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Why wash your mouth with chemicals, when natural, time-tested herbal remedies have been proven to work at least as well?
According to the American Academy of Periodontology , "one in every two adults age 30 and older is suffering from periodontal disease, commonly referred to as gum disease." That's close to 65 million Americans according to the Centers for Disease Control and Prevention . Gum diseases such as gingivitis and periodontitis can be prevented with proper daily oral hygiene.
When undergoing surgical dental procedures as part of treatment for gingivitis or periodontitis, a chlorhexidine based mouthwash or rinse might be prescribed. Chlorhexidine kills bacteria and reduces plaque, while being active long enough in the mouth to be effective . However, it stains teeth and the tongue after long-term use, it eliminates beneficial bacteria in the mouth, and can cause mouth or throat irritation .
How Could Herbs Compete?
Herbs have been employed to maintain oral health in traditional societies for thousands of years. The chemical complexity that a single herb delivers, let alone an herbal formula containing multiple herbs, is staggering. A single herb contains thousands of different phytochemicals, orchestrating a suite of effects in the body in subtle ways. This is why herbs tend to have an extensive list of different actions associated to them.
A number of studies have come out comparing herb-based mouthwashes against chlorhexidine across a variety of standard metrics that measure plaque levels, inflammation, and other attributes relevant to gum diseases.
According to a study published in the Journal of Contemporary Dental Practice ,
"...it can be concluded that chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control methods in prevention of plaque and gingivitis."
The study measured 3 metrics:
- Plaque Index (PI) which assesses the level of plaque
- Gingival Index (GI) assesses severity of gingivitis
- Total Microbial Count, which assesses the level of microbes
While it seemed like turmeric was not able to compete, with respect to the Plaque Index, it was as good as chlorexdine with respect to the Gingival Index and the Total Microbial Count. This is yet another way to use the colorful Indian spice turmeric.
The turmeric mouthwash consisted of 10mg of curcumin extract dissolved in 100ml of water. Curcumin is one of the main active ingredients in turmeric and a tremendous amount of research has been conducted on it.
A recent double-blind randomized clinical trial published in the Ethiopian Journal of Health Sciences points to how Aloe Vera was as effective as chlorhexidine with respect to plaque reduction over a 4 day period . This study too, used the Plaque Index as means to measure effectiveness.
"The results showed that Aloe vera mouthrinse is equally effective in reducing plaque as Chlorhexidine compared to placebo over a period of 4 days."
A purported 100% Aloe Vera juice was used as the mouthwash, however, it was supplied by a particular company and the ingredients weren't specified.
Triphala is a foundational formula used in the Indian Ayurvedic system and contains 3 fruits assembled in a specific proportion. The results of a recent double-blind randomized clinical trial published in the Journal of Periodontol & Implant Science, showed its effectiveness as well :
"The triphala mouthwash (herbal) is an effective antiplaque agent like 0.2% chlorhexidine. It is significantly useful in reducing plaque accumulation and gingival inflammation, thereby controlling periodontal diseases in every patient. It is also cost effective, easily available, and well tolerable with no reported side effects."
In this study, the triphala mouthwash was a prepared as a decoction, where 10g of triphala was boiled in 10ml of water. Furthermore, the triphala was prepared with equal parts of the standard three fruits typically found in the formula: Phyllanthus emblica (Amla), Terminalia chebula (Haritaki), Terminalia bellirica (Bahera).
A recent study published in the Journal of Indian Society of Periodontology, shows that green tea catechins, an extract of green tea containing predominantly the "catechin" constituents, also seems to be comparable to chlorhexidinein efficacy :
"The results showed that both the groups that is green tea catechin mouthwash (0.25%) and chlorhexidine mouthwash (0.12%) have comparable results in plaque reduction."
The green tea mouthwash consisted of 250mg of Catechins, along with other supporting ingredients in 100ml of water.
Additionally, each of these herbs provides a variety of other benefits to oral health. Turmeric is a broad-spectrum, anti-inflammatory operating through a multitude of mechanisms, potentially useful in an inflammatory condition like gum disease. Aloe Vera has a reputation for healing epithelial tissue, which is the type of tissue the mouth is lined with. Triphala, has a tonifying or strengthening action on lax tissue, potentially benefiting residing gums. Lastly, research has shown that Green Tea catechin's act as powerful antioxidants, making them potentially useful in mitigating the damage caused by the bacteria and inflammation in the mouth.
 American Academy of Periodontology (2014). Gum Disease Prevalence Surpasses Diabetes with Nearly 65 million Affected. Retrieved from https://www.perio.org/consumer/love_the_gums_you%27re_with
 Gupta RK1, Gupta D2, Bhaskar DJ2, Yadav A3, Obaid K4, Mishra S5. (2014). "Preliminary antiplaque efficacy of aloe vera mouthwash on 4 day plaque re-growth model: randomized control trial." Ethiop J Health Sci. 2014 Apr;24(2):139-44.
 Kaur H, Jain S, Kaur A. (2014). "Comparative evaluation of the antiplaque effectiveness of green tea catechin mouthwash with chlorhexidine gluconate." J Indian Soc Periodontol. 2014 Mar;18(2):178-82. doi: 10.4103/0972-124X.131320.
 Naiktari RS, Gaonkar P, Gurav AN, Khiste SV. (2014). "A randomized clinical trial to evaluate and compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases." J Periodontal Implant Sci. 2014 Jun;44(3):134-40. doi: 10.5051/jpis.2014.44.3.134. Epub 2014 Jun 5.
 Waghmare PF1, Chaudhari AU, Karhadkar VM, Jamkhande AS. (2011) "Comparative evaluation of turmeric and chlorhexidine gluconate mouthwash in prevention of plaque formation and gingivitis: a clinical and microbiological study." J Contemp Dent Pract. 2011 Jul 1;12(4):221-4.
 WebMD (2014). Drugs & Medications - Chlorhexidine Gluconate MM. Retrieved from: https://www.webmd.com/drugs/drug-5356-Chlorhexidine+Gluconate+MM.aspx?drugid=5356&drugname=Chlorhexidine+Gluconate+MM
 Wikipedia (2014). Chlorhexidine. Retrieved from:https://en.wikipedia.org/wiki/Chlorhexidine