Use of Traditional Herbal Medicine as an Alternative in Dental Treatment in Mexican Dentistry a Review

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  Full Terms & Conditions of access and use can be found at Pharmaceutical Biology ISSN: 1388-0209 (Print) 1744-5116 (Online) Journal homepage: Use of traditional herbal medicine as analternative in dental treatment in Mexicandentistry: a review Cindy Cruz Martínez, Martha Diaz Gómez & Myung Sook Oh To cite this article:  Cindy Cruz Martínez, Martha Diaz Gómez & Myung Sook Oh (2017) Use of traditional herbal medicine as an alternative in dental treatment in Mexican dentistry: a review,Pharmaceutical Biology, 55:1, 1992-1998, DOI: 10.1080/13880209.2017.1347188 To link to this article: © 2017 The Author(s). Published by InformaUK Limited, trading as Taylor & FrancisGroup.Published online: 25 Jul 2017.Submit your article to this journal Article views: 1652View related articles View Crossmark dataCiting articles: 1 View citing articles  REVIEW ARTICLE Use of traditional herbal medicine as an alternative in dental treatment inMexican dentistry: a review Cindy Cruz Mart  ı nez a , Martha Diaz G  omez b and Myung Sook Oh a,c a Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea;  b Deparment of History,College of Dentistry, National Autonomous University of Mexico (UNAM), Coyoacan, Mexico;  c Department of Life and NanopharmaceuticalSciences, Graduate School, Kyung Hee University, Seoul, Republic of Korea ABSTRACT Context:  Herbal therapies are used worldwide to treat health conditions. In Mexico, generations haveused them to treat gingivitis, periodontitis, mouth infections, and discoloured teeth. However, few studieshave collected scientific evidence on their effects. Objective:  This study aimed at searching and compiling scientific evidence of alternative oral and dentaltreatments using medicinal herbs from Mexico. Methods:  We collected various Mexican medicinal plants used in the dental treatment from the databaseof the Institute of Biology at the National Autonomous University of Mexico. To correlate with existing sci-entific evidence, we used the PubMed database with the key term  ‘ (scientific name) and (oral or dental) ’ . Results:  Mexico has various medical herbs with antibacterial and antimicrobial properties, according toancestral medicinal books and healers. Despite a paucity of experimental research demonstrating the anti-bacterial, antimicrobial, and antiplaque effects of these Mexican plants, they could still be useful as analternative treatment of several periodontal diseases or as anticariogenic agents. However, the number of studies supporting their uses and effects remains insufficient. Discussion and conclusion:  It is important for the health of consumers to scientifically demonstrate thereal effects of natural medicine, as well as clarify and establish their possible therapeutic applications. Through this bibliographical revision, we found papers that testify or refute their ancestral uses, and con-clude that the use of plants to treat oral conditions or to add to the dental pharmacological arsenalshould be based on experimental studies verifying their suitability for dental treatments. ARTICLE HISTORY Received 18 March 2016Revised 31 March 2017Accepted 22 June 2017 KEYWORDS Mexican herbs; oral disease;dental herb therapy Introduction Humans have sought cures for diseases in nature since ancienttimes; even recently, the use of herbal medicines in dietary sup-plements, energy drinks, multivitamins, massage, and weight lossproducts has gained popularity (Petrovska 2012). These uses havebroadened the field of herbal medicine and also increased itscredibility.The field of dentistry also has begun to exploit herbal proper-ties for the purpose of relieving tooth pain, gum inflammation,and canker sores (Kumar et al. 2013). However, it is of utmostimportance to understand the interactions of plant extracts withthe body and other medications, as many of these extracts haveanti-inflammatory effects and prevent bleeding, which is import-ant in dental treatment (Taheri et al. 2011). Antiseptics, antibac-terial, antimicrobial, antifungal, antioxidant, antiviral, andanalgesic agents derived from plants are of widespread interest indentistry (Sinha and Sinha 2014). For example, in recent years,in the field of periodontics and endodontics, several plantextracts such as a propolis, noni fruit, burdock root, and neemleaf have been used as intra-canal medications with excellentresults, opening up a novel function for herbal agents in globaldental therapy (Pujar and Makandar 2011; Shah et al. 2015). In Mexico, the Aztec and Mayan cultures developed many uses for medicinal plants (Galarza 1981); this development ceasedafter the conquest, when the Spaniards controlled and evange-lized the Aztecs (Cortez et al. 2004). The Spaniards introducednew products from the Old World to Mexico and, combinedwith native methods, thus enriched the natural medicine arsenal(Garcia 1991). Historical knowledge is essential because, withoutit, we would lack clarity and our medical practices would lack coherence (Estrada 1996). The effectiveness and possible applica-tion of numerous Mexican medicinal plants has not yet beenstudied with respect to dentistry. Dental services even in theurban and in the rural areas of Mexico are expensive, and it isdifficult for people to access the appropriate drugs (Medina-Soliset al. 2006; Maupome et al. 2013). For these reasons, herbal rem- edies in Mexico are commonly used despite the lack of scientificsupport for their use, dosage, and effects (Andrade-Cetto 2009).In fact, people use them without caution because they believesuch alternative treatments have no risks or no possibility of allergic reactions or other adverse effects as they come from nat-ural sources. Therefore, it is important to study, analyse, and testthe efficacy of traditional medicinal plants to establish and pro-mote their use as alternative treatments or as potential sourcesfor obtaining or developing new drugs. CONTACT  Myung Sook Oh Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea; Department of Life and Nanopharmaceutical Sciences, Graduate School, Kyung Hee University, 26,Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea   2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use,distribution, and reproduction in any medium, provided the srcinal work is properly cited. PHARMACEUTICAL BIOLOGY, 2017VOL. 55, NO. 1, 1992 – 1998  This study describes and clarifies the types of alternative oraland dental treatments based on herbal therapies that are com-monly used in Mexico. We also reviewed the limited experimen-tal evidence regarding herbal therapy to support the use of traditional Mexican medicine as a possible aid in the treatmentof dental and oral pathologies, as well as a potential source forthe development of drugs. Literature search We collected the various Mexican medicinal plants used in dentaltreatment from the database of the Institute of Biology at theNational Autonomous University of Mexico (Digital Library of Traditional Mexican Medicine; DLTMM). We searched the elec-tronic literature in the PubMed database with the keyword  ‘ (sci-entific name) and (oral or dental) ’  to correlate with existingscientific evidence on the Mexican plants. Uses of herbal medicines in ancient Mexican cultures The rise of Mexican medicine occurred during the Aztec andMaya empires and all or almost all of information on theseancestral medicinal skills was collected in codices by religiousorders, such as the Franciscans (Galarza 1981; Garcia 1991). Aztec medicine had a magical-religious approach to healing orthe treatment of disease (Estrada 1985). Using the sameapproach, the medicinal skills of Mayans included methods toheal wounds and counter rattlesnake venom, massage techniquesto restore dislocations or banish inflammation, hot baths involv-ing herbal steam cooking, and the use of pricks from porcupinespines to treat neuralgia, similar to the principle of Chinese acu-puncture (Berdaguer 1991; Ca ~ nigera et al. 2003; Santana et al.2015). With regard to oral or dental treatments, the Mayans usedquartz powder as an abrasive to clean out carious cavities beforesealing them with a powder mixture that had a high resistance tomastication (De la Cruz 1975). For the treatment of the dentalpain, they used the root of Chicalote (  Argemone Mexicana  L.[Papaveraceae]) as a reliable anaesthetic (Galarza 1981; Estrada1996; Cortez et al. 2004). The Florentine Codex, which was written in N  ahuatl, thenative language, and translated into Spanish by Fray Bernardinode Sahag  un in 1557, describes the names and uses of many medi-cinal plants and animal materials (Galarza 1981; Terraciano2010). The  Libelus de medicinabilus indorum herbis  was writtenby Mart  ı n de la Cruz, an indigenous Mexican doctor, and trans-lated by Juan Badiano from N  ahuatl into Latin. It containsdescriptions of herbs ’  effects and their applications along withcolour illustrations, covering all diseases of the human body by beginning with the head and ending with the signs of death. Itincludes a section on oral health and dental conditions, andultimately paints a holistic view of stomatology (De la Cruz 1975;Garcia 1991; Estrada 1996; Salas and Rivas 2001). In 1712, the  Anthology Medicinal   also described many Mexican herbal dentaltreatments (Rojas 2009).Despite the fact that Mexico is rich in medicinal plants, thisarea of medicine has not been completely developed, or at least,is not a priority in Mexican medicine (Lautie et al. 2008). Herbalculture is transmitted orally from generation to generation (De laRosa 1980). Herbal products are preferred over prescription med-ications for treating certain illnesses because of their lower costor because people may believe the herbs to be less toxic, giventhat they are natural (Rivera et al. 2005a; Brindis et al. 2013). Generally, people visit the doctor only if they do not respond tohome remedies (Waldstein 2008). In rural communities, trad-itional medicine is the best choice for the people, even if thecommunity has medical services (Arrieta-Baez et al. 2012). Astudy of the use of complementary and alternative medicineamong Hispanics found that the most commonly reported alter-native therapies were herbs, prayer, and dietary supplements(Mikhail et al. 2004). Mexican street markets offer plants that areused as analgesics, anti-inflammatory treatments, and antiseptics,as well as treatments for pathologies as varied as scorpion stingsand cancer (Josabad Alonso-Castro et al. 2012). Medicinal plantsare used for a wide variety of purposes and are traded bothnationally and internationally (Moreno et al. 2006). Traditional uses of Mexican herbs in dentistry In Mexico, the most common oral diseases are caries and peri-odontal disease. However, dental services in rural areas are very expensive and do not represent a primary health concern forrural people, who prefer to use alternative medicine for this com-mon but simple oral disease. Approximately 59.6 %  of people inMexico have signs of periodontal disease and the prevalence of caries in the population over age 40 is close to 97 %  (Cruz andPicazzo 2017). The method of preparation of medicinal plants varies depending on the kind of plant, as well as the portionsused (stems, leaves, and roots), route of administration (local,topical, and rinse), and time of ingestion. In some areas, peoplewho have dental pain prepare fillings from a plant or chew thebark of multiple trees to treat inflammation, as well as use plantextracts as mouthwashes or teas.The use of medicinal plants can be an advantage in dentalpractice, for example eugenol is a part of our therapeutic arsenal(Rojas 2009; Da Silva et al. 2012). Some herbal products have recently undergone a thorough investigation with regards to theirpotential for preventing oral diseases, such as dental caries(Moreno et al. 2006). Although many years had elapsed withoutresearch on medicinal plants, this trend reversed when theNational Medical Institute was established in 1888, creating new possibilities for herbal remedies (Rojas 2009; De Micheli-Serraand Izaguirre-Avila 2014). Because plants are often the sourcesfor novel drugs, their screening should be a priority in drugdevelopment (Lautie et al. 2008).Medicinal plants are an important element of indigenousmedical system in Mexico (Heinrich 2000). However, interest intheir effects and subsequent demonstrative studies are lacking.Table 1 presents a summary of the plants in DLTMM that areeither used in Mexico or are of Mexican srcin and used else-where for oral disease.Dentistry is seeking novel and effective alternative healingtechniques. One possible approach is to review historical dataand evaluate how people of the past cured oral disease. Throughsuch review and analysis, new horizons in dentistry and otherfields of medicine may be reached. Experimental evidence related to the use of Mexicanherbs in dentistry Although Mexico has a great diversity of medicinal plants,research to confirm or refute their popular uses has been very limited. However, due to the popularity of these plants in differ-ent countries, we have developed great interest in learning moreabout Mexican medicine. Table 2 presents a summary of theplants that are used in Mexico for oral disease with experimentalevidence. PHARMACEUTICAL BIOLOGY 1993  Mexican  Sanguinaria  ( Polygonum aviculare  L.[Polygonaceae]), which was shown to be an anti-inflammatory,astringent, and diuretic plant, is commonly used in the treatmentof gingivitis to decrease the inflammatory process (GonzalezBegne et al. 2001). A clinical study in students between the agesof 18 – 25years who used the Mexican  Sanguinaria  extract as oralrinse for 14days found that the extract significantly decreasedgingivitis from day 0 to 14 (  p  0.05) (Gonzalez et al. 1999). Table 2.  Mexican plants used in the treatment of the oral disease according to experimental evidence.Scientific name (Family name) Subjects Outcomes Reference  Aloe vera  (L.) Burm.f. (Asphodelaceae) 120 volunteers with gingivitis aged18 – 25 years oldInhibition of gingivitis and plaque accumu-lation after oral rinseChandrahas et al. (2012)45 patients with plaque-induced gingi-vitis aged 18 – 65 years oldReduction of gingival inflammation Ajmera et al. (2013)345 healthy subjects Reduction of gingival bleeding and plaqueindicesKarim et al. (2014)76 intubated patients in intensive careunit aged 18-64 years oldReduction of gingival index compared withchlorhexidineRezaei et al. (2016)390 healthy subjects Reduction of gingival index compared withchlorhexidineVangipuram et al. (2016) Capsicum frutescens  L. (Solanaceae) Human buccal mucosa fibroblast cell line Suppression of cell growth and total celldeathVan Wyk et al. (1995) Chenopodium ambrosioides  L.(Dysphaniaceae)Minimum bactericidal concentrationdetermination in culture platesIneffective antibacterial activity against  S.mutans Vieira et al. (2014) Opuntia ficus-indica  (L.) Miller(Cactaceae)Burning mouth syndrome patients Amelioration of hyposalivation and mouthpainCastillo and Aldape (2006) Persea americana  Miller. (Lauraceae) Human periodontal ligament and humanalveolar bone cell linePreventive action on the deleterious effectsexerted by interlukin-1beta in periodon-tal diseasesAndriamanalijaona et al. (2006)Minimum bactericidal concentrationdetermination in culture platesHigh antibacterial activity against  S. mutans or  Porphyromonas gingivalis Rosas-Pinon et al. (2012) Polygonum aviculare  L.(Polygonaceae)60 volunteers with gingivitis aged 18 – 25years oldInhibition of gingivitis after oral rinse Gonzalez Begne et al. (2001) Punica granatum  L. (Punicaceae) 23 volunteers with gingivitis and dentalplaque aged 22 – 28 years oldNo significant activities between controland experimental groups for the visibleplaque index and gingival bleedingindexSalgado et al. (2006) Theobroma cacao  L. (Sterculiaceae) Caries rats induced by  S. mutans  Reduction of caries development and dentalplaque accumulationOoshima et al. (2000)Broth medium with  S. mutans  Reduction of the growth rate of oral strep-tococci by decrease of acid production28 volunteers with plaque depositionsaged 19 – 29 years oldAntibacterial activity against  S. mutans  Matsumoto et al. (2004)Perpendicular steel wire with artificialdental plaqueAntiplaque formationThe selected children with scaling of theteethReduction of colonization by  S. mutans  andplaque depositionSrikanth et al. (2008)50 children of both sexes aged 6 – 10years oldAntimicrobial activity similar tochlorhexidineVenkatesh Babu et al. (2011) Uncaria tomentosa  (Willd. ex Schult.)DC (Rubiaceae)Minimum bactericidal concentrationdetermination in culture platesHigher antimicrobial activity on Enterobacteriaceae ,  S. mutans , and  S. aur-eus  isolatesCcahuana-Vasquez et al. (2007) Table 1.  Mexican plants used in the treatment of the oral disease from the Digital Library of Traditional Mexican Medicine.Scientific name (Family name) Common name Used part Indications  Acacia cornigera  (L.) Willd (Leguminosae) Cornezuelo Leaf Inflammation of gums  Acacia farnesiana  (L.) Willd. (Leguminosae) Huizache Stem Cold sore and toothache  Amphipterygium adstringens  Schiede ex Schlech. (Anacardiaceae) Cuachalalate Latex Peridontitis  Asclepias curassavica  L. (Asclepiadaceae) Quiebra muelas Latex Caries and toothache Bidens odorata  Cav. (Compositae) Aceitilla Leaf Canker sores Byrsonima crassifolia  (L.) Kunth (Malpighiaceae) Nanche Leaf and flower Toothache Caesalpinia pulcherrima  (L.) Swartz (Leguminosae) Tabachin Fruit and root Canker sores Capsicum frutescens  L. (Solanaceae) Chile de arbol Leaf Toothache Carica papaya  L. (Caricaceae) Papaya Leaf and fruit Canker sores Chenopodium graveolens  (Willd.) Weber (Chenopodiaceae) Epazote Leaf Toothache Chiranthodendron pentadactylon  Lam. (Sterculiaceae) Flor de manita Flower Toothache Dorstenia contrajerva  L. (Moraceae) Contrayerba Root Caries, toothache, and tooth abscess Heterotheca inuloides  Cass. (Compositae) Arnica Flower Canker sores Heliopsis longipes  (A. Gray) S.F. Blake. (Asteraceae) Chilcuague Root Toothache  Jatropha gaumeri   Greenm. (Euphorbiaceae) Pomolche Latex or leaf Canker sores, oral candidiasis, and tooth abscess Lobelia laxiflora  Kunth. (Campanulaceae) Aretillo or zarcillo All plant Canker sores and toothache Opuntia ficus-indica  (L.) Miller (Cactaceae) Nopal Fruit and flower Oral ulcer and tooth abscess Persea americana  Miller. (Lauraceae) Aguacate Fruit Canker sores, gingivitis, periodontal disease, and toothache Sida rhombifolia  L. (Malvaceae) Escobilla or malvilla Stem and leaf Gingivitis and toothache Theobroma cacao  L. (Sterculiaceae) Cacao Bean Oral ulcer and toothache 1994 C. CRUZ MART  INEZ ET AL.
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