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Preface xix Foreword xxiii Part I: Natural Oral Care 1 1 Natural Oral Care in Dental Therapy: Current and Future Prospects 3 Durgesh Nandini Chauhan, Prabhu Raj Singh, Kamal Shah and Nagendra Singh Chauhan 1.1 Introduction 3 1.2 Safety of Natural Oral Care 15 1.3 Advantage of Natural Oral Care 15 1.4 Limitations of Natural Oral Care 16 1.5 Future Prospects of Natural Oral Care 16 References 17 2 Herbal Products for Oral Hygiene: An Overview of Their Biological Activities 31 Ummuhan Sebnem Harput 2.1 Introduction 31 2.2 Oral Hygiene and Current Treatments 33 2.3 Plants Traditionally Used in Oral Hygiene 33 2.4 Clinically Studied Plant Product for Oral Hygiene 35 2.5 In Vitro Studied Herbal Product for Oral Hygiene 37 2.6 Discussion 40 2.7 Conclusion 41 References 41 3 Go Green-Periodontal Care in the Natural Way 45 Siddhartha Varma and Sameer Anil Zope 3.1 Introduction 45 3.2 Plaque Control 46 3.3 Dant Dhavani (Brushing) 46 3.4 Jivha Lekhana (Tongue Scrapping) 47 3.5 Gandusha (Gargling) or Oil Pulling 48 3.6 Oxidative Stress in Periodontitis 48 3.7 Green Tea 48 3.7.1 Components 48 3.7.2 Beneficial Effects of Various Tea Components 49 3.7.2.1 Antioxidative Effect 49 3.7.3 Role in Managing Periodontitis 49 3.8 Turmeric (Curcumin longa, Haldi) 49 3.8.1 Applications of Turmeric in Dentistry 49 3.9 Amala (Emblica officinalis, Amalaki, Phyllanthus emblica, Indian Gooseberry, Dhatriphala) 50 3.10 Anar/Dalima (Punica granatum) 50 3.11 Launga/Clove (Syzygium aromaticum) 50 3.12 Gotu Kola (Centella asiatica) 51 3.13 Amra/Mango (Magnifera indica) 51 3.14 Neem (Azadirachta indica) 51 3.15 Tulsi (Ocimum sanctum) 51 3.16 Nilgiri (Eucalyptus globulus) 52 3.17 Tila/Sesame (Sesamum indicum) 52 3.18 Triphala 52 3.19 Tea Tree Oil (Melaleuca Oil) 52 3.20 Rumi Mastagi/Mastic Gum (Pistacia lentiscus) 53 3.21 Wheat Grass 53 3.22 Goldenseal (Hydrastis canadensis) 53 3.23 Licorice Root 53 3.24 Myrrh (Commiphora glileadenis) 54 3.25 Psidium guajava 54 3.26 Ginkbo Biloba 54 3.27 Honey 54 3.28 Other Herbs Which Can Be Potentially Used for Treating Periodontitis 55 3.29 Conclusion 55 References 56 4 Role of Herbal and Natural Products in the Management of Potentially Malignant Oral Disorders 61 P. Kalyana Chakravarthy, Komal Smriti and Sravan Kumar Yeturu 4.1 Introduction 61 4.2 Oral Submucous Fibrosis (OSMF) 62 4.2.1 Background 62 4.2.2 Beta-Carotene 63 4.2.3 Lycopene 64 4.2.4 Aloe Vera 65 4.2.5 Colchicine 66 4.2.6 Tea Pigments 66 4.2.7 Spirulina 66 4.2.8 Chinese Herbal Medicines 67 4.2.9 Turmeric and Derivatives, Nigella sativa, Ocimum 68 4.2.10 Polyherbal Formulations 68 4.2.11 Ayurvedic Formulations 69 4.2.12 Conclusion 69 4.3 Oral Leukoplakia (OL) 70 4.3.1 Background 70 4.3.2 Green Tea and Extracts 70 4.3.3 Beta-Carotene ( C) 71 4.3.4 Lycopene 72 4.3.5 Curcumin 72 4.3.6 Miscellaneous 73 4.3.6.1 Alpha-Tocopherol 73 4.3.6.2 Chinese Herbs 73 4.3.6.3 Bowman-Birk Inhibitor Concentrate (BBIC) 73 4.3.7 Conclusion 73 4.4 Oral Lichen Planus (OLP) 74 4.4.1 Conclusion 75 References 75 Part II: Studies of Plants Used in Dental Disease 81 5 Studies on the Anticariogenic Potential of Medicinal Plant Seed and Fruit Extracts 83 Disha M. Patel, Jenabhai B. Chauhan and Kalpesh B. Ishnava 5.1 Introduction 83 5.2 Materials and Methods 85 5.2.1 Plant Materials 85 5.2.2 Preparation of Plant Seed and Fruit Extracts 85 5.2.3 Cariogenic Bacterial Strains 85 5.2.4 Preparation of Inoculums 86 5.2.5 Anticariogenic Activity Screening of Plant Extracts 87 5.2.5.1 Agar Well Diffusion Assay 87 5.2.5.2 Determination of Minimum Inhibitory Concentration (MIC) 87 5.2.6 Preliminary Phytochemical Analysis 87 5.2.7 Analytical Thin Layer Chromatography 87 5.2.8 TLC-Bioautography 88 5.3 Result and Discussion 88 5.3.1 MIC Value of Effective Plant Extracts 91 5.3.2 Phytochemical Screening and Bioautography 92 5.4 Conclusion 94 Acknowledgments 95 References 95 6 Cytotoxic and Anti-Inflammatory Effect of Turmeric and Aloe Vera in a Gingivitis Model 97 Karen Esperanza Almanza-Aranda, Miguel Aranda-Fonseca, Gabriela Velazquez-Plascencia and Rene Garcia-Contreras 6.1 Introduction 97 6.2 Gingivitis and Periodontitis 98 6.3 Aloe Vera 99 6.3.1 Aloe Vera for Gingivitis and Periodontitis 100 6.3.2 Aloe Vera: Other Oral Applications 100 6.4 Turmeric 100 6.4.1 Turmeric for Gingivitis and Periodontitis 101 6.4.2 Turmeric: Other Oral Applications 101 6.5 Methodology 102 6.5.1 Materials and Methods 102 6.5.1.1 Authorization 102 6.5.1.2 Cell Culture 102 6.5.1.3 Cell Subculture 102 6.5.1.4 Cytotoxicity Test 103 6.5.1.5 Anti-Inflammatory Activity in a Gingivitis Model 103 6.5.1.6 Statistical Analysis 104 6.5.2 Results 104 6.5.2.1 Cytotoxicity 104 6.5.2.2 Anti-Inflammatory Activity in a Gingivitis Model 105 6.5.3 Discussion 105 6.5.3.1 Cytotoxicity 105 6.5.3.2 Anti-Inflammatory Activity 106 6.6 Perspectives for the Future 107 6.7 Conclusions 107 References 107 7 Effects of Bauhinia forficata Link in Reducing Streptococcus mutans Biofilm on Teeth 111 Julio Cesar C. Ferreira-Filho, Mariana Leonel Martins, Andressa Temperini de Oliveira Marre, Juliana Soares de Sa Almeida, Leandro de Araujo Lobo, Adriano Gomes Cruz, Marlon Maximo de Andrade, Thiago Isidro Vieira, Maria Teresa Villela Romanos, Lucianne Cople Maia, Ana Maria Gondim Valenca and Andrea Fonseca-Goncalves 7.1 Introduction 112 7.2 Materials and Methods 112 7.2.1 Recognition, Production, and Chemical Characterization of Ethanolic Tincture From B. forficata L. Leaves 112 7.2.2 Microbial Strains and Preparation of Inoculum 113 7.2.3 Minimum Inhibitory Concentration and Minimum Bactericidal Concentration (MBC) 113 7.2.4 Kill-Kinetic Assay 113 7.2.5 Cytotoxic Potential 114 7.2.6 Tooth Selection and Preparation for Microbiologic Assay Using an S. mutans Biofilm 114 7.2.7 Statistical Analysis 115 7.3 Results and Discussion 115 7.4 Final Considerations 118 Acknowledgments 118 References 119 8 Antimicrobial Effect of a Cardamom Ethanolic Extract on Oral Biofilm: An Ex Vivo Study 121 Marina Fernandes Binimeliz, Mariana Leonel Martins, Julio Cesar Campos Ferreira Filho, Lucio Mendes Cabral, Adriano Gomes da Cruz, Lucianne Cople Maia and Andrea Fonseca-Goncalves 8.1 Introduction 121 8.2 Materials and Methods 122 8.2.1 Cardamom Extract Production 122 8.2.2 Physical Analyses 123 8.2.3 Bacterial Strains and Determination of Minimum Inhibitory Concentration and Minimum Bactericidal Concentration 123 8.2.4 Salivary Collection for Biofilm Formation (Ex Vivo Experiment) 124 8.2.5 Biofilm Formation and Treatment 124 8.2.6 Statistical Analyses 127 8.3 Results and Discussion 127 8.4 Final Considerations 129 Acknowledgment 129 References 129 9 Effect of Punica granatum Peel Extract on Growth of Candida albicans in Oral Mucosa of Diabetic Male Rats 133 Maryam Eidi and Fatemeh Noorbakhsh 9.1 Introduction 133 9.2 Materials and Methods 134 9.2.1 Hydro-Methanolic Extract 134 9.2.2 Candida albicans Inoculation 134 9.2.3 Animal 134 9.2.4 Statistical Analysis 135 9.3 Results and Discussion 135 9.4 Conclusion 136 Acknowledgment 136 References 137 Part III: Applications of Natural Products in Oral Care 139 10 Effect of Oil Pulling on Oral Health 141 Sameer Anil Zope and Siddhartha Varma 10.1 Introduction 141 10.2 What is Oil Pulling (Snaihik Gandoosh)? 142 10.3 How Does Oil Pulling Work? 143 10.4 Composition and Various Activities of Most Commonly Used Oils for Oil Pulling 143 10.4.1 Sesame Oil 143 10.4.1.1 Antioxidant Activity 143 10.4.1.2 Antimicrobial Activity 144 10.4.2 Coconut Oil 145 10.4.2.1 Antibacterial, Antifungal, and Antiviral Activity 145 10.4.2.2 Antinociceptive, Anti-Inflammatory, Antioxidant, and Anti-Ulcer Activity 145 10.5 Procedure of Oil Pulling 146 10.6 Effects of Oil Pulling on Oral Health 146 10.6.1 Dental Caries 146 10.6.2 Plaque-Induced Gingivitis 147 10.6.3 Halitosis 148 10.6.4 Oral Thrush 149 10.6.5 Xerostomia and Burning Mouth Syndrome 149 10.7 Drawbacks of Oil Pulling 150 References 150 11 Role of Proteolytic Enzymes in Dental Care 153 P. Kalyana Chakravarthy and Sravan Kumar Yeturu 11.1 Introduction 153 11.2 Role of Proteolytic Enzymes in Oral Surgery 154 11.2.1 Post-Extraction Management 154 11.2.2 Post-Surgical Facial Ecchymosis and or Edema 155 11.2.3 Enhanced the Action of Antibiotics 156 11.2.4 Effect of Bromelain on Blood Coagulation and Fibrinolysis 156 11.3 Role of Proteolytic Enzymes in Cancer and Oral Mucositis 156 11.3.1 Cancer 156 11.3.2 Management in Oral Mucositis 157 11.4 Osteoarthritis 157 11.5 Anti-Microbial Action 158 11.6 Treatment of Dental Carious Lesions 159 11.6.1 Laboratory Studies 159 11.6.2 Clinical Studies 160 11.7 Improvement in Bonding of Orthodontics Brackets 161 11.8 Role on Biofilm Control (Plaque, Gingivitis, and Oral Malodor) 163 11.9 Extrinsic Stain Removal on the Teeth 164 11.10 Role in Replantation of the Avulsed Tooth 165 11.11 Effect of Bromelain on Immunogenicity 165 11.12 Other Possible Applications and Scope for Future Research 165 References 165 12 The Effect of Probiotic on Oral Health 171 Patricia Nadelman, Marcela Barauna Magno, Mariana Farias da Cruz, Adriano Gomes da Cruz, Matheus Melo Pithon, Andrea Fonseca-Goncalves and Lucianne Cople Maia 12.1 Introduction 171 12.2 Overview of Oral Communities and Probiotic-Based Therapy to Oral Dysbiosis 172 12.3 Probiotics Mechanisms of Action 175 12.4 Dental Caries 176 12.4.1 Definition and Etiopathology 176 12.4.2 Probiotics and Dental Caries 179 12.4.3 Probiotic-Contained Dairy Products and Dental Caries 179 12.4.4 Probiotic Powder and Dental Caries 180 12.4.5 Probiotic Tablets and Lozenges and Dental Caries 180 12.4.6 Probiotic Mouthwashes and Dental Caries 181 12.5 Periodontal Disease 181 12.5.1 Definition and Etiopathology 181 12.5.2 Probiotics and Periodontal Diseases 182 12.6 Oral Candidiasis 183 12.6.1 Definition and Etiopathology 183 12.6.2 Probiotics and Oral Candidiasis 184 12.7 Halitosis 185 12.7.1 Definition and Etiopathology 185 12.7.2 Probiotics and Halitosis 185 12.8 Conclusion 186 Acknowledgments 186 References 186 13 Charcoal in Dentistry 197 Abhilasha Thakur, Aditya Ganeshpurkar and Anupam Jaiswal 13.1 Introduction 197 13.2 Charcoal Production Methods 199 13.2.1 The Traditional Method 199 13.2.2 The Modern Methods 199 13.3 Uses of Charcoal 200 13.3.1 Medicinal Uses 200 13.3.2 Non-Medicinal Uses 201 13.4 Charcoal Containing Oral and Dental Care Products 201 13.5 Benefits of Using Charcoal Containing Oral and Dental Care Products 204 13.5.1 Removes Stains and Whitens Teeth 204 13.5.2 Removes Acidic Plaque 204 13.5.3 Gives Fresh Breath and Improves Halitosis 204 13.5.4 Remineralize Teeth 205 13.5.5 Helps Overall Dental Health 205 13.5.6 Protects From Infection 205 13.5.7 Cost Effective for Regular Basis Use 205 13.6 Precautions to be Taken While Using Charcoal Containing Oral and Dental Care Products 206 13.7 Conclusion 207 References 207 14 Propolis Benefits in Oral Health 211 Mariana Leonel Martins, Karla Lorene de Franca Leite, Yuri Wanderley Cavalcanti, Lucianne Cople Maia and Andrea Fonseca-Goncalves 14.1 Introduction 211 14.2 Types of Propolis 213 14.2.1 Brown Propolis 213 14.2.2 Green Propolis 214 14.2.3 Red Propolis 214 14.3 Biological Properties of Propolis 215 14.3.1 Oral Antibacterial Activity 216 14.3.2 Oral Antifungal Activity 219 14.4 Other Biological Properties of Propolis 220 14.4.1 Anti-Inflammatory Activity 220 14.4.2 Antioxidant Activity 221 14.4.3 Anticancer Activity 221 14.5 Benefits for Oral Health and Applications in Dentistry 221 14.6 Final Considerations 222 Acknowledgment 223 References 223 15 Grape Seed Extract in Dental Therapy 229 Anusuya V, Ashok Kumar Jena and Jitendra Sharan 15.1 Introduction 229 15.2 Part I: Basics About Grape Seed Extracts 230 15.2.1 Components of Grape Seed Extracts 230 15.2.2 Chemical Structure 231 15.2.3 Types of GSEs 232 15.2.4 Methods of Separation 232 15.2.5 Factors Influencing the Quality and Quantity of Polyphenols in the GSEs 234 15.2.6 Physical Properties of Polyphenols 235 15.2.7 Biochemical Properties (Biological and Pharmacological) 236 15.3 Part II: Biological Applications in Dentistry 240 15.3.1 GSEs in Dental Caries 240 15.3.2 Anti-Erosive Agent (Prevention of Enamel erosion) 242 15.3.3 Antiplaque Effect 243 15.3.4 Antibacterial Agent 244 15.3.5 Biomodifier 245 15.3.6 GSEs as a Remineralizing Agent-Existing Dilemma 247 15.4 GSEs in Restorative Dentistry 248 15.4.1 GSE as Cross-Linking Agent 248 15.4.2 GSE in Bonding 249 15.5 GSEs in Endodontic Treatment 250 15.5.1 Endodontic Irrigants 250 15.5.2 Post Endodontic Restorations 251 15.6 GSEs in Periodontics 251 15.6.1 Anti-Inflammatory Action in Periodontitis 252 15.6.2 Anti-Oxidative Action in Periodontitis 252 15.6.3 Antibacterial Action Against Periodontal Pathogens 253 15.6.4 Antimicrobial Activity in Peri-Implantitis 253 15.7 GSEs in Oral Cancer 254 15.8 Conclusion 254 References 255 16 Ocimum Sanctum L: Promising Agent for Oral Health Care Management 259 Trinette Fernandes, Anisha D’souza and Sujata P. Sawarkar 16.1 Introduction 259 16.2 History of Ocimum sanctum 260 16.3 Chemical Constituents of Ocimum sanctum 260 16.4 Therapeutic Significance of Ocimum in Dental Health and Preventive Care Management 262 16.5 Novel Drug Delivery Formulations and Its Application in Dentistry 264 16.5.1 Nanofibers 264 16.5.2 -Cyclodextrin Complexes 264 16.5.3 Nanoparticles of Biocompatible Ocimum sanctum-Coated Silver Nanoparticles 264 16.6 Conclusion 265 References 266 17 Coconut Palm (Cocos nucifera L.): A Natural Gift to Humans for Dental Ministrations 271 Navneet Kishore and Akhilesh Kumar Verma 17.1 Introduction 271 17.2 Traditional Usage and Ethnopharmacological Relevance 272 17.3 Pharmacological Properties of Coconut 273 17.4 Role of Coconut Tree in Dental Ministrations 274 17.5 Exemplary Potential of Coconut Water in Dentistry 275 17.6 Other Significance of Coconut 276 17.6.1 Economic Value of Coconut Leaves 276 17.6.2 Use of Coconut Heart 277 17.6.3 Significance of Spathe and Inflorescence 277 17.6.4 Potential of Coconut Fruits 277 17.6.5 Usage of Coconut Milk 277 17.6.6 Importance of Coconut Shell 277 17.6.7 Commercial Usage of Husk Fibers 278 17.6.8 Economic Importance of Coconut Stems 278 17.6.9 Convention of Coconut Roots 278 17.7 Active Constituent Identified from Coconut 278 17.8 Future Prospective 279 17.9 Conclusions 280 Acknowledgments 280 References 281 18 Salvadora persica L. (Miswak): An Effective Folklore Toothbrush 285 Sujata P. Sawarkar, Anisha D’souza and Trinette Fernandes 18.1 Introduction 285 18.2 History 286 18.3 Chemical Constituents 286 18.4 Extraction, Isolation, Identification of Chemical Constituents 287 18.5 Pharmacology-Therapeutic Activity of Salvadora persica L. 287 18.5.1 Theories for Miswak Activities 287 18.5.2 Antibacterial and Antifungal 288 18.5.3 Anti-Viral Effect 290 18.5.4 Anti-Cariogenic Effect 290 18.5.5 Antiplaque Effect 290 18.5.6 Antiperiodontitis Effect 290 18.5.7 Whitening Effect 291 18.6 Conclusion 292 References 292 19 Triphala and Oral Health 297 Kamal Shigli, Sushma S Nayak, Mrinal Shete, Vasanti Lagali Jirge and Veerendra Nanjwade 19.1 Introduction 297 19.2 Taxonomical Classification 298 19.3 Chief Phytoconstituents 298 19.4 Role of Triphala in Dentistry 300 19.4.1 Anti-Caries Activity 300 19.4.2 Triphala as a Root Canal Irrigant 300 19.4.3 Anti-Microbial and Anti-Oxidant Effect of Triphala 306 19.4.4 Role of Triphala in Periodontal Diseases 306 19.4.5 Triphala as a Mouth Rinse 306 19.4.6 Anti-Candida Activity of Triphala 306 19.4.7 Anti-Collagenase Activity of Triphala 306 19.5 Pharmacological Activities of Triphala and Future Research 307 19.5.1 Anticancer and Antioxidant Activity of Triphala 307 19.5.2 Wound Healing Properties 307 19.5.3 Antibacterial Activity of Triphala 307 19.5.4 Anti-Diabetic Effect 307 19.5.5 Anti-Inflammatory, Analgesic, and Antipyretic Effect 307 19.5.6 Immunomodulatory Effect 308 19.6 Public Health Importance 308 19.7 Formulation Using Triphala 308 19.6 Conclusion 308 References 309 20 Azadirachta indica (Neem): An Ancient Indian Boon to the Contemporary World of Dentistry 313 Sri Chandana Tanguturi, Sumanth Gunupati and Sreenivas Nagarakanti 20.1 Introduction 313 20.2 Vital Bioactive Compounds of Neem 314 20.2.1 Nimbidin 314 20.2.2 Azadirachtin 315 20.2.3 Nimbolide 315 20.2.4 Gedunin 315 20.2.5 Mahmoodin 315 20.2.6 Tannins 315 20.2.7 Diterpenoids 315 20.3 How to Distinguish Azadirachta Indica (Neem) from its Common Adulterant Melia Azedarach 316 20.4 Therapeutic Applications of Neem 316 20.4.1 Neem as an Anti-Inflammatory, Analgesic Agent 317 20.4.2 Antioxidant Activity 317 20.4.3 Anticancerous Activity 317 20.4.4 Antimicrobial Activity 318 20.4.4.1 Antibacterial Activity 318 20.4.4.2 Antiviral Activity 318 20.4.4.3 Antifungal Activity 318 20.4.4.4 Antimalarial Activity 318 20.4.5 Wound Healing Effect 318 20.5 Applications of Neem in Dentistry 318 20.5.1 Neem in Treatment of Periodontal Diseases 319 20.5.2 Role of Neem in Endodontics 319 20.5.3 Potent Role of Neem in Preventive Dentistry 320 20.5.3.1 Application in Dental Erosion Therapy 320 20.5.3.2 Anti-Microbial Activity 320 20.5.3.3 Anticaries Activity of Neem 320 20.5.3.4 Anti-Candidiasis Property 321 20.5.3.5 Anti-Cancer Property 321 20.6 Literature Supporting the Use of Neem in Dentistry 321 20.7 Toxicity and Safety 322 20.8 Contamination and Adulteration 322 20.9 Drug Interactions 322 20.10 Neem’s Prospects in Dentistry 323 20.11 Action Points and Recommendations for Health Care Professionals 323 20.12 Conclusion 323 References 324 21 Ginger in Oral Care 329 Aditya Ganeshpurkar, Abhilasha Thakur and Anupam Jaiswal 21.1 Introduction 329 21.2 Description 330 21.3 Macroscopic Characteristics 330 21.4 Pharmacognostic Standards 330 21.5 Nutrient Composition 331 21.6 Pharmacological and Medicinal Effects 331 21.6.1 Oral Analgesic Effect 331 21.6.2 Antimicrobial Effect 332 21.6.3 Anti-Carries Activity 333 21.6.4 Anti-Decay Effect 333 21.6.5 Healing Effect in Root Canal Therapy 334 21.6.6 Anti-Xerostomia Effect 334 21.6.7 Anti-Pyorrhea Effect 335 21.6.8 Anti-Thrush Effect 335 21.6.9 Anti-Herpes Effect 336 21.6.10 Tooth Polishing 336 21.6.11 Mouth Deodorizing Effect 336 21.6.12 Anticancer Effect 338 21.6.13 Protection Against Aphthous Stomatitis 338 21.6.14 Effect on Dentin Hardness 338 21.7 Pharmacokinetics 339 21.8 Toxicological Studies 339 21.9 Conclusion 339 References 340 22 Effectiveness of Allium sativum on Bacterial Oral Infection 345 Vesna Karic, Anupam Jaiswal, Heidi Abrahamse, Abhilasha Thakur and Aditya Ganeshpurkar 22.1 Introduction 345 22.1.1 History and Origin of Garlic 347 22.1.2 Medicinal Values of Garlic 348 22.2 Types of Allium sativum 349 22.2.1 Allium sativum Ophisocorodon/Hard-Necked Garlic 349 22.2.2 Allium sativum Sativum/Soft-Necked Garlic 349 22.3 Chemical Constituents 351 22.3.1 Allicin 351 22.3.2 Ajoenes 351 22.3.3 Alliin 351 22.4 Dental Infections and Epidemiology 352 22.5 Dental Infection and Antibiotic Resistance 352 22.6 The Antibacterial Application of Garlic in Dentistry 354 22.6.1 The Use of Garlic to Treat Oral Infections 354 22.6.1.1 Periodontitis 354 22.6.1.2 Pediatric Endodontitis 35

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