A review on four medicinal plants in dentistry

Dental caries and periodontal problems still remain a global health care burden. In developing and underdeveloped countries, the unmet treatment needs of a large part of population is a challenge to the service providers. WHO believes that oral health is a right to everyone. The use of traditional medicine helps in achieving these goals to a large extent. Medicinal plants are a basis for conventional medicine and a substitute for them. Thus, it becomes a matter of importance to have a greater understanding of the pharmacologically active components of the herbal components and their various uses in dentistry. This article aims to understand the phytotherapeutic uses of four commonly used herbal plants, miswak, moringa, triphala and neem.

A Case Study on Ayurvedic Management in Insulin Resistance in Polycystic Ovarian Disease

Polycystic ovarian disease is highly prevalent hormonal and metabolic disorder among reproductive aged women worldwide characterised by hyperandrogenism, chronic anovulation and polycystic ovaries. Insulin resistance is now recognised as a basic underlying pathology of PCOD and found in approximately 50-70% of patients. It is defined as a state in which greater than normal amounts of insulin are required to produce a quantitatively normal response. It is associated with an increased risk of various metabolic disorders including type 2 diabetes mellitus, hypertension, dyslipidaemia and cardiovascular diseases, which indicates that timely therapeutic intervention in PCOS could prevent or at-least delay the onset of type 2 diabetes mellitus and other long-term health risks. Most of the features of PCOD associated with insulin resistance can be found under Santharpanajanya vyadhis with involvement of three Doshas and Dhathus like Rasa, Raktha and Medus. Here is a case report of 18-year-old female who presented with irregular menstruation, rapid weight gain and blackish discoloration of back of neck. Her USG findings shows bilateral polycystic pattern of ovaries. Based on clinical features and laboratory values, treatment principles adopted are Agni deepana, Ama pachana, Vatha-kaphahara and Lekhana. Varanadi kashyam and triphala choorna with takra given internally for 3 months and Udwartana was done externally for 14 days. After 3 months of treatment considerable reduction in weight and improvement in insulin resistance were noticed and her menstrual periods were normal with normal USG findings. The present case signifies the importance of Ayurvedic management in insulin resistance of PCOD to prevent forthcoming complications.

Review on Effects of Triphala in Patients with Periodontal Disease

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.

Effect of herbal combination of triphala and Garcinia cambogia extracts on liver function test and kidney function test in high fat diet induced obesity in rats

Background: Obesity, a global epidemic, is a major risk factor for diabetes mellitus and cardio vascular diseases. Despite advances, the pharmacotherapy for obesity remains limited. Almost all medications for long term management of obesity have health issues. Due to the adverse drug reactions (ADRs) associated with many antiobesity medicines, the clinical trials are focussing on screening herbal medicines for use in the treatment of obesity, which have minimal ADRs.Methods: Rats were divided into eight groups of six each. The rats were first made obese by feeding high fat diet (HFD) for three weeks. Then treatment with the herbal extracts was given simultaneously with the HFD to the experimental groups. Rats were fed HFD for six weeks along with herbal extracts and the effect on their liver function test and kidney function test were evaluated.Results: The rats fed HFD and supplemented with herbal preparations of Triphala and G. cambogia for six weeks, showed significant improvement in liver function test and kidney function test related parameters as compared to the control group rats fed with HFD alone.Conclusions: Triphala and G. cambogia can counter the effects of HFD intake and have the potential for use as anti-obesity agents with desirable liver function test and kidney function test related parameters modulating properties.

Immunomodulatory Activity Of Chaturthamalaka Rasayana: An Experimental Evaluation

Triphala, a simple combination of Amalaki, Haritaki and Bibhitaki, have proven antioxidant and immunomodulatory activities. But, work on Chaturthamalaka Rasayana, containing Triphala, under four alternate combinations, was not found reported yet. For this, a study was conducted to evaluate the effect of different four combinations under Chaturthamalaka Rasayana on leucocytes and immunoglobulin with special reference to immunomodulatory activity in albino wistar rat model. Four combinations of test drugs were prepared as per classical textual guidelines mentioned in Charaka Samhita. 36 wistar strain albino rats were used in the study. Immunosuppression done by Cyclophosphamide which induced neutropenia. Total leucocyte count (TLC) (cells/mm3), % Neutrophil count and Serum immunoglobulin level (in ZST units) were parameters used to evaluate. All the data were collected and analysed using paired‘t’ test and one way ANOVA test, followed by Dunnett’s multiple comparison ‘t’ test. All the test formulations showed much better effect in comparison with the improvement noted in control group, as a cytoprotective agent. However, with respect to immunostimulation, the control group showed better effect in comparison to the test formulation. Chaturthamalaka Rasayana possesses significant cytoprotective activity and moderate immunostimulant activity. Among the four combinations, all test samples were found effective in immunosuppressive rats. Test sample IV containing Amalaki, Haritaki and Bibhitaki found more potent than or as similar as response in comparison of standard group (Levamisole). Chaturthamalaka Rasayana might be consider as a cost effective and adulteration free alternative formulation over used of costly Chyavanaprasha Avaleha.

Effect of herbal combination of triphala and garcinia cambogia extracts on anthropometric measurements and lipid profile in high fat diet induced obesity in rats

Background: Obesity, occurring at epidemic rates globally, is a major risk factor for DM and CVD. Despite advances in understanding its pathogenesis, the pharmacotherapy for obesity remains limited for achievable weight loss, safety and tolerability of the medicines. Almost all approved medications for long term use in obesity treatment result in health issues. Due to the ADRs associated with many antiobesity drugs, the drug trials have focused on screening herbal medicines that are reportedly used in the treatment of obesity and which have minimal side effects.Methods: In this study rats were divided into eight groups of six rats each. In the first approach, the rats were first made obese by feeding HFD for three weeks. In the second, treatment with the herbal extracts was given simultaneously with the HFD to the experimental rats. Rat were fed HFD for six weeks along with treatment of herbal extracts and the effect on their body weight, daily food intake and lipid-profile were evaluated.Results: Results showed that rats fed HFD for a six week period, supplemented with herbal preparations of triphala and G. cambogia presented with significant reduction in body weight, energy intake, and improved the lipid-profile as compared to the rats fed with HFD group.Conclusions: Our findings suggest that triphala and G. cambogia can counter the effects of HFD intake and have the potential for use as antiobesity agents with desirable body weight, food intake, fluid intake, and lipid-profile modulating properties.

Pharmaceutical Evaluation Of Chaturthamalaka Rasayana-an Ayurveda Compound

In Ayurveda, Rasayana is mentioned as a unique preventive as well as curative therapy to achieve healthy long life. The modern medical world is seeking for an alternative class of immunomodulatory drugs, which is nothing but the category of Rasayana. Among this Rasayana formulation, Chaturthamalaka Rasayana (CR) is the one that formulation, mentioned just after Chyavanprasha Avaleha in classical literature of Charaka Samhita. CR consists of four formulations. It is nothing but the simple permutation and combination of Amalaki (Emblica officinalis Gaertn.), Bibhitaki (Terminalia bellerica Roxb.) and Haritaki (Terminalia chebula Retz.) collectively called as Triphala. In present study, it was prepared according to the classical standard operative procedure (SOP) so as to evaluate a physicochemical and phytochemical profile of CR as per standard lab protocols, for all the four formulations under CR, along with the main three raw drugs which ensure the quality. This pharmaceutical analysis differentiates one compound from another by developing its identification markers. As the CR has not been yet studied before, it will be more helpful to evaluate the pharmaceutical screening of this four formulations as an initial step towards standardization. In the future, this study will be helpful to prepare the monograph of CR in the Ayurvedic formulary of India (AFI).

The Effect of Triphala and Chlorhexidine Mouthwash on Dental Plaque and Gingival Inflammation

Introduction: Mechanical removal of plaqueby means of brushing and flossing is time-consuming and is also technique sensitive. Hence, effective plaque control of 100% may not be rendered always by these techniques. Adjuncts in the form of medication or mouthwashes are always recommended to assist tooth brushing in plaque control. The use of herbal mouthwashes has been a boon to control the oral health-related problems. Triphala is one of the best-known combinations used for various ailments in Ayurveda. The present study is thus aimed at comparing chlorhexidine and triphala,asan anti-plaque agent, and for treating gingivitis among adult patients. Materials and Methods:Atotal of 210 patients were randomly divided into three groups: Group 1: Chlorhexidine (0.2%) Group 2: Triphala (0.6%) Group 3: Control group with no mouthwash. The examinations were done at baseline, 7 days, and 15 days using the gingival index and plaque index.Chi-square test was used to compare the inter- and intra-group findings usingSPSS 20.0 (Chicago, U.S.A). Results:Even though a higher percentage of patients showed greater improvement with Group 2 intervention than Group 1, the difference was not found to be statistically significant after 7 days of observation. After 15 days, the Group 2 patients showed lesser plaque accumulation compared to Group 1, yet this difference was not found to be statistically significant. With respect to gingivitis, even though more patients were showed improvement with respect toGroup 2 than Group 1 after 7 days and 15 days of observation, the difference was not found to be significant. Overall, the intervention with triphala provided better results than with chlorhexidine, but this was not statistically significant. Conclusion: Triphala and chlorhexidine help as an adjunct to toothbrushing for the control of plaque and resultant gingivitis. Triphala can be used as a substitute to avoid the side effects of the long-term use of chlorhexidine.

Research Process of Chemical Constituents and Pharmacological Effects of Tibetan Medicine Triphala / 世界科学技术-中医药现代化

Triphala consists of Terminalia chebula Retz, Terminalia bellirica (Gaertn.) Roxb. and Phyllanthus emblica L, which are made into Dasanguo Powder. Triphala is rich in a variety of chemical components, including tannins, phenolic acids, triterpenoids and flavonoids. The content of tannin is abundant in Triphala, which are often used as the main indicators of analysis. Modern research found that Triphala has a variety of pharmacological activities such as prevention of gastrointestinal diseases, antibacterial, anti-inflammatory, anti-oxidation, anti-tumor and so on. This paper briefly summarized the chemical constituents and pharmacological effects of Triphala, combining the relevant national and international literature in recent years to provide reference for the development and further study of Triphala.

Comprehensive Evaluation of the Quality of Tibetan Medicine Triphala's Tannin Parts Based on There Characteristic Components and the Total Tannin Content / 世界科学技术-中医药现代化

To determine there characteristic components content of Tibetan Medicine Triphala through establishing a HPLC method and its total tannin content through spectrophotometry. The chromatographic column of Agilent ZORBAX SB-Aq (250 × 4.6 mm, 5 μm) with methanol-0.1％ formic acid/water as the mobile phase, the flow rate 1 mL/min, and the detection wavelength 270 nm was applied to determine the Gallic acid, colijing and ellagic acid content in medicinal materials and the tannin parts of Tibetan Medicine Triphala. With the gallic acid as control group, total tannin content of Triphala and its tannin parts was determined through spectrophotometry. It revealed in the HPLC test that the linear range of gallic acid, coracine and ellagic acid was 0.91-4.55 μg, 0.274-1.368 μg and 0.329-2.634 μg respectively. It also showed that the average recovery rates of the three components in the medicinal materials were 101.06％, 101.72％and 100.27％ respectively. And the average recovery rates of the three components in the tannins were 100.4％, 100.85％and 101.70％ respectively. The result of spectrophotometry showed that gallic acid was linear in1.008-10.08 μg·mL-1, and that the recovery rate of medicinal materials and tannin parts were 100.25％ and 100.52％ respectively. The method is rapid, accurate and repeatable, and it can provide basis for the quality control of Tribescens and its tannins.

Protective effect of Triphala Rasayana against paracetamol‑induced hepato–renal toxicity in mice.

Background: Paracetamol, a widely used analgesic and antipyretic, is known to cause liver and renal injury in humans when administered in higher and repeated doses that cause acute liver injury. Triphala is a well‑known Ayurvedic Rasayana formulation that is prescribed for balancing of Vata, Pitta and Kapha. Traditionally, it is used for the treatment of liver and kidney diseases. Objective: The present study was undertaken to examine the protective effect of Triphala extract against paracetamol‑induced hepato–renal injury in Swiss albino mice. Materials and Methods: Swiss albino mice (weight 20–25 g) were used in this study. The mice were divided into five groups of six animals each. The aqueous extract of Triphala was given orally at two different doses (100 and 300 mg/kg body weight) for seven consecutive days, followed by a single intraperitoneal injection of paracetamol (500 mg/kg body weight) to induce hepato–renal toxicity. Serum levels of liver enzymes, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, creatinine, urea and uric acid were measured as indices of liver and renal injury. Statistics: All the statistical analyses were performed with the help of one‑way analysis of variance (ANOVA) followed by Student–Newman–Keuls test as post hoc test. Results were considered statistically significant when P < 0.05. Results: Pre‑treatment with Triphala extract at 100 mg/kg and 300 mg/kg body weight exhibited a significant (P < 0.01) hepatoprotective activity. The protective effect of Triphala extract at 300 mg/kg body weight appears more effective than 100 mg/kg body weight. Conclusion: The present study gives an evidence of the protective role of Triphala extract against paracetamol‑induced hepato–renal toxicity and validates its traditional claim in the Ayurveda system.

Antimicrobial analysis of Triphala and comparison with its individual constituents.

Triphala, a well known ayurvedic formulation is used against number of ailments since ancient times. It consists of Emblica officinalis, Terminalia chebula and Terminalia bellerica in equal proportion. Triphala as a whole and its three individual constituents show specific antimicrobial activity against certain bacteria and fungi. Antimicrobial activity of aqueous extract of triphala and its constituents was studied against P.aeruginasa, E.coli , B.subtilis, K. pneumoniae and S.aureus by cup-plate method. Triphala was found strongly bactericidal against P. aeruginosa with 1.8 cm of inhibitory zone. This was on account of T. chebula which showed 1.2 cm of inhibitory zone against the same pathogen, followed by E. coli and other two Gram positive bacteria. T. bellerica however showed maximum inhibitory activity against B.subtilis by showing 2.2 cm of inhibitory zone. It was confirmed that antimicrobial activity against Gram negative bacteria is due to T. chebula and E. officinalis while antimicrobial activity against Gram positive bacteria is on account of T. bellerica. Antifungal activity of Triphala and its constituents was studied against two pathogenic fungi viz. Aspergillus niger and Candida albicans by the same method. Triphala was found more efficient against A. niger, this was on account of T. bellerica which showed nearly 2 cm zone of inhibition. T. bellerica and Triphala showed more than 2 cm inhibitory zone against C. albicans. Inhibitory zone of Emblica officinalis was observed to be of 1.5-2 cm against both the fungi, whereas T. chebula did not show inhibitory activity against C. albicans but showed nearly 1 cm of inhibitory zone against A. niger. This confirms that the antifungal activity of Triphala is primarily due to T. bellerica and E. offiicinalis.

Effect of Morinda Citrifolia Juice and Triphala as Root Canal Irrigants on Sealer Penetration Depth Into the Dentinal Tubules. – A Confocal Laser Microscope Study.

Aim: The aim of this study was to evaluate the effect of Morinda citrifolia juice (MCJ) and Triphala on sealer penetration depth into the dentinal tubules as root canal irrigants. Materials and Methods: Forty five single rooted extracted human teeth were collected; decoronated and root canal length were standardized to16mm. Cleaning and shaping was done with protaper universal rotary instruments till F5. 30 samples were selected randomly and divided into two groups with 15 samples in each, according to the final irrigation regimen. In Group I, 5 ml of MCJ was used for 1min and in Group II; 5 ml of Triphala was used. The remaining 15 samples were irrigated with 5ml of Smear clear which acted as a positive control Group. Obturation was done with corresponding gutta-percha points and AH 26 sealer (Dentsply; DeTrey, Konstanz, Germany) labelled with fluorescent dye and left to set for 48 hrs. Then, the roots were sectioned and subjected to confocal laser microscope. Results: Statistical analysis was done by two-way analysis of variance (ANOVA) and Tukey multiple post-hoc procedures. The sealer penetration depth is higher in the MCJ group than the Triphala group at all three levels. Conclusion: MCJ showed a significant sealer penetration depth than Triphala.

Safety and usefulness of Laghu shankha prakshalana in patients with essential hypertension: A self controlled clinical study.

Background: Yoga and Ayurveda texts emphasize the role of cleansing the bowel as an important component of management of hypertension (HTN). Observations during our clinical experience and pilot studies on Laghu shankha prakshalana kriya (LSP), a yogic bowel cleansing technique, appeared to be safe and complimentary. Objective: To test the safety and effectiveness of LSP in patients with essential hypertension. Materials and Methods: This self control study recruited 32 patients with mild to moderate essential HTN admitted for a week long residential integrated yoga therapy program at the integrative health home in Bengaluru. Patients had a daily routine of 6 hours of integrated approach of yoga therapy (IAYT) module for HTN that included physical postures, relaxation sessions, pranayama and meditations. LSP, an additional practice, that involved drinking of luke‑warm water (with or without a herbal combination, triphala) followed by a set of specific yoga postures that activates defecation reflex, was administered on 2nd (LSP without triphala) and 5th day (LSP with triphala). Assessments (sitting blood pressure and pulse rate) were done just before and after both the sessions of LSP. Secondary outcome measures such as body mass index (BMI), symptom scores, medication scores, fatigue, state and trait anxiety, general health and quality of life were assessed on 1st and 6th day of IAYT intervention. Results: There was significant (P < 0.001, paired t test) reduction in blood pressure (systolic and diastolic) and pulse rate immediately after both the sessions (LSP with and without triphala). There were no adverse effects reported during or after LSP. There was no significant difference between the two techniques (P < 0.505, independent samples t test), although the percentage change appeared to be higher after triphala LSP session. The number of visits to clear the bowel during the procedure was significantly (P < 0.001, independent samples t test) higher after LSP with triphala than LSP without triphalā. After weeklong IAYT, there were significant reductions in blood pressure (P < 0.001), BMI (P < 0.004), medication score (P < 0.001), symptoms score (P < 0.001), fatigue (P < 0.001), state and trait anxiety (STAI, P < 0.001), scores of general ill health (GHQ, P < 0.001), and increase in comfort level (P < 0.001) and quality of sleep (P < 0.001). Conclusion: LSP (a part of IAYT) is a safe and useful procedure for patients with essential hypertension. LSP with triphala is more useful.

Evaluation of antimicrobial efficacy of Triphala (an Indian Ayurvedic herbal formulation) and 0.2% chlorhexidine against Streptococcus mutans biofilm formed on tooth substrate: An in vitro study.

Background: Streptococcus mutans is one of the most important cariogenic species of the human oral microbial flora. Biofilm style of microbial growth thought to resist the actions of antimicrobials. Aim: The purpose of this study was to evaluate the antimicrobial efficacy of Triphala, and 0.2% chlorhexidine against S. mutans biofilm formed on tooth substrate. Settings and Design: Randomized control trial. Methods: Extracted human mandibular premolars sectioned below the cemento‑enamel junction were placed in the tissue culture wells exposing the crown surface to S. mutans to form a biofilm. At the end of 3rd and 7th day, all groups were treated for 10 min with the test solutions and control and were analyzed qualitatively and quantitatively. Statistical Analysis Used: One‑way ANOVA. Results: Qualitative assay with 3 days biofilm showed complete inhibition of bacterial growth with Triphala, but 0.2% chlorhexidine and saline showed the presence of bacterial growth. In quantitative analysis, 0.2% chlorhexidine and Saline treated tooth samples have shown 1052 × 104 ± 15.1 × 104 CFU/ml, 141.3 × 109 ± 2.1×109 CFU/ml, respectively. Qualitative assay with 7 days biofilm on crown portion showed dense growth when treated with 0.2% chlorhexidine and saline, whereas Triphala has shown minimal growth. In Quantitative analysis, Triphala showed statistically significant result when compared with 0.2% chlorhexidine and saline. Conclusion: Triphala showed statistically significant antibacterial activity against S. mutans biofilm formed on tooth substrate. The incorporation of Triphala in mouth rinse could prove to be effective in reducing S. mutans count in the oral cavity.

Evaluation And Comparison Of Antimicrobial Activity Of Tulsi (Ocimum Sanctum), Neem (Azadirachta Indica) And Triphala Extract Against Streptococcus Mutans&Lactobacillus Acidophilus: An In Vitro Study.

Background and Objectives: This in vitro study was designed to evaluate and compare the antimicrobial effects of extracts of Neem sticks, Tulsi leaves and Triphala against Streptococcus Mutans and Lactobacillus Acidophilus.Materials and Methods: Sterile solutions of 10% & 25% concentrations were prepared from Neem, Tulsi and Triphala extracts. After growing on culture plates micro-organisms were transferred to nutrient agar; antimicrobial activity of the extracts was tested after 48 h. Results: Mean zones of inhibition against Streptococcus Mutans&Lactobacillus Acidophilus after 24hrs for 10% neem extract is 0.7 & 0.2mm and for 25% neem extract is 1.1 & 0.9 mm respectively. For 10% tulsi extract is 0.3 & 0.2mm and for 25% tulsi extract is 0.5 & 0.6 mm respectively. And for 10% triphala extract is 0.0 & 0.0mm and for 25% triphala extract is 0.1 & 0.0 mm respectively. Interpretation and conclusion: Extracts of neem and tulsi demonstrated an antimicrobial activity but triphla has been failed to show antimicrobial activity against S Mutans and L Acidophilus. This in vitro evaluation is an attempt to encourage further studies comparing the antimicrobial effects of different ayurvedic extracts on prevalence of caries.

Anticandidal efficacy of denture cleansing tablet, Triphala, Aloe vera, and Cashew leaf on complete dentures of institutionalized elderly.

With an increase in the number of dependent elderly, there is a need to introduce few natural products for denture cleansing, which are easily and economically available. Hence the aim of this study was to compare the anticandidal efficacy of denture cleansing tablet (sodium bicarbonate and sodium perborate monohydrate), Triphala (Phyllanthus emblica, Terminalia chebula and Terminalia belerica fruits powders in equal proportion), cashew leaf, Aloe vera and water (control) on complete dentures of institutionalized elderly. Study population consisted of 50 institutionalized elderly of Mangalore, Karnataka, with 10 in each group. Swabs were collected from the dentures before and after the use of denture cleansing tablet, Triphala, cashew leaf, Aloe vera, and water (control). Thereafter, the swabs were cultured on Sabouraud dextrose agar and the total candida counts were determined. Denture cleansing tablet and Triphala Churna showed a statistically significant reduction in Candida counts (P < 0.05). Denture cleansing tablet and Triphala Churna were found to be more effective.

A randomized clinical trial to evaluate and compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases

PURPOSE: Triphala is a combination of three medicinal plants, extensively used in Ayurveda since ancient times. Triphala mouthwash is used in the treatment of periodontal diseases because of its antimicrobial and antioxidant properties. The aim of this study is to compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized periodontal disease patients. METHODS: In this double-blind, randomized, multicenter clinical trial, 120 patients were equally divided into three groups. Patients in group A were advised to rinse their mouths with 10 mL of distilled water, group B with 0.2% chlorhexidine, and group C with triphala mouthwash for 1 minute twice daily for two weeks. The plaque index (PI) and the gingival index (GI) were recorded on the first and the fifteenth day. RESULTS: There was no significant difference when the efficacy of triphala was compared with 0.2% chlorhexidine in hospitalized patients with periodontal disease. However, a statistically significant difference was observed in PI and GI when both group B and group C were compared with group A and also within groups B and C, after 15 days (P<0.05). CONCLUSIONS: The triphala mouthwash (herbal) is an effective antiplaque agent like 0.2% chlorhexidine. It is significantly useful in reducing plaque accumulation and gingival inflammation, thereby controlling periodontal diseases in every patient. It is also cost effective, easily available, and well tolerable with no reported side effects.

Antibacterial potential of hydroalcoholic extracts of Triphala components against multidrug-resistant uropathogenic bacteria – A preliminary report.

“Triphala”, the Ayurvedic wonder is used traditionally for the treatment of different types of diseases since antiquity. The hydroalcoholic extracts of the three components of Triphala powder demonstrated varying degrees of strain specific antibacterial activity against multidrug-resistant uropathogenic bacteria. Terminalia chebula fruit extract was active against all the test isolates followed by Terminalia belerica and Emblica officinalis. There was a close association between antibacterial activity and total phenolic content of Triphala components.The test plant extracts were also found to be non-toxic on human erythrocyte membrane at recommended and even higher doses. The preliminary results of the present study may help in developing effective and safe antimicrobial agents from Triphala components for the treatment of urinary tract infections caused by multidrug-resistant bacteria.

Antibacterial efficacy of triphala against oral streptococci: An in vivo study.

Background: Triphala is a botanical preparation consisting of equal parts of three herbal fruits. Much revered in Ayurveda, triphala has been proven to have antibacterial, antiviral, antifungal actions. Aims and Objectives: The objective of this study was to investigate the effect of 6% triphala in a mouthwash formulation on the salivary streptococci levels at the end of 48 h and 7 days, of twice a day usage, and to compare the same with 0.2% chlorhexidine. Materials and Methods: Sixty undergraduate student volunteers aged between 18 and 25 years were randomly allocated into three study groups. (a) 6% triphala mouthwash, 15 ml twice a day; (b) 0.2% chlorhexidine mouthwash, 15 ml twice a day (active control group); (c) passive control group asked to rinse with plain water, twice a day. The oral streptococci colony forming units/ml (CFUs/ml) was assessed by inoculating blood agar with saliva samples at the end of 48 h and at 7 days. Results: The triphala group showed a 17% and 44% reduction, while the chlorhexidine group showed 16% and 45% reduction at the end of 48 h and 7 days (P < 0.001). The reduction in CFUs/ml seen in triphala group closely paralleled that of chlorhexidine group. Conclusion: Triphala has been used in Ayurveda from time immemorial and has many potential systemic benefits. The promising results shown by Triphala call for further investigations of its antimicrobial effects against the numerous oral microorganisms.