|Year : 2012 | Volume
| Issue : 3 | Page : 112-114
Ethnomedicine: Applications of Neem (Azadirachta indica) in dentistry
Atul Kaushik1, Renu Tanwar1, Monika Kaushik2
1 Department of Oral Medicine, Diagnosis and Radiology, S G T Dental College and Hospital, Farukh Nagar Road, Gurgaon, Haryana, India
2 Meenakshi's Innovative Dentistree, 1217, Near Shopping Complex, Sector-21, Gurgaon, Haryana, India
|Date of Web Publication||27-Nov-2012|
Meenakshi's Innovative Dentistree, 1217, Near Shopping Complex, Sector-21, Gurgaon, Haryana-122001
Source of Support: None, Conflict of Interest: None
Ethnomedicine is the study of traditional medicines having relevant written sources (Ayurveda, traditional Chinese Medicine) as well as those whose knowledge and practices have been orally transmitted over the centuries. The Neem tree (Azadirachta indica) has been known as the wonder tree for centuries in the Indian subcontinent. It has become important in the global context today because it offers solutions to the multiple concerns faced by mankind. Each part of the Neem tree has some medicinal property and the broad range of biologic activities and pharmacologic actions of Neem tree are very well established. Although literature search reveals that Neem tree has multiple potential uses in dentistry, its application is limited in routine dental practice. The following manuscript is an attempt to throw light on the potential and immense uses of Neem tree products for oral care, which forms a critical issue in both developing countries where professional dental care is limited and in developed nations where populations are aging.
Keywords: Azadirachta indica, dental usage, medicinal property, pharmacological actions
|How to cite this article:|
Kaushik A, Tanwar R, Kaushik M. Ethnomedicine: Applications of Neem (Azadirachta indica) in dentistry. Dent Hypotheses 2012;3:112-4
| Background|| |
Ethnomedicine is a sub-field of ethnobotany or medical anthropology that deals with the study of traditional medicines: Not only those that have relevant written sources (traditional Chinese medicine, Ayurveda), but especially whose knowledge and practices have been orally transmitted over the centuries.  Azadirachta indica, popularly known as Indian Neem, Margosa tree or Indian lilac, is well known in India and its neighboring countries for more than 2000 years as one of the most versatile medicinal plants having a wide spectrum of biological activity. Importance of Neem tree has been recognized by United States (US) National Academy of Sciences where Neem is entitled as 'a tree for solving global problems'.  Neem finds immense use in a number of products ranging from cosmetics to agriculture and from pharmaceuticals to Ayurveda. Although literature search reveals that Neem tree has multiple potential uses in dentistry, its application is limited in routine dental practice. The current manuscript highlights various usage of Neem tree related to oral health and suggests including Neem derivatives in conventional dental practices. The inclusion of Neem based products into future dental practice will be a major improvement over the existing practice.
| Antibacterial Efficiency of Neem Extract on Micro Organisms Causing Dental Caries|| |
The microbial flora of the mouth is highly complex, containing a wide variety of bacterial species. The most common oral disease, dental caries is related to dental plaque and seem to occur when the normal balance between the microorganisms and the host is disturbed. Extracts from Neem sticks or bark have been shown to inhibit the growth of Streptococcus mutans and significant reductions in bacterial adhesion in vitro, suggesting that it can reduce the ability of some streptococci to colonize tooth surfaces. Neem extract produced the maximum zone of inhibition on Streptococcus mutans at 50% concentration. In addition, other Streptococcus species which are involved in the development of dental caries such as Streptococcus salivarius, Streptococcus mitis and Streptococcus sanguis are also inhibited by Neem extracts.  A considerable antibacterial activity of Neem aqueous extract on Lactobacillus sp has also been noticed at higher concentrations. 
| Neem Extract as a Potent Root Canal Irrigant|| |
Candida albicans and Enterococcus faecalis are the most predominant microorganisms recovered from root canals of teeth. Thorough debridement of an infected root canal and complete elimination of microorganisms are objectives of an effective endodontic therapy. Several in vitro studies have shown that Neem leaf extract is a viable medicament against C. albicans, E. faecalis and even their mixed state.  However, preclinical and clinical trials are needed to evaluate biocompatibility and safety before Neem can conclusively be recommended as an intracanal irrigating solution, but in vitro observation of Neem effectiveness appears promising.
| Efficiency of Neem Extract in the Treatment of Chronic Gingivitis and Periodontal Diseases|| |
The most effective method of prevention and maintenance of periodontal diseases is mechanical oral hygiene combined with proper professional maintenance. However in reality the degree of motivation and dexterity required for an optimal oral hygiene level may be beyond the ability of the majority of the patients.  From this perspective, the utilization of antimicrobial mouth rinses has been considered as a useful adjunct to oral hygiene. Various studies have demonstrated that Azadirachta indica based mouth rinses are highly efficacious and may be used as an alternative therapy in the treatment of periodontal diseases. 
| Usage of Neem Extract in Oral Care Industry|| |
Neem bark is used as an active ingredient in a number of tooth pastes and tooth powders because of its antibacterial properties. It's usage are proven to be beneficial for tooth and gums health. Herbal ingredients like Neem tree extracts have become very popular in last few years not only because of their therapeutic value but also because of no adverse side effects.
| Anti-Carcinogenic Properties of Neem Extracts|| |
Isolated components of Neem tree have shown impressive efficacy against cancer cells and in boosting the body's immune response against carcinogenesis. Various mechanisms have been suggested in this context such as boosting the lymphocytic and cell mediated immunity, including the natural killer cells, which are able to destroy viruses, bacteria and cancer cells. Neem extracts can also protect against chemically induced carcinogenesis and liver damage by increasing the antioxidant levels of body. 
| Various Therapeutic Usage of Neem Extract|| |
Various other important therapeutic effects have been associated to Neem extract like treating diabetes mellitus, improving liver functions, neuroprotective effects, stress and ulcer reduction, treatment of sexually transmitted diseases, skin diseases and malaria. The best information is that Neem may be helpful in prevention and cure of acquired immune deficiency syndrome (AIDS). It may be possibly treated by ingesting whole Neem leaves or Neem tree extracts.  As oral health is deeply related to overall systemic health of the individuals, management of various systemic diseases will automatically improve the oral health.
| Conclusion|| |
As the global scenario is now changing towards the use of nontoxic plant products that have traditional medicinal usage-ethnomedicine-extensive research and developmental work therefore should be undertaken on Neem and its products for their better economic and therapeutic utilization. Preclinical and clinical trials are needed to evaluate biocompatibility and safety before Neem can be recommended conclusively for oral care. Once the Neem tree extracts become the mainstay for the management of various oral diseases, it can be truly regarded as "aristha", which means "reliever of sickness" in Sanskrit.
| References|| |
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