Herbal extracts in oral health care - A review of the current scenario and its future needs.

BACKGROUND: Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. OBJECTIVE: To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. MATERIALS AND METHODS: A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. SUMMARY AND CONCLUSION: The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. "Herbal shotgun" or "synergistic multitarget effects" are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance.

Oral health promotion among rural school children through teachers: an interventional study.

BACKGROUND: The lack of national oral health policy and organized school dental health programs in the country call for affordable, accessible, and sustainable strategies. OBJECTIVES: The objective was to compare the oral hygiene, plaque, gingival, and dental caries status among rural children receiving dental health education by qualified dentists and school teachers with and without supply of oral hygiene aids. MATERIALS AND METHODS: This interventional study was conducted among 15-year-old children selected randomly from four schools in Nalgonda district between September 2009 and February 2010. Schools were divided into four different intervention groups. The intervention groups varied in the form of intervention provider and frequency of intervention one of which being the control group. The oral hygiene, plaque, gingival, and dental caries status was assessed at baseline and 6 months following the intervention. SPSS 16 was used for analysis. RESULTS: The preintervention and postintervention comparison within each group revealed a substantial reduction in mean oral hygiene index-simplified (OHI-S), plaque index (PI), and gingival index (GI) at postintervention compared to baseline in group 4 (1.26, 0.87, and 0.74, respectively) followed by group 3 (0.14, 0.37, and 0.12, respectively). The OHI-S, PI, and GI scores increased in group 1 (0.66, 0.37, and 0.34, respectively) and group 2 (0.25, 0.19, and 0.14, respectively). Mean decayed, missing filled surfaces score between the groups was not statistically significant at baseline and postintervention. CONCLUSION: The dramatic reductions in the OHI-S, PI, and GI scores in the group supplied with oral hygiene aids call for supplying low cost fluoridated toothpastes along with toothbrushes through the school systems in rural areas.

Malocclusion status among 15 years old adolescents in relation to fluoride concentration and area of residence.

OBJECTIVES: To compare the overall dental aesthetic index scores between rural and urban areas, males and females, and to correlate dental aesthetic index score with fluoride concentration in drinking water. SETTINGS AND DESIGN: The study was cross sectional and conducted among 15 year old adolescents in the rural and urban areas of Nalgonda district, Andhra Pradesh, India (an endemic fluoride belt). MATERIALS AND METHODS: Six out of 59 mandals in Nalgonda district were first selected by simple random sampling technique. Then 24 secondary schools were selected from these six selected mandals. All eligible grade X children from these sixteen rural and eight urban schools, having different fluoride concentrations in drinking water, selected by simple random sampling, were considered for the study. Dentofacial anomalies with criteria of dental aesthetic index were used for assessing malocclusion. The information on the dietary habits, orthodontic treatment history, parafunctional habits, continuous residence etc., was collected using a pre-designed questionnaire. The examination was carried out by three trained and calibrated dentists. The Dental Aesthetic Index (DAI) scores, in areas with below optimal, optimal and above optimal fluoride concentrations, between urban and rural areas were compared and analyzed using SPSS windows version 16. RESULTS: The mean DAI scores, for the rural and urban population were 21.37 ± 5.845 (mean ± SD) and 22.26 ± 6.115, for males and females, it was 20.86 ± 5.100 and 22.70 ± 6.713 respectively. The mean DAI scores in areas with below optimal, optimal and above optimal fluoride concentration were 23.42 ± 7.205 (mean ± SD), 20.85 ± 4.658 and 19.93 ± 4.312 respectively. CONCLUSION: The prevalence and severity of malocclusion was more in urban than rural areas, more among females than males, and it decreased with increasing concentration of fluoride in drinking water.

The use of school teachers to promote oral hygiene in some secondary school students at Hyderabad, Andhra Pradesh, India: A short term prospective pilot study.

STUDY DESIGN: It was a short term prospective pilot study on a group of 116 secondary school students. OBJECTIVES: To assess the feasibility of using the services of school teachers to promote oral hygiene in secondary school students and compare the effectiveness of dental health education (DHE) offered by school teachers on a fortnightly basis with what is offered by dental professionals at three- monthly intervals. MATERIALS AND METHODS: Six secondary schools were randomly selected. The base-line Oral Hygiene Index simplified (OHI-S) and Plaque index (PI) scores for all the students were recorded. The teachers were trained on dental health facts. The six schools were divided into three groups of two schools with different intervention techniques: Group 1- Schools given no health education, Group 2 - Schools given health education by their school teachers on a fortnightly basis together with simple screening for deposits of gross calculus , Group 3 - Schools which were given health education by dental professionals at intervals of three months without any screening. Grade nine students were selected for pre and post intervention evaluation. The second examination was done six months following the intervention to find out the OHI-S and Plaque index scores. The examination was done by three trained and calibrated dentists. Data analysis was done with SPSS 16 with relevant statistical tests. RESULTS: The mean OHI-S and PI scores were significantly less in group 2 and there was a statistically significant difference between the baseline OHI - S, PI score and the scores after six months in all the three groups. CONCLUSION: The concept of utilizing the teachers for frequent DHE and screening for any gross deposits of food debris and calculus is feasible. Also frequent DHE by teachers was more effective than the infrequent DHE by the professionals.