ABSTRACT
Periodontal disease is a chronic inflammatory disease which destructs the supporting structures of the tooth and causes tooth loss. Dental plaque is the most common causative agent for periodontal diseases. Based on the location, dental plaque are of two types – supra gingival and sub gingival plaque. Supra gingival plaque is responsible for caries and gingival disease whereas sub gingival plaque is responsible for periodontal destruction. Plaque control can be achieved by combination of mechanical and chemical methods. Mechanical methods aid in removing the irritants during initial phase of treatment, and to maintain the condition, chemical methods like mouthwash, floss and interdental brushes were used. Chlorhexidine is the most commonly used antimicrobial mouthwash for many periodontal conditions and it is known for its substantivity property. Although it has various advantages, prolonged usage of chlorhexidine causes sensitivity of teeth and other side effects. Most of the researches were performed to find an alternative to chlorhexidine mouthwash to overcome its side effects and they believed that herbal mouthwashes with various combinations can be used for prophylactic measures which has no side effects and also act as good anti-microbial agents. Herbal mouthwashes contain phytochemicals that contains anti-microbial and anti-inflammatory effect which works without alcohol, artificial preservatives, flavour, or colours. “Triphala” is among the most common formulas used in traditional ayurvedic medicine. It contains fruits of three trees, and they are Indian gooseberry Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica), and Haritaki (Terminalia chebula). It has anti-plaque effect due to the presence of tannic acid which adheres to the bacterial cell surface and causes protein denaturation and ultimately to bacterial cell death. Triphala also has antioxidant, anti-inflammatory, anti-collagenase activity. It inhibits the collagenases derived from leukocytes which are responsible for connective tissue destruction in periodontal disease. Hence the usage of Triphala mouthwash treatment of periodontal disease becomes significant. The reason for this review is to give detailed information about the effects of Triphala mouthwash in periodontal disease. Most commonly chlorhexidine mouthwash is used in periodontal therapy even though it has several disadvantages. This review helps in providing effects comparatively similar to chlorhexidine without any adverse effects.