Oral health is a core indicator of a healthy lifestyle. Poor oral hygiene can give rise to the development of harmful bacteria that not only cause dental cavities or gum diseases, but also may lead to heart diseases, lung diseases, stomach diseases, and cancer. According to the Global Burden of Disease Study 2017, around 3.5 billion people globally suffer from oral diseases. And, another shocking fact is that about 30% of people aged between 65-74 years suffer from the condition of toothlessness.

Maintaining a healthy lifestyle contributes to exceptional oral health. But, unfortunately, people often neglect the importance of lifelong commitment to good oral health. Some of the worst practices followed across the globe are brushing your teeth using unnatural toothpaste, smoking and drinking frequently, unhealthy diets, and the use of medications that decrease the quantity of saliva. These unhealthy practices lead to oral problems such as bad breath, bleeding or swollen gums, ulcers or sores, dry mouth, toothache, and so on. Neglecting these symptoms result in severe oral diseases.

In this feature, we aim at lifting the lid on the oral structure and the oral diseases associated with it. And, most importantly to share the best ayurvedic practices for your tooth and gum care.

• Oral Structure
• Oral Diseases
• Ayurvedic Herbs and its Oral Health Benefits

Oral Structure

Before getting into oral diseases and their prevention, it is necessary to understand the buccal cavity structure. Let’s discuss the structure:

• Teeth
• Periodontium
• Tongue
• Salivary glands

Teeth

Teeth are of different types that have different functions. In the case of canine teeth, they are sharp and pointed out that tear the food apart. Whereas, molar teeth are flatter, and its function is to chew the food.

Based on the type, number, and arrangement of natural teeth, there are two types of tooth dentition:

• Deciduous dentition (20 baby teeth): It consists of incisors, canines, and molars.
• Permanent dentition (32 adult teeth): It consists of incisors, canines, premolars, and molars.

Tooth Structure

The tooth structure consists of different hard layers that protect the inner pulp – nerves and blood vessels. And, they can be categorized as Enamel, Dentine, and Cementum. This hard tooth structure consists of organic and inorganic matter.

Here organic defines the living structure of teeth such as water, cells, fiber, and proteins. And, inorganic means the non-living matter – minerals – that gives strength to the teeth. Let’s discuss this in detail.

• Enamel
• Dentine
• Cementum
• Pulp

Enamel

Enamel is made up of crystals of hydroxyapatite called prisms that provide its strength. These prisms are supported by organic materials, mainly keratinized cells.

According to studies, enamel has 96% inorganic matter and 4% organic matter. It is the hardest substance in the human body and is insensitive to hot, cold, or sweet substances. But, it can cause fractures due to dentine decay and also darkens with age due to tannin-rich foods, drinking, smoking, and so on.

Dentine

It has millions of microscopic tubules that comprise the main bulk of the teeth. Dentine has 70% inorganic and  30% organic matter. Dentine is softer than enamel but harder than cementum and bone. It is sensitive to hot, cold, and sweet substances. And it has a light yellowish color.

Cementum

It coats the surface of the root, and it has 45% inorganic and 55% organic matter. Its hardness is similar to bone, and it protects the root from wear and tear that occurs due to chewing and movement.

Pulp

It is a soft living tissue that consists of blood vessels, nerves, fibers, and cells. The pulp is placed within the pulp chamber and root canal of the tooth.

Periodontium

Periodontium comprises the following:

Periodontal ligament
It is a connective tissue that keeps the tooth in the alveolar bone. Periodontal ligament contains blood vessels, nerves, cells, and collagen fibers.

Cementum
Cementum acts as a supporting structure for the tooth.

Alveolar bone
Alveolar bones are projections of the upper jaw and lower jaw.

Gingivae (gums)
Gingivae consists of mucous membranes and fibrous tissue, and It has four sections. They are attached gingiva, free gingiva, gingival crest, mucogingival junction.

Tongue

The tongue is a muscular, mobile organ that has four surfaces. They are:

• Dorsal (upper)
• Ventral (under)
• Tip
• Root

And, there are two groups of tongue muscles. They are intrinsic (inside) and extrinsic (outside). The main functions of the tongue are taste, mastication (chewing), deglutition (swallowing), speech, cleansing, and protection.

Conditions that affect the tongue

Let’s look into the conditions that affect the tongue:

• Glossitis (inflammation of the tongue): It can be due to dry mouth, infections, vitamin B12 deficiency, lichen planus, and so on.
• Soreness of the tongue: It can be due to anemia, vitamin B deficiency, and hormonal imbalances.
• Black hairy tongue: Chromogenic bacteria, medication or smoking causes black hairy tongue.
• Geographic tongue: It is the irregular areas on the dorsal surface.

Salivary Glands

Saliva is important for the oral cavity and to the whole body as well. Salivary glands produce saliva.

The three major salivary glands are:

• Parotid gland: It produces serous saliva that contributes 25% of the total amount of saliva. Parotid glands are the largest salivary glands.
• Submandibular gland: It consists of a mixture of serous and mucous saliva, and contributes 70% of total saliva.
• Sublingual gland: It produces 5% of total saliva, and it is mainly in the form of mucous.

Functions of Saliva

The functions of saliva are as follows:

1. Mucous in saliva helps to form the food bolus that aids mastication and deglutition.
2. It has antibacterial properties that maintain oral hygiene.
3. Saliva helps taste buds to recognize the taste, by dissolving substances.
4. Maintains the water balance by producing thirst
5. Helps digestion
6. Maintains the pH of the mouth

Oral Diseases

Numerous factors cause oral disease: genetic, environmental, diet, lifestyle, and so on. Let’s discuss the different type of oral diseases in detail

• Caries
• Tooth surface loss
• Sensitivity
• Xerostomia
• Aphthous Ulcers

Plaque

Plaque is a soft, non-classified adherent film that is found on the surface of the teeth. Mostly, it is found on occlusal pits and fissures, cervical margins of the teeth, and in periodontal pockets.

Plaque consists of 70% of microorganisms (bacteria, fungi, virus) and 30% of matrix – proteins, carbohydrates, red blood cells, white blood cells, enzymes, toxins, lactic acid and mineral salt.

The bacteria in plaque form new colonies by consuming carbs and sugars. It releases an acid during metabolism, and this acid destroys the enamel and the roots of the teeth.

Calculus

Calculus is a mineralized deposit of calcium salts; it attracts more plaque and results in periodontal disease. Calculus consists of 70% inorganic salts and 30% of microorganisms.

Calculus is of two types –  supragingival calculus and subgingival calculus. Supragingival calculus affect above the gingival margin and subgingival is seen in the periodontal pocket. 

Staining

Staining can be classified as intrinsic staining and extrinsic staining.

Intrinsic staining occurs in the tooth structure during the teeth development process. Major causes of intrinsic staining are:

• Due to antibiotics, taken by a small child or passed to the fetus during pregnancy.
• Excess fluoride intake.
• Inherited imperfections in enamel or dentine.
• Death of a pulp

Extrinsic staining occurs on the enamel of teeth, and it is caused by tannin (tea/coffee), tobacco, iron supplements, chlorhexidine, and so on.

Chronic Gingivitis

Chronic Gingivitis is a condition that refers to continuous gum inflammation. Since it rarely causes pain, most of them neglect it and hence lead to serious issues.

Due to poor oral hygiene, plaque bacteria release toxins that cause chronic gingivitis. Other factors include malpositioned teeth, implants, calculus, hormone changes, drugs, and so on. Some of the signs of chronic gingivitis are:

• Rubor (Redness) and Tumor (Swelling)
• Bleeding on brushing
• Calor (temperature increase in tissue)

Chronic Periodontitis

Chronic Periodontitis is the inflammation of the gums, followed by the destruction of the periodontium. It can be characterized as follows:

• Periodontal probing
• Loss of bone support
• Loose teeth

The main reason for chronic periodontitis cause is due to the release of enzymes and toxins by mature plaque bacteria. As goes on, it breaks down the tissues of the periodontium.

Another factor is smoking; Smoking reduces the blood flow in the gingivae and impairs healing. It also increases cytokines (inflammatory substances)

And, few other factors are poor oral hygiene, age, crowding and malocclusion, cavities, and so on.

During the early stage, patients may experience gums recede, hot and cold-sensitive teeth, and also feel bad taste (due to the accumulation of bacteria). During a later stage, patients experience loose teeth, pain, and pus oozing from pockets. And, more aggressive periodontitis results in rapid loss of attachment, destruction of the periodontal ligament, and underlying bones.

Necrotising Ulcerative Gingivitis (NUG)

NUG is one of the worst oral cavity illnesses that can make the patient feel extremely uncomfortable. It is mainly caused by anaerobic bacteria – Treponema denticola -, invades oral tissue.

It can result in acute inflammation and bleeding, sloughing ulcers, halitosis, swollen glands, general malaise. And, finally, it leads to the destruction of tissues and permanent loss of interdental papillae.

Caries

Caries is the destruction of enamel, dentine, and cementum due to microbial activity. This destruction happens mainly due to the consumption of sugar or fermentable carbohydrates.  Here bacteria, such as streptococcus mutans and lactobacilli, produces lactic acid and reduce the pH level of the mouth

When the pH level reduces to 5.5, an acid attack occurs. As a result, calcium hydroxyapatite releases from the enamel and dissolves into the saliva as calcium and phosphate ions. This process is called demineralization, the first stage of caries. The stages of caries as follows:
Small pit -> Blue/white lesion -> Open cavity -> Pulpitis -> Apical abscess  

Tooth Surface Loss

It is the loss of dental hard tissue (not caused by bacteria). There are 4 main types of TSL.

• Erosion: It is caused due to the high acidity
• Attrition: This type of loss is caused by friction due to tooth-to-tooth contact.
• Abrasion: It describes the loss due to outside factors such as destructive toothbrushing techniques, oral and facial piercing, and so on.
• Abfraction: It is the loss of tooth enamel and dentine due to the biomechanical loading force that results in tooth flexure.

Sensitivity

It is a chronic dental condition where you feel a sharp pain arising from exposed dentine due to external stimuli. Some of the external stimuli are cold air, hot/cold foods and drinks, sweet foods, and chemicals.

It mainly occurs on the buccal and labial surfaces of cervical margins. The permanent canines and premolars are the most affected teeth.

Xerostomia

A decrease in the flow of saliva causes insufficient oral secretion. This condition leads to Xerostomia. Some of the factors that cause Xerostomia are age, drugs, anxiety, acute illness, salivary calculi, and so on.

Aphthous Ulcers

It can affect the non-keratinized mucosa, tongue border, floor of the mouth, lips. Some of the reasons for its cause are chemical reaction (sodium lauryl sulfate in toothpaste), vitamin or mineral deficiency (B12, zinc, iron, folic acid), gastrointestinal disease, stress, and so on.

Ayurvedic Herbs and its Oral Health Benefits

Our mouth contains over 700 types of bacteria. It includes both good bacteria and bad bacteria. Good bacteria produce hydrogen peroxide that controls the growth of bad bacteria. But, using unnatural toothpaste, mouthwashes, and antibiotics causes the elimination of good bacteria. In the long run, the strains of these bad bacterias develop resistance against antibiotics and grow abundantly. Here, we will reveal the best ayurvedic herbs for your tooth and gum care that can prevent the growth of bad bacterias and can nourish the good bacterias.

Cloves

Clove is an aromatic dried flower bud, and it is one of the natural immune-boosting remedies. During the ancient days, clove is mainly used to control mouth odor and pain. The eugenol, one of the main components of the clove, has pain-relieving and antiseptic properties.

Let’s look into the oral health benefits of the clove.

• Fight toothache, foul breath, and cavity.
• Reduces the bacteria that cause gum disease.
• Reduces gum swelling.
• Remineralize teeth and protect against acid attack.
• Stimulates circulation and enhances gum tissue health.
• It relieves pain from tooth sensitivity.

Spearmint

Spearmint is also known as garden mint that has a sweet taste. It provides a flavor to toothpaste and also freshens the breath. It also has numerous other oral health benefits.

• It reduces gum diseases and gingivitis.
• The terpenoid carvone, a component of spearmint, acts as an antitumor.
• It shows excellent antimicrobial activity – it acts against gram-positive bacteria.
• Reduces gum bleeding.
• Relaxes the gum tissues.

Ginger

Ginger contains hundreds of compounds and metabolites that contribute to health and healing. Ginger provides amazing oral health benefits such as strengthen your teeth, gum line and also has teeth whitening properties.

Tea Tree Oil

Tea tree oil or melaleuca oil has antimicrobial, antifungal, antiviral, antioxidant, and anti-inflammatory properties. Terpinen-4-ol compounds in tea tree oil promote healing and fight against fungal biofilms. And, cineole compounds in tea tree oil has disinfectant properties. The benefits of tea tree oil as follows:

• It prevents adhesion of periodontopathic and cariogenic bacteria – P.gingivalis and S.mutans.
• It is used in the treatment of aphthous ulcers, herpes simplex virus, dental pain, and periodontitis.

Camphor

Camphor is extracted from the bark of Cinnamonun camphora. It acts as a cooling agent, pain killer, relieves toothache, and prevents germs. 

Neem

Neem has amazing medicinal benefits. It has anti-bacterial, anti-carcinogenic, anti-helminthic, anti-diabetic, anti-oxidant, astringent, ant-viral, cytotoxic, and anti-inflammatory activity. Neem boosts up the immunity in gum, and tissues of the mouth. It plays a major role in curing mouth ulcers, tooth decay, and acts as a pain reliever.

Let’s look into its dental applications.

• The antimicrobial property of Neem fights against S.mutans and S.faecalis.
• It works against C.albicans that prevent colonization by Candida Albicans.
• It helps in treating dental caries.
• Neem fight against dental plaque.
• It can prevent gingivitis and also reduces the bad salivary bacterial count.

Eucalyptol

Eucalyptol is an antibacterial agent that penetrates deep to fight against plaque and keep your mouth clean. It reduces the inflammation and also increases the healing activity.

Tulsi

Tulsi is considered as a sacred plant and is also known as Holy Basil, the queen of herbs.

Tulsi has numerous oral benefits.

It acts against toothache
Eugenol in tulsi acts as a COX-2 inhibitor that works against toothache.

Prevents Oral Infections
Carvacrol and Terpene are the antibacterial agents present in tulsi, which provides effective treatment against oral infections.

Effective against Candidiasis
Tulsi is also well known for its antifungal activities. It is effective against candida that causes oral candidiasis.

Treats Aphthous Ulcers
Anti Ulcer properties of Tulsi helps to treat Aphthous Ulcers.

It can treat oral precancerous lesions
The polyphenol rosmarinic acid in tulsi acts as a powerful antioxidant, which helps treat oral precancerous lesions – Leukoplakia and oral submucous fibrosis.

Tulsi prevents Periodontal diseases
The anti-inflammatory properties of tulsi are effective against Gingivitis and Periodontal diseases.

Mulethi

Mulethi or Liquorice is effective in treating oral and dental issues such as oral candidiasis, aphthous ulcer, caries, and periodontitis. It has a sweet-tasting bio ingredient called Glycyrrhizin. This bio ingredient provides freshness and natural sweetness and also exhibits anti-cariogenic properties.

Peppermint

We all know peppermint acts as a mouth freshener. But, it also offers numerous benefits for your oral health. It ensures an effective treatment against anaerobic bacterias that grow in a low oxygen environment. It plays a major role in post teeth extraction by preventing swelling and bleeding.

The potassium, magnesium, calcium, iron, and phosphorous in peppermint increases the bone density of tooth and jaw. Whereas minerals and vitamins help in the formation of enamel. The alkaline nature of peppermint controls the effect of acidic nature. Not only it benefits teeth but also contributes to the production of saliva and enzymes.

References

1. Ayurveda Encyclopedia : Natural Secrets to Healing, Prevention, & Longevity
2. Felton, Simon, and Alison Chapman. Basic Guide to Oral Health Education and Promotion, John Wiley & Sons
3. https://www.todaysrdh.com/oral-benefits-of-tea-tree-oil/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441161/
5. https://www.gijhsr.com/GIJHSR_Vol.3_Issue.4_Oct2018/7.pdf
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095623/
7. https://www.ncbi.nlm.nih.gov/books/NBK92775/

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