Significant herbs

Several herbs are incorporated into antiplaque dentifrices and mouthwashes. They function primarily as antimicrobial agents, inhibiting bac- terial adherence to newly formed pellicle and preventing it from being converted into plaque.

Bloodroot (sanguinaria) One of the most popular of these herbs is bloodroot. The dried rhizome of Sanguinaria canadensis L. of the family Papaveraceae contains about 4–7

percent of a mixture of isoquinoline alkaloids, about one-fifth of which is sanguinarine. Bloodroot was once widely used as a stimulating expecto- rant in various cough preparations; it also enjoyed a considerable folkloric reputation as a treatment for cancer. 65

Sanguinaria extract, representing a mixture of the total alkaloids, has been incorporated into toothpaste (0.075 percent) and a mouthwash (0.03 percent). A large number of clinical and toxicological studies have been conducted to test the efficacy and safety of these products. The results are mixed, but the consensus is that they may have some merit

in plaque and gingivitis reduction. 66 In addition, mouthwashes containing sanguinaria extract are more effective than sanguinaria-containing

Chapter ten: Problems of the skin, mucous membranes, and gingiva 193 toothpastes. 67 Effectiveness of sanguinaria applies only to the commer-

cial bloodroot products when used in accordance with the manufacturer’s instructions. Use of self-prepared dosage forms of this herb is definitely not recommended.

Minor herbs

Some potentially useful herbs for the prevention of plaque include the leaves of

• neem— Azadirachta indica A. Juss.(family Meliaceae); • mango— Mangifera indica L. (family Anacardiaceae); • basil— Ocimum tenuiflorum L. (family Lamiaceae); • tea— Camellia sinensis (L.) O. Kuntze (family Theaceae); and • curry leaf— Murraya koenigii (L.) Spreng. (family Rutaceae).

In India, these individual plant materials are simply rubbed against the teeth to inhibit plaque formation and to treat periodontal disease. Limited in vitro studies confirm the antimicrobial effects of the herbs, and some clinical evidence supports the utility of their aqueous extracts as antiplaque agents in humans. Neem is an ingredient in commercial

toothpastes currently marketed in India and Pakistan. 68 Because of the preliminary nature of the clinical studies on the antiplaque value of these five plants, they are not necessarily recommended but, rather, are men- tioned here as a matter of record.

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chapter eleven

Performance and immune deficiencies

Significant herbs