|
 
 |
| REVIEW ARTICLE |
|
| Year : 2022 | Volume
: 13
| Issue : 1 | Page : 22-24 |
|
Oral health benefits of Phyllanthus emblica: A narrative review
Chaitali U Hambire1, Umesh Vishnu Hambire2
1 Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Aurangabad, Maharashtra, India
2 Department of Mechanical Engineering, GECA, Aurangabad, Maharashtra, India
| Date of Submission | 27-Dec-2021 |
| Date of Decision | 28-Jan-2022 |
| Date of Acceptance | 07-Feb-2022 |
| Date of Web Publication | 14-Mar-2022 |
Correspondence Address:
Chaitali U Hambire
17, Shreekunj, Samadhan Colony, Aurangabad, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/srmjrds.srmjrds_102_21
Globally the oral disorders of teeth and periodontium are causing serious health issues. Most of the times antibiotics and other antimicrobial drugs are used for their management. However, the resistance to these drugs stress on the role of antimicrobial extracts obtained from plant sources. The Indian gooseberry, also known as Amla comes from family of Euphorbiaceae. It has various health beneficial properties such as antiaging, antidiabetic, and hepatoprotective. Phyllanthus emblica is commonly found in Asia. P. emblica fruit contains Vitamin C and many biologically active phytochemicals. It has antimicrobial and anti-ulcerative properties. It is used for the management of oral ulcers and periodontal diseases. This article aims to review the literature currently available on the benefits, usage, and effects of P. emblica.
Keywords: Amla, oral health, Phyllanthus emblica, tannins
How to cite this article:
Hambire CU, Hambire UV. Oral health benefits of Phyllanthus emblica: A narrative review. SRM J Res Dent Sci 2022;13:22-4 |
| Introduction | |  |
Oral diseases of hard and soft tissues such as dental caries, gingivitis, and periodontitis are global health issues. Antibiotics and other antimicrobial agents have been commonly used in their management. Drug resistance, hypersensitivity, and immunosuppression are some of the problems arising due to the inappropriate use of these drugs.[1] Hence, it is very important to investigate the role of compounds obtained from the plants. Various studies have shown the therapeutic potential of phytocompounds derived from plant extracts without any harmful side effects. Tannins, saponins, flavonoids, steroids, etc., from plants have shown potent antioxidant, antimicrobial, anticarcinogenic, and anti-inflammatory action.[2]
The Indian Gooseberry or Phyllanthus emblica belongs to the family of Euphorbiaceae. It is a deciduous tree having a significant role in Ayurveda. The fruit is rich in minerals, Vitamin C as well as various amino acids.[3] Different types of chemicals such as phenol, emblicol, curcuminoids, phyllembelin rutin, and tannins are obtained from this medicinal plant. The fruit is used in the management of various diseases such as inflammation, diarrhea, and jaundice.[4] P. emblica has multiple therapeutic benefits which have been validated by various evidence-based scientific studies. The purpose of this narrative review is to explore the current literature available on the benefits, usage, and effects of P. emblica.
| Description of Phyllanthus Emblica in Ayurveda | | |
It is described in Ayurveda as a fruit having five tastes, including sweet, bitter, and pungent with sour taste being dominant. It is effective in Vata, kapha, and pitta humor. It has cooling nature making it beneficial in the management of inflammation and fever.[5] All the tastes such as bitter, sour, pungent, and sweet are well balanced naturally. This provides the stimulation to the brain to achieve the disturbed balance of water, air, and fire elements inside the body.[6]
| Phyllanthus Emblica - Chemical Composition | | |
The most commonly used herbal formula is composed of equal quantities of Terminalia bellirica, Terminalia chebula, and Emblica officinalis, known as Triphala. T. bellirica is composed of tannic acid, gallic acid, ellagic acid, anolignan B, flavonoids and termilignan. It has antioxidant, antibacterial, anti-spasmodic, cardioprotective, hepatoprotective, hypoglycemic, and bronchodilatory properties.[7] Therefore, it is beneficial in the management of various diseases such as diarrhea, hypertension asthma, and inflammation. T. chebula is composed of tannin, polyphenols, and anthraquinones. It is antiviral, antifungal, antibacterial, antioxidant, anti-mutagenic in nature. It is beneficial in the management of diabetes, retinopathy as well as hypercholesterolemia. The composition of E. officinalis is Vitamin C, tannins, riboflavin, nicotinic acid, and carotene. It has antipyretic, analgesic, immunomodulatory, anti-tussive, and cytoprotective properties. It is effectively used in the management of ulcers, diabetes, cancer, ophthalmic disorders, and liver disorders.[8] Triphala is also composed of carbohydrates, phenolic compounds, alkaloids, tannins, and amino acids. The fruit extract is composed of 478.55 mg/100 mL of Vitamin C. It also contains gallic acid, ellagic acid, 1-O-galloyl-beta-D-glucose, 3, 6-di-O-galloyl-D-glucose, chebulinic acid, quercetin, chebulagic acid, corilagin, 1, 6-di-O-galloyl beta D glucose, 3-ethylgallic acid (3-ethoxy-4, 5-dihydroxy benzoic acid), and isostrictiniin. P. emblica is also composed of flavonoids, kaempferol-3-O-alpha-L-(6”- methyl)-rhamnopyranoside, and kaempferol-3-O-alpha-L-(6”-ethyl)-rhamnopyranoside. A new acylated apigenin glucoside (apigenin-7-O-(6” - butyryl-beta-glucopyranoside) was isolated from the methanolic extract of the leaves of P. emblica together with the known compounds; gallic acid, methyl gallate, 1, 2, 3, 4, 6-penta-O-galloylglucose, and luteolin-4'-O-neohesperiodoside were also reported.[9]
Tannins
It is a group of polymeric phenols possessing astringent properties. The tannins have shown to inactivate the microbial enzymes and adhesions thereby having antimicrobial activity. They stimulate the phagocytic cells as well as the host-mediated tumor activity thereby having an anti-infective effect.[10]
Quinone
It has an antimicrobial property. Its potential sites of action are membrane-bound enzymes, cell wall polypeptides, and surface-exposed adhesins. It causes the inactivation of proteins by the provision of free radicals.[11]
Flavones, flavanols, and flavonoids: they bind with the extracellular proteins and form complex with the bacterial cell wall thereby having antimicrobial effect.[12]
| Mechanism of Action of Phyllanthus Emblica | | |
Disease is the result of the imbalance in the natural homeostasis of the body. It causes increased production of free radicals or the inability of antioxidants to scavenge free radicals to provide protection from the harmful free radicals. P. emblica contains Vitamin-C and hydrolyzable tannins having antioxidant properties. Tannins in the form of emblicanin A, emblicanin B, punigloconin, and pendunculagin protect the body against oxidized free radicals. The antioxidant property increases its natural killer cell activity, thereby protecting the gingiva against oral micro pathogens.[13]
| Oral Health Benefits of Phyllanthus Emblica | | |
Cancer prevention
P. emblica has potent free radical scavenging activities. This could be beneficial in preventing the damage to DNA caused by free radicals. Its anti-inflammatory effect can reduce the inflammation caused by cancer. Various studies have shown that the fruit extract prevents the progression of tumor at the early stages. The tannins such as gallic acid and ellagic acid have shown to prevent lipid peroxidation due to carcinogens, inhibition of NF- kappa B as well as antiproliferative action against tumor cells.[14],[15]
Oral ulcers
The tannins and phenolic compounds, having antioxidant properties, are effective in the management of oral ulcers. It is beneficial in the healing of oral ulcers when used in the combination with honey. A concentrate of the leaves is found to be effective as a mouthwash in the management of aphthous stomatitis.[16]
Candidiasis
Various in-vitro studies have shown that the extracts of P. emblica have inhibitory effect on the growth of different fungus such as Candida albicans, Torulopsis glabrata, and Trichophyton species. Hence, it can be used as an antifungal agent.[17]
Gingival and periodontal diseases
P. emblica has a significant quantity of Vitamin C as well as other phytoconstituent. Due to its antioxidant and antibiotic properties, it can be used in the treatment of desquamative gingivitis. A study using 10% P. emblica mouthwash has found to significantly reduce plaque index, bleeding index, and pocket depth. Many studies have shown that its decoction as mouthwash has effectively controlled the growth of plaque-causing bacteria. Hence, it can be used as an effective plaque controlling agent.[18] It can also be used for the treatment of Scurvy when consumed as equal quantities of sugar and the powder of the dried herb, three times a day in, in dosage of one teaspoon, along with milk.[19]
Dental caries
P. emblica extract has shown to inhibit the growth as well as sucrose and glucan-induced adherence of Streptococcus mutans. This would prevent plaque accumulation and acid production, thereby preventing the development of dental caries.[20],[21],[22],[23]
Endodontic infections
Various studies have shown that extracts of P. emblica have an anti-bacterial effect on the facultative anaerobic bacteria present in the root canals. It is an effective irrigant of root canal in endodontic infections during root canal treatment.[24],[25],[26]
| Conclusion | | |
P. emblica is beneficial against various diseases such as respiratory disorder, diarrhea, cardiac, and dental diseases. It is an effective antimicrobial agent in mouthwash. It increases cell survival and decreases free radical production. P. emblica has anti-cariogenic effect. It is recommended to use the extract for root canal irrigation and management of periodontal diseases.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Jamil K, Jayaraman A, Ahmad J, Joshi S, Yerra SK. TNF-alpha -308G/A and -238G/A polymorphisms and its protein network associated with type 2 diabetes mellitus. Saudi J Biol Sci 2017;24:1195-203.  |
| 2. | Barathkumar TR. Studies on influence of different seed treatments on dormancy breaking in aonla ( Phyllanthus embolic L). J Pharmacogn Phytochem 2019;2:131-3. |
| 3. | Geethika E, Triveni HN, Srirama R, Siva R, Setty S, Ravikanth G. Development and characterization of microsatellite markers for Phyllanthus emblica Linn., important nontimber forest product species. J Genet 2018;97:1001-6. |
| 4. | Gunti L, Dass RS, Kalagatur NK. Phytofabrication of selenium nanoparticles from Emblica officinalis fruit extract and exploring its biopotential Applications: antioxidant, antimicrobial, and biocompatibility. Front Microbiol 2019;10:931. |
| 5. | Chaphalkar R, Apte KG, Talekar Y, Ojha SK, Nandave M. Antioxidants of Phyllanthus emblica L. bark extract provide hepatoprotection against ethanol-induced hepatic damage: A comparison with silymarin. Oxid Med Cell Longev 2017;2017:3876040. |
| 6. | Renuka R, Devi KR, Sivakami M, Thilagavathi T, Uthrakumar R, Kaviyarasu K. Biosynthesis of silver nanoparticles using Phyllanthus emblica fruit extract for antimicrobial application. Biocatal Agric Biotechnol 2020;24:101567. |
| 7. | Rose K, Wan C, Thomas A, Seeram NP, Ma H. Phenolic compounds isolated and identified from amla ( Phyllanthus emblica) juice powder and their antioxidant and neuroprotective activities. Nat Prod Commun 2018;13:1934578X1801301019. |
| 8. | Sharma P, Joshi T, Joshi T, Chandra S, Tamta S. In silico screening of potential antidiabetic phytochemicals from Phyllanthus emblica against therapeutic targets of type 2 diabetes. J Ethnopharmacol 2020;248:112268. |
| 9. | Kumari P, Khatkar BS. Assessment of total polyphenols, antioxidants and antimicrobial properties of aonla varieties. J Food Sci Technol 2016;53:3093-103. |
| 10. | Prakash S, Shelke AU. Role of Triphala in dentistry. J Indian Soc Periodontol 2014;18:132-5. [ PUBMED] [Full text] |
| 11. | Kumar A, Singh A, Dora J. Essentials perspectives for Emblica officinalis. Int J Pharm Chem Sci 2012;1:11-8. |
| 12. | Habib-ur-Rehman, Yasin KA, Choudhary MA, Khaliq N, Atta-ur-Rahman, Choudhary MI, et al. Studies on the chemical constituents of Phyllanthus emblica. Nat Prod Res 2007;21:775-81. |
| 13. | Baliga MS, Dsouza JJ. Amla ( Emblica officinalis Gaertn), a wonder berry in the treatment and prevention of cancer. Eur J Cancer Prev 2011;20:225-39. |
| 14. | Khan KH. Roles of Emblica officinalis in medicine: A review. Bot Res Int 2009;2:218-28. |
| 15. | Mohanapriya M, Ramaswamy L. Amla – The wonder of ayurvedic medicine. Int J Ayurvedic Herb Med 2012;2:828-34. |
| 16. | El-Desouky SK, Ryu SY, Kim YK. A new cytotoxic acylated apigenin glucoside from Phyllanthus emblica L. Nat Prod Res 2008;22:91-5. |
| 17. | Singh E, Sharma S, Pareek A, Dwivedi J, Yadav S, Sharma S. Phytochemistry, traditional uses and cancer chemopreventive activity of Amla ( Phyllanthus emblica): The sustainer. J Appl Pharm Sci 2011;2:176-83. |
| 18. | Kumar KP, Bhowmik D, Dutta A, Yadav AP, Paswan S, Srivastava S, et al. Recent trends in potential traditional Indian herbs Emblica officinalis and its medicinal importance. J Pharmacogn Phytochem 2012;1:18-28. |
| 19. | Poltanov EA, Shikov AN, Dorman HJ, Pozharitskaya ON, Makarov VG, Tikhonov VP, et al. Chemical and antioxidant evaluation of Indian gooseberry ( Emblica officinalis Gaertn., syn. Phyllanthus emblica L.) supplements. Phytother Res 2009;23:1309-15. |
| 20. | Naiktari RS, Dharmadhikari C, Gurav AN, Kakade S. Determining the antibacterial substantivity of Triphala mouthwash and comparing it with 0.2% chlorhexidine gluconate after a single oral rinse: A crossover clinical trial. J Indian Soc Periodontol 2018;22:498-502. [ PUBMED] [Full text] |
| 21. | Bajaj N, Tandon S. The effect of Triphala and Chlorhexidine mouthwash on dental plaque, gingival inflammation, and microbial growth. Int J Ayurveda Res 2011;2:29-36. [ PUBMED] [Full text] |
| 22. | Jagadish L, Anand Kumar VK, Kaviyarasan V. Effect of Triphala on dental bio-film. Indian J Sci Technol 2009;2:30-3. |
| 23. | Pandita V, Patthi B, Singla A, Singh S, Malhi R, Vashishtha V. Dentistry meets nature-role of herbs in periodontal care: A systematic review. J Indian Assoc Public Health Dent 2014;12:148-56. [Full text] |
| 24. | Tandon S, Gupta K, Rao S, Malagi KJ. Effect of Triphala mouthwash on the caries status. Int J Ayurveda Res 2010;1:93-9. [ PUBMED] [Full text] |
| 25. | Jain I, Jain P, Bisht D, Sharma A, Srivastava B, Gupta N. Use of traditional Indian plants in the inhibition of caries-causing bacteria – Streptococcus mutans. Braz Dent J 2015;26:110-5. |
| 26. | Grover HS, Deswal H, Singh Y, Bhardwaj A. Therapeutic effects of amla in medicine and dentistry: A review. J Oral Res Rev 2015;7:65-8. [Full text] |
|
Search Pubmed for