An analysis of scientific evidences for design of an ideal herbal dental formulation

INTRODUCTION

The oral cavity serves as a major gateway for pathogens and microbes to enter the human body, making its hygiene essential for overall health and quality of life. Maintaining good oral health primarily depends on use of oral medicaments, such as toothpastes and dentifrices, which play a crucial role in preventing oral diseases. However, a closer look at many commercially available products reveals the inclusion of potentially harmful chemicals. Ingredients like sodium fluoride, listed among 100 chemicals with substantial developmental neurotoxicity evidence; sodium lauryl sulphate, a known skin irritant; triclosan, a pesticide and suspected human carcinogen; and hydrated silica, which may erode enamel, raise serious safety concerns when used long term.^1-3

Despite the wide availability of allopathic oral care formulations, awareness regarding their possible adverse effects has increased. This shift in perception has led to growing consumer preference for herbal products, viewed as safer alternatives. Consequently, many pharmaceutical companies have introduced numerous herbal-based dental formulations. However, this surge has also resulted in the irrational use of herbs, often without sufficient pharmacological validation. Herbal components in toothpaste formulations, due to their direct contact with the oral mucosa, can enter the bloodstream and potentially exert both therapeutic and adverse effects-especially with prolonged use. Many marketed herbal toothpastes contain multiple herbal extracts and make exaggerated claims about their efficacy. Yet, critical analysis often reveals a mismatch between the claimed benefits and the actual pharmacological actions of these ingredients. This manuscript aims to examine and review the therapeutic mechanisms of key herbal ingredients used in dental products, with the objective of identifying the most effective and scientifically justified herbs for inclusion in an ideal, evidence-based oral care formulation.

IDEAL HERBAL COMPOSITION

Learning upon these very side effects of allopathic formulations, various herbal formulations have been introduced in the market for daily use. These formulations have been designed on the basis of knowledge obtained from ancient literature and their classic use. These herbal formulations have not only gained significant popularity but have also proved to be as effective as allopathic formulations with minimal side effects. Various herbs have been used by our ancestors for protecting their oral cavity and fighting with various oral problems like bleeding gums, inflammation, tooth decay, tooth ache, loosening of gums, bad breath (halitosis) etc. After a thorough analysis of ancient use of various herbs by the ancestors authors have enlisted nine herbs (Table 1) that could be used in the formulation of ideal herbal toothpaste.

MECHANISM OF ACTION OF THE KEY COMPONENTS OF IDEAL HERBAL DENTAL CREAM

Eugenia caryophyllata (Clove)

It is widely used in herbal toothpaste for its antifungal, antiseptic, antiviral, analgesic, and flavoring properties.⁴ It contains active compounds such as calcium, phosphorus, potassium, sodium, and most notably eugenol, which provides a soothing effect and relieves dental pain. Clove oil is also used to treat sore gums, oral ulcerations, bad breath, and prevent cavities. Its germicidal action makes it a vital antiseptic in oral care.⁴

Eugenol suppresses sensory receptors involved in pain and inhibits prostaglandins and leukotrienes, reducing inflammation. GC-MS analysis of clove oil identifies Eugenol (88.58%), eugenyl acetate (5.62%), and β-caryophyllene (1.38%) as the primary active components.⁶ Eugenol also acts as an NMDA receptor antagonist, inhibiting pain signals.⁷ It depresses nerve conduction in A and C fibers, explaining its analgesic action. Caryophyllene exhibits anti-inflammatory activity in various models, supporting its therapeutic role in oral health.⁸

Barleria prionitis (Vajradanti)

Barleria prionitis is an annual shrub with its habitat in Asia (India and Sri Lanka) and South Africa. In India this plant is commonly used for treating toothache and also used as a haemostatic, analgesic, anti-inflammatory, anti-microbial in the oral products. The methanolic extract of B. prionitis bark shows much potent activity against all the tested oral fungi namely S. cerevisiae and C. albicans, than the standard drug amphotericin-B thus having a great potential to control candidiasis and other fungal infections.⁹

The anti-microbial activity of the methanolic extract of bark analyzed with disc diffusion method has been shown due to tannins, saponins, phenolic compounds, essential oils and flavonoids. These are chemically originated with iridoid glucoside esters, acetylbarlerin (6, 8-di-O-acetyl shanzhiside methyl ester), barlerin (8-O-acetyl shanzhiside methyl ester), shanzhide methyl ester and 6-O-acetyl shanzhiside methyl ester, verbascoside (6-O-trans-p-coumaroyl-8-O-acetylshanzhiside methyl ester).¹⁰ The crude extract of Barleria prionitis has been shown to be very effective against oral bacteria this degrades layer of enamel and triggers the formation of cavity.¹¹

Salvadora persica (Meswak)

Meswak (Salvadora persica), a member of the Salvadoraceae family, is an evergreen shrub widely recognized for its traditional use as a natural toothbrush, especially in Muslim communities. Its efficacy against dental issues has been well-documented. Chemically, Meswak contains flavonoids, salvadorine, cyanogenic glycosides, lignans, saponins, alkaloids, tannins, linoleic and oleic acids, stearic acid, vitamin C, silica, and various salts such as sodium and potassium chlorides-all contributing to its antimicrobial action.¹² Silica acts as a mild abrasive for stain removal and whitening, while tannins help reduce gingival inflammation and plaque formation.¹³ Resins form a protective layer over enamel, reducing caries risk. Alkaloids like salvadorine stimulate gingival tissue and exhibit bactericidal properties. Vitamin C aids in tissue repair, and sodium bicarbonate serves as a mild germicide. Calcium supports enamel remineralization, working synergistically with saliva.

Meswak also contains benzyl nitrate and BIT, known for antibacterial, antifungal, and chemopreventive properties. Other compounds, including N-benzyl-2-phenylacetamide and butanediamide derivatives, exhibit broad-spectrum antimicrobial effects. Trimethylene reduces plaque and acts as an anti-inflammatory agent.¹⁴ Fluoride contributes anti-decay benefits, and essential oils promote salivation and antiseptic effects. Chloride helps prevent calculus and removes surface stains.

Mechanistically, S. persica inhibits Streptococcus mutans colonization by raising plaque pH, thus preventing caries formation.¹⁵ Its aqueous extracts have demonstrated strong antibacterial activity against gram-positive and gram-negative oral bacteria, as well as antifungal effects against Candida species.^17,18

Glycyrrhiza glabra (Jesthamadh)

Liquorice (Glycyrrhiza glabra) is a hardy herb native to the Mediterranean and China, with glycyrrhizin (2-14%) as its primary sweet-tasting compound.¹⁹ It contains phytoestrogens like formononetin, glabrone, neoliquiritin, and hispaglabridin A & B. In oral care, it acts as an analgesic, astringent, anti-inflammatory, rejuvenator, and antiseptic.²⁰ Found in both herbal and allopathic toothpaste, liquorice helps prevent gum inflammation.²¹ Licoricidin and licorisoflavan A inhibit bacteria linked to dental caries and gingivitis.²²

Curcuma longa (haldi/ turmeric)

Curcuma longa (Turmeric) is widely used in Indian medicine. Its rhizomes contain curcuminoids such as curcumin, demethoxycurcumin, and bis-demethoxycurcumin, known for antioxidant and anti-inflammatory effects.²³ Curcumin inhibits leukotrienes, platelet aggregation, and stabilizes lysosomal membranes. Turmeric oil is effective against pathogens like B. subtilis, S. aureus, E. coli, and P. aeruginosa.²⁴ It also inhibits MRSA (MIC: 125-250 μg/mL).²⁵ Novel curcumin compounds like indium-curcumin show superior antibacterial activity in vitro. Additionally, curcumin disrupts cytokinesis in B. subtilis by inhibiting Z-ring formation, impairing cell division.²⁶

Acacia Arabica (Babul)

Acacia arabica (Babul), a member of the Leguminosae family, is widely used in ethnomedicine for treating skin, stomach, sexual, and dental issues.²⁷ In dental creams, it serves as a natural astringent, freshens breath, maintains gingival integrity, and promotes oral tissue healing. It also acts as a haemostatic by aiding in clot removal and exhibits anti-helminthic, antimicrobial, and antibacterial properties essential for daily oral hygiene.²⁸ Extracts of Acacia arabica show antimicrobial activity against both gram-positive bacteria (Staphylococcus aureus, S. epidermidis and E. coli) and gram-negative strains like Aspergillus Niger. Alcoholic extracts from gum, leaves, and fruits exhibit strong in-vitro antibacterial action against S. aureus, Salmonella typhimurium, Proteus vulgaris, and Pseudomonas aeruginosa. Additionally, air-dried powdered extracts are effective against Streptococcus pyogenes, Klebsiella sp., and Salmonella typhimurium, supporting its use in therapeutic toothpaste formulations.²⁹

Anacyclus pyrethrum (Akarkara)

Akarkara of family Asteraceae has got a very high medicinal value. The plant roots consist of anacycline, pellitorine, enetriyene alcohol, hydrocarolin, inulin traces of volatile oils, sesamin, amides.³⁰ The roots of the plant are believed exert stimulant, cordial and rubefacient action.

In dental cream it plays a significant role of a sialogogue that stimulates secretion of saliva from the salivary glands. It is well known that saliva plays significant role in cleansing of the oral cavity by flushing mechanism and it also prevents the oral mucosa from drying.³¹ Dryness of the oral mucosa leads to various problems like difficulty in speech, chewing and engulfing food particles. Akarkara is used in the cure of sore throat, tonsillitis and even plays role in tooth ache relief.³² The ethanolic extract of Akarkara is capable of scavenging H₂O₂ radicals that have potential of damaging oral mucosa. H₂O₂ can easily cross the cell membrane and exert an injurious effect on tissue through a number of different mechanisms such as perturbing intracellular Ca²⁺ monostat, increased intracellular ATP, inducing DNA Damage and inducing apoptosis.

Mimusops elengi (Bakul)

Bakul (Mimusops elengi) is revered in Hindu culture and literature, symbolizing love and beauty.³³ This evergreen tree, native to the Deccan Peninsula and Andaman Islands, is widely cultivated for its ornamental and shade value. Medicinally, the bark serves as a cooling agent, cardiotonic, stomachic, anti-helminthic, tonic, and astringent, traditionally used to treat gum disease, biliousness, and dental disorders.³⁴ The fruit acts as a bowel astringent, seeds help fix loose teeth and relieve head ailments, and the root is used as a gargle with soothing effects on the gums.³⁵

Various extracts hexane, ethyl acetate, ethanol, and methanol exhibit strong antibacterial effects against Streptococcus mutans, a primary cause of dental caries. Bark extracts also show activity against other oral pathogens including S. aureus, S. salivarius, S. sanguis, Lactobacillus acidophilus, and Candida albicans, making Bakul a valuable herb in dental formulations.³⁶

Mentha spicata (Mint)

Mint (Mentha spp.), a genus in the Lamiaceae family, includes 18 species and 11 named hybrids, identified through morphological and phylogenetic analysis. Peppermint and spearmint are widely known for their essential oils, with menthol being the primary component responsible for the characteristic cooling sensation.³⁷ These oils are extensively used in both medicinal and culinary applications.

In oral care, mint contributes significantly to mouth and throat hygiene. It acts as an analgesic, antibacterial, antifungal, antiviral, anti-inflammatory, and anti-helminthic agent.³⁸ Besides enhancing flavor and providing breath freshness in dental creams, mint’s essential oils show strong antimicrobial activity-particularly against E. coli, Salmonella enteritidis, Helicobacter pylori, and methicillin-resistant S. aureus strains.³⁹ Its efficacy stems from the oils’ lipophilic nature, which disrupts bacterial membranes, as well as specific functional chemical groups.⁴⁰

OUTCOME

Ten herbal toothpaste formulations were purchased from the market, codified, and their herbal components tabulated (Table 2). The composition of each formulation and pharmacological actions of included herbs were compared and analyzed (Table 3). Herbs that can be safely used in crude form on daily basis were also identified (Table 4).

The study found that each formulation was developed with a specific therapeutic intent, and the inclusion or exclusion of herbs was based on the intended therapeutic purpose. However, it was also observed that most formulations contained analgesic and anti-inflammatory herbs, despite these not being required for daily use. Only 20% of the formulations included astringents, despite their daily necessity for oral health maintenance. Similarly, only 10% included antiviral components, and 30% included anti-carcinogenic agents, which are valuable for daily oral care. Alarmingly, some toothpaste formulations did not include any herbal ingredients, despite being marketed as herbal products, suggesting a trend among OTC brands to exploit the consumer demand for herbal products without delivering on efficacy. Additionally, 30% of the formulations included anti-allergic components, whose regular use may suppress the immune system and potentially lead to immunocompromised conditions.

Among the ten formulations analyzed, toothpaste coded E was identified as the most effective in terms of both composition and intended therapeutic benefits. Of the nine most important herbs recommended for ideal toothpaste formulations, Meswak (Salvadora persica) and Vajradanti (Barleria prionitis) were found to have the broadest therapeutic actions (Table 5). However, the widespread inclusion of analgesics in daily-use toothpastes was deemed unnecessary and potentially harmful due to the risk of increasing pain threshold over time.

CONCLUSION

The study concludes that although herbal toothpaste formulations are widely marketed, many do not meet the necessary therapeutic criteria for daily oral care. The inclusion of analgesic and anti-inflammatory herbs, despite their limited relevance to daily needs raises concerns about long-term side effects such as increased pain threshold. Furthermore, essential components like astringents, antiviral, and anti-carcinogenic agents are underrepresented in current market formulations, while unjustified components such as anti-allergic agents are often overused.

These findings highlight the need for stricter evaluation and formulation standards for OTC herbal toothpaste products. A more rational, evidence-based selection of herbs focused on long-term safety and daily utility is essential to ensure that such products provide genuine health benefits rather than just appealing marketing narratives.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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