Spice-Based Herbal Oral Care Products as an Intervention in the Periodontal Diseases: A Systematic Scoping Review

Spices and herbs are dried, aromatic, vegetable, or plant substances that contribute flavour in whole or ground form (Beegum et al., 2019). Herbs are generally derived from dried leaves and are a subset of spices (Sindhuja et al., 2019). Around the world, different spices or herbs are available in various forms and used for other purposes. These spices have been used extensively in dentistry worldwide based on their availability in specific regions (Beegum et al., 2019). This review includes spices or herbs like curcumin, clove oil, sage, cinnamon, ginger, cardamom, pepper, sumac, black seed, and peppermint oil. All these spices share common antimicrobial, antioxidant, anti-inflammatory, antibacterial, antiviral, antifungal, and analgesic effects.

Gingivitis (Beegum et al., 2019) is the mildest of these diseases and most prevalent among the general population, indicating a lack of proper oral hygiene. Gingivitis is characterised by bleeding, plaque formation, and gum inflammation. Pathogenic bacterial overgrowth, the release of bacterial toxins, and the host's inflammatory response all lead to the development of periodontal disease, an infectious and inflammatory condition. Periodontal disease is an infection characterised by inflammatory and immune responses that result in clinical attachment loss, alveolar bone loss, and cementum destruction (Kumar et al., 2009).

Several chemical agents, such as fluorides, bis-biguanides, essential oils, quaternary ammonium compounds, sanguinarine, metronidazole, and triclosan, have been incorporated in mouth rinses and dentifrices to improve the outcome of mechanical oral hygiene procedures, which have been extensively advocated. Some novel ways are using fibres, strips and compacts, films, microparticles, gels, and nanoparticles; they have all been employed as periodontal local delivery methods for the targeted release of antimicrobial drugs to reduce periodontal diseases (Lindhe et al., 2003). Chlorhexidine gluconate (CHX) is regarded as a gold standard antimicrobial drug in dentistry with effective bactericidal properties and has been extensively researched for the prevention of dental plaque and to maintain periodontal health. Although efficient, CHX mouthwash has several side effects, including brown teeth staining, erosion of the oral mucosa, and a bitter taste (van der Ouderaa, 1991, Abullais et al., 2015). Furthermore, it kills all types of microbes, not just bacteria. Therefore, there is little risk of developing opportunistic infections. Antimicrobial resistance is caused by antimicrobial agents and antibiotics, leading to the emergence of previously uncommon diseases. Natural phytonutrients are effective substitutes for this synthetic compound (Yin and Zhong, 2020).

The herbal extract, a simple, safe, and non-invasive method with no significant side effects, is used to reduce the number of microorganisms in the periodontal pocket (Elavarasu et al., 2016). To treat chronic periodontitis, curcumin strips and mouthwash can be used as an antioxidant in the subgingival environment (D and A, 2015, Chatterjee et al., 2017). Cinnamon can reduce plaque levels and gingivitis, making it an effective agent (Janakiram et al., 2020, Chandulal et al., 2015). In several clinical trials, comparing spice-based and traditional oral care products for treating periodontal diseases was effective. Traditional medical systems, such as Ayurveda, use these spices to treat various conditions based on practical experience passed down through generations. Chemicals found in these spices have been studied, and their medicinal uses have been confirmed.

The goal of this scoping review is to identify evidence and the extent of literature on the use of spice-based oral care products to treat periodontal diseases. The following research question was formulated: What is known about the intervention, type of vehicle, and administration of spice-based oral care products in periodontal diseases based on the literature?

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