May 4, 2016
By Virender Sodhi, MD (Ayurved), NMD & Priya Walia, MS (Ayurveda), NMD
Ayurveda & the Mouth
“Swasthyavrit: Circle of Health”
In continuation of this series on “Swasthyavrit,” we are going to take a look at what the ancient wisdom of Ayurveda has to offer for oral health.
Just like any body system or organ, Ayurveda has its individualistic approach in looking at the health of the mouth. This is further defined by each individual’s constitution (Prakriti) and current environmental influences (weather, relationships, mental/emotional state, diet, and lifestyle) that make up an individual’s current state of imbalance (Vikriti).
Each dosha withholds characteristics that help define the various “oral types.” These qualities further predetermine what potential “problems” one may experience in his/her mouth.
|Vata Dominant / Imbalance (ether & air)||Pitta Dominant / Imbalance (fire & water)||Kapha Dominant / Imbalance (earth & water)|
|Characteristics||Dry, rough, cracked, thin, receding gums, tooth pain, cavities||Sensitive, prone to redness, itchy, ulcers, bleeding gums, allergies||Mucus (can be thick), dental plaque & tarter, thick white coating on tongue|
Healthy Nutrients for Oral Health:
As Benjamin Franklin mentioned, “One should eat to live, not live to eat,” it is essential to recognize what we are putting into our mouth and how that is affecting our health. In this case, let’s consider what nutrients impact the health of the mouth. Key nutrients are outlined below.
Water Soluble Vitamins for Oral Health
|Function in the Mouth||Source||Deficiency Symptoms|
|Vitamin C- Ascorbic Acid||
|B1- Thiamine||Produce energy, new cells||
||Burning mouth (symptom in a condition known as Beriberi)|
|B2- Riboflavin||Produce energy, new cells||
||Ariboflavinosis: angular cheliosis, glossitis|
|B6-Pyridoxine||Metabolize carbohydrates, fats, proteins||
|Biotin||Structure and support- collagen||
Fat Soluble Vitamins for Oral Health
|Function in the Mouth||Source||Deficiency Symptoms|
|Vitamin A & Beta Carotene||
|Vitamin K||Used in formation of clotting||
||Failure to stop bleeding|
Minerals for Oral Health
|Function in the Mouth||Source||Deficiency Symptoms|
|Calcium||99% stored in teeth and bones||
|Fluorine||Stored in teeth and bones||Tea, gelatin, seafood, fluoridated water||
|Magnesium||60% in bones and teeth||
||Hypertrophy of gum tissue|
||Red meat (beef), chicken liver, clams, mollusks, mussels, oysters, sardines, turkey, salmon, halibut, tuna, veal, beans/lentils, spinach, pumpkin seeds, sesame seeds, squash seeds, potato, broccoli, nuts, Nettles||Angular cheliosis, pallor of lips and mouth tissue, glossitis, candidiasis, dysphagia|
||Oysters, beef, crab, lobster, liver, pork, chicken, yogurt, cashews, cheese, oatmeal, milk, almonds, beans, peas, flounder, sole, nuts and seeds||
To note: most all nutrients that have been highlighted above are and can be sufficiently consumed by food alone. Before the advent of synthetic vitamins and supplements, the human species relied heavily on nutrition from food. Although a primitive thought, we are still primitive beings that prosper with consuming natural products so the body can utilize such products as it needs.
- Crunchy, fibrous vegetables and fruits increase salivary flow, which helps provide antibacterial effects. Other food sources that stimulate salivary flow include: cool, sour, and tart nutrient dense foods.
- All simple sugars are potentially cariogenic (cavity causing). These include: refined sugar products, candy, cookies, cakes, pastries, corn syrup soda, juice, and chips.
- A lukewarm water swish in the mouth after meals may help rinse and prevent food from sticking to or in between the teeth. In Ayurveda, this is a routine practice and is known as water pulling (gandusha).
Oral Care and Cleansing:
Oil Pulling (Kavala Gandusha/Graha)
Newer to the Western world, oil pulling has been touted in Ayurveda as a practice that cures over 30 systemic illnesses, including headaches, hypertension, diabetes, and asthma. Oil pulling also helps prevent bad breath, decay, bleeding gums, dry mouth/throat, loss of taste, cracked lips, strengthens teeth, gums and the jaw, and purifies the entire system.[15,16]
Recent studies have validated the use of oil pulling in oral health. Specifically, there has been significant benefit in gingival index scores, plaque index scores, and total colony count of aerobic microorganisms, including Streptococcus mutans and Lactobacillus count. The effects have been found to be comparable to the “gold standard” of chlorhexidine mouthwash.[17,18]
The Two Methods:
In Kavala Graha, the mouth is filled in the mouth and then swished for 15-20 minutes in the morning and evening. In Kavala Gandusha, the oil is filled in the mouth and just kept closed for 15-20 minutes in the morning and evening.
Over time, the viscous oil becomes thin and white as it fills with toxins and bacteria and should be spit out. This is done in the morning when first waking, prior to using a toothbrush or chewing stick.
Oil pulling is typically done with sesame oil, which is tridoshic, coconut oil, or olive oil.
For an added benefit, powdered herbs can be added to the oil. Herbs that are specific to the oral cavity will be highlighted below.
Brushing with Chewing Sticks (Datun)
Before tooth brushes, chewing sticks of different herbal twigs were and are continued to be used to cleanse the teeth. Recent studies have validated the use of chewing sticks as being equal to and greater than the cleansing, mechanical, and gingivitis and cavity prevention effects when compared to the common toothbrush. Such herbal twigs are kashaya (astringent), katu (acrid), or tikta (bitter) in taste and quality.[19,20,21,22] The basic method includes chewing the twig at one end. Generally, a fresh stick is taken from the tree of specific plants. Common plant sticks used include:
- Common to experience receding gums
- Recommend bitter-sweet or astringent tastes:
- Licorice (Glyccrhiza glabra)
- Black catechu or the cutch tree (Acacia catechu linn)
- Common to have inflamed gums
- Recommend bitter taste:
- Neem (Azadirachta indica)
- Arjuna (Terminalia arjuna),
- Common to have pale or hypertrophic gums
- Recommend pungent taste:
- Fever nut (Caesalpinia bonduc)
- Milkweed plant (Caltropis procera)
Other common herbs to use for general oral health:
- Prickly ash (Zanthoxylum americanum)
- Babul tree, or Gum accacia (Acacia arabica)
- Amla (Emblica officinalis)
- Known to be a traditional Rasayana (rejuvenator), amla helps to rebuild and maintain tissue health.
- Most potent source of antioxidants and vitamin C.
- Amla supports healing, develops connective tissue, and tonifies the tissue of the oral cavity.
- Curcumin (Curcuma longa)
- Extracted from turmeric, curcumin is a potent anti-inflammatory and anti-bacterial herb to support the health of the mouth
- Known as the “three fruits,” Trifal has been used as an overall Rasayana (rejuvenator) in Ayurveda.
- Recent studies have shown that Triphala has antibacterial properties against S. mutans bacteria, plaque and gingival index, and is as or more effective than the standard mouthwash, Chlorhexidine.[23,24,25]
According to Ayurveda, parts of the tongue are related to different organ systems, such as: the lungs, the heart, the stomach, the liver, the spleen, the kidneys, thyroid, spine, and the intestines. Thus, by maintaining the health of the tongue, one can affect different organs in a positive manner. This simple procedure will remove excess coating on the tongue, prevent and remove bad breath (halitosis), remove stagnation, remove toxins, and help with functioning of the digestive system.
One does this with an empty stomach in the morning. The scraper is placed as far back and on the surface of the tongue as the tongue is extended out as far as possible. Next, the tongue scraper is pulled, gently, forward towards the tip of the tongue. The tongue scraper is then rinsed the procedure is repeated as needed, usually about 5-7 times.
As such, the general hygiene of the mouth extends from just a toothbrush, floss, and mouthwash. Daily practices are held in place to not only maintain the health of the oral cavity, but the health of the entire body, as each body part is connected and impacted by one another.
In continuing with the “Circle of Health,” our next topic will discuss the promotion and maintenance of the other sense structures: the eyes, ears, and nose.
-  Vernetti-Callahan, Diane. Nutrition and oral health: Eating well for a healthy mouth, 2016.
-  “Vitamin C- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Thiamin- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Riboflavin- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Vitamin B6- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Pantothenic acid and biotin”. Medline Plus 2015.
-  “Vitamin A- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Vitamin D- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Vitamin K- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Calcium- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Food sources of phosphorus”Dietitians of Canada 2014
-  “Fluoride in the diet”. Medline Plus 2015
-  “Magnesium- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
-  “Zinc: Fact Sheet for Health Professionals” National Institutes of Health: Office of Dietary Supplements.
-  Bethesda M. A closer look at Ayurvedic medicine. Focus on complementary and alternative medicine. National Center for Complementary and Alternative Medicine, US National Institutes of Health, US National Institutes of Health. 2006;XII(4).
-  Hebbar A, Keluskar V, Shetti A. Oil puling – Unraveling the path to mystic cure. J Int Oral Health. 2010;2:11-4.
-  Asokan et al. Effect of oil pulling on plaque induced gingivitis: A randomized, controlled, triple-blind study. Indian J Dent Res. 2009;20:47-51.
-  Singla, N et al. Effect of oil gum massage therapy on common pathogenic oral microorganisms – A randomized controlled trial. J Indian Soc Periodontal. 2014;18(4):441-446.
-  Malik et al. Comparative effectiveness of chewing stick and toothbrush: A randomized clinical trial. N Am J Med Sci. 2014; 6(7): 333-337)
-  Bhambal et al. Comparative effect of neem stick and toothbrush on plaque removal and gingival health- A clinical trial. J Adv Oral. 2011;2:51-6.
-  Patel at al. Clinical effect of Miswask as an adjunct to tooth brushing on gingivitis. J Indian Soc Periodontal. 2012; 16:84-8.
-  Ezoddini-Ardakani F. Efficacy of Miswask (Salvadora persica) in preventing dental caries. Health. 2010; 2:499-503.
-  Sriagesh J, Krishnappa P, Somanna SN. Antibacterial efficacy of triphala against oral streptococci: an in vivo study. Indian J Dent Res. 2012 Sep-Oct;23(5):696. Pubmed ID: 23422630
-  Prabhakar J, Balagopal S, Priya MS, Selvi S, Senthilkumar M. Evaluation of antimicrobial and 0.2% chlorhexidine against Streptococcus mutans biofilm formed on tooth substrate: an in vitro study. Indian J Dent Res. 2014 Jul-Aug;25(4):475-9. Pubmed id: 25307912
-  Naiktari RS, Gaonkar P, Gurav AN, Khiste SV. 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):134-140. Epub 2014 Jun 5. Pubmed Id: 24921057