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- Neem (Azadirachta indica)
- Plaque-induced Gingivitis
| Date:
07-13-2012 | HC# 041233-452
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Re: Neem Extract Mouth Rinse Reduces Symptoms of Periodontal Disease
Chatterjee
A, Saluja M, Singh N, Kandwal A. To evaluate the antigingivitis and antipalque [sic] effect of an Azadirachta indica (neem) mouthrinse on plaque induced gingivitis:
a double-blind, randomized, controlled trial. J Indian Soc Periodontol. 2011;15(4):398-401.
Periodontal
disease, characterized by inflammation and/or destruction of the supporting
tissue of the teeth, is best prevented and managed by mechanical as well as
chemical plaque control. Several chemical plaque control agents (e.g.,
chlorhexidine) have been evaluated for their effectiveness on supragingival
plaque but have been associated with various adverse side effects that deter
their long-term use. Neem (Azadirachta
indica) has been used in India and South Asia for thousands of years to
maintain healthy periodontium and to treat gingivitis and periodontitis. Neem's
antibacterial, antiviral, and antihyperglycemic activities have been reported.
These authors conducted a double-blind, randomized, parallel, controlled trial
to assess the antigingivitis and antiplaque properties of a neem-based mouth
rinse in plaque-induced gingivitis.
The
authors point out that the possible mechanism of neem's anti-inflammatory
action is through inhibiting prostaglandin E and 5-hydroxytryptamine and thus reducing inflammation. The
antibacterial action can be explained by the plant's component azadirachtin,
which is known to destroy the bacterial cell wall and thus inhibit the growth
of bacteria.1
For
this study, 45 patients were recruited from the outpatient department at the
Institute of Dental Sciences in Bareilly, Uttar Pradesh, India. The subjects
had to be from 18 to 65 years of age and had to have a minimum of 10 teeth, a
mean plaque index of at least 1.05, and a mean gingival index of at least 1.0.
The
subjects were randomly assigned to 3 groups to use 15 mL of a particular mouth
rinse twice daily for 1 minute (after breakfast and after lunch):
-
Group
1 subjects received 0.19% neem mouth rinse;
- group
2 subjects received 0.2% chlorhexidine mouth rinse; and
- group
3 received saline mouth rinse.
The authors used the
Loe and Silness index and the Muhlemann-Son Sulcus Bleeding Index to measure
severity of the gingivitis, bleeding, and plaque development. Scores were
recorded on days 7 and 21 and were compared with baseline values.
The authors report
statistically significant decreases in the mean bleeding, mean gingival, and mean
plaque indices at days 7 and 21 for groups 1 and 2 compared with baseline
values (P>0.05). No significant changes were noted in group 3. No
statistically significant differences were noted between groups 1 and 2 for any
of the clinical parameters.
Results of this trial
indicate that neem extract mouth rinse is as equally effective as chlorhexidine
in reducing symptoms of periodontal disease. The results are consistent with an
earlier study that reported that neem-based mouth rinse is highly efficacious
and that it may be used as an alternative therapy in the treatment of
periodontal disease.2
As the authors point
out, these findings could lead to creating an effective and inexpensive oral
health intervention for low socioeconomic communities.
—Shari Henson
References
1Trewari DN. Monograph
on neem (Azadirachta indica). Dehradun,
India: International Book Distributors; 1992:179.
2Botelho MA, dos Santos
RA, Martins JG, et al. Efficacy of a mouthrinse based on leaves of the neem
tree (Azadirachta indica) in the
treatment of patients with chronic gingivitis: a double-blind, randomized,
controlled trial. J Med Plants Res.
2008;2(11):341-346.
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