International Dental Journal 2011; 61: 287–296

REVIEW ARTICLE
doi: 10.1111/j.1875-595X.2011.00064.x

Herbs in dentistry
Jamile B. Taheri1, Somayyeh Azimi2, Nasrin Rafieian3 and Hosein Akhavan Zanjani4
1
Oral Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran; 2Oral Medicine, Qazvin University of Medical Science, Qazvin, Iran;
3
Oral Medicine, Hamedan University of Medical Science, Hamedan, Iran; 4Dentist, Tehran, Iran.

Herbs have been used for centuries to prevent and control disease. Herbal extracts are effective because they interact with
specific chemical receptors within the body and are in a pharmacodynamic sense, drugs themselves. By using herbal
medicines, patients have averted the many side effects that generally come with traditional medicines, but this does not mean
that side effects do not occur. Only knowledgeable practitioners can prescribe the right herb and its proper dosage. Herbal
medicines had been considered in every culture, however, pharmaceutical companies overturned this type of thinking. Now,
pharmaceuticals are called traditional and herbs are libeled as the ‘alternative’. The biggest challenge and problem is lack of
information about the effect of herbs in oral tissues, mechanism of effect, and side effects. Several popular conventional drugs
on the market are derived from herbs. These include aspirin (from white willow bark), digitalis (from foxglove), and sudafed
(modelled after a component in the plant ephedra). Herbal products can vary in their potency. Therefore, care must be taken
in selecting herbs, even so, herbal medicines have dramatically fewer side effects and are safer to use than conventional
medications. The herbs described in this article are Bloodroot, Caraway, Chamomile, Echinacea, Myrrh, Peppermint,
Rosemary, Sage, Thyme, Aloe Vera, Propolis, and a summary of other herbs that are useful in dentistry. Herbs may be good
alternatives to current treatments for oral health problems but it is clear that we need more research.
Key words: Oral health, oral health promotion

Practitioners and consumers of complementary and
alternative medicine (CAM) are no longer at the
periphery of clinical practice1. Herbal medicine is a
popular form of CAM2. Herbs, botanically speaking,
are any plants that lack the woody tissue characteristic
of shrubs or trees. More specifically, herbs are plants
used medicinally or for their flavour or scent. Herbs
with medicinal properties are a useful and effective
source of treatment for various disease processes. Many
drugs used in Western medical science called allopathic
medicine have their origin in medicinal plants3,4.
Many who support herbal therapies, believe that
extracting the chemical rather than using the whole
plant eliminates such active ingredients as minerals,
volatile oils, bioflavonoids, and other substances that
support a particular herb’s medicinal properties3,4.
Herbs are used to cleanse the blood, warm and
stimulate the body, increase surface circulation,
increase elimination of wastes, reduce inflammation,
and calm and soothe irritation. Herbs may be used
internally as pills, syrups, and infusions, or externally
as poultices, plasters, and liniments. A topical applica-
tion of clove oil, for instance, will stop the pain of
toothache. Moist herbal wraps, either hot or cold, can
be used on specific affected parts of the body. These
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wraps are especially effective for sore, tense muscles
such as those in the neck, shoulders, back, or jaw when
temporomandibular joint syndrome (TMJ) is pres-
ent3,4.
There is an urgent need for a use of Evidence Based
Herbal Medicine and the efficacy and safety of herbal
remedies. The section on each herbal preparation
contains information on uses, pharmacology, evidence,
adverse effects, and interactions and cautions, along
with dosages, and a summary of herbs that are useful in
dentistry. The evidence is associated with significant
adverse effects, interactions, or risks to certain popu-
lations with herbal medicine. The accumulation of
evidence is a dynamic and rapid process with many new
clinical trials of herbal remedies being undertaken and
published each year4. As a result, Evidence-Based
Herbal Medicine lacks the contribution of more recent
trials on herbal products5–7. This article provides useful
information on use of herbs, especially in dentistry.
Bloodroot (Botanical name: Sanguinaria Canadensis)
(Figure 1)
Alkaloids – principally sanguinarine – constitute the
primary active compounds in bloodroot. These are used
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Taheri et al.
Figure 1. Bloodroot (Botanical name: Sanguinaria Canadensis).
for gingivitis and periodontal disease and sometimes
used in toothpaste or other oral hygiene products
because they inhibit the growth of oral bacteria8,9.
Bloodroot tincture is sometimes included in cough-
relieving formulas, and 10 drops or less may be taken
three times per day10.
Side effects
Although previous studies have suggested the long-term
use of dental products containing sanguinarine is safe, a
recent report suggests that use of dental preparations
containing blood root may be associated with leukopla-
kia – a condition characterised by white spots or patches
in the mouth that is thought to be precancerous11,12.
Only small amounts of bloodroot should be taken, since
amounts as small as 1 ml of tincture or 1 g can cause
nausea and vomiting10,13. Long-term use or overdose of
bloodroot can also cause stomach pain, diarrhoea, visual
changes, paralysis, fainting, and collapse14. Long-term
oral intake of sanguinarine-contaminated cooking oils
has been linked in India to glaucoma, oedema, heart
disease, miscarriage, and diarrhoea15. The plant is
unsafe for use in children and should not be used by
pregnant or lactating women. Recently the practice of
applying ointments containing bloodroot, such as the so-
called ‘black salve’, has been promoted for treatment of
skin and other types of cancer16.
Caraway (Botanical name: Carum carvi) (Figure 2)
Caraway contains 3–7% volatile oil, with the main
components divided into carvone (50–60%) and limo-
nene (40%)10. Caraway may help in gingivitis or peri-
odontal disease (as a mouth wash) and to alleviate bowel
spasm17. It has been used with success in combination
with enteric-coated peppermint oil in the treatment of
288
Figure 2. Caraway (Botanical name: Carum carvi).
irritable bowel syndrome (IBS)18,19. People using this
combination reported experiencing less pain and noted an
overall improvement in their bowel symptoms compared
to those who took a comparable placebo. A combination
of caraway with the other carminative herbs (anise and
fennel) has shown to be helpful in flatulence and mild
abdominal cramping, especially in children. Some prop-
erties of caraway include: antihistaminic, antimicrobial,
antiseptic, diuretic, expectorant, spasmolytic, caraway
has been used as a flavour component in toothpaste,
mouthwash products, cosmetics and perfumes, and as a
flavouring in foods. It is also a traditional remedy for
dyspepsia, intestinal colic, menstrual cramps, poor appe-
tite, laryngitis, and bronchitis20.
Side effects
Caraway is generally safe for use. However, the purified
volatile oil should not be used by children under 2 years
of age, as oil from caraway and other herbs in the
Umbelliferae family can be irritating to the skin and
mucous membranes20,21.
Chamomile (Botanical name: Matricaria recutita)
(Figure 3)
The flowers of chamomile contain 1–2% volatile oils22.
Other active constituents include the flavonoids, apige-
nin, luteolin, and quercetin. These active ingredients
contribute to chamomile’s anti-inflammatory, antispas-
modic, and smooth-muscle relaxing action, particularly
in the gastrointestinal tract23–27.
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Figure 3. Chamomile (Botanical name: Matricaria recutita).
It also is used for gingivitis and periodontal disease as
a mouth wash. Topical applications of chamomile have
been shown to be moderately effective in the treatment
of eczema22. One double-blind trial found it to be about
60% as effective as 0.25% hydrocortisone cream28.
Topical use of chamomile ointment was also found to
successfully treat mild stasis ulcers bed sores in elderly
bedridden patients29. In dentistry chamomile is used as
mouthwash to prevent periodontal disease. Chamomile
is often taken three to four times daily between meals as
a tea. Common alternatives are to use 2–3 g of the herb
in tablet or capsule form or 4–6 ml of tincture three
times per day between meals. One to two capsules
containing 300–400 mg may be taken three times daily.
Topical creams or ointments can be applied to the
affected area 3–4 times daily30.
Side effects
Allergic reactions to chamomile have been reported31.
These reactions have included bronchial constriction
with systemic use and allergic skin reactions with
topical use32. While reports of such side effects are
uncommon, people with allergies to plants of the
Asteraceae family (ragweed, aster, and chrysanthe-
mums), as well as mugwort pollen should avoid using
chamomile33. Chamomile is usually considered to be
safe during pregnancy or breast-feeding. However,
there is one case report in which a pregnant woman
who took chamomile as an enema had an allergic
reaction that led to the death of her newborn34.
Echinacea (Common name: Purple coneflower)
(Figure 4)
Echinacea is thought to support the immune system by
activating white blood cells35. Three major groups of
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Herbs in dentistry
Figure 4. Echinacea (Common name: Purple coneflower).
constituents may work together to increase the produc-
tion and activity of white blood cells (lymphocytes and
macrophages), including alkylamides ⁄ polyacetylenes,
caffeic acid derivatives, and polysaccharides The mouth
wash of Echinacea is effective in gingivitis and peri-
odontal disease in combination with sage, peppermint
oil, menthol and chamomile36.
Side effects
No acute or chronic toxicity reactions have ever been
reported in the long history of use of echinacea.
Chronic administration of echinacea to rats at doses
many times the human therapeutic dose produced no
toxic effects37.
Several double-blind studies have confirmed the
benefit of echinacea for treating colds and flu38–40. In
terms of other types of infections; research in Germany
using injectable forms or an oral preparation of the
herb along with a medicated cream (econazole nitrate)
reduced the recurrence of vaginal yeast infections as
compared to women given the cream alone41.
Myrrh (Botanical name: Commiphora molm) (Figure 5)
The three main constituents of myrrh are the resin, the
gum, and the volatile oil. The resin has reportedly been
shown to kill various microbes and to stimulate macro-
phages42. Myrrh also has astringent properties and has a
soothing effect on inflamed tissues in the mouth and
throat. Studies continue on the potential anticancer and
pain-relieving actions of myrrh resin43,44.
In a preliminary trial, patients with a parasitic
infection were treated with a combination of resin
289
Taheri et al.
Figure 5. Myrrh (Botanical name: Commiphora molm).
and volatile oil of myrrh, Myrrh is used for topical
treatment of mild inflammations of the oral and
pharyngeal mucosa45. It is also used as a gargle to treat
pharyngitis and tonsillitis and as a mouthwash for
gingivitis and ulcers46. Topical use is approved for the
treatment of small wounds, for nasal congestion from
the common cold, and for local application as an
anodyne to treat infections of the buccal cavity and ⁄ or
the oropharynx46,47. Myrrh tincture is used for inflam-
mations of the gums and oral mucosa such as gingivitis
and stomatitis48.
For making mouthwash, add 30–60 drops of tincture
to a glass of warm water.
Apply the undiluted tincture to the affected areas on
the gums or the mucous membranes of the mouth and
paint with a brush or swab, 2–3 times daily.
Side effects
None known49.
Peppermint (Botanical name: Mentha piperita)
(Figure 6)
Peppermint leaves yield approximately 0.1–1.0% vol-
atile oil which is composed primarily of Menthol (29–
48%) and menthone (20–31%)50. Peppermint oil is
classified as a carminative (prevents and relieves
intestinal gas)51. Peppermint oil or peppermint tea is
often used to treat gas and indigestion.
Three double-blind trials found that enteric-coated
peppermint oil reduced the pain associated with intesti-
nal spasms, commonly experienced in irritable bowel
syndrome (IBS)51–53. Peppermint oil’s relaxing action
also extends to topical use. When applied topically, it
acts as an analgesic and reduces pain54. A trial of topical
peppermint oil applied to the temples of healthy
volunteers (with or without eucalyptus oil) found that
peppermint oil had a muscle-relaxing action and it
290
Figure 6. Peppermint (Botanical name: Mentha piperita).
decreased tension55. Topical peppermint oil alone
reduced pain in people with tension headaches as well.
Peppermint may interfere with iron absorption. Pepper-
mint oil can be used for toothache by soaking a cotton
ball in the oil and placing it in the cavity or rubbing it on
the tooth. Peppermint leaf tablets and capsules, 3–6 g per
day, can be used as a mouthwash to relieve gum
inflammation. For headaches, a combination of pepper-
mint oil and eucalyptus oil diluted with base oil can be
applied to the temples at the onset of the headache and
every hour after that or until symptom relief is noted56.
Side effects
Peppermint tea is generally considered safe for regular
consumption. Peppermint oil can cause burning and
gastrointestinal upset in some people57. It should be
avoided by people with chronic heartburn, severe liver
damage, inflammation of the gallbladder, or obstruc-
tion of bile ducts58. People with gallstones should
consult a physician before using peppermint leaf or
peppermint oil. Some people using enteric-coated
peppermint capsules may experience a burning sensa-
tion in the rectum. Rare allergic reactions have been
reported with topical use of peppermint oil. Peppermint
oil should not be applied to the face – in particular, the
nose – of children and infants59.
Rosemary (Botanical name: Rosmarinus officinalisy)
(Figure 7)
This volatile oil, including eucalyptol (cineole), is
considered a potent antibacterial agent, it is effective
in chronic candidiasis60 and to relax smooth muscles in
the lungs61.
Rosmarinic acid has antioxidant activity62 and
another ingredient of rosemary, known as carnosol,
has been shown to inhibit cancer formation in animal
studies63. No human studies have confirmed rosemary’s
use for these conditions. The oil possesses antibacterial
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Figure 7. Rosemary (Botanical name: Rosmarinus officinalisy).
and antifungal properties, and antimicrobial activity
has been documented towards moulds, Gram-positive
and Gram-negative bacteria including Staphylococcus
aureus, Staphylococcus albus, Vibrio cholerae and
Escherichia coli. Carnosol and ursolic acid inhibit a
range of food spoilage bacteria64.
Tea can be prepared by adding two teaspoons (10 g)
of herb to one cup (250 ml) of boiling water and
allowing it to steep in a covered container for 10–
15 minutes. This tea can be taken several times per day.
Rosemary tincture, 1 ⁄ 2 to one teaspoon (2–5 ml) three
times per day, may also be used. The concentrated
volatile oil should not be taken systemically65.
Side effects
There is no evidence to indicate that intermittent intake
of moderate amounts of rosemary poses any threat
during breast-feeding. However, internal intake of the
herb and oil should be avoided during pregnancy
because the oil may act as an agent that may induce
abortion. Frequent use of rosemary could, in theory,
promote the development of iron deficiency in suscep-
tible individuals66.
Sage (Botanical name: Salvia officinalis) (Figure 8)
The volatile oil of sage contains the constituent alpha-
and beta-thujone, camphor, and cineole67. It also
contains rosmarinic acid, tannins and flavonoids. In
modern European herbal medicine, a gargle of sage tea
is commonly recommended to treat a sore throat,
inflammations in the mouth, and gingivitis68. Sage oil
has antibacterial, antifungal, and antiviral activity
which may partially explain the effectiveness of sage
for these indications68.
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Herbs in dentistry
Figure 8. Sage (Botanical name: Salvia officinalis).
Sage is used to remedy inflammation of the mouth,
throat and tonsils68. For treatment, 3 g of the chopped
leaf can be added to 150 ml of boiling water and
strained after 10 minutes69. This is then used as a
mouthwash or gargle several times daily. Alternatively,
one may use 5 ml of fluid extract (1:1) diluted in one
glass of water, several times daily. For systemic use, the
same tea preparation described above may be taken
three times per day or as an infusion by pouring a cup
of boiling water onto 1–2 teaspoonfuls of the leaves
and let infuse for 10 minutes. This should be drunk
three times a day. As a mouthwash: put two teaspoon-
fuls of the leaves in half a litre (one pint) of water,
bring to the boil and let stand, covered, for l5 minutes.
Gargle deeply with the hot tea for 5–10 minutes
several times a day69.
Side effects
Small amounts of sage for long periods of time may
cause increased heart rate and mental confusion. Very
high amounts (several times greater than one receives if
taking sage as instructed above), may lead to convul-
sions.
Extracts of sage made with alcohol are likely to be
higher in thujone than those made with water. Sage oil
should never be consumed without being first diluted in
water. Sage should not be used systemically during
pregnancy. These concerns do not extend to the use of
sage as a gargle or mouthrinse. Sage should be avoided
when fever is present68.
Thyme (Botanical name: Thymus vulgaris) (Figure 9)
The primary constituents are the volatile oils, which
include the phenols, thymol and carvacol70. These are
complemented by the actions of flavonoids. Thyme,
either alone or in combination with herbs such as
sundew, continues to be one of the most commonly
291
Taheri et al.
Figure 9. Thyme (Botanical name: Thymus vulgaris).
recommended herbs in Europe for the treatment of dry,
spasmodic coughs as well as whooping cough71.
Use a salve made of thyme, myrrh, and goldenseal to
treat oral herpes. Also use thyme to treat chronic
candidiasis and halitosis71.
A fluid extract, 1 ⁄ 4–3 ⁄ 4 teaspoon (1–4 ml) three
times per day, can also be used72.
Side effects
Thyme herbal preparations are generally safe. How-
ever, a spasmodic cough, particularly in a young child,
may be dangerous and a healthcare professional should
be consulted before deciding on the proper course of
treatment. The use of thyme by pregnant or breast-
feeding women is considered to be safe. Thyme oil
should be reserved for topical use, as when ingested it
may lead to dizziness, vomiting, and breathing difficul-
ties73. Some people may be sensitive to use of thyme oil
topically on the skin or as a mouthrinse73.
Aloe vera (Figure 10)
The components of aloe vera include: vitamins,
enzymes, minerals, sugars, fatty acids, amino acids
and salicylic74. Aloe vera (in the form of a gel) improves
healing and so can be used for burns, insect bites and
many other skin lesions. Aloe and propolis hand cream
prevents skin damage resulting from frequent hand
washing and the wearing of latex gloves; the aloe
activator spray is excellent for throat infections,
painfully erupting wisdom teeth and joint pains; aloe
juice can also be taken as a drink. This is used in
conjunction with any topical treatment for skin lesions,
joint lesions and, in itself, as amelioration in irritable
bowel syndrome75.
The juice is also a strong detoxifying agent and if
used in conjunction with the planned removal of
292
Figure 10. Aloe Vera.
mercury amalgams acts as a scavenging agent for
mercury, a neuro-sedative and immune enhancer.
Because of the many properties and functions of aloe,
it is a powerful nutritional supplement and anti-
oxidant. It protects and promotes healing. The gel has
been shown to be bactericidal and fungicidal against
Candida albicans (the cause of moniliasis or ‘denture
sore mouth76.
The aloe vera gel formula was found to be virucidal
against Herpes simplex and Herpes zoster viruses and
to be just as effective as Prednisolone and Indometh-
acin, without having the long term toxicity of either
drug77.
Aloe vera gel formula is nontoxic, bactericidal,
veridical, and fungicidal against a broad range of
micro-organisms, and a stimulator of cellular life-
extension.
There are eight main uses of Aloe Vera in dental
practice:
• Applications directly to the the sites of periodontal
surgery
• Applications to the gum tissues when they have been
traumatised or scratched by toothbrush dentifrice
abrasion, sharp foods, dental floss, and toothpick
injuries
• Relief of chemical burns are relieved quickly from
accidents with aspirin
• Extraction sites respond more comfortably and dry
sockets do not develop when aloe vera is applied
• Acute mouth lesions are improved by direct applica-
tion such as on herpetic viral lesions, aphthous ulcers,
canker sores, and cracks occuring at the corners of lips.
Gum abscesses are also soothed by the applications
• Other oral diseases, chronic in nature, respond to
applications such as lichen planus and benign pem-
phigus and gingival problems associated with AIDS
and leukaemia. Migratory glossititis, geographic
tongue and burning mouth syndrome are improved
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• Denture patients with sore ridges and ill-fitting
dentures can benefit as fungal and bacterial contam-
ination is reduced as is the irritation from inflamma-
tion
• Aloe vera can also be used around dental implants to
control inflammation from bacteria contamination
Other oral disorders such as candidiasis, desquama-
tive gingivitis, vesiculobullous diseases, acute mono-
cytic leukemia, hematological disorders and nutritional
problems all respond to aloe vera use as can diabetes
mellitus, Sjorgen’s syndrome, menopausal patients and
those on medications which can cause xerostomia or
dry mouth. Aloe vera has an unlimited future in new
applications, and in dentistry we are just on the cutting
edge of promising uses for these anti-inflammatory,
antiviral, and immunological benefits74,75,78.
Propolis
A list of possible actions of propolis includes: antibac-
terial, antifungal, antiviral (including anti HIV-1 activ-
ity), antioxidant, anticarcinogenic, antithrombotic and
immunomodulatory79. The mechanism of the possible
actions of propolis may be understood by reviewing
research findings on some of the individual compounds
found in it. It is difficult to study the mechanism of
actions of more than one compound at a time.
Therefore, the following descriptions apply only to
single compounds. The contribution of any single
compound to the possible action of such a complex
substance as propolis is difficult to establish80. Caffeic
acid phenethyl ester (CAPE) inhibits the lipoxygenase
pathway of arachidonic acid, resulting in anti-inflam-
matory activity. CAPE is also known to have anticar-
cinogenic, antimitogenic and immunomodulatory prop-
erties. CAPE has been found to completely inhibit the
activation of the nuclear transcription factor NF-Kappa
B by tumour necrosis factor (TNF), as well as by other
pro-inflammatory agents. The inhibition of NF-Kappa
B activation may provide the molecular basis for its
immunomodulatory, anticarcinogenic, anti-inflamma-
tory and antiviral activities. It is possible that CAPE
exerts its effects by inhibiting reactive oxygen species
(ROS) production. ROS are known to play a major role
in the activation of NF-Kappa B. Compounds in
propolis found to have antibacterial activity include a
polyisoprenylated benzophenone, galangin, pinobank-
sin and pinocembrin. The exact mechanism of antimi-
crobial action of these compounds is not known.
There is evidence that propolis has some broad
antimicrobial activity and that it may have anti-
inflammatory effects that could make it useful in the
treatment of some forms of arthritis, among other
disorders. There is also some evidence of anti-cancer
activity.
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Herbs in dentistry
Propolis is available in several different preparations,
including lozenges, tablets, creams, gels, mouth rinses,
toothpastes and cough syrups81.
Summary of other herbs that are useful in dentistry82
Alfalfa
• Useful in cases of haemorrhaging and fungal
infections
Anises
• An anti-inflammatory herb, anise is commonly used
in tea form to soothe the gums
Annatto
• Apply after tooth extraction or gum surgery
Black cohosh
• Use to relieve cramps in the jaw or neck
Burdock
• Burdock poultices are excellent for the relief of
muscle tension and headaches associated with
temporomandibular joint disorders (TMJ)
Catnip
• Drink catnip tea or take in capsules to help
relaxation before dental treatment
Cayenne
• Saturate cotton with oil of cayenne and place it on
an aching tooth for emergency relief
Chickweed
• Chickweed mouthwash soothes inflamed, irritated
mouth tissues associated with oral cancer; it also
helps to relieve pain from canker sores and other
mouth sores
Cloves
• Rub oil of cloves on sore gums and teeth to ease
pain
Comfrey
• Use as a compress to ease jaw tension and relieve
the pain of jaw and tooth fractures or adjustments
to braces
Dandelion
• Dandelion is useful for treating abscesses in the
mouth
Elderberry
• Prepare mouthwash after gum surgery or after
sutures have been placed
Evening primrose
• Rub evening primrose oil on sore, inflamed gums
for temporary relief
Ginseng
• Use in a tonic to promote circulation and to help
repair irritated gum tissue
Goldenseal
• When used as a toothpaste or mouthwash,
goldenseal is excellent for soothing inflamed
gums
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Taheri et al.

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Correspondence to:
Somayyeh Azimi,
Oral Medicine,
Qazvin University of Medical Science,
Qazvin, Iran.
Email: somayyeh_azimi@yahoo.com
ª 2011 FDI World Dental Federation