|Year : 2021 | Volume
| Issue : 6 | Page : 892-897
Complementary and alternative medicines in oral health care: An integrative review
Basem Mohammed Abuzenada1, Fawaz Pullishery2, Mohamed Samir Abdelmagid Elnawawy3, Samaher Abdullah Alshehri4, Rowayda Mohammed Basheer Alostath4, Batool Mabrook Bakhubira4, Walaa Farhan Amerdash4
1 Department of Restorative Operative Dentistry, KingAbdul Aziz University and Batterjee Medical College, Kingdom of Saudi Arabia
2 Departments of Community Dental Practice and Research, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
3 Department of Operative Dentistry, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
4 Dental intern, Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
|Date of Submission||21-Feb-2021|
|Date of Decision||19-Mar-2021|
|Date of Acceptance||17-Apr-2021|
|Date of Web Publication||10-Nov-2021|
Department of Community Dental Practice, Batterjee Medical College, Jeddah 21442
Kingdom of Saudi Arabia
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Complementary and alternative medicine (CAM) uses a holistic approach that finds natural solutions that help the immune system to fight off infection and diseases. In conventional medicine, the diseases are treated as a series of symptoms developed and not its actual cause or etiology, but CAM commonly targets the exact cause of the disorder thereby stimulating the body's healing process. This is based on an integrative literature review of methods and techniques used as complementary and alternative approaches for oral health care. A comprehensive electronic database search was conducted in PubMed, CINAHL, MEDLINE, EMBASE, Google, Google Scholar, and SCOPUS. Medicinal plants such as Medicago Sativa, Aloe Barbadensis Miller (Aloe Vera), and Trifolium Pratense (Red Clover) have excellent applications in treating gum disorders, prevent tooth decay, and have demonstrated good antifungal activity in the oral cavity. Homeopathic medicines such as Belladonna, Antimonium crudum, and Chamomilla have useful applications in relieving toothache. In Chinese medicine, various acupressure points (Acupuncture) have been used to relieve pain related to tooth, head-and-neck region, sinusitis, etc. Dental professionals can utilize these treatment modalities in their practice along with other conventional procedures as an integrative treatment approach to achieve better outcomes.
Keywords: Ayurveda, healing, herbs, holistic, nature, oral medicine
|How to cite this article:|
Abuzenada BM, Pullishery F, Elnawawy MS, Alshehri SA, Alostath RM, Bakhubira BM, Amerdash WF. Complementary and alternative medicines in oral health care: An integrative review. J Pharm Bioall Sci 2021;13, Suppl S2:892-7
|How to cite this URL:|
Abuzenada BM, Pullishery F, Elnawawy MS, Alshehri SA, Alostath RM, Bakhubira BM, Amerdash WF. Complementary and alternative medicines in oral health care: An integrative review. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Jun 28];13, Suppl S2:892-7. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/892/330152
| Introduction|| |
Complementary and alternative medicine (CAM) is one type of health-care system which includes diverse practices and products that conventional medicine does not use. These treatment modalities are efficient, economical, and safe to be adopted as an alternative health-care approach in dentistry. As CAM is more widely discussed by the media and in mainstream medicine, patients feel more comfortable in the use of these therapies.
CAM system includes domains such as Ayurveda, Naturopathy, Homeopathy, Chinese Medicine (acupuncture), and other interventions such as meditation, massage therapy, music therapy, and biofield therapies (Reiki). This study is aimed to discuss the possibilities of application of these alternative systems in dentistry.,,,
| Materials and Methods|| |
An integrative literature search was conducted on various Internet-based search engines (Google and Google Scholar) and bibliographic databases (PubMed, PubMed Central, MEDLINE, Medknow, EMBASE, SCOPUS, CINAHL, and AMED) for articles published from the year 1975 to 2017 using the keywords and phrases: “Dentistry” OR “Oral health care” AND “Complementary medicine” OR “Alternative medicine” OR “Holistic Dentistry” OR “Traditional medicine” OR “Ayurveda” OR “Chinese Medicine” OR “Homeopathy,” OR “Naturopathy.” The search was limited to articles published in English.
A bibliographic management software “EndNote” (Thomson Reuters, New York, NY, USA) was used for importing the search results. Articles published only in English language were included. The contents with duplicity were removed, and the remaining articles were screened and assessed by the titles and abstracts. The initial search identified 287 articles. A total of 55 articles were finally considered for the review after thoroughly examining the quality and content of each one [Figure 1]. Two authors were assigned to assess the quality of all the selected articles. The article does not intend to be a systematic review, rather a narrative review that illustrates the application of holistic or complementary medicines in the field of oral care.
| Ayurveda|| |
Ayurveda is one of the ancient Indian health-care systems which still has a high acceptance worldwide. Ayurvedic treatments are based on a comprehensive knowledge base about physical, spiritual, mental, and social health of an individual. The fundamentals of Ayurveda are fully documented in the ancient holistic books “Charaka Samhita” and “Sushruta Samhita. According to the principles of Ayurveda, the human body is made up the three doshas: Vata (wind, air); Pitta (Bile, fire); and Kapha (mucus, water); these “tridoshas” are physiological entities which play a vital role in performing all the metabolic functions of the body.,
The structure and functions of teeth and gums, various toothpaste available and how to select the tooth powder depending on the constitution and character of the gums, various teething disorders, beneficial and harmful diet, congenital anomalies, traumatic injuries, ANUG, gingivitis, periodontitis, dental caries and toothache, alveolar abscess, malignancies of jaw bones, and dislocation of TMJs along with their treatment are all described in Ayurveda. Some of the commonly used medicinal plants for problems associated with oral health are illustrated in [Table 1]. Evidence suggests that Ayurvedic treatments received much attention worldwide in the field of prevention and cure compared to the western medicinal system. Ayurveda treatments cannot completely substitute conventional dental therapies but could be used as adjunctive methods.
| Homeopathy|| |
Homeopathy medicine is gaining acceptance worldwide for the treatment of various diseases. Dr. Samuel Hahnemann propounded the principles of homeopathy. Homeopathy utilizes the body's healing capacity to cure the diseases, and Hahnemann was of the view that the symptoms of the diseases are nothing but the struggle to overcome the illness. Homeopathy explores the essence of disease through the symptom syndrome. Homeopathy can be unified into the practice of dentistry by replacing the conventional drugs or as a treatment for conditions for which there is no other alternative. However, it cannot replace the mechanical arts of dentistry. Some of the commonly used homeopathy medicines for oral health care and treatment are depicted below [Table 2].
| Naturopathy|| |
It is a system of curative science that takes advantage of the body's natural or instinctive capabilities to restore the health. Naturopathy can be seen as integrative science which includes healing practices applied in Homeopathy, Herbal Medicines, etc. It is a drugless system which utilizes some of the environmental forces such as air, temperature, and water to cure the disease. The treatment model in Naturopathy is based on the principles similar to Ayurveda and Homeopathy. Some nontraditional techniques used consist of electrodermal screening, Contact Reflex Analysis, hypnosis, magnets, herbal plants, magnets, Homeopathy, therapies that utilize heat and cold, kinesiology, hydrotherapy, etc., Some of these techniques are being applied in dental practice such as hypnosis, kinesiology, and craniosacral interventions (used in orofacial orthopedics). Hypnosis is widely practiced in dental sleep medicine to treat bruxism, obstructive sleep apnea, pain control of orofacial structures, etc., Kinesiology is utilized for TMJ-related disorders, chronic and acute orofacial pain, and neck problems.
| Traditional Chinese Medicine and Dentistry|| |
Chinese medicine has a long history and has been in practice for >2500 years and includes treatment modalities such as Acupuncture, Herbal Medicine, and Tai Chi and qigong exercises., In Acupuncture, practitioners make use of very thin needles to activate certain points on the body which controls the flow vital energy (Qi), stimulates the body's healing response, and restores the natural balance bringing relief to the patient thereby correcting the disturbed flow of Qi to the Zang-Fu. Studies have proved that Acupuncture is proved to be effective in managing certain pain such as postoperative dental pain, myofascial pain, headache, musculoskeletal disorders associated with dental practice such as carpal tunnel syndrome, lumbar pain, cramps, and tennis elbow., Herbal medicines act as Zang-Fu organs internally. Qigong is a stretching exercise commonly used in Chinese medicine. This technique helps to restore the flow of vital energy (Qi) which can be useful in relieving pain associated with maxillofacial region. Different applications of acupuncture points are depicted in [Table 3].
| Aromatherapy|| |
Aromatherapy is a complementary technique that makes use of essential oils obtained from medicinal plants or trees. It is efficiently used as ailments in stress or anxiety-related disorders, migraine, muscular, and jaw pain. The essential oils are either inhaled or topically applied on the skin. When the oils are inhaled, the nerve cells in the nasal cavity get stimulated by the scents and activate the limbic system. Thus, it is responsible for the dominant effect on moods and the general state of mind and plays a vital role in controlling the heart rate and blood pressure by interacting with the kidney., Dental anxiety is considered as one of the obstacles to avoid dental treatment. Anxiety in patients may cause stress and irritation in dental health professionals and could result in reduced performance considerably affecting the treatment outcomes. Aromatherapy has been found effective in reducing fear and stress during conventional dental treatments. Commonly used essential oils for managing some of the dental problems are shown in [Table 4].
| Mind Body Interventions|| |
Mind and body interventional techniques such as Hypnosis, Yoga, and Biofeed training can be used to reduce pain associated with the orofacial region. Biofeedback training is the process that enables an individual to learn control over his/her body functions that involuntary. Because mind and body are made of the same basic substance, and that if we can regulate mind, we can regulate the body. This technique is used to prevent or treat a migraine, headaches, chronic pain, high blood pressure, etc., Studies have proved that relaxation techniques such as yoga and deep breathing and visualization techniques can be helpful for pain control. The dental health professionals can make utilize of these mind and body intervention techniques such as yoga and relaxation techniques to encounter problems such as musculoskeletal pain (associated with dental ergonomics) and also reduce stress.
| Spa Dentistry|| |
Spa Dentistry is an emerging practice in dentistry where they offer some traditional and nontraditional techniques that are usually not associated with dental care. Therapies such as hand massage, head massage, or spa-like amenities seemed to provide relaxing environments for the patients that ease their fear and anxiety which are often associated with dental visits. The facility runs under the supervision of a practicing dentist. It combines the routine restorative, cosmetic, and holistic treatment. Spa facilities in a dental clinic could help the patients to overcome dental fear or anxiety and make the visit a pleasant and sweet experience.
Some of the ideas to incorporate Spa-style dental clinic includes:
- At the waiting area:
- Remote-controlled massage mats to set kneading pattern and heat intensity
- Refreshments such as coffee, tea, juice assortments, and bottled water.
- Cascading water fountains, salt aquarium to distract patient
- Hotel-style concierge services: while the patient is receiving treatment, the staff attends cell-phone calls, babysits, orders the food, or does just about anything the patient asks
- Pain treatment from an acupuncturist.
- Within the operatory
- Use of nitrous oxide for which can make the patient relaxed helping the dentist to perform the procedures efficiently
- Virtual reality glasses or devices to watch a movie during dental treatment
- Use of headphones with music could help in reducing the shriek of the drill
- Dental chair with a cushion system for neck and back can be used to give the patient pleasant effect
- Hot stone massages, hot paraffin-wax hand treatment, herbal eye masks, foot massages, during invasive procedures to keep the patient relaxed.
| Conclusion|| |
CAM brings together the best of all traditions emphasizing disease prevention, general well-being, and holistic approach to health. Most of these holistic approaches are found to be relatively nontoxic and biocompatible. Understanding each of these methods and its applications in oral health care is still an ongoing process. By use of these CAM therapies, dental practitioners can better meet their patient needs, establish a patient-centered, prevention oriented, and a class apart dental practice.
Financial support and sponsorship
This study was carried out without any funding.
Conflicts of interest
There are no conflicts of interest.
| References|| |
National Center for Complementary and Alternative Medicine (NCCAM). The Use of Complementary and Alternative Medicine in the United States. Bethesda, MD.: National Institutes of Health; December 2008. Available from: http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm
. [Last accessed on 2017 Mar 15].
Ernst E, Cassileth BR. The prevalence of complementary/alternative medicine in cancer: A systematic review. Cancer 1998;83:777-82.
Waldman SA, Terzic A. Pharmacology and Therapeutics: Principles to Practice. Philadelphia: Elsevier/W. B. Saunders; 2008. p. 1536.
Vohra S, Feldman K, Johnston B, Waters K, Boon H. Integrating complementary and alternative medicine into academic medical centers: Experience and perceptions of nine leading centers in North America. BMC Health Serv Res 2005;5:1-7.
Little JW. Complementary and alternative medicine: Impact on dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:137-45.
Sharma S. Realms of Ayurveda. 1st
ed. New Delhi: Arnold Heineman Publishers; 1979. p. 117-34.
Sharma PV, Dash B. Charaka Samhita: Sutrasthanam. A House of Oriental and Antiquarian Books. 23rd
ed. Varanasi, India: Chaukhambha Orientalia; 1981. p. 112-4.
Athavale VB. Dant rogas. In: Athavale VB, editor. Dentistry in Ayurveda. 1st
ed. New Delhi: Chaukhamba Sanskrit Pratishthan; 1999. p. 7-11.
Amruthesh S. Dentistry and Ayurveda-V: An evidence based approach. Indian J Dent Res 2011;2:3-9.
Sujatha G, Kumar GS, Muruganandan J, Prasad TS. Aloe vera in dentistry. J Clin Diagn Res 2014;8:ZI01-2.
Mangaiyarkarasi SP, Manigandan T, Elumalai M, Cholan PK, Kaur RP. Benefits of Aloe vera in dentistry. J Pharm Bioallied Sci 2015;7:S255-9.
Rasooli I, Shayegh S, Astaneh S. The effect of Mentha spicata
and Eucalyptus camaldulensis
essential oils on dental biofilm. Int J Dent Hyg 2009;7:196-203.
Sadlon AE, Lamson DW. Immune-modifying and antimicrobial effects of Eucalyptus oil and simple inhalation devices. Altern Med Rev 2010;15:33-4.
Wang P, Wei X, Zhang F, Yang K, Qu C, Luo H, et al
. Ginsenoside Rg1 of Panax ginseng stimulates the proliferation, odontogenic/osteogenic differentiation and gene expression profiles of human dental pulp stem cells. Phytomedicine 2014;21:177-83.
Vlaisavljevic S, Kaurinovic B, Popovic M, Djurendic-Brenesel M, Vasiljevic B, Cvetkovic D, et al
. Trifolium pratense
L. as a potential natural antioxidant. Molecules 2014;19:713-25.
Seyyedi SA, Sanatkhani M, Pakfetrat A, Olyaee P. The therapeutic effects of chamomilla tincture mouthwash on oral aphthae: A Randomized Clinical Trial. J Clin Exp Dent 2014;6:e535-8.
Ulman D. Discovering Homeopathy: Medicine for the 21st
Century. California, U.S.A: North Atlantic Books; 1991.
Grudianov AI, Bezrukova IV, Aleksandrovskaia II. Comparative study of homeopathic remedies clinical efficacy in comprehensive treatment of inflammatory periodontal diseases in patients with burdened allergic status. Stomatologiia (Mosk) 2006;85:25-8.
Hoseinishad M, Nosratipour A, Moghaddam SM, Khajavi A. Homeopathy in dentistry: A review. Int J Contemp Dent Med Rev 2015;2015:1-5.
Farrer S, Baitson ES, Gedah L, Norman C, Darby P, Mathie RT. Homeopathic prescribing for chronic and acute periodontal conditions in 3 dental practices in the UK. Homeopathy 2013;102:242-7.
Shealy CN, Thomlinson RP, Cox RH, Borgmeyer V. Osteoarthritic pain: A comparison of homeopathy and acetaminophen. Am J Pain Manage 1998;8:89-91.
Albertini H, Goldberg W, Sanguy B, Toulza CL. Homeopathic treatment of dental neuralgia by Arnica and Hypericum. J Am Inst Homeopath 1985;3:126-9.
Mojaver YN, Mosavi F, Mazaherinezhad A, Shahrdar A, Manshaee K. Individualized homeopathic treatment of trigeminal neuralgia: An observational study. Homeopathy 2007;96:82-6.
Haila S, Koskinen A, Tenovuo J. Effects of homeopathic treatment on salivary flow rate and subjective symptoms in patients with oral dryness: A randomized trial. Homeopathy 2005;94:175-81.
Shaw D. Unethical aspects of homeopathic dentistry. Br Dent J 2010;209:493-6.
Mousavi F, Molaver YN, Asadzedari M. Homeopathic treatment of minor apthous ulcer – A randomized controlled trials. Homeopathy 2009;98:137-41.
Alibeu JP, Jobert J. Aconite in homeopathic relief of post-operative pain and agitation in children. Pediatrie 1990;45:465-6.
Mathie RT. The research evidence base for homeopathy: A fresh assessment of the literature. Homeopathy 2003;92:84-91.
Tanwar R, Dang V. Homeopathy in dentistry – A new avenue visited. Indian J Dent Adv 2011;3:737-41.
Sanadhya YK, Sudhanshu S, Jain SR, Sharma N. Naturopathy system – A complimentary and alternative aid in dentistry – A review. J Evol Med Dent Sci 2013;2:7077-84.
Sherwin DC. Traditional Chinese medicine in rehabilitation nursing practice. Rehabil Nurs 1992;17:253-5.
Ernst E, Pittler MH. The effectiveness of acupuncture in treating acute dental pain: A systematic review. Br Dent J 1998;184:443-7.
Rosted P. Introduction to acupuncture in dentistry. Br Dent J 2000;189:136-40.
Seckman CH. Complementary and alternative medicine helps alleviate common patient ailments, including the nervousness about being in your chair. RDH 2002;22:74-9.
Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2009;11:CD003281.
Lee YT. Principle study of head meridian acupoint massage to stress release 166 via Grey data model analysis. Evid Based Complement Alternat Med 2016;1:1-9.
Moradi Z, Akbarzadeh M, Moradi P, Toosi M, Hadianfard MJ. The effect of Acupressure at GB-21 and SP-6 acupoints on anxiety level and maternal-fetal attachment in primiparous women: A randomized controlled clinical trial. Nurs Midwifery Stud 2014;3:e19948.
Rosted P. Practical recommendations for the use of acupuncture in the treatment of temporomandibular disorders based on the outcome of published controlled studies. Oral Dis 2001;7:109-15.
Kwon S, Seo BK, Kim S. Acupuncture points for treating Parkinson's disease based on animal studies. Chin J Integr Med 2016;22:723-7.
Sert H, Usta B, Muslu B, Gözdemir M. Successful treatment of a resistance trigeminal neuralgia patient by acupuncture. Clinics (Sao Paulo) 2009;64:1225-6.
Kim JT, Wajda M, Cuff G, Serota D, Schlame M, Axelrod DM, et al
. Evaluation of aromatherapy in treating postoperative pain: pilot study. Pain Pract 2006;6:273-7.
Williams AC, Barry BW. Essential oils as novel human skin penetration enhancers. Int J Pharm 1989;57:R7-9.
Chen J, Jiang QD, Wu YM, Liu P, Yao JH, Lu Q, et al
. Potential of essential oils as penetration enhancers for transdermal administration of ibuprofen to treat dysmenorrhoea. Molecules 2015;20:18219-36.
Leger J. Aromatherapy in dentistry. Chir Dent Fr 1986;56:43-7.
Ali B, Al-Wabel NA, Shams S, Ahamad A, Khan SA, Anwar F. Essential oils used in aromatherapy: A systemic review. Asian Pac J Trop Biomed 2015;5:601-11.
Cavanagh HM, Wilkinson JM. Biological activities of lavender essential oil. Phytother Res 2002;16:301-8.
Ghelardini C, Galeotti N, Mazzanti G. Local anaesthetic activity of monoterpenes and phenylpropanes of essential oils. Planta Med 2001;67:564-6.
Iacobellis NS, Lo Cantore P, Capasso F, Senatore F. Antibacterial activity of Cuminum cyminum
L. and Carum carvi
L. essential oils. J Agric Food Chem 2005;53:57-61.
Toet A, Smeets MA, van Dijk E, Dijkstra D, van den Reijen L. Effects of pleasant ambient fragrances on dental fear: Comparing apples and oranges. Chemosens Percept 2010;3:182-9.
Dillard JN, Knapp S. Complementary and alternative pain therapy in the emergency department. Emerg Med Clin North Am 2005;23:529-49.
Al Wassan KA, Almas K, Al Shethri SE, Al-Qahtani MQ. Back and neck problems among dentists and dental auxiliaries. J Contemp Dent Pract 2001;2:17-30.
Glick M. One-stop shopping. J Am Dent Assoc 2007;138:282, 284.
Shoben EJ Jr., Borland L. An empirical study of the etiology of dental fears. J Clin Psychol 1954;10:171-4.
[Table 1], [Table 2], [Table 3], [Table 4]