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1. Pawar VP et al. International Reasearch Journal Of Pharmacy, 2022, , 13:07:7-12 THE PART OF HOMEOPATHIC MEDICINE IN MANAGING THE DENTAL DISEASES Dr Vijay Parasharam Pawar,1* Dr Dilip Nana Kadam,2 Dr Prashant Manik Patil,3 Dr Devendra Sheshrao Patil,4 Dr Sharad Nana Kedar5 1*BHMS MD, Head and Associate Professor, Department of Surgery and Homoeopathic Therapeutics, Sharadchandraji Pawar Homoeopathic Medical College, Shrirampur, Ahmednagar, Maharashtra 2BHMS, MD, Professor and Head, Department of Homeopathic Pharmacy, SJSHMC Kopergaon, Ahmednagar, Maharashtra 3BHMS, MD, PhD (Scholar), Associate Professor, Department of Pathology and Microbiology, Merchant Homoeopathic Medical College, Mehsana, Gujarat 4BHMS, MD, Principal and Professor, Department of Homeopathic Matria Medica, VIHMC, Sangamner, Ahmednagar, Maharashtra 5BHMS MD, Associate Professor, Department of Organon of Medicine, Sharadchandraji Pawar Homoeopathic Medical College Shrirampur, Ahmednagar, Maharashtra Corresponding Author: Dr Vijay Parasharam Pawar Email id: drvijayppawar@gmail.com Article Received: 07/06/2022, Article Accepted: 15/06/2022, Article Published: 12/07/2022 How To Cite: Pawar VP, Kadam DN, Patil PM, Patil DS, Kedar SN. The part of homeopathic medicine in managing the dental diseases. International Reasearch Journal Of Pharmacy, 2022, 13:07:7-12. DOI: 10.32937/2230-8407.3728 ABSTRACT Dentists, in recent times, are having trouble in managing various recurrent and chronic dental conditions including the commonly presented toothache which can be attributed to side effects from conventional dental management and recurrence of the disease symptoms. The association of various systems of the body to the dental disorders that works continuously to maintain the dental health of an individual is usually a neglected and overlooked topic considering this, many other alternative medicine and remedies, apart from allopathy including ozone therapy, magnetic field therapy, acupuncture, nosode therapy, regulation thermography, and/or homeopathy. Homeopathy is one such kind of alternative medicine that is largely used in child as well as adult subjects owing to its advantages such as safety, effectiveness, and low price in comparison to allopathic treatment. Homeopathy has been used in dentistry as an adjunct to standard treatment since the 18th century. Homeopathy has been identified as the largest medical practice by WHO. Homeopathy is emerging as a tool for managing the disorders and diseases of the orofacial structures. Homeopathic medicine is also helpful for the psychological conditions of dental patients. The present review aimed to assess the efficacy of homeopathic treatment in the management of dental disorders. Keywords: Alternative Therapy, Dentistry, Homeopathic Medicine, Orofacial Disorders INTRODUCTION Since ancient times, dentistry has evolved extensively where the teeth were fabricated from ivory, wood, silver, and gold. Now artificial teeth are mainly fabricated from zirconia and ceramics with various advancements in technologies and procedures often. One such progressively emerging modality is homeopathy.1 The Homeopathy term is derived from the Homios which is a Greek word meaning similar and 7

2. Pawar VP et al. International Reasearch Journal Of Pharmacy, 2022, , 13:07:7-12 Pathos another Greek word for illness and suffering. Law of similar is the basic law governing Homeopathy. This law of similar states that an illness can be treated by a substance if it raises symptoms in a subject with better health compared to sick subjects.2 The idea of homeopathy was raised by a German Physician, Samuel Christian Friedrich Hahnemann in the 1800s. The inclusion of homeopathy in the field of dentistry proved helpful for straightforward mild pain in a carious tooth to long-lasting chronic conditions that are difficult to treat including post-extraction osteitis, burning mouth syndrome, atypical facial pain, and fear of dental treatment. Homeopathy is a reliable complementary therapy along with conventional dental treatment to treat hemorrhage, inflammation, and toothache. However, homeopathic treatment can not completely replace mechanical dental treatment, but homeopathy makes dental treatment peaceful and comfortable for the subject as well as treating dentists.3 Homeopathic treatment can manage chronic dental conditions along with providing relief from acute dental conditions. As most, dental conditions develop from the overall condition of a subject, homeopathy can reinforce the general health and well-being of a subject, and hence, can help manage dental health and prevent oral diseases along with providing the treatment plan for dental diseases.4 Homeopathy Principle The practice of homeopathic management follows the four main principles including the Law of similar also known as Similia similibus curantur. This principle state that like should be cured by like only which depicts that the correct cure for illness in a subject is the substance that produces the manifestation in the healthy subject that is almost similar to the one seen in the diseased subject.5 Another principle is the law of single remedy which suggest that medication for the treatment of any ailment should be a single substance and straightforward rather than an amalgamation of different substances. The collective effect of this substance amalgamation can be entirely different compared to the use of the individual substance.6 Homeopathic treatment also utilizes the law of minimum dose where when a substance given in a minute dose can cure a disease in the sick person. However, the large doses given to a healthy person will lead to the presentation of the disease symptom.7 Another principle in homeopathy is the concept of vital force where homeopathic doctor trust in a vital force that exists in the body that is responsible for various manifestations in life and derangements in these vital forces can cause abnormal body function and sensations that could lead to disease.8 Dental diseases origin Homeopathic management is vital in managing dental anomalies in a manner not wondered by many. Initially, dental problems are considered uncomplicated, easy, and simple needing only oral hygiene maintenance and adequate toothbrushing for their prevention. The treatment of dental diseases, on the other hand, depends on the general body conditions and various systems working rather than only oral hygiene maintenance and preventive steps. Hence, the use of allopathic medicine in addition to mechanical dental treatment can largely benefit the outcome of treating dental diseases.9 Gum diseases and tooth decay are considered to mainly arise secondary to below-par teeth maintenance and substandard care of the dentition and associated structures of the oral cavity. Also, salivary glands have a large impact on the occurrence of dental caries which has a vital role in fighting against dental caries by acid neutralization produced microorganisms.10 The overall general health of an individual can be seen in the gingival health of the subjects. In gum health, hormones play a vital role. Abnormality in the thyroid hormones secondary to the thyroid gland function derangement can cause damage in the periodontal ligament which can be confined to the teeth and associated soft tissues supporting the teeth. Also, the perfusion and blood supply of the gums is reduced in the abnormal release of thyroid hormone.11 Abnormalities in the levels of the progesterone and estrogen hormones can make a subject more susceptible to dental anomalies which can be a cause why dental conditions are more aggravated in female subjects, especially, in times when the hormone levels are unbalanced including menstruation, and/or puberty.12 The reduced oxygen levels carried in the blood are mainly caused by anemia and can decrease the blood oxygen volume and blood supply to the gingiva making a subject more susceptible to gum disease. Stress, which is commonly seen these days can affect the by caries-causing menopause, pregnancy, 8

3. Pawar VP et al. International Reasearch Journal Of Pharmacy, 2022, , 13:07:7-12 firmness of the connective tissues between the gums and teeth.13 The amount of calcium in the human body is regulated by the parathyroid hormone, and many dental disorders are caused by calcium deficiency which can be secondary to parathyroid disorders. Adequate and appropriate homeopathic medicine can help in managing deranged body functions and play a vital role in the restoration of dental health along with routine dental health maintenance done for various dental problems.14 Homeopathic Medicines for Dental Problems – Foremost, homeopathic medicine is not a replacement or alternative to mechanical dental treatment and is an adjunct to conventional dental treatment. Homeopathy is useful in treating toothache. However, it is necessary to detect the pain origin to provide it permanent relief. For the abscess pain, which is throbbing in nature, the abscess needs to be managed and not only the pain caused by it. Homeopathic medicine aims to fight the expectation, fright, and worry of a subject visiting the dental clinic rather than only the dental problem. Irrespective of the logic or not logic of the feelings, homeopathic medicine seems to be efficacious for these. Monkshood (Aconite) is a homeopathic medicine usually given to child subjects to manage their fear of visiting the dental clinic. Usually, children are often irritated, uneasy, and enraged by stamping and kicking actions along with a tendency towards supreme responsiveness from the feel of the instruments and touch by the dentist. Another, homeopathic medicine, Gelsemium (potency 12C) has wonderful effects in decreasing the anxiety and fear in subjects reporting to the dental clinic. These drugs have high efficacy in child subjects when taken a dose in the morning before the procedure, and reduce the anxiety of a subject. Also, a relaxed subject makes the treatment gentle and easy for dentists.3,7,15 To evaluate adequate homeopathic medicine for dental pain, it is vital to locate the pain origin. In cases with a dental abscess, Silicea, Hepar sulph, Mercurius, and Belladonna are given. Belladonna of potency 6C is utilized in the early pus formation period when an increased temperature and redness are seen, and the swelling is not seen. Merc sol (potency 6C) helps in treating oral malodor and hypersalivation. It also helps in treating the throbbing pain which is severe at night and is affected by the hot or cold. Hepar sulph is an effective homeopathic medicine in chronic abscess cases with pus formation and discharge. Silicea is usually suggested after the pus discharge in the dental patients.6,16 Despite the proven efficacy of this homeopathic medicine in relieving and curing dental pain, it is usually vital to drain the abscess and conduct root canal treatment. In dental cases inflammation, Arnica (Potency 30C) is used along with routine dental treatment.14 With basic and simple dental treatments, a dentist inadvertently produces little tissue disturbance in the oral cavity and makes it sore. This use can lead to a reduction in the swelling seen postoperatively after any surgical procedure along with the insertion of new partial or complete dentures.17 Silica (Potency 6C) has efficacy by causing splinters and root fragments of bone for exfoliation after any surgical procedure and is usually prescribed after the tooth extraction. Hypericum (Potency 9C) has high efficacy in treating post-surgical nerve pain.14 Ledum (Potency 30C) has excellent results in a reduction of the post-traumatic effects following dental injections especially the inferior alveolar nerve blocks and the palatal injections as they are the most commonly given injections. Chamomilla (Potency 12C) acts as a good antidote for dental treatments where local anesthetics are used. It can take up to 15 minutes to wear off the effect of the local anesthesia after procedure completion. It can also reduce the incidence of lip bites in child subjects after inferior alveolar nerve block which is of longer duration.18 Arnica (Potency 200C) when given a quarter-hourly, can decrease the post-surgical hemorrhage which is not controlled by the pressure with the moist gauze. In cases with bright red hemorrhage, phos (Potency 6C) is given every 15 minutes, whereas, in dark-colored cases, Lachesis (Potency 30C) is given every hour. Both these drugs have superior hemostatic actions and show good patient compliance after their homeopathic insertion.3,19 The most common complication following a tooth extraction is a dry socket. The pain associated with the dry socket can be effectively managed with salvia- infused mouthwash which is given many times a day. Another homeopathic medicine used is Hypecal which is a tincture of Calendula and Hypericum in slightly warm water to decrease the desiccation and make the oral cavity more pleasant. Coffea (Potency 30C) is with trauma and 9

4. Pawar VP et al. International Reasearch Journal Of Pharmacy, 2022, , 13:07:7-12 given in intolerable pain and belladonna (Potency 30C) is given in intolerable pain.7 In subjects undergoing orthodontic treatment, Ruta can be given and is proved efficacious. It is usually given during removable and fixed orthodontic treatment and adjustment of the braces. In child subjects with delayed or difficult tooth eruption, Chamomilla (Potency 15C) is the best homeopathic management, whereas, Hypericum (Potency 9C) is given in subjects with pain associated with tooth eruption.13 In subjects anxious for amalgam restorations and in subjects where amalgam restorations need to be removed, Merc sol (Potency 30C) is given to minimize the adverse effect of mercury in the human body which has the advantage of getting mercury removed from the body without any harm.11 Usually, tooth preparation can cause hypersensitivity. In these subjects, Hypericum can be given owing to its nerve healing efficacy as tooth cutting has tiny nerve endings in the dental tubules of dentin. Hot and cold sensitivity to a tooth, Plantago tincture can be used by placing it in the oral cavity or massaging around the tooth with hot and cold sensitivity. Tooth sensitivity is also caused by tooth abrasion where Calendula tincture and Hypericum can be applied on abraded tooth area thrice a day till the symptoms subsided.20 Conventional dental management aims to get more in less time as nowadays, dentists perform a procedure in a single-sitting which was earlier done in multiple sittings making the appointment time longer than usual, especially, in cases where cosmetic treatment is done including tooth bleaching, veneers, inlays, ceramic crowns, and/or Hollywood smiles. These procedures impose a positive effect on the psychic status and identity of a subject. Also, these procedures demand mouth opening for a longer time along with the extended jaws posing difficulties for many patients. In these cases, Causticum and Magnesium phosphorus are advised to relieve the pain and stiffness in the jaws or the inability to open the mouth for a long time. In bruising and tenderness cases, Arnica can be used. Hypercal in two to three drops consisting of calendula tincture and Hypericum in slightly warm water can be used to prevent desiccation and make the oral cavity soothing and pleasant, especially, after a surgical procedure. In temporomandibular joint pain during swallowing, Arum triphyllum whereas,Calcarea Flourica is used in cases with hypermobile TMJ joint.7,12,17 Ferrum phosphoricum and Arsenicum album are used to treat severe gingivitis cases, whereas, Merc sol (potency 30C) is used in cases of covered tongue thrice a day. Kali Chlor (Potency 30C) is used thrice a day for extensive tissue destruction, and Nit ac (Potency 30C) is used for cleaning the tongue thrice a day. For pregnancy gingivitis, which is a transient form of Gingivitis, Mercurius solubilize (6C) is given twice daily. Oral herpetic lesions are treated with Arsenicum album (Potency 7C), Rhus Toxicodendron (Potency 7C), Petroleum (Potency 9C), and Graphites (Potency 7C) causing early resolution of these ulcers with minimal discomfort. Discomfort the mouth ulcers can be relieved using Feverfew which is continued for a couple of days after ulcer healing to prevent a recurrence. On the other hand, Natrum phosphoricum 30C once daily and Arsenicum album 6C twice daily is usually given in lichen planus-type of mucosal lesions.4,19 Spigellia 200C and Sanguinari 200C are used to treat migraine on the left and right sides respectively. In painful areas of the mucosa and skin, Plantago can be applied every 15 minutes. Calcarea carbonica 6C two times a week is given to subjects having various sialoliths, and Mercurius solubilis 6C and Thuja occidentalis 6C once daily are given for the ranula. Hydrofluoricum acidum Silicea 6C effectively managed a case of oro-sinus fistula that showed no improvement with the conventional treatment.21 The most common opportunistic infection seen in the oral cavity is candidiasis where the main homeopathic medicine used is Broax 30C along with Natrum muriaticum 6C and Kali muriaticum 6C given every four hours. Pulsatilla and Bryonia are given to subjects without and with thirst respectively.13 Halitosis is another oral concern that is usually reported to be disturbing to the affected subjects. In these cases, Merc sol (potency 30C) along with Carboveg (potency 30C) is given twice daily after the conventional dental treatment for halitosis. Another psychological disorder usually seen in subjects visiting the dental clinic is Bruxism which is managed by nux vomica (potency 30C) given twice daily and Cina (potency 30C) given one hour before sleeping till the bruxism is stopped.7 The dental health of a subject is largely governed by the systemic condition of an individual. When the systemic is potent, 10

5. Pawar VP et al. International Reasearch Journal Of Pharmacy, 2022, , 13:07:7-12 condition is not maintained, its outcomes are seen in dental treatment. In the Indian scenario, nearly 10 crore subjects have comorbidity which is from old age that can alter the treatment strategies.22 Also, periodontitis is a complication in diabetic subjects with poor glycemic control. The subjects with comorbid conditions such as diabetes along with extra-pulmonary tuberculosis or lung tuberculosis should be continually observed, and the sugar levels should be kept within the normal limits followed by the appropriate treatment. The drugs used for managing diabetes mainly aim to make insulin production orderly as needed by the body. These drugs include Oxalicum Acidum, Heper Sulph, Tarentula, and Plumbum Met.13,17 Potency choice Homeopathic medicine is usually prescribed in the low potency of <12X, medium potency of 12X to 30X, and high potency of 30X to 200X depending on the symptoms of a subject. The X in the potency shows 10 and showed that mother tincture is diluted in one part of a 100. The acute or chronic nature of the dental anomaly governs and decides the potency of the homeopathic treatment. In acute conditions, low potency is used and high potency is used in chronic conditions.3 Limitations in Homeopathy Some dental diseases lead to irreversible changes in the structures including root fractures, root caries, stones, trauma, and wounds. In these cases, conventional dental treatment should be performed. However, homeopathic treatment can improve the outcomes of recovery and decrease pain.4 Also, homeopathy might not help subjects with advanced stages of cancer where it is not possible to reinstate the vital force of the body. In cases requiring urgent medical intervention, acute pain conditions, shock, and cardiovascular emergencies cannot utilize homeopathic care.6 Subjects with vitamin deficiencies, polycystic kidney diseases, epilepsy, cysts and tumors, thrombosis, and foreign body cases need medical care and are not managed with homeopathy.19 CONCLUSION Homeopathy has a dignified space in modern dental practice of today. It is not an alternative and cannot replace conventional dental treatment. However, it is a complementary therapy that can help anxious subjects with dental disorders that are unresponsive to traditional dental management. Homeopathic medicine also helps in the vast and extensive therapeutic range from acute and mild dental pain to long-standing and persistent pain cases. Homeopathy is a field of dental medicine that is emerging and is used to treat and manage orofacial structures. Homeopathy, along with its advantage of having minimal ill-effects and good outcomes, its applications in dentistry open the door for new scientific and clinical possibilities and options as various manifestations of systemic diseases presents themselves first in the oral cavity. Homeopathy is an emerging branch in dentistry and should be considered as an adjunct to conventional mechanical dental treatment for the cure and prevention of dental conditions. Homeopathy can be used for the general welfare of the subjects and as a supportive management therapy for dental health management. REFERENCES 1.Mahmoud Hoseinishad, Azam Nosratipour, Samineh Mozzaff ar Moghaddam, Homeopathy in dentistry: A review, Int J Contemp Dent Med Rev, vol. 2015, Article ID: 030815, 2015. 2.Homeopathy in Dentistry - An overview Priyanka Chopra and Puneet Chopra, IJCD MARCH, 2011 2(2). 3.Homeopathy and its ethical use in dentistry: British dental journal 210, 299-301(2011). VOLUME 210 NO. 7 APR 9 2011. 4.The complete book of dental remedies by Flora Parsa Stay DDS, Avery publishing group, 1996. 5.Sinha N, Chakraborty HM, Singh RK, Chakraborty N, Sinha G. Review of the Role of Homeopathic Applications in Dentistry. Int J Oral Health Med Res 2015;2:77-80. 6.Dev Jain C, Bhaskar DJ, Bumb SS, Singh V, Kadtane SS. Ethical Use of Homeopathy and How Can We Use It in Dentistry. Iran J Public Health. 2013;42:1476-7. 7.Saini P, Al-Shibani N, Sun J, Zhang W, Song F, Gregson KS, et al. Effects of Calendula officinalis on human gingival fibroblasts. Homeopathy. 2012;101:92-8. 8.J.E. Abraham, C.W. Svare, and C.W. Frank, “The effects of Dental Amalgam Restorations on Blood Mercury levels” Journal of Dental Research. 1984;63:71-3. 9.Mercury in Dental fillings: Is there a Problem?" The Medical Letter, November 1985. 10.Role of homeopathic medicines in dentistry, Dr. Tanuja B and Dr. Siva Rami Reddy E International Journal of Homoeopathic Sciences. 2017;1:08-10. deficiencies, nutritional 11

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