacteria that cannot survive in an oxygenated environment. There is a body of literature to show that chlorine dioxide reduces oral malodor. One in vitro study shows the potential for microbial kill. This study states that it is "an attractive option to induce compliance in patients concerned with taste and discoloration."

    The advantage of using rinses with chlorine dioxide is that they do not contain alcohol, they do not cause staining, they are pH-balanced, and can be used with or without flavorings. They do not require a prescription. However, more long-term research needs to be done.12,13

    There is a new ingredient on the US market that shows great promise: Delmopinol hydro­chloride 0.2% in G·U·M PerioShield (Sunstar Americas) is a proprietary key ingredient that creates a less-adhesive environment for bacteria and biofilm. This rinse prevents bacteria from sticking to the teeth, forming an invisible protective shield over the teeth and gingiva that bacteria cannot penetrate, essentially reducing biofilm buildup. The product breaks down the biofilm and bacteria, making them easier to remove, while coating the teeth and gums to prevent additional biofilm from sticking. As a result, continual use helps maintain a healthy, balanced microflora. In other words, delmopinol does not directly kill anything. There is a small amount of alcohol (1.5%). It is less staining than CHX and has shown good results in clinical trials.14-17

    The product has been available in Europe for at least 10 years, and just recently came to the US market. This rinse was studied in meta-analyses of 8 double-blind studies looking at it as an adjunct to gingival health and biofilm control measures. Delmopinol met the efficacy criteria of the ADA in studies of extended durations. Ac­cording to the manufacturer, G·U·M PerioShield was developed for patients with chronic gum inflammation, gingivitis, and severe biofilm buildup. It has been proven safe and effective for long-term use. The product is currently the only oral rinse available approved by the FDA as a device (Class II medical device), whereas all other antibiofilm/antigingivitis rinses are classified as drugs. An FDA Class II medical device is defined as: "…intended to affect the structure or any function of the body of man or other animals, and which does not achieve any of its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes."

     

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