Herbal remedies for toothache Clove oil

Herbal remedies for toothache Clove oil

Probably the best-known herbal product used to obtain transient relief from toothache is clove oil. This is obtained by steam distillation from clove (cloves), the dried flower bud of Syzygium aromaticum (L.) Merr. &

T.M. Perry of the family Myrtaceae. For many years, the correct scientific name of the plant was considered to be either Eugenia caryophyllata Thunb.

or Caryophyllus aromaticus L. These names are still encountered in the older herbal literature. All three designations refer to the same species. Clove of good quality yields about 15–25 percent of a volatile oil that has both local analgesic and antiseptic properties. These are due to a number of phenolic substances contained in the oil, the principal one of which is eugenol, constituting 85 percent of the total.

Although clove oil is sufficiently irritating to preclude general inter- nal usage, it has long been employed as a local analgesic or obtundent for the relief of toothache. Eugenol, like other phenols, acts on contact to depress cutaneous sensory receptors involved in pain perception. Additional analgesic activity results from pronounced inhibition of pros- taglandin and leukotriene biosynthesis resulting from blockages of the cyclooxygenase and lipoxygenase metabolic pathways. 139 In practice, a

pledget of cotton is dipped in the undiluted oil and applied to the sur- face of the aching tooth and surrounding tissue or, if possible, inserted directly into the cavity, where it will alleviate the pain for several hours. The oil is also used in mouthwashes, in concentrations of 1–5 percent, for its antiseptic effects.

Various forms of clove (actually listed as cloves), including the volatile oil, appear as safe food additives on the GRAS (generally recognized as safe) list of the Food and Drug Administration. Because they can cause

Chapter seven: Nervous system disorders 143 damage to viable pulp and soft tissue when applied indiscriminately to

an aching tooth, the American Dental Association has accepted clove oil, or its constituent eugenol, for professional use only, not for nonprescrip- tion use. In Germany, Commission E has approved the use of clove oil as

a local anesthetic and antiseptic. 140

Prickly ash bark The barks of two species of Zanthoxylum are used more or less interchange- ably as toothache remedies in the United States. Both Z. americanum Mill., the northern prickly ash, and Z. clava-herculis L., the southern prickly ash, are sometimes referred to as toothache trees. These members of the family Rutaceae both yield prickly barks that, when chewed, produce a tingling sensation in the mouth and are also effective remedies for toothache. For all practical purposes, the barks of the two species may be considered as a single herb. It was valued by the American Indians, who chewed the bark and then packed the masticated quid around the ailing tooth to relieve the pain. 141

Although prickly ash bark, under the title Xanthoxylum, held official status in the USP and then the NF from 1820 to 1947 and was employed as a diaphoretic and antirheumatic, the principles responsible for its local anesthetic effect appear not to have been investigated scientifically. Older sources simply attribute the bark’s pungency when it is chewed to its resin content. 142 More recent studies on a related West African species that has

similar properties, Z. zanthoxyloides (Lam.) Watson, associate at least some of its anti-inflammatory action with the presence of fagaramide, an aro- matic acid amide. Fagaramide apparently acts as an inhibitor of prosta- glandin synthesis and might account for some of the analgesic effects of the bark as well, although it is approximately twenty times less potent than indomethacin. 143 It is not known if the American Zanthoxylum species

contain fagaramide. Prickly ash bark is used for toothache today in the same manner as it was employed long ago by Native Americans. A small amount of the bark is chewed, and the moist mass is packed around the painful tooth as an emergency method of relieving pain. Adverse effects have not been reported from short-term use.