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PROLOTHERAPY FOR PAIN

PROLOTHERAPY

Prolotherapy (proliferative therapy), also know as sclerotherapy, ligament reconstruction therapy, and fibro-osseous injection therapy, is a recognized orthopedic procedure that stimulates the body’s nature healing processes to strengthen joints weakened by traumatic or over-use injury. Joints when ligaments or tendon attachments are stretched , torn, or fragmented, become hypermobile and painful. Traditional approaches with surgery and anti-inflammatory drugs often fail to stabilized the joint and relieve this pain permanently. Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new fibrous tissues, resulting in permanent stabilization of the joint. Prolotherapy can also be used to treat varicose veins, spider veins, hemorrhoids, other vascular abnormalities and other similar conditions.

Prolotherapy
Q: How does Prolotherapy work?
A: With a precise injection of a mild irritant solution directly on the site of the torn or stretched ligament or tendon, prolotherapy creates a mild, controlled injury that stimulates the body’s natural healing mechanisms to lay down new tissue on the weakened area. The mild inflammatory response that is created by the injection encourages growth of new ligament or tendon fibers, resulting in a tightening of the weakened structure. Additional treatments repeat this process, allowing a gradual buildup of tissue to restore the original strength to the area. Injection of varicose veins and other similar abnormalities creates a mild inflammatory response causing them to contract so that they become smaller or even vanish.


Q: What is in the solution that is injected?
A: The prolotherapy injections contain anesthetic agents and natural substances which stimulate the healing response. There are numerous substances, and each treating physician tailors the selection of substance according to the patient’s need.


Q: Is the Prolotherapy treatment painful?
A: Any pain involving an injection will vary according to the structure to be treated, the choice of solution, and the skill of the physician administering the injection. The treatment may result in mild swelling and stiffness. The mild discomfort passes fairly rapidly and can be reduced with pain relievers such as Tylenol. Anti-inflammatory drugs, such as aspirin and ibuprofen, should not be used for pain relief because their action suppresses the desired inflammatory process produced by the injection.


Q: Can Prolotherapy help everyone?
A: Each patient must be evaluated thoroughly with patient history, physical exam, X-ray exam, and full laboratory work up before treatment will be administered. With this information, your physician can evaluate your potential success with this therapy. Success depends on factors which include the history of damage to the patient, the patient’s overall health and ability to heal, and any underlying nutritional deficiencies that would impede the healing process.


Q: Who administers Prolotherapy?
A: Physicians who administer this form of therapy are trained by The American Osteopathic Association of Prolotherapy Regenerative Medicine. Postgraduate training is a prerequisite before treating any patient with a medical orthopedic problem, vein problem, or other condition which might benefit from prolotherapy.

Q: What areas of the body can be treated?
A: This form of therapy can be used to treat dislocation of the joints, knee pain, shoulder pain, Temporal Mandibular Joint dysfunction, Carpal Tunnel Syndrome, and disc problems at any level of the spine. The therapy affects only the area treated and does not cause any problem in any other area. Spider veins, abnormal or bulging veins and other similar conditions can be treated on the legs, feet, hands, arms, breast, face, and most other areas.

Q: How often do I need these treatments?
A: The treatments should be administered every one, two, or three weeks, as determined by your treating physician. Vein treatments are usually scheduled four or more weeks apart.

Q: What’s the rate of success in treatment?
A: The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal, and the type of solution used. In patients with low back pain with hypermobility, 85% to 95% of patienst treated experience remission of pain with this form of therapy. In comparison, the Journal of Bone and Joint Therapy reports on a 52% improvement in patients treated surgically for disc involvement. Varicose veins can usually be 90% to 100% eliminated. Spider veins can usually be improved 70% to 90%.

Artificially Sweetened Beverages, Stroke,and Dementia

Published in Primary Care

Journal Scan / Research · April 27, 2017

TAKE-HOME MESSAGE

  • The association between sugar- and artificially sweetened drink intake and risk for stroke or dementia was evaluated in the Framingham Heart Study Offspring cohort. After adjusting for multiple confounders, both recent intake and cumulative intake of artificially sweetened drinks were associated with significantly greater risks for ischemic stroke and dementia.
  • Similar associations were not found for sugar-sweetened drinks.

 

Artificially sweetened soda, stroke, and dementia

“As for butter versus margarine, I trust cows more than chemists.”

This quote by nutritionist Joan Dye Gussow supports how our manipulation of nature can get us in trouble. Last week, we reviewed how banning trans-fatty acids (a product of chemists, not nature) resulted in fewer heart attacks in New York. This week, we can see how artificial sweeteners in soda (also made by chemists) are associated with high risk of stroke (HR, 2.96) and dementia (HR, 2.89). This association was not seen with sugar-sweetened drinks.

This study should not be taken as suggesting that sugar-sweetened beverages are okay. We know that too much sugar is associated with many negative outcomes, including obesity, dysbiosis, and metabolic dysfunction. But the study should lend some caution as to the safety of artificial sweeteners. One that has had the most controversy is aspartame.

Aspartame is composed of 50% phenylalanine, 40% aspartic acid, and 10% methanol. One of several potentially toxic byproducts of aspartame is formaldehyde. Humphries et al summarized the potential cellular mechanisms aspartame has on the brain in the European Journal of Clinical Nutrition.1 They state that aspartame disturbs integrity of neuronal function, causes nerves to fire excessively, depletes ATP function in mitochondria, and causes dysfunction of the endothelium, leading to a compromised blood–brain barrier. The literature has mentioned concern for aspartame in relation to headaches, malignancies, and learning disabilities.

This was an observational study and thus causation cannot be made. An additional caveat to keep in mind when interpreting the results of this study is that participants with diabetes, who are more likely to develop stroke and dementia, also consumed more artificially sweetened beverages. While the authors adjusted for diabetes in supplementary analyses, it is likely that residual confounding in both primary and supplementary analyses has not been eliminated.

But this study is reminder that nature is smarter than we are. We are likely better off eating whole foods artfully combined by a good chef than a processed food put together by a biochemist.
Artificially Sweetened Soda and Stroke

Reference

  1. Humphries P, Pretorius E, Naude H. Direct and indirect cellular effects of aspartame on the brain. Eur J Clin Nutr. 2008;62(4):451-462. http://www.nature.com/ejcn/journal/v62/n4/full/1602866a.html

BACKGROUND AND PURPOSE

Sugar- and artificially-sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. We examined whether sugar- or artificially sweetened beverage consumption was associated with the prospective risks of incident stroke or dementia in the community-based Framingham Heart Study Offspring cohort.

METHODS

We studied 2888 participants aged >45 years for incident stroke (mean age 62 [SD, 9] years; 45% men) and 1484 participants aged >60 years for incident dementia (mean age 69 [SD, 6] years; 46% men). Beverage intake was quantified using a food-frequency questionnaire at cohort examinations 5 (1991-1995), 6 (1995-1998), and 7 (1998-2001). We quantified recent consumption at examination 7 and cumulative consumption by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 10 years. We observed 97 cases of incident stroke (82 ischemic) and 81 cases of incident dementia (63 consistent with Alzheimer’s disease).

RESULTS

After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer’s disease dementia. When comparing daily cumulative intake to 0 per week (reference), the hazard ratios were 2.96 (95% confidence interval, 1.26-6.97) for ischemic stroke and 2.89 (95% confidence interval, 1.18-7.07) for Alzheimer’s disease. Sugar-sweetened beverages were not associated with stroke or dementia.

CONCLUSIONS

Artificially sweetened soft drink consumption was associated with a higher risk of stroke and dementia.

Probiotic Reduces Depression and Alters Brain Activity in IBS

Published in Gastroenterology and
Journal Scan / Research · May 26, 2017
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TAKE-HOME MESSAGE

  • The effect of the probiotic Bifidobacterium longum NCC3001 on psychiatric symptoms was evaluated in 44 individuals with IBS and mild to moderate anxiety and depression in this randomized placebo-controlled trial. Compared with the placebo group, significantly more patients in the probiotic group had reduced depression scores, but not anxiety scores, at week 6.
  • The probiotic group also had increased quality-of-life scores and decreased limbic responses to negative stimuli on brain fMRI.

BACKGROUND & AIMS

Probiotics can reduce symptoms of irritable bowel syndrome (IBS), but little is known about their effects on psychiatric comorbidities. We performed a prospective study to evaluate the effects of Bifidobacterium longum NCC3001 (BL) on anxiety and depression in patients with IBS.

METHODS

We performed a randomized, double-blind, placebo-controlled study of 44 adults with IBS and diarrhea or a mixed-stool pattern (based on Rome III criteria) and mild to moderate anxiety and/or depression (based on the Hospital Anxiety and Depression scale) at McMaster University in Canada, from March 2011 to May 2014. At the screening visit, clinical history and symptoms were assessed and blood samples were collected. Patients were then randomly assigned to groups and given daily BL (n=22) or placebo (n=22) for 6 weeks. At week 0, 6 and 10, we determined patients’ levels of anxiety and depression, IBS symptoms, quality of life, and somatization using validated questionnaires. At week 0 and 6, stool, urine and blood samples were collected, and functional magnetic resonance imaging (fMRI) test was performed. We assessed brain activation patterns, fecal microbiota, urine metabolome profiles, serum markers of inflammation, neurotransmitters and neurotrophin levels.

RESULTS

At week 6, 14/22 patients in the BL group had reduction in depression scores of 2 points or more on the Hospital Anxiety and Depression scale, vs 7/22 patients in the placebo group (P=.04). BL had no significant effect on anxiety or IBS symptoms. Patients in the BL group had a mean increase in quality of life score compared with the placebo group. The fMRI analysis showed that BL reduced responses to negative emotional stimuli in multiple brain areas, including amygdala and fronto-limbic regions, compared with placebo. The groups had similar fecal microbiota profiles, serum markers of inflammation, and levels of neurotrophins and neurotransmitters, but the BL group had reduced urine levels of methylamines and aromatic amino acids metabolites. At week 10, depression scores were reduced in patients given BL vs placebo.

CONCLUSION

In a placebo-controlled trial, we found that the probiotic BL reduces depression but not anxiety scores and increases quality of life in patients with IBS. These improvements were associated with changes in brain activation patterns that indicate that this probiotic reduces limbic reactivity.

Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth

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Link to Publisher's site
Glob Adv Health Med. 2014 May; 3(3): 16–24.
Published online 2014 May 1. doi:  10.7453/gahmj.2014.019
PMCID: PMC4030608

Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth

Victor Chedid, MD, Sameer Dhalla, MD, John O. Clarke, MD, Bani Chander Roland, MD, Kerry B. Dunbar, MD, Joyce Koh, MD, Edmundo Justino, MD, Eric Tomakin, RN, and Gerard E. Mullin, MDcorresponding author
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Abstract

Objective:

Patients with small intestine bacterial overgrowth (SIBO) have chronic intestinal and extraintestinal symptomatology which adversely affects their quality of life. Present treatment of SIBO is limited to oral antibiotics with variable success. A growing number of patients are interested in using complementary and alternative therapies for their gastrointestinal health. The objective was to determine the remission rate of SIBO using either the antibiotic rifaximin or herbals in a tertiary care referral gastroenterology practice.

Design:

One hundred and four patients who tested positive for newly diagnosed SIBO by lactulose breath testing (LBT) were offered either rifaximin 1200 mg daily vs herbal therapy for 4 weeks with repeat LBT post-treatment.

Results:

Three hundred ninety-six patients underwent LBT for suspected SIBO, of which 251 (63.4%) were positive 165 underwent treatment and 104 had a follow-up LBT. Of the 37 patients who received herbal therapy, 17 (46%) had a negative follow-up LBT compared to 23/67 (34%) of rifaximin users (P=.24). The odds ratio of having a negative LBT after taking herbal therapy as compared to rifaximin was 1.85 (CI=0.77-4.41, P=.17) once adjusted for age, gender, SIBO risk factors and IBS status. Fourteen of the 44 (31.8%) rifaximin non-responders were offered herbal rescue therapy, with 8 of the 14 (57.1%) having a negative LBT after completing the rescue herbal therapy, while 10 non-responders were offered triple antibiotics with 6 responding (60%, P=.89). Adverse effects were reported among the rifaximin treated arm including 1 case of anaphylaxis, 2 cases of hives, 2 cases of diarrhea and 1 case of Clostridium difficile. Only one case of diarrhea was reported in the herbal therapy arm, which did not reach statistical significance (P=.22).

Conclusion:

SIBO is widely prevalent in a tertiary referral gastroenterology practice. Herbal therapies are at least as effective as rifaximin for resolution of SIBO by LBT. Herbals also appear to be as effective as triple antibiotic therapy for SIBO rescue therapy for rifaximin non-responders. Further, prospective studies are needed to validate these findings and explore additional alternative therapies in patients with refractory SIBO.

Key Words: Irritable bowel syndrome (IBS), rifaximin, Antibiotics, Small Intestine Bacterial Overgrowth (SIBO), Dysbiosis, Complementary and Alternative Medicine (CAM), Herbal Therapies

Antimicrobial efficacy of five essential oils against oral pathogens: An in vitro study

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Link to Publisher's site
Eur J Dent. 2013 Sep; 7(Suppl 1): S71–S77.
Nilima Thosar,1 Silpi Basak,2 Rakesh N. Bahadure,3 and Monali Rajurkar2
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This article has been cited by other articles in PMC.

Abstract

Objectives:

This study was aimed to find out the minimum inhibitory concentration (MIC) of five essential oils against oral pathogens and to find out the minimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) of five essential oils against oral pathogens.

Materials and Methods:

The antimicrobial activities by detecting MIC and MBC/MFC of five essential oils such as tea tree oil, lavender oil, thyme oil, peppermint oil and eugenol oil were evaluated against four common oral pathogens by broth dilution method. The strains used for the study were Staphylococcus aureusATCC 25923, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 and Candida albicans ATCC 90028.

Results:

Out of five essential oils, eugenol oil, peppermint oil, tea tree oil exhibited significant inhibitory effect with mean MIC of 0.62 ± 0.45, 9.00 ± 15.34, 17.12 ± 31.25 subsequently. Mean MBC/MFC for tea tree oil was 17.12 ± 31.25, for lavender oil 151.00 ± 241.82, for thyme oil 22.00 ± 12.00, for peppermint oil 9.75 ± 14.88 and for eugenol oil 0.62 ± 0.45. E. fecalis exhibited low degree of sensitivity compared with all essential oils.

Conclusion:

Peppermint, tea tree and thyme oil can act as an effective intracanal antiseptic solution against oral pathogens.

Keywords: Antimicrobial activity, essential oils, oral pathogens

INTRODUCTION

The spread of drug resistant pathogens is one of the most serious threats to successful treatment of microbial diseases. Essential oils and other extracts of plants have evoked interest as sources of natural products.[1] Essential oils also called volatile oils, are aromatic oily liquids obtained from plant materials such as flowers, buds, seeds, leaves, twigs, bark, herbs, wood, fruits and roots. An estimated 3000 essential oils are known, of which 300 are commercially important in the fragrance market.[2] The antimicrobial activity of essential oils is due to a number of small terpenoids and phenol compounds.[3] Several of these are classified as generally recognized as safe.[4] Essential oils such as tea tree oil, lavender oil, thyme oil, peppermint oil and eugenol oil have been traditionally used by people for various purposes in different parts of the world.

The root canal environment after chemomechanical treatment becomes unfavorable for microorganisms; there is reduced oxygen tension, limited nutrient availability and antimicrobial agents that act as driving forces in survival balance of bacteria in the root canal system.[5] Root canal dentinal tubules harbor microorganisms; also bacterial biofilm may be present at the apical portion of root canal and extra-radicular regions.[6] Therefore, irrigation with a broad spectrum antiseptic substances and interappointment intracanal medication has become a standard regimen in root canal therapy. Many species and herbs exert antimicrobial activity due to their essential oil fractions. For thousands of years clove oil (eugenol) has been used in dentistry. Eugenol has been used topically in dental practice to relieve pain arising from a variety of sources, including pulpits and dentinal hypersensitivity. Interestingly, eugenol exhibits irritant action in addition to its analgesic effect as found in certain studies.[7] So in search of plant essential oils possessing antimicrobial activity, this study was undertaken to determine in vitro, antimicrobial action of eugenol, thyme oil, tea tree oil, peppermint oil and lavender oil against four pathogenic oral micro-organisms.

In this study, it was aimed to detect in vitro antimicrobial efficacy of five essential oils against oral pathogens. Firstly, it was aimed to find out the minimum inhibitory concentration (MIC) of five essential oils against oral pathogens. Secondly, it was aimed to find out the minimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) of five essential oils against oral pathogens.

MATERIALS AND METHODS

We used five essential oils as following:

Tea tree oil, lavender oil, thyme oil, peppermint oil, and eugenol oil.

Essential oils

Five essential oils such as tea tree oil, lavender oil, thyme oil, peppermint oil and eugenol oil were obtained from Arromatantra, Mumbai, India. These oils were selected based on the literature survey and their use in traditional medicine. Quality of oils was ascertained to be pure.

Test organism

Microorganisms were obtained from the Department of Microbiology, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India. The strains used for the study were Staphylococcus aureus(ATCC 25923), Enterococcus fecalis (ATCC 29212), Escherichia coli (ATCC 25922) and Candida albicans (ATCC 90028). Stock cultures of bacteria were used for the study.

MIC and MBC/MFC determination

The antimicrobial activities by detecting MIC of five essential oils such as tea tree oil, lavender oil, thyme oil, peppermint oil and eugenol oil were evaluated against four common oral pathogens by broth dilution method [Figure 1].[8] MBC was detected by subculturing onto blood agar from the tube showing no turbidity (i.e., MIC) and the next tube to it. The blood agar plates were incubated at 37°C overnight for 18-20 h and on the next day the readings were taken. For MFC, subcultures were done on Sabouraud’s dextrose agar plates following the same procedure [Figures ​[Figures22–5]. Various concentrations of five essential oils used against oral pathogens were in doubling dilutions [Table 1]. Results were analyzed statistically by using the one-way analysis of variance.

Figure 1

Minimum inhibitory concentration of thyme oil forStaphylococcus aureus

Figure 2

Minimum bactericidal concentration for Enterococcus fecalis

Figure 5

Minimum fungicidal concentration for Candida albicans

Table 1

Different concentrations of essential oils against common oral pathogens

Figure 3

Minimum bactericidal concentration for Escherichia coli

Figure 4

Minimum bactericidal concentration for Stapholococcus aureus

RESULTS

Out of five essential oils, eugenol oil, peppermint oil, tea tree oil exhibited significant inhibitory effect [Table 2] with mean MIC of 0.62 ± 0.45, 9.00 ± 15.34, 17.12 ± 31.25 subsequently. There was no statistical significant difference in five essential oils (F = 1.61, P = 0.221) [Table 3]. Mean MBC/MFC for tea tree oil was 17.12 ± 31.25, for lavender oil 151.00 ± 241.82, for thyme oil 22.00 ± 12.00, for peppermint oil 9.75 ± 14.88 and for eugenol oil 0.62 ± 0.45 (F = 1.30, P = 0.312) [Table 4]. Eugenol showed antimicrobial activity at the lowest concentration compared with all essential oils i.e., for C. albicans: MIC, MFC: 0.1 μl/ml, for S. aureus: MIC, MBC: 0.4 μl/ml, for E. coli and for E. facelis: MIC, MBC: 1 μl/ml respectively [Figures ​[Figures22–5].

Table 2

MIC and MBC/MFC of five essential oils (μl/ml)

Table 3

MIC of five essential oils

Table 4

MBC/MFC of five essential oils

DISCUSSION

Tea tree oil is the volatile essential oil derived mainly from the Australian native plant, Melaleuca alternifolia. Tea tree oil is composed of terpene hydrocarbons, mainly monoterpenes, sesquiterpenes and their associated alcohols. Terpenes are volatile, aromatic hydrocarbons and may be considered polymers of isoprene, which has the formula C5H8.[9] Antibacterial activity in literature appeared from 1940 to 1980.[10,11,12,13] From the early 1990s onward, many reports describing the antimicrobial activity of tea tree oil appeared in the scientific literature.[9]

Antimicribial activity of tea tree oil is due to terpinen-4-ol, α-terpineol and 1,8-, which cause leakage of 260 nm-light absorbing material and render cells susceptible to sodium chloride.[14] Thus, tea tree oil causes lysis and the loss of membrane integrity and function manifested by the leakage of ions and the inhibition of respiration.[9] Antimicrobial resistant isolates of S. aureus,[15,16] C. albicans,[17] and E. faecium[18,19] have been found to have in vitro susceptibilities to tea tree oil. In this study, antimicrobial effect of tea tree oil for C. albicans (MIC: 0.5 μl/ml, MFC: 0.5 μl/ml) was found at the lowest concentration followed by S. aureus (MIC: 1 μl/ml, MBC: 2 μl/ml) and E. coli (MIC: 2 μl/ml, MBC: 2 μl/ml), lastly E. faecalis (MIC: 64 μl/ml, MBC: 64 μl/ml).

Much of pure lavender oil (Lavandula officianalis L. angustifolia [Miller] or L. vera-Labiatae/Lamiaceae) comes from Balkans. France still produces the finest quality, but production there is tumbled with the advent of the hybrid. Essential oil of lavender is obtained from the flowering tops by steam distillation method. Its principal constituents include monoterpens, Oxides, linalyl and geranyle esters, geraniol, linalool etc., It has variety of properties, which includes that it is anti-depressant, hypotensive, soothing, alleviates stress, anxiety and general debility. It is antiseptic and anti-inflammatory for colds, flu and sinusitis and throat infections. It is balancing, antiseptic, anti-inflammatory and regenerative; soothes acne, eczema, dandruff, hair loss, head lice, diaper/nappy rash, sunburn, insect bites and boils; relieves Athlete’s foot and herpes simplex. It has cleansing and calming effect; helps colic, dyspepsia, indigestion, flatulence and gastroenteritis. It is sedative and decongestant; lowers blood pressure reduces palpitations. It has musculo-analgesic and anti-inflammatory effect in neuritis, neuralgia, muscular sprains, cramps, aches and pains. It is also used in inhalations, vaporizers, compresses, bath application or massage.[20] In the study of Zuzarte et al., 2009[21] antifungal activity of lavender oil was found with MIC values of 0.32-0.64 μl/ml. In the study of Zuzarte (2011)[22] candida species, were found to be sensitive to lavender oil with MIC of 0.64 μl/ml. In our study, it was achieved with a higher concentration i.e., 8 μl/ml for C. albicans. S. aureus and E. faecalis were susceptible at the concentration of MIC: 32 μl/ml and MBC: 64 μl/ml respectively. E. coli was least susceptible with MIC: 128 μl/ml and MBC: 512 μl/ml.

The name thyme actually comes from the Greek word “thymos,” meaning small because of the fragrance of the plant. Thyme belongs to over 300 species of hardy, perennial herbaceous plants and shrubs that are native to Europe, particularly around Mediterranian. It is one of the Hippocrates 400 simple remedies. Essential oil of thyme (Thymus Spp, T. citriodorits, T. vulgaris-Labiatae/Lamiaceae) is obtained from the leaves and flowering tops by steam distillation method. Its principal constituents include 20-40% thymol and carvacrol with borneol, cineol, linalool, menthone, B-cymene, pinene and triterpenic acid. Thyme oil is a tonic stimulant and stomachic and digestive relieves gastritis, enterocolitis and mouth thrush. It is useful for respiratory infections, asthma and bronchitis. It is effective for treating swelling provoked by gout or rheumatic problems, for joint pains, backache and sciatica. Thyme oil is also useful for urinary and vaginal infections, endometritis (candida), prostrates and vaginitis.[20] Thyme oil exhibits antibacterial activity and has been useful in dental practice.[23] A component of thyme, known as thymol, appears to inhibit growth of oral pathogens in the mouth and in combination with other essential oils, may reduce dental caries.[24,25] In patients with orthodontic brackets, a dental varnish containing thymol reduced the proportion ofStreptococcus mutans in supragingival plaque near the bracket.[26] Thymol is one of the essential oils with antibacterial effects found in Listerine.[27] In the study of Gislene et al., 2000[28] Hili et al.,1997[29] and Nzeako et al., 2006[30] thyme and clove oil possessed antimicrobial activity againstS. aureus, E. coli and C. albicans at various concentration of the extracts. In our study, antimicrobial susceptibility in order of sequence for thyme oil was E. coli with MIC: 2 μl/ml, MBC: 8 μl/ml, C. albicans with MIC, MFC: 16 μl/ml, E. faecalis with MIC, MBC: 32 μl/ml and S. aureus with MIC, MBC: 32 μl/ml respectively.

Essential oil of peppermint (Mentha piperita-Lamiaceae/Labiatae) is cultivated on a wide scale in Europe, USA and Japan. It is extensively used in toiletry, food and pharmaceutical industries. A variety of products ranging from toothpastes, mouthwashes and digestive tablets to sweets, ice cream and liquors are flavored with peppermint. Essential oil of peppermint is obtained from the leaves by steam distillation method. Its principal constituents include monoterpinic alcohols mainly menthol (38-48%), ketones mainly menthones (20-30%), some monoterpens and oxides. It is a good antiseptic, antibacterial and antiviral. It has light, clean, refreshing aroma and is a good insect repellant. It has stimulating and strengthening effect; in treatment of shock, helpful for neuralgia and relief of general debility, headaches and migraines. It has antiseptic and anti-spasmodic effect; in reducing mucus and relieving coughs, sinusitis, throat infections, colds, flu, asthma and bronchitis. It is also used in inhalations, baths or applications. It has got cooling and cleansing effect; soothes itchy skin, relieves inflammation. It has soothing and anti-spasmodic effect; relieves acidity, heartburn, diarrhea, indigestion and flatulence, also effective for travel sickness and nausea. It has cooling effect in case of varicose veins and hemorrhoids.[20] Peppermint oil makes the mouth feel fresh and of course, makes the formula taste good. Peppermint oil can also increase salivation, which is useful because dry mouth may result in halitosis.[31] In our study, antimicrobial effect was achieved at the concentration of 0.5 μl/ml for C. albicans and at the concentration of 32 μl/ml for E. coli, S. aureus, E. faecalis (32 μl/ml).

The clove plant grows in warm climates and is cultivated commercially in Tanzania, Sumatra, the Maluku (Molucca) Islands and South America. The tall evergreen plant grows up to 20 m and has leathery leaves. The clove spice is the dried flower bud of Eugenia caryophyllata species. Essential oils are obtained from the buds, stems and leaves by steam distillation. The buds or cloves are strongly aromatic. Clove buds yield approximately 15-20% of a volatile oil that is responsible for the characteristic smell and flavor. The bud also contains a tannin complex, a gum and resin and a number of glucosides of sterols. The principal constituent of distilled clove bud oil (60-90%) is eugenol (4-allyl-2-methoxyphenol). The oil also contains about 10% acetyleugenol and small quantities of gallic acid, sesquiterpenes, furfural and vanillin and methyl-n-amyl ketone. Other constituents include flavonoids, carbohydrates, lipids, oleanolic acid, rhamnetin and vitamins.[32]

Eugenol is widely used and well-known for its medicinal properties. Traditional uses of clove oil include the use in dental care, as an antiseptic and analgesic.[33] It is active against oral bacteria associated with dental caries and periodontal disease[34] and effective against a large number of other bacteria[35,36,37,38] and virus.[39] Previous studies have reported biological activities of eugenol including antifungal,[40,41,42] anti-carcinogenic,[43] anti-allergic,[44,45] anti-mutagenic activity,[46] antioxidant[47] and insecticidal[48] properties. In our study, eugenol oil showed antimicrobial activity at the lowest concentration against all organisms compared with all essential oils such as for C. albicans with MIC, MFC: 0.1 μl/ml, for S. aureus with MIC, MBC: 0.4 μl/ml, forE. coli and for E. facelis with MIC, MBC: 1 μl/ml respectively.

CONCLUSION

Hence, this study concludes that apart from traditional use of eugenol, antibacterial effects of essential oils such as peppermint oil, tea tree oil, thyme oil also can provide an effective intracanal antiseptic solution against oral pathogens.

Footnotes

Source of Support: Nil.

Conflict of Interest: None declared

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