3. Classical stream/Great traditional medicine
Folk stream/ Little traditional medicine
Importance of traditional medicinal plants
Medicinal plants and their use towards oral health care by various
Indian Tribal population
3
5. INTRODUCTION
• 80% of the population of developing countries rely on
traditional medicine mostly plant drugs, for their primary
health care needs. (WHO)
Natural
Non-narcotic
No side effects
5
6. 705 tribal communities
227 ethnic groups
5000 villages
Tropical zone
Forests of Western and
Eastern Ghats
Tribal medicinal knowledge - new drugs in modern medicine
6
7. • So the study about the tribal medicine assumes much relevance in the
context of the 'health for all' concept of the WHO.
Modern allopathic
medicines
Ever-increasing price
Dangerous side effects
Scientific validations
of many tribal
knowledge of
medicine
Greater awareness
in India towards
tribal medicines
7
8. WHO TRADITIONAL MEDICINE STRATEGY 2002-2005
Policy: integrate TM/CAM(complementary and
alternative medicine) with national health care systems
Safety, efficacy and quality: provide guidance and
support for effective regulation
Access: ensure availability and affordability of
TM/CAM
Rational use: promote therapeutically-sound use of
TM/CAM by providers and consumers
8
9. TRIBAL MEDICINE
• Tribal medicine can be considered as a part of the traditional
medicine, which is mainly practiced by the tribals settled in the forest
area
• Mainly confined to the medicinal plants available from the forest
9
10. Definition
A tribal medicine or folk system of medicine is a set of dynamic
medicinal practices, based on the principles of trial and error, and
on empirical evidence, which has evolved over a period of time
within a unique socio-cultural and physical- environment
(Johari and Karki, Tribal folk medicinal plant resources of south Asia, 1999)
10
11. DEFINITIONS BASED ON VARIOUS
DICTIONARIES:
• 1) Health practices arising from superstition, cultural traditions, or empirical use of
native remedies, especially food substances.
• (Dictionary.com)
• 2) Traditional medicine as practiced by nonprofessional healers or embodied in
local custom or lore, generally involving the use of natural and especially herbal
remedies.
• (The American Heritage® Stedman's Medical Dictionary)
• 3) Traditional medicine that is based especially on the use of plants instead of
modern scientific principles
• (cambridge dictionary)
11
12. TRADITIONAL MEDICINE
• Traditional medicine has been prevalent in every country since the
beginning of the civilization.
• According to Siegerist (1951), a medical historian "every culture had
developed a system of their own medicine and medical history is one
aspect of the history of culture"
12
13. • The term "traditional medicine" refers to ways of protecting
and restoring health that existed before the arrival of
modern medicine.
• Not all health practices are health traditions
13
14. • Traditions are those practices that are self-perpetuating.
• They form the unwritten repertory of health practices that have been
passed down the generations through word of mouth for at least one
century and continue to be passed down even today
Shankar et al, 2001
14
15. DEFINITION
"The sum total of all the knowledge and practices, used in diagnosis,
prevention and elimination of physical, mental or social imbalance and
relying exclusively on practical experience and observation handed down
from generation to generation, whether verbally or in writing"
WHO, 1978
15
16. • Traditional medicine (TM).
• According to WHO definition adopted in 2000, traditional
medicine is “the sum total of the knowledge, skills and practices
based on the theories, beliefs and experiences indigenous to
different cultures, whether explicable or not, used in the
maintenance of health, as well as in the prevention, diagnosis,
improvement or treatment of physical and mental illnesses.”.
16
17. • According to WHO definition adopted in 2003, traditional
medicine refers to health practices, approaches, knowledge and
beliefs incorporating plant, animal and mineral based medicines,
spiritual therapies, manual techniques and exercises, applied
singularly or in combination to treat, diagnose and prevent
illnesses or maintain well-being.
17
18. TRADITIONAL HEALERS:
• Some one who is recognised by the community in which
he lives as competent to provide health care by using
vegetable, animal & mineral substances and certain other
methods based on the social, cultural and religious
backgrounds as well as prevailing knowledge, attitudes
and beliefs regarding physical, mental and social well
being and the causation of disease and disability in the
community.
18
Ramashankar et al (2015) Traditional healing practices in north east India; journal of history of
science,50(2),324-332.
19. INDIAN CONTEXT
• 2000 B.C. – disease - wrath of gods and effect of evil spirits
• Healing art - prayers, several hymns and often aided by the herbal
remedies
• In course of time the science of medicine, which came to be known as
Ayurveda was formed.
19
20. • . Rigveda, which is considered to be the oldest available record
in India, dating back to 4000-5000 B.C. recounts some
medicinal plants. Atharvaveda, another religious book of Hindus,
has described about 2000 plants having medicinal properties
• Charaka and Susruta (700 B.C) contributed to popularise the
Ayurveda in India by bringing out Sanskrit medical manuals
namely, the Charaka Samhita and Susruta Samhita respectively.
20
21. • A hospital in the true sense of the term is clearly described by
Fahsien, the Chinese traveller who visited India at the very
beginning of the 5th century AD.
• Soon other systems of medicines like Sidha and Unani also
emerged and continued to develop with Ayurveda.
21
22. • Medicinal plants are nature’s gift to mankind and are rich
heritage of India. India is well known as an “Emporium of
medicinal plants”. About 70% of the rural folk depend on
medicinal plants for their health care. India is a treasure of
biodiversity which host a large variety of plants and ranks
tenth among plant rich countries of the world and fourth
among the Asian countries.
22
23. • India is considered as one of the 12 mega-biodiversity countries of
the world having rich vegetation of about 45,000 vascular plants,
with concentrated hotspots in the regions of Eastern Himalayas,
Western Ghats and Andaman & Nicobar Islands. Of these, the folk
medicine system of India use about 5,000 plant species with about
25,000 formulations for treating a variety of ailments, whereas the
tribal medicine involves the use of over 8,000 wild plants with about
1,75,000 specific preparations/applications. The classical
indigenous systems of Indian medicine prescribe 10,000 designated
formulations.
23
24. CLASSIFICATION OF TRADITIONAL MEDICINE
Traditional medicine
Little traditional
medicine/folk streams
Great traditional
medicine/classical streams
Folk medicine
Or
Ethno medicine
Or
Tribal medicine
Ayurveda
Unani
Sidha
Naturopathy
Yoga
Homeopathy
Task Force Report,
Government of India
(2000)
24
25. CLASSICAL STREAM
Ayurvedic Medicine
• Ayurveda tends to focus on the use of single herbs for most symptoms.
• Ayurveda is based on theories more closely related to the Greco-Roman
concept of the four humors - blood, phelgm(mucous secretion), yellow bile
and black bile than to the Chinese concept of yin and yang.
25
26. • The Ayurvedic forces are the three doshas - Kapha (cold, moist), pitta
(hot, dry) and vata (wind).
• These tridoshas interact with the gunas (basic psychological qualities of
the mind) and other characteristic that are perceived to be relevant
factors that govern life and health.
Aggarwal, 1998
26
27. AYURVEDAAND OROFACIAL DISEASES
• According to the Shalyatantra and Shalakyatantra (one of the branches of
Ayurveda), 65 varieties of oral diseases can arise in seven anatomic
locations-eight on the lips, 15 on the alveolar margin, eight in connection
with the teeth, five on the tongue, nine on the palate, 17 in the oropharynx
and three in a generalized form.
• Oral cleansing, extractions, excisions, flap surgeries
Chakravorty RC. Head and neck diseases in an ancient Indian surgical text (The Sushruta-samhita) Med Hist. 1971;15:393–6.
27
28. • Along with the treatment of orofacial diseases, Ayurveda recommends
some daily use therapeutic procedures for the prevention and
maintenance of oral health.
• These include: Dant Dhavani (Brushing), Jivha Lekhana (Tongue
scrapping) and Gandoosha (gargling) or oil pulling and tissue
regeneration therapies.
28
29. • Dant Dhavani (brushing): Avurveda recommends chewing sticks in the
morning as well as after every meal to prevent diseases.
• The neem (margosa or Azadirachta indica) is a famous herbal chewing
stick.
• Fresh stems of liquorice (Glycyrrhiza glabra), black catechu or the cutch
tree (Acacia Catechu Linn.), Arjuna tree (Termmalia arjuna), can also be
used for brushing.
29
30. • Chewing on these stems is believed to cause attrition and leveling of biting
surfaces, facilitate salivary secretion and possibly, help in plaque control
while some stems have an anti-bacterial action.
• Present-day research has shown that all the chewing sticks described in
ancient Ayurveda texts have medicinal and anti-cariogenic properties
Telles S, Naveen KV, Balkrishna A. Use of Ayurveda in promoting dental health and preventing dental caries. Indian J Dent Res. 2009;20:246.
30
31. • Jivha Lekhana (tongue scrapping): It is ideal to use gold, silver, copper, stainless
steel for the scrapping of the tongue. Tongue scrapping stimulates the reflex
points of the tongue, removes bad odor and improves the sense of taste.
• Clinical evidence also shows that use of tongue scrapers on a regular basis, has a
significant improvement on eliminating anaerobic bacteria and decreases bad
odor.
Kadam A, Prasad BS, Bagadia D, Hiremath VR. Effect of Ayurvedic herbs on control of plaque and gingivitis: A randomized controlled trial. Ayu. 2011;32:532–5.
31
32. • Gandusha (gargling) or oil pulling: Oil pulling is an ancient Ayurveda procedure
that involves swishing oil in the mouth for oral and systemic health benefits.
• It is mentioned in the Avurvedic text Charaka Samhita where it is called Kavala
or Gandusha and is claimed to cure about 30 systemic diseases ranging from
headache, migraine to diabetes and asthma.
• Oil pulling therapy can be done using oils like sunflower oil or sesame oil.
32
33. • Tissue regeneration therapies: In Avurveda, the well-known herb, Amla
(Phyllanthus emblica) is considered a general rebuilder of oral health.
• One to two grams per day can be taken orally in capsules for the long-term
benefit to the teeth and gums.
• Amla supports the healing and development of connective tissue when taken
internally.
Singh A, Purohit B. Tooth brushing, oil pulling and tissue regeneration: A review of holistic approaches to oral health. J Ayurveda Integr Med. 2011;2:64–8.
33
34. UNANI MEDICINE
• Unani-tibb or Unani Medicine also spelled Yunani Medicine (in Arabic,
Hindi-Urdu and Persian) means “Greek Medicine.”
• Its origin is traced back to the Greek literature, which has been a source of
quite a lot of scientific contributions and also was developed by Arabs and
Persians into an elaborate medical science.
• Since that time Unani Medicine has been known as Greco-Arab Medicine
34
35. • The World Health Organization (WHO) has recognized the Unani System of
Medicine (USM) as an alternative system to cater(serve) the health care
needs of human population.
• Unani is one of the most well-known traditional medicine systems and
draws on the ancient traditional systems of medicine of China, Egypt, India,
Iraq, Persia and Syria
Unani Medicine in India. Its Origin and Fundamental Concepts by Hakim Syed Zillur Rahman, History of Science, Philosophy and Culture in Indian Civilization, Vol. IV Part 2
(Medicine and Life Sciences in India), Ed. B. V. Subbarayappa, Centre for Studies in Civilizations, Project of History of Indian Science. Philosophy and Culture, New Delhi.
2001:298–325.
35
36. UNANI AND OROFACIAL DISEASES
Unani formulations like Sunune Zard,
Sunune Mulook, Buzidan, Majoon Suranjan,
Majoon Azaraqi, Habbe Gule Aak etc. have
been shown effective anti-bacterial, anti-
inflammatory and analgesic effect and are
used in the treatment of orofacial diseases
Hongal, S., Torwane, N. A., Pankaj, G., Chandrashekhar, B. ., & Gouraha, A. (2014). Role of Unani System of Medicine in Management of Orofacial Diseases: A Review. Journal of
Clinical and Diagnostic Research : JCDR, 8(10),12–15.
36
37. SIDDHA MEDICINE
• Siddha medicine emerged 2000 years ago from south-eastern state of India,
Tamil Nadu.
• The name Siddha signifies Siddhi which symbolizes an attainment in life arts
such as yoga, wisdom, philosophy, medicine and above all the art of longevity.
• The individual, who acquired this Siddhi, were courteously called Siddhars.
Narayanaswamy V. Ayurveda and Siddha system of medicine- A comparative study. Subramanian S.V. and Madhaven V.R., (Eds), Heritage of Tamil Siddha medicine.
International Institute of Tamil Studies, Madras, India, 1983; 568-576.
37
38. • Agasthiyar, one among the 18 Siddhars; is believed to be ‘Hippocrates of
Siddha medicine’.
• Siddhars are the spiritual scientists of Tamil Nadu who reviewed and
unfold the reality of nature and its association to man by their yogic
awareness and experimental discoveries furthermore; they hypothesized
the idea of spiritualism for self-improvement.
Sampath C.K. () Evolution and development of Siddha medicine. Subramania S.V. and Madhaven V.R. (Eds), Heritage of Tamil Siddha medicine. International Institute of Tamil Studies,
Madras, India, 1983; 1-20.
38
39. SIDDHAAND OROFACIAL DISEASES
• In Siddha system of medicine, a total of 108 herbs, collectively known as karpa
mooligaigal are dominantly used for the human ailments including management
of oral disorders.
• Most of the herbs prescribed in Siddha, possess anti plaque, cariogenic,
antibacterial, anti-inflammatory, analgesic, antitumor, anti-stress, anti-fungal,
rapid healing properties.
Borchers AT. Traditional Asian medicine and oral health. J Tradit Med., 2004; 21: 17-26.
39
40. NATUROPATHYAND YOGA MEDICINE
• This could be taken as integration of folk medicine and ayurvedic medicine.
• The concept was popularised by Gandhiji through personal experiences and
observance with natural cures.
• This system of health care includes indigenous medicine, dietary regulation and
yogic exercise relating to the specific areas of bodies as well as external application
like mud bath, sunbath, body massage as well as exercise on mental concentration.
40
41. HOMEOPATHY
• The system is originated in Germany and later practiced and developed in
Asia and European countries.
• The concept of this medicine is of creating a resistance to an illness by
administering small doses of specially grounded medicines in biological
ritualism
41
42. HOMEOPATHIC MEDICINE IN ORAL HEALTH
• Mouthwash of Salvia infusions was given several times a day to diminish pain of “dry socket”
and a few drops of hypercal (Hypericum and Clandedula tinctures) was also given, in a small
glass of warm water to relieve dryness and make mouth much more comfortable.
• ORAL HERPES LESIONS:
Patients with oral herpes lesions could be given Graphites, Petroleum, Rhus toxicodendron and
Arsenicum album and the lesions resolve early with minimum discomfort to patients.
Homeopathy in Dentistry – An Overview, International Contemporary Dental Journal, March 2011 2 (2).
42
43. • SEVERE GINGIVITIS:
Arsenicum album and Ferrum phosphoricum were given to the patient who reported with
severe gingivitis.
• PAIN:
Chamomilla, one hour prior to surgery, and repeated every 15 minutes
• BRUXISM:
Patients were given cina one hour before sleep and while awake nux vomica twice daily till
the symptoms subside
43
44. TRIBAL MEDICINE/FOLK MEDICINE/ETHNO MEDICINE
• The tribes who lives in isolation, practices their own system of medicine,
which is known as tribal medicine or ethno medicine.
• The tribal population of the country, as per 2011 census, is 10.43 crore,
constituting 8.6% of the total population.
• 89.97% of them live in rural areas and 10.03% in urban areas.
44
45. • Andhra Pradesh has 27,39,919 tribal population as per 2011 census
which constitutes 5.53% of the total population.
• District Wise Population of Scheduled Tribes of A.P. 2011 census, www.aptribes.gov.in; accessed
on 13th may 2017.
45
46. ANDHRA PRADESH
• Ayurveda hospitals: 3
• Unani : 2
• Homeopathy: 3
• Total allopathy hospitals: 270
• Total phc’s: 1155( as of march 2017)
46
48. • The use of medicinal plants for the treatment of disease was known to the
tribals many centuries ago.
• From time immemorial the people especially tribal people realized the curing
and healing properties of the herbs and roots (Sharma, 1999).
• There are estimated to be around 25,000 effective plant based formulations
used in folk medicine and known to rural communities all over India.
Planning Commission of India, 2000
48
49. • Different tribal communities utilize different plants or different parts of
the same plants for particular ailments.
• This indicates a deep knowledge about these herbs and plant as well as
combination and dose of such indigenous objects for cure of different
diseases (Chaudhari, 1989).
49
50. • A survey conducted by the All India co-ordinated Research project on
Ethnobiology (AICRPE) recorded over 8000 species of wild plants used by
the tribals and other traditional communities in India for treating various
health problems (ISMH, 2001).
• The maximum numbers of medicinal plants are utilized by the folk
traditions, followed by Ayurveda, Sidha, Unani, Homeopathy, Tibetan and
Modern respectively (Shankar et al, 2000).
50
59. FOLK TREATMENTS:
Bee Stings
a) Ice is put on the sting. If ice is not available, the wound is washed with cold water or mud is smeared on it.
b) A bunch of parsley is wrapped around the affected area.
c) The victim rubs garlic on the sting.
High Temperatures
a) A towel is moistened with vinegar and pressed onto the brow, neck, hands, feet and the whole body. This operation is
repeated untill the patient’s temperature gone down.
b) An aspirin is dissolved in lemon juice and rubbed on the patient’s body, beginning with the forehead.
c) A mixture of grain alcohol, aspirin and few drops of olive oil is rubbed on the articular parts of the body.
Asthma
A pigeon egg is consumed every morning for 40 days as the first meal of the day.
Aches
a) The leaf of a black cabbage is heated and placed on the affected area. This operation is repeated frequently.
b) A mixture of boiled and mashed linen seeds, henna and naphtha oil is rubbed on aching parts of the body. This operation
continues a few times a day.
c) A cream is made from dry tobacco and raki. The affected areas covered with this cream.
d) Thin sand is roasted, a few olives are added and the affected areas are covered with this mixture while it is still warm or hot.
This operation goes on for three or four days.
Sore Feet
Unrefined salt is dissolved in hot water, and the feet are washed in this solution for ten minutes.
Sprains
An onion is mashed with either salt or olives and placed on the sprained area
59
60. Headaches:
a) A potato is cut into slices and coffee sprinkled on them. These slices are placed on the
forehead. b) Round lemon slices are placed on the forehead.
c) The patient covers his head with the gall of an animal, mixed with henna, for a few
hours. Bronchitis:
a) Linen seeds are mashed with sugar and eaten.
b) A piece of bread is roasted, moistened with vinegar and placed on the chest. Tonsilitis
The throat is covered with a piece of cotton with pepper and grain alcohol.
Kidney Stones:
a) Medlar leaves are boiled and drunk as tea. This continues until the stone is ejected. b)
Water with parsley or yogurt is drunk every morning.
Nosebleeds:
The shell of an egg is burned till it becomes ash. The victims breaths in this ash when his
or her nose starts to bleed.
Haemorrhoids:
a) Garlic is rubbed on every morning.
b) The middle parts of wild roses are boiled and drunk as tea.
60
61. Eczema
a) Eggplant is cooked in hot ashes and mixed with powdered henna. The ointment is placed on the affected
area and covered with a clean towel.
b) Peach leaves are boiled and drunk as tea for ten days.
c) The patient eats hedgehog meat.
d) The patient swallows the seeds of the elderberry plant.
Shortness of Breath
a) Stingling nettle tea is drunk every day.
b) Black radish is hollowed out and filled with honey. A small hole is opened in the radish and a cup put under
it. The patient eats the honey that flows out a!er waiting for a night.
c) Cones are boiled and drunk as tea.
Coughs
a) The patient drinks a spoonful of honey mixed with a spoonful of lemon juice every morning for a few days.
b) Apple and lemon peel and linden flowers are together boiled and drunk every morning.
c) The patient eats raw parsley.
Heat Rash
Dry cat tail is heated and the ashes rubbed onto the affected parts of the body.
61
62. PUBLIC HEALTH SIGNIFICANCE
• Folk healers continue to play a key public health role contributing to
availability of human resources in countries where the population to
physician ratio is high.
• Traditional medicine is one of the surest means to achieve' total health care
coverage of the whole population using acceptable safe, economically feasible
method
62
63. • The advantages of traditional medicine include its diversity, flexibility,
availability and affordability in many parts of the world; its widespread
acceptance in low- and middle- income countries; its comparatively low cost;
and the relatively low level of technological input required.
• As a result, traditional medicinal therapies have the potential to contribute to
a better health care system in many countries.
63
64. POLICY IMPLICATIONS
• India is blessed with rare species of medicinal plants possessing effective
curative value and a number of tribal practitioners having valuable
medicinal knowledge about these plants.
• If these natural resources are properly utilised and projected at global level
with adequate legal framework to protect Intellectual Property Right (IPR)
issues, India can make tremendous development.
64
65. • While making tribal medicine a tool for development, the Government
must recognise the cultural, intellectual and commercial importance of
tribal medicine.
• Government should safeguard the cultural heritage and background of
the tribals and tribal medicine.
65
66. • Government should also enact proper legislation to protect the intellectual
property right of the tribals.
• Government should tap the commercial potentiality of the trading of
medicinal plants and the tourism aspects of the tribal surroundings.
66
67. • Appropriate health policy has to be formulated to integrate tribal
medicine with modern medicine.
• On a broader plane, it could be said that the government has given all
its patronage to the spread of Allopathic system of medicine.
• This approach has to be changed.
67
68. 68
Advantages:
Reduced the risk of side effects
Effective with chronic conditions
Lower cost
Widespread availability
Disadvantages:
Inappropriate for many conditions(Modern medicine treats sudden and
serious illness and accidents)
Lack of dosage instructions
Poison risk associated with wild herbs
Medication interactions
Lack of regulation(The quality of the herbs may vary)
69. • The dentist needs to be more informed regarding the use, safety and
effectiveness of the various traditional medicines.
• As this is hardly explored part for the field of dentistry, there is a need for
integration of professional dental treatment modalities and complementary
alternative medical systems to provide the best and unique from each
system to patients as a complementary therapy and an alternative choice of
treatment
Conclusion:
69
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74
76. `
Effect of Ayurvedic herbs on control of plaque and gingivitis: A randomized controlled trial.
• Kadam A1, et al.(2011) Present study was conducted for evaluating the effect of one of such
Ayurvedic toothpowder named UDM, in controlling plaque and reducing gum inflammation in
patients of moderate gingivitis. Scaling, root planning, and polishing were done for all the
patients participating in the study. Oral hygiene instructions were given that included brushing
twice/day with assigned tooth powder using BASS method for tooth brushing and also massage
over gum tissue with finger. All the patients were recalled after 15 days. Scores of plaque index
and gingival index was recorded on day 1 and day 15 of treatment. Total of 15 patients were
recruited in each group. The mean reduction in gingival index was 1.15 (P<0.05) and 1.26
(P<0.05) in positive control and UDM treatment groups, respectively. However, the mean
reduction in plaque indices were found to be 2.03 (P<0.05) and 2.16 (P<0.05) in positive control
and UDM groups, respectively. No significant difference was seen in both the parameters
between the two groups.
76