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Introduction

In 2019, a new corona virus was identified as the cause of a disease outbreak that originated in China. Coronaviruses are single stranded positive-sense RNA viruses that possess large viral RNA genomes. Sequence analysis showed that the 2019-nCoV possesses a typical genome structure of coronavirus and belongs to the cluster of beta corona viruses. The coronavirus belongs to a family of viruses that may cause various symptoms such as pneumonia, fever, breathing difficulty, and lung infection.1

Oral hygiene is very supreme important to remain healthy because many of the infections start from the mouth. Dental hygiene to maintain health and beauty. The healthy teeth, tongue is very much necessary for healthy body. 2 Concept of dentistry was well practiced and fully developed in ancient Ayurveda. Ayurveda had mentioned various herbal drugs and procedures for maintaining oral hygiene. It describes various procedures and herbals to keep appropriate oral hygiene with use of herbs like Neem, Amalaki, Karanja, Khadir, Miswak and procedure like Dantdhawan, Jivhanirlekhan, Gandush, Kawaldharan etc.  Preventive measures for Covid-19 are the current strategy to limit the spread of cases. Early screening, diagnosis, isolation, and treatment are necessary to prevent further spread. The most important strategy for the population to undertake is to frequently wash their hands and use hand sanitizer and avoid contact with their face and mouth.3 It is essential to clean and brush the teeth in the morning after getting up, after lunch and dinner or after eating anything for the prevention of various dental problem.  Common signs and symptoms can include fever, cough, breathlessness  and tiredness. It was also observed that in most of cases symptoms of COVID- 19 include a loss of taste and loss of smell. In some case symptoms like muscle aches, chill, sore throat, runny nose, headache, chest pain.5

In this scenario most worsen symptoms was loss of taste of mouth, which was further result in Anorexia and it leads to weakness due to loss of energy that’s why it is reason to worry for these types of symptoms in covid-19 cases. In this regards Ayurveda had mentioned various procedures for maintaining oral hygiene. These include procedures like Gandusha, Kavala, Dantadhavana and Jivha lekhana (cleaning tongue).6 The Ayurveda literature observed that there are several Ayurvedic herbal drugs, which can be commonly used in prevention as well as management of oral diseases, so Ayurveda medicinal plant and procedure can be implemented in the patients of covid-19 for getting relief from specific condition like loss of taste.

Objectives: To review on various Ayurvedic remedies in dental health care.

Methodology:

                  Literatures on advance research on the Dental health care and Ayurvedic Medicine including original articles and paper in PubMed

database were taken into the study for review. Conceptual review done from Various Ayurvedic treatises and other classical Ayurveda books, similarly textbooks on Oral hygiene.

Ayurvedic procedures for Oral hygiene:

Herbal Tooth powder : (Dantashodhan Churna)

                  Tooth powder can be prepared with  equal quantity of Sunthi, Maricha, Pippali, Tvak, Lavanga, Tamalapatra, Triphala, Khadira and Saindhava which, should be used as a paste after mixing it with Tila Taila . Before use, powder must be filtered through a fine cloth.

Dantadhavana (Cleaning the Teeth):

                  Tooth brushing (Dant Dhawan) with Bakul (Mimusops elengi) ensures good dental health and hygiene. It acts against cavities, pyorrhoea, halitosis bleeding gums, gingivitis, sensitive teeth and cleans teeth.

For the purpose of brushing of teeth, A soft brush can be made by biting and chewing the tips of fresh stems of Arka, Nyagrodha, Khadira, Karanja, Arjuna or katunimba, mastication of stems acts as a good exercise for the teeth and gums. Each tooth should be brushed individually. Chewing on these stems for tooth cleaning is supposed to cause attrition and levelling of biting surfaces, facilitate salivary secretion and possibly, help in plaque control, while some stems have an anti-bacterial action. 7

 

Tongue scrapping (Jivha Lekhana)

It is also a part of cleaning the oral cavity. Cleaning of tongue is known as ‘Jihva-Nirlekhana’. For Tongue scrapping thin plate of gold, silver, copper or leaf or a thin wooden plate may be used as a tongue cleaner. 8 Tongue scrapping on a regular basis stimulates the reflex points of the tongue. This procedure helps to removes microorganism growth in superficial coating of tongue  followed by bad odour or halitosis. Also tongue scrapping improves the sense of taste and stimulates the secretion of digestive enzymes. Gold, silver, copper, stainless steel products can be used as an ideal for the scrapping of the tongue.9

Kavala / Gandusha (Gargling ):

                  Gandusa is like Gargling in Mouth with medicated herbal decoction and Kavala both are therapeutic measures. Each type is used to treat  different  oral cavity disorders.

                  Kavala: Medicated liquid particularly decoction (kwath ) is kept in the mouth incompletely and patient is advised to rotate in the mouth for a specific time and then asked to spit it out. As per Sharangadhara, Kalka (medicated fluid) drugs are used in Kavala and Liquids are used in Gandusa.10 In Gandusha, decoction(water processed with various medicinal herbs)  is held in mouth for certain duration. In Kavala, water is moved in mouth. However, Danta-dhavana is cleaning of teeth and it is to be done with stem of certain plants like Neem (Azadirachta indica) as it acts as Antibacterial, Antiviral, Antifungal, analgesic, immune-stimulator and it has also antioxidant properties. Gandush with using Neem decoction  is very effective in the loos of taste as neem having properties of cleaning superficial coating of tongue and taste buds  get fresh.11 Turmeric has antiseptic, anti-viral and anti-allergic properties. As per Ayurveda it is said to have Deepana (carminative) and Pachana (digestive) action. Kawala with turmic and hot water is beneficial in loss of taste. Kali Mirch (Black pepper) - Piper nigrum  and Tulasi decoction Kawal  also very useful in oral hygiene.

Discussion

Now a days, demand of herbal dental health care products are raised, various Herbal products in the form of tooth pastes, gum paints, mouth washes, and root canal irrigants are used in oral health care etc.12 Recently COVID-19  outbreak , due to poor immunity and  poor personal hygiene and more  chances of getting susceptible to such communicable diseases. Kawalgraha or Gandhusha are described well in  ayurvedic treatise like of Charaka Samhita and Sushruta Samhita. Kavala and Gandush kriyas are claimed to cure several systemic diseases. Keeping the medicated oil or Kashaya of herbal mentioned as above (decoction) in the mouth for some time until the eyes start watering  keeps the oral cavity clean, strengthens the gums, and clears the mucus plugs if adhered in the channel while Gandush (Gargling) with Oil or medicate herbal decoction  which helps to clear the sinuses and keeps the channel patent. Regular gandoosha are swarabalam (strength to voice) is also beneficial if voice is affected in covid-19.13 Thus, Gandush is the act of holding liquid or herbal decoction or oil in the mouth for 10–20 min and spits it out without swallowing. It is proved and accepted  that the act of swishing oil draws out microbes from various parts of the mouth and detoxifies the toxins.14 Dantadhavana (tooth brushing) followed as per Ayurvedic method  stimulates taste perception and increases the salivation. Saliva contains lysozyme and secretory IgA which act as antimicrobial agents. As the herbs used in Danta-Dhavan method  includes Neem, Arka, Neema (Azadirachta indica), Karanja (Millettia pinnata), Khadira, Black Catechu (Acacia Catechu) sticks which are antibacterial, antiviral,  antiparasitic, anti-inflammatory, anticarcinogenic, antioxidant, immune upregulation.15

Jhihwanirlhekhana is used for cleaning tongue with the help of tongue scraper. It should be made up of either metal or branches of the tree. Ayurveda places great importance scraping the tongue every morning.  It helps in removing dirt from tongue, bring freshness of mouth and increase taste sensation, it stimulates the reflex points of the tongue. stimulate the secretion of digestive enzymes. 16

So, it is only way to prevent infections from virus  is to maintain self-immunity as well as oral hygiene by adopting wearing mask and various method mentioned in Ayurvedic literature for good oral health in patients or healthy person.  A healthy lifestyle involves eating nutritious food, practicing hygienic habits, regular hand wash  walking and regular exercise or yoga , maintaining good emotional and mental health, adequate sleep and measure given in Indian system of medicine are mostly useful for preventing spread of any disease including COVID-19.

Conclusion

COVID-19 is a pandemic which affected human living badly.  In Covid loss of taste is typical symptoms observed in most of case. There are Kawal, Gandush, Jivha Nirlekhan, Dantadhawan are some procedures mentioned in Ayurveda which has proven beneficial in  Oral health. Appropriate  therapy of Gandusa and Kavala definitely works in  alleviation of disease, clears the mouth, improves depth of voice and stimulates the sense organs and it can reinstate the taste of mouth, anorexia, which badly affect in covid-19 infection.  Dantdhavann found useful in  get rid from bad odour of mouth along with increase interest towards food. Tongue scrapping( Jivha Nirlekhan) stimulates the reflex points of the tongue also removes bad odour (halitosis). It further improves the sense of taste and ultimately stimulate the secretion of digestive enzymes. So further research can be conducted on patients of covid-19 to generalised the results and it can be implemented  treatment plan along with covid-19 treatment protocol.