EFFECT OF DASANASAMSKARA CHOORNA FOR DANTADHAVANA IN ORAL HYGIENE
1 2 3
Anusree.C,Jayan.D, Jyothi.R1Asst.professor,DepartmentofSwasthavritta,P N.PancikarSouhrudaAyurvedaMedicalCollege,Kanhangad,Kerala,India.
2Professor,DepartmentofSwasthavritta,Govt.AyurvedaCollege,Thiruvananthapuram,Kerala,India.
3Professor,DepartmentofSwasthavritta,Govt.AyurvedaCollege,Tripunithura,Kerala,India.
ABSTRACT
Oralhygieneisthepracticeofkeepingthemouthandteethcleantopreventdentalproblems.Globalburdenofdiseaseestimates69%ofpopulationwithoraldiseases. Thisstudyventuresattheuseof Dasanasamskara choorna in Bhaishajyaratnavali for dantadhavana anditseffectinoralhygienebasedonOralHygieneIndex–Simplified score and microbiological examinations. Calcium carbonate, the most common mild abrasives used by modern dentists is the major ingredient of this researchmedicineintheformof khatika choorna Otheringredients sunthi, haritaki, musta, khadira, ghanasara, guvaka bhasma, marica, devapuspa, tvak arealso effectiveinpreventionofteethdiseasesasperclassicsandresearches.
Thestudywasnonrandomizedcontroltrail,conductedin40volunteersinagegroup18-45years.20consentedvolunteerswithOHI-Spoorandfairwereselectedin studygroupand20volunteerswithOHI-Spoorandfairwereselectedincontrolgroupusingconsecutivesamplingtechnique.5volunteerswereselectedbylottery method and their saliva were taken and sent for microbiological examinations (total bacteria count and Streptococcus mutans count). For the study group, DasanasamskarachoornawasgivenandforthecontrolgroupparticulartoothpasteacceptedbyIndianDentalAssociationwasprovided.Bothgroupswereadvisedto do regular brushing for 2 minutes twice a day for one month. OHI-S of 40 volunteers was assessed on 0th, 15th & 31st day Microbiological examinations of 5 volunteers selected by lottery method from both groups taken were repeatedly done on 0th, 15th, 31st days.The results were analyzed statistically within groups consideringtheoutcomevariablesOHI-SandmicrobiologicalexaminationofsalivausingWilcoxonsignedranktestandbetweengroupsusingMann-WhitneyTest. Thisstudyissignificantlyeffectiveinimprovingoralhygiene.
KEYWORDS:Dasanasamskarachoorna,dantadhavana,oralhygiene.
INTRODUCTION:
Ayurveda hasarichreservoirfordentalsciencesandhasmentionedvariousproceduresformaintainingoralhygienelike dantadhavana, gandusha, kabala and jihwanirlekhana Dantadhavana-cleaningofteethisthemainprocedurefororal hygiene.
Oralhygieneisthepracticeofkeepingthemouthandteethcleantopreventdentalproblemsie.mostcommonlydentalcavities,gingivitis,periodontal(gum)dis1 eases and bad breath Dental diseases are a significant public health burden in Indiaaswellasacrosstheglobe.WHOrecognizesoralhealthasanintegralpart ofgeneralhealth.Theconsequencesofwidespreadpoororalhealthcanbeseen onbothpersonalandcommunitylevelsasdentalcariesandperiodontaldisease deteriorate the individual health and wellbeing, decrease economic 2productivity Overthepastdecadeagrowingbodyofscientificevidenceseems tosuggestasignificantassociationbetweenperiodontalinfectionsandsystemic conditionslikecoronaryheartdisease,respiratoryinfections,pretermlowbirth 3 weightbabiesetc
EstimatesfromGlobalBurdenofDiseasedemonstratethatoraldiseasesaffect 3.9billionpeopleandcoveringabout69%ofthepopulation.Prevalenceoforal diseasesisveryhighinIndiawithdentalcaries50%,52.5%,61.4%,79.2%and 84.7%in5years,12years,15years,35–44yearsand65–74yearsrespectivelyand periodontal diseases 55.4%, 89.2% and 79.4% in 12 years, 35- 44years and 4 65–74yearsrespectivelyasthetwomostcommonoraldiseases
Most of the dental diseases permanently destroy the tissues which cannot be 5 repairedandreplacedbythebody Treatmentsofdentaldiseasesareveryexpensiveandtimeconsuming.Thefoodstickingtothedentalcreviceservesasagood mediumforbacterialgrowth.Sooralhygieneisinevitableinthecontroloforal diseases.
Various compounds such as fluorides, detergents, abrasives, dyes, calcium and 6 agentsfortastearepresentinatoothpaste Swallowingtoomuchfluoridefrom toothpaste potentially causes fluorosis, stomach ailments, acute toxicity, skin rashes, and impairment in glucose metabolism. Other chemicals ingested from toothpastes can cause toxic effect on teeth, bones, blood, muscles, nerves and 7 other parts of the body Considering the increasing prevalence of antibiotic resistance due to their use and also their side effects, medicinal plants are now consideredforuseagainstbacterialinfectionsandeffectiveinwithdentalproblems.
Typical toothpaste constitutes at least 50% of abrasive, which removes food debrisandstainsfromteeth.Calciumcarbonateisthemostcommonmildabra-
8 sive in practice. Dasanasamskara choorna in Bhaishajyaratnavali written in th18 century contains calcium carbonate as major ingredient in the form of khatika choorna Anti-bacterial effect of calcium carbonate nanoparticles has 9 beenscientificallyproved Theanti-bacterialactivityofmedicinalplantsisdue tothepresenceofpotentialbioactivecompounds,whichhelptoreducebacterial loadintheoralcavityandthuspreventtheformationofplaque,dentalcariesand ulcers With this background the present study ventures at the use of Dasanasamskara choorna for dantadhavana and to find out its effect in oral hygiene.
OBJECTIVESOFTHESTUDY:
1. ToassesstheeffectofdantadhavanawithDasanasamskarachoornainOHI –Sscore.
2. Toassesstheeffectof dantadhavana with Dasanasamskara choorna on oralmicroflora(Totalbacteriacount,streptococcusmutantscount)
MATERIALSANDMETHODS:
Studysetting: OPD of Department of Swasthavritta, Government Ayurveda College, Thiruvananthapuram.
Studypopulation: Volunteers registering in OPD of Swasthavritta with OHI-S poor (1.3-3.0) and fair(3.0-6.0)
Inclusioncriteria: 1. Agegroup18-45years 2. Bothsexes 3. Thosewhoarewillingtoparticipateinthestudy
Exclusioncriteria
Volunteerswith 1. Mouthulcers,gingivitisandperiodontitis 2. GoodOralHygieneIndex-Sscore(0-1.2) 3. Dentalbraces 4. Anyotherknownsystemicdiseases
Samplesize: 40(20studygroupand20controlgroup)
Studydesign:
Primaryobjective-Nonrandomizedcontroltrail
Secondaryobjective-Simplerandomsampling-Lotterymethod
Samplingtechnique: 40volunteersselectedfromthestudysettingasperinclusionandexclusion criteriausingconsecutivesampling.
Datacollection:
1. OralHygieneIndexscore-S(GreenandVermillion)
2. Microbiologicalexaminationofsaliva
3. Caseproforma
Studytool
1. OHI-Sscore(GreenandVermillion)
2. Microbiologicalexaminationofsaliva
IngredientsandmethodofpreparationofDasanasamskarachoorna: Ingredients-Sunthi (Zingiber officinale), Haritaki (Terminalia chebula), Musta (Cypress rotundus), Khadira(Acacia catechu), Ghanasara(Cinnamomum camphora), Guvaka bhasma (Areca catechu), Marica (Piper nigrum), Devapuspa(Syzygium aromaticum), Tvak(Cinnamomum verum, Khatika choorna (limestone/calcium carbonate). 200g each of sunthi, haritaki, musta, khadira,ghansara/karpura,guvakabhasma,marica,devapuspa,tvakand1800 gm of khatika choorna was used for the preparation. Guvaka bhasma was pre0 paredbyone puta under700 Celsiusfor6hours. Khatika wastakeninastainless-steel vessel and added enough quantity of clean water, macerated and filtered.Thewetpowderobtainedwasspreadonsteelplateanddriedundersuntill thepowdergetsdried.Itwasthensievedwellandthepowderisstoredinaseparate air tight container All the powdered drugs were taken in equal quantity (200gm) except khatika choorna which is taken 9 times (1800gm) and all the ingredientsmixedwell.Theprepared Dasanasamskara choorna wasstoredina largeairtightbottleanditwasthenpackedin100gairtightbottlesfordrugdispense.
Drugdispenseandapplicationofmedicine:
Forthestudygroup,100gof Dasanasamskara choorna wasgiveninanairtight bottle for 15 days and are advised to do regular brushing with 3g of Dasanasamskara choorna usingasofttoothbrushduringmorningandevening for2minutesfollowedbytonguecleaning.Forthecontrolgroup100gofparticulartoothpasteacceptedbyIndianDentalAssociationwasprovidedfor15days th and asked to do brushing similarly. On 15 day, again same procedures were repeated. Both of the groups are and asked to continue regular brushing as advisedaboveforthenext15days.
Collectionofsalivasamples: th Salivawascollectedincontainers(sterile)30mlsizeonzerothday,15 dayand st on31 day
Assessmentoftotalbacterialcountandstreptococcusmutanscount: Themethodusedforassessingthetotalbacterialcountandstreptococcusmutans countwasQuantitativemethod.ThesalivasampleswereinoculatedintoMutassanguisagarplateintwoways-1:10dilution&1:100dilutionmethod.
Assessmentofstudy th th th OHI-S of 40 volunteers was assessed on 0 , 15 and 31 days. Microbiological examination(totalbacteriacount,Streptococcusmutanscount)ofsalivaof5volth unteersselectedbylotterymethodfrombothgroupswasrepeatedlydoneon0 , th th 15 and31 day Theresultswereanalyzedstatisticallywithregardstochanges inOHI-Sandmicrobiologicalexaminationofsaliva.
Outcomevariables:
1. ChangeinOHI-S
2. Changesinmicrobiologicalexaminationofsaliva(Totalbacteriacountand Streptococcusmutanscount)
Statisticalanalysis: Descriptivestatisticssuchasfrequenciesandpercentagesaredeterminedinthe case of socio-demographic data, clinical features of the condition, data before andafterinterventioninordertogetabasicideaabouttheirdistribution.Forthe threestudyvariablesOHI-S,totalbacteriacount,Streptococcusmutanscount,at first the normality assumption of the data distribution was tested using Kolmogorov-Smirnov test. Since the data showed that the distribution of all studyvariableswerenon-normal,non-parametricstatisticalmethodswereused for analyzing the data. The effect of research medicine with in groups was assessedusingWilcoxonsignedranktest.Mann-WhitneyTestwasemployedfor betweengroupscomparisonbasedonstudyvariables.Theresultswerepresented
asmedian(rangeforeachvariable).Acalculatedvaluelessthan0.05isconsideredtobestatisticallysignificant.AlltheanalysiswasdonewiththehelpofsoftwareSPSSVersion22.0.
Ethicalconsideration: Noknownsideeffectsandtoxicityfortheproposedstudymedicine.Textualevidence supporting the therapeutic use is available. Certificate of consent from patientswillbeobtainedpriortothestudy
RESULTS:
1. OHI-SScore: TableNo.1:Dataandtestofsignificanceforthecomparisonofcontrol andstudygroupsbasedonpercentagelossinOHI-SScore
Group MedianRange Stage p Study Control 15.98(0.00-45.00) 0.00(-7.52-18.03) th th 0 day-15 day 0.000* Study Control 14.73(.00-33.50) 0.00(0.00-18.80) th st 15 day-31 day 0.000* Study Control 31.82(0.00-50.21) 7.58(-7.52-22.86) th st 0 day-31 day 0.000*
*Significant(p<0.05)
Aspertable1,instudygroupandcontrolgrouptheinterventionhassignificant th th th st effectonOHI-Sduring0 dayto15 day(p<0.05),15 dayto31 day(p<0.05) th st th th th st and0 to31 day(p<0.05). During0 dayto15 day,15 dayto31 dayand0th to31stdaystudygroupreportedsignificantlyhigherlevelofpercentagelossas comparedtocontrolgroupregardingOHI-S.
2. TotalBacterialCount: TableNo.2:Dataandtestofsignificanceforthecomparisonofcontrol andstudygroupsbasedonpercentagelossintotalbacteriacount
Group MedianRange p Stage Study Control
5 5 5 91.1905×10(8.57×10-94.03×10) 5 5 5 -5.0000×10(-26.83×10 -4.76×10) 0.008* th th 0 day-15 day Study Control 5 5 5 87.5000×10(37.00×10-94.62×10) 5 5 5 12.5000×10(-73.08×10-16.67×10) 0.008* th st 15 day-31 day Study Control 5 5 5 98.5366×10(88.57×10-99.51×10) 5 5 5 0.0000×10(-119.51×10-16.67×10) 0.008* th st 0 day-31 day
*Significant(p<0.05)
Aspertable2,inthestudygroup,theinterventionhassignificanteffectontotal th th th st bacteriacountduring0 dayto15 day(p<0.05),15 dayto31 day(p<0.05)and th st 0 to31 day(p<0.05).Thecontrolgrouphasnostatisticalsignificanteffecton th th th st totalbacteriacountduring0 dayto15 day(p>0.05),15 to31 day(p>0.05) th st th th th st th st and0 to31 day(p>0.05).During0 -15 day,15 -31 day,0 day-31 daystudy groupreportedsignificantlyhigherlevelofpercentagelossascomparedtocontrolgroupregardingtotalbacteriacount.
3. StreptococcusMutans: TableNo.3:Dataandtestofsignificanceforthecomparisonofcontroland studygroupsbasedonpercentagelossStreptococcusmutanscount
Group MedianRange Stage p Study Control 5 5 90.75×10(64.77×105-97.41×10) 5 5 6.25×10(-2.50×105-35.14×10) th th 0 day-15 day 0.008* Study Control 5 5 28.14×10(6.25×105-59.38×10) 5 5 21.95×10(-40×105-95.00×10) th st 15 day-31 day 0.548 NS Study Control 5 5 91.34×10(84.09×105-97.65×10) 5 5 49.86×10(0.00×105-95×10) th st 0 day-31 day 0.222 NS
*Significant(p<0.05)
NS:Notsignificant(p>0.05)
In the study group, the intervention has significant effect on streptococcus th th st mutanscountduring0 dayto15 day(p<0.05),15thdayto31 day(p<0.05)and th st 0 to31 day(p<0.05).Inthecontrolgroup,theinterventionhasnostatisticalsigth th nificance on average streptococcus mutans count during 0 day to 15 day th st th st (p>0.05),15 dayto31 day(p>0.05)and0 to31 day(p>0.05).
As per table 3, there exist significant percentage loss in streptococcus mutans th th countbetweencontrolandstudygroupduring0 day-15 day(p<0.05).Between th st th st 15 -31 dayandduring0 day-31 dayalsotheredonotexistsignificantpercentageloss(p>0.05)betweencontrolandstudygroups.Eventhoughthepercentage lossisstatisticallyinsignificant,thereisanobservedreductionoflossinStreptoth st coccusmutanscountbetweencontrolandstudygroupsfrom15 to31 dayand th st 0 to31 dayofsample.
DISCUSSION:
Oraldisorderscansignificantlyaffectthegeneralwell-beingofapersonbycausing pain and discomfort thus affecting the quality of life. Maintaining a clean mouth benefits overall health. Despite several chemical agents being commerciallyavailable,thesecanalteroralmicrobiotaandhaveundesirableside-effects suchasvomiting,diarrhoeaandtoothstaining.
Ayurveda hasbeenshowneffectiveinmaintainingoralhealth.Preventivedentistryisthepracticeofcaringteethtokeepthemhealthy Thepreventivepractices ofAyurvedaformaintainingoralhygienearenoteworthy Thepresentstudyaims to assess the effect of one such procedure of dinacharya–dantadhavana with Dasanasamskarachoornainoralhygiene.
In the study group, 60% of the volunteers use excessive sweets. In the control group,55%ofthevolunteersuseexcessivesweets.Sugarislikeamagnetforbad bacteria. The two destructive bacteria found in the mouth are streptococcus mutansandstreptococcussorbins.Bothofthesebacteriafeedonthesugarand formdentalplaque.Iftheplaqueisnotwashedawaybysalivaorbrushing,the environmentinthemouthbecomesmoreacidicandcavitiesmaystarttoform.In thestudygroup,70%ofvolunteershadbadbreath.Inthecontrolgroup,45%of volunteershadbadbreath. Improperoralhygienepracticesleadstobadbreathas thefoodparticlesremaininmouth.Inthestudygroup,50%ofvolunteerswere havingdentalcaries,70%ofvolunteersfromcontrolgroupwerehavingdental caries.Efficientoralhygienewasfoundtohaveacariespreventiveeffect.Dental caries is one of the most common infectious diseases affecting the oral cavity Among the oral bacteria, streptococcus mutans have been indicated as major cariogenic bacteria as they produce high levels of dental caries causing substancessuchaslacticacidandextracellularpolysaccharides.
1. OHI-SScore: StudygroupandcontrolgrouphassignificanteffectonOHIth th th st th Sduring0 dayto15 day(p<0.05),15 dayto31 day(p<0.05)and0 to st th th st th st 31 day(p<0.05). During0 dayto15 day,15thdayto31 dayand0 to31 day study group reported significantly higher level of percentage loss as compared to control group regarding OHI-S Thus, effect of Dasanasamskara choorna is more significant in oral hygiene considering OHI-Sscore.
2. TotalBacterialCount:Inthestudygroup,theinterventionhassignificant th th th st effectontotalbacteriacountduring0 dayto15 day,15 dayto31 dayand th st 0 to31 day Thecontrolgrouphasnostatisticalsignificanteffectontotal th th th st th st bacteriacountduring0 dayto15 day,15 to31 day and0 to31 day
.Thereexistsignificantpercentagelossintotalbacterialcountbetweenconth th th st trolandstudygroupduring0 day-15 day(p<0.05),15 -31 day(p<0.05) th st th th th st th and during15 day-31 day (p<0.05). During 0 -15 day, 15 -31 day, 0 stday-31 day study group reported significantly higher level of percentage lossascomparedtocontrolgroup.Thus,effectofDasanasamskarachoorna ismoresignificantinreducingthetotalbacterialcountinstudygroup.
3. StreptococcusMutans:Inthestudygroup,theinterventionhassignificant th th effectonstreptococcusmutanscountduring0 dayto15 day(p<0.05),15th st th st dayto31 day(p<0.05)and0 to31 day(p<0.05).Inthecontrolgroup,the interventionhasnostatisticalsignificanceonaveragestreptococcusmutans th th th st th countduring0 dayto15 day(p>0.05),15 dayto31 day(p>0.05)and0 st to31 day(p>0.05).
There exist significant percentage loss in streptococcus mutans count th th betweencontrolandstudygroupduring0 day-15 day(p<0.05).Between th st th st 15 -31 dayandduring0 day-31 dayalsotheredonotexistsignificantpercentage loss (p>0.05) between control and study groups. Even though the percentagelossisstatisticallyinsignificant,thereisanobservedreductionof loss in Streptococcus mutans count between control and study groups th st th st from15 to31 dayand0 to31 daysample.
PROBABLEMODEOFACTIONOFDASANASAMKARACHOORNA
Mode of action of Dasanasamkara choorna can be correlated with the rasapanchaka,doshakarma,vyadhiharapropertiesoftheingredients.
Sunthi is katu rasa, guru, ruksha, tikshnaguna, madhura vipaka and vathakaphahara in dosha karma It is mukharogagni, ruchya and krimidoshahara. Anti-inflammatory, anti-bacterial, action of shundi is proven bystudies.Evidencesfrominvitro,animal,andepidemiologicalstudiessuggest thatgingeranditsactiveconstituentssuppressthegrowthandinduceapoptosis of variety of cancer types including oral cancer Zingiber officinale extract has significantanti-microbialeffectsonS.mutans. Sunthi containcalciumandphosphorouswhichmayalsohelpindentalhealth.
Haritaki is pancharasa in rasa, kashaya rasa mainly Guru,tikshna, ushnaveerya,madhuravipaka,tridoshaharaindoshakarma Itiskrimihara.Itis one of the ingredients of triphala, which seems to full fill most of the requirementswithoutanyadverseeffectonoraltissuesandatveryminimalcost EthanolextractsofTerminaliachebulaprovedtopreventperiodontaldiseaseinduced bydentalplaquebacteria.AnaqueousextractofT chebulausedasamouthrinse seemstobeaneffectiveanticariesagent.Anti-inflammatory,antimicrobialproperties are proved by studies. Previous studies prove that haritaki is effective
anticariesmouthwash,owingtoitsabilitytoincreasesalivarypHandinhibitthe growthofStreptocooccusmutans.
Musta is of tiktha ,katu, kashaya rasa, laghu, rukshguna, seethavirya, katuvipakaandkaphapittaharaindoshakarma Ithasspecificactiononaruchi, krimi. It is janthujith according to kayyadevanigandu, janthuhrit according to Bhavaprakasha. Itisanti-inflammatory,anti-microbial. Cyperus rotundus alcoholicextracthadthegreatesteffectoninhibitionofgrowthanddeathofStreptococcusmutans.Itissuitableforthetreatmentandpreventionofperiodontitisand toothdecay
Khadira is tiktha kashaya rasa, laghu, rookshaguna, seetavirya and katuvipaka. Kapha-pitta hara in dosha karma Khadira isusedfor dantadhavana according to Charaka and Vagbhata It has action on kusta, krimi, kandu, vrana. It is sothahara and sleshmahara in karma It has bhoothahara action according to Raja nigandu Antiseptic, anti-inflammatory, anti-microbial actions of khadira areprovedbystudies.Itistonicandusefulinulcersandwounds,inflammations, odontopathy, pharyngodynia.Acacia catechu bark extract have got good antimicrobialactivityagainststreptococcusmutans.
Karpura is tikta, katu, madhura rasa, rukshaguna, seetavirya, katuvipaka and kaphahara in dosha karma. Itis aasyavairasyahara accordingto Bhavaprakasa and dourgandhyahara accordingto Bhavaprakasa and Charaka samhitha.Itis kustahara,krimihara,vranaharaandpossesslekhanaproperty Antiseptic,antimicrobialandanti-inflammatoryisprovenbystudies.Theextractactsisagood sourceofantimicrobialagentagainstvariousbacterialpathogensandexhibited broad spectrum of antibacterial activity Cinnamomum camphora significantly inhibitthegrowthoforalmicrobes,leadingtohealthygumsandfreshbreath.
Guvaka is kashaya madhura rasa, guru,ruksha, vikashiguna, seetavirya, katuvipaka, kaphapitta hara.It is ruchya, aasyavairasyanaasanam. Guvaka (betal-nut)iscoolingandanervinetonic.Chewingofitsnutspreventsdecayof teeth. It was used in this formulation as bhasma form. Bhasma are unique Ayurvedic preparation which means an ash obtained through incineration. These neutralize harmful acids that lead to illness.Achieve a healthy alkaline levelbyneutralizingacid. Guvaka bhasma containscarbonparticleswhichisa goodcleaningagent.FurtherresearchesoncharcoalashesshowedthatitishelpfulinchangingthepHandhealthofthemouth,andassuchiseffectiveinpreventingcavitiesandkillingthebadbacteriapresentintoothdecayandgingivitis.
Marica is katu rasa, laghu, rukshaguna, ushnavirya, katuvipaka and kaphavataharain doshakarma It possess krimihara property It is ruchikara (RN),janthunasanaandbhoothanasana(RN) Itpossesschedana(SN)property Its antioxidant, anti-inflammatory and anti-microbial properties are proven by studies.
Devapuspa/lavanga is tiktha, katu rasa, laghu, snigdaguna, seta virya, katuvipaka and kaphavatahara in dosha karma It is soolahara and peenasahara.Itsantibacterialactionisprovenbystudies.Itisusefulinhalitosis, odontalgia,burningsensation,anddentalcaries.Syzygiumaromaticumisantimicrobial,anti-fungal,andantioxidant.Researchdidonthephytochemicalproperties of Syzygium aromaticum have action against oral microorganisms like streptococcusmutans.Cloveoilalsopossessesbacterialeffectsondentalcarries andgingivitis.
Tvak is of katu, tikta and madhura rasa, laghu, rooksha ,tikshnaguna, ushnavirya and katuvipaka. Vatapitta hara in dosha karma It is beneficial in kusta and kandu It possesses specific action on peenasa It increases annabhiruchi Cinnamomum verum isusefulinodontalgia,halitosis,inflammations etc. Its antibacterial effect on oral bacteria has been reported. It also increasesthesalivaryflowwhichaidsincleaningtheoralcavity Cinnamicaldehyde is famous for its ability to impede the action of Streptococcus mutans, therebyresultinginaneffectivepreventionofdentalcaries.
Khatika choorna (calcium carbonate) is of tikta madhura rasa, seetaguna, seetaveerya, pitta hara in dosha karma. Sothahara, vranaropaka, dahahara are the properties of khatikachoorna. ItchemicallycontainsCaCo3,whichremoves fooddebrisandstainsfromteeth.Itisanti-inflammatoryandhascleansingproperty Anti-bacterialeffectofcalciumcarbonatenanoparticleshasbeenscientificallyproved.Itre-mineralizesthetoothsurface.
Sunthi, marica, musta, karpura, devapuspa, tvak possess katu rasa. Musta, khadira, devapuspa, tvak and khatika choorna possesses tiktha rasa Guvaka bhasma, khadira are of kashaya rasa Haritaki is of pancharasa dominant of kashayarasa Ghanasara,guvaka,tvakandkhatikachoornahavemadhurarasa. So majority of the drugs are here with katu,tiktha,kashaya or madhura rasa. Thesearetherasasindicatedfor dantadhavana byour Acharyas. Madhura rasa is additionally added by Acharya Susrutha and Bhavaprakasa. Katu rasais ruchya, sodhana, kledaupsoshana(driesup kleda),opensupthemetabolicpathways pacifies kapha, vaktramsodayathi (it keep the mouth clean) Mukhavaisadyakara ie. cleansing the oral cavity Even though tiktha rasa is arochaka it could reduce arcuchi(distaste) in the mouth. It is krimihara, daha and trishnasamana, lekhana, kledaupasoshana, ruksha,seeta, kandavisodana. Kashayarasaiskledavisoshana,kaphasamanaandruksha.
Sunthi, haritaki, khadira, ghanasara, guvaka bhasma and tvak possess rukska guna. Marica and tvak possess tikshna guna. Devapushpa have snigdaguna. Sunthi,haritaki, marica, tvak areof ushna virya and musta, khadira, ghanasara, guvaka bhasma, devapuspa, khatika choorna areof seetavirya. So,the yoga balances in ushna and seetavirya. Considering the dosha karma, sunthi, musta, khadira, ghanasara, guvaka bhasma, marica, devapuspa have kaphahara properties. Musta, khadira, guvakas bhasma, devapuspa, khadika possess pittahara properties.Sundthandmaricaarevatahara Haritaki istridoshasamana
Majority of the ingredients are of katu(astringent) and tikta rasa(bitter), laghu (light), rooksha (rough) and tikshna (strong) guna (properties), katuvipaka; seetavirya (cold potency) and kaphapittasamana karma in nature Vyadhiprabhava of some of the ingredients are very relevant in the context of mukharoga like aruchi and krimighna Sunthi, haritaki, musta, khadira, karpura, marica possess krimihara properties.Someoftheingredientspossess the action of lekhana and sodhana property also These properties of Dasanasamskarachoornamayhelpedtodecreasedebris,calculusandthebacterialload.
The katu and tikta rasa, laghu, ruksha and tikshnaguna, katu vipaka and kaphapitta samana karma of Dasanasamskara choorna may be considered as thefactorsforreducingsinusitis.Theinterventionwasalsoeffectiveinreducing stains, halitosis, distaste and feeling of coating in the mouth. Vitiated kapha along with food debris causes halitosis or dourgandhya in oral cavity Kaphahara action of the drugs and ruchikara properties of sunthi, musta, marica, tvak, guvaka may be considered for the positive changes in the study The reduction in coating of mouth (upadeha)may be due to laghu, ruksha and tikshnagunasofthedrugs.AllthesepropertiesofDasanasamskarachoornamay beconsideredforsignificanceofthestudy
CONCLUSIONS:
1. The study drug Dasanasamskara choorna mentioned in Bhaishajyaratnavali ishighlyeffectiveinimprovingoralhygiene.Itiseffectiveinreducing totalbacteriacountandStreptococcusmutanscount.
2. Theinterventioniseffectiveinreducingstains,halitosis,distasteandfeeling ofcoatinginthemouth.
3. Theinterventionismoreeffectivein kapha predominated prakrithi volunteers.
4. DasanasamskarachoornaishighlyeffectiveinimprovingoralhygieneconsideringOHI-Sscoreatp<0.05level.
5. Dasanasamskara choorna issignificantlyeffectiveinreducingtotalbacteriacountandStreptococcusmutanscountatp<0.05.
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