Evidence-Based Analysis of Dinacharya Modalities for Oral Hygiene: An Ayurvedic Perspective

Abstract

Oral hygiene plays a fundamental role in maintaining overall health and preventing systemic diseases. Ayurveda, the ancient Indian system of medicine, emphasizes daily regimens (Dinacharya) as a means of sustaining health and preventing disease. Among these, several procedures specifically address oral hygiene, including Dantadhavana (herbal tooth brushing), JihwaNirlekhana (tongue scraping), Gandusha and Kavala (oil retention and gargling), and Pratisarana (massaging the teeth and gums). These practices are intended to cleanse the oral cavity, balance doshas, prevent oral disorders, and enhance systemic immunity. Aim: To critically review and analyze the Ayurvedic concept of Dinacharya in relation to oral hygiene and to assess its relevance through evidence-based modern scientific research. Materials and Methods: Classical Ayurvedic texts, including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, andBhavprakash,were reviewed. A literature search was conducted using PubMed and Google Scholar to identify studies on Ayurvedic oral hygiene practices, herbal formulations, and their comparison with conventional dental care.Results:Research has confirmed that herbal agents like Azadirachta indica (Neem), Triphala, and Glycyrrhiza glabra (Yastimadhu) are effective in lowering plaque, gingivitis, and harmful bacteria. Oil pulling with sesame or coconut oil has shown beneficial effects in reducing Streptococcus mutans counts and improving gingival health. Tongue scraping has been shown to effectively reduce halitosis and bacterial colonization. These practices align well with modern preventive dentistry and offer holistic benefits with minimal side effects. Conclusion:Ayurvedic Dinacharya modalities for oral hygiene offer a scientifically supported, low-cost, and culturally sustainable approach to oral health. Integrating these traditional practices with contemporary dental care may enhance preventive strategies and support broader public health outcomes.

Introduction

Ayurveda is an ancient Indian system of medicine that focuses primarily on maintaining health and preventing disease through a balanced lifestyle. Central to this philosophy is Dinacharya (daily regimen), which includes several practices designed to maintain physical and mental well-being. Oral hygiene is an important component of Dinacharya because the oral cavity is the main gateway to the digestive system and plays a key role in overall health.

According to Ayurveda, health is achieved through the balance of Doshas, proper digestion (Agni), healthy tissues (Dhatus), proper excretion, and mental well-being. Poor oral hygiene can lead not only to dental diseases such as toothache, stomatitis, and infections, but also to systemic illnesses due to toxin accumulation (Ama). Modern research supports these ideas by linking poor oral health with conditions such as cardiovascular disease, diabetes, and respiratory infections.

The study reviews several Ayurvedic oral hygiene practices described in classical texts such as Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya, and evaluates them with modern scientific evidence.

Key practices include:

• Dantadhavana (tooth brushing): Using medicinal twigs like neem, khadira, or karanja for cleaning teeth. These twigs provide mechanical cleaning and antimicrobial effects. Studies show neem has strong antibacterial and anti-plaque properties.

• Jihwa Nirlekhana (tongue scraping): Removes tongue coating, reduces bad breath, and improves taste. Research shows it reduces oral bacteria and volatile sulfur compounds responsible for halitosis.

• Gandusha and Kavala (oil pulling and gargling): Holding or gargling oils or herbal liquids such as sesame oil, coconut oil, or Triphala decoction. Clinical studies show these methods reduce plaque, gingivitis, and harmful oral bacteria.

• Tambula Charvana (chewing betel leaves): Traditionally used to improve digestion and oral freshness, though excessive use—especially with tobacco—can cause serious oral diseases.

• Pratisarana (gum massage): Applying herbal powders or pastes to teeth and gums to strengthen gums and reduce plaque. Studies confirm anti-inflammatory and antimicrobial benefits from herbs like turmeric and Triphala.

Conclusion

The Ayurvedic regimen of Dinacharyapresents a time-honored, holistic framework for daily self-care that extends far beyond cosmetic cleanliness to encompass systemic health and disease prevention. Oral hygiene, as conceptualized in Dinacharya through modalities such as Dantadhavana (tooth brushing with herbal twigs), JihvaNirlekhana (tongue scraping), Gandusha(oil retention), and Kavala,(herbal gargling), and Pratisarana (massaging the teeth and gums), reflects a nuanced understanding of the interconnectedness between oral and systemic well-being. Scientific validation of these practices is steadily emerging. Contemporary research has demonstrated that herbs like Neem(Azadirachta indica), Triphala, Yastimadhu(Glycyrrhiza glabra), and Lavang (Syzygium aromaticum), traditionally used in Ayurvedic oral hygiene, possess antimicrobial, anti-inflammatory, antioxidant, and anti-cariogenic properties. These findings affirm that Dinacharya modalities are not only culturally and historically significant but also clinically relevant in the context of modern preventive dentistry. Furthermore, the constitutional approach of Ayurveda, which tailors oral care based on an individual’s Prakriti (body constitution), lifestyle, and seasonal changes (Ritucharya), offers a personalized healthcare model. This integrative, preventive strategy has particular promise in low-resource settings where access to commercial oral hygiene products is limited. By leveraging indigenous knowledge systems, Ayurveda provides sustainable, cost-effective, and ecologically sound alternatives that align with global public health goals. Procedures like Dantadhavana using Dattuna (chewing sticks) offer a natural alternative to commercial toothbrushes. Research has shown these twigs possess medicinal, anti-plaque, and anti-cariogenic benefits. Similarly, Gandusha and Kavala have been associated with broader systemic effects, indicating their therapeutic value beyond oral health. These practices involve minimal cost, use readily available natural materials, and have a longstanding record of safety and efficacy. In light of these findings, integrating Ayurvedic oral hygiene into modern dental practice can be a valuable addition to preventive dentistry and integrative medicine. However, to promote widespread acceptance and clinical application, further interdisciplinary research, including randomized controlled trials, phytochemical studies, and longitudinal evaluations, is essential to establish standardized protocols and dosage regimens. In conclusion, Dinacharya-based oral hygiene is more than just a set of traditional practices; it represents a convergence of ancient wisdom and contemporary science, offering a sustainable, holistic, and evidence-based model for oral and general health promotion. By revisiting and rigorously evaluating these age-old interventions, we can redefine the scope of dental care, contribute to integrative health models, and address global oral health challenges with culturally sensitive and ecologically responsible solutions.

References

[1] Misra Brahmasankara and Vaidya Rupalalaji, Bhava prakashapoorva khanda with Vidyotinihindi commentary, varanasi, chaukhambasanskrit sansthan:2007;5:12 13:108 [2] Acharya JT, editor. Charaka Samhita of Agnivesha. Sutra Sthana, Ch. 30, Ver. 26. Varanasi: Chaukhamba Sanskrit Sansthan; 2017. [3] Shastri AD. Ashtanga Hridaya of Vagbhata. Sutra Sthana, Ch. 2. Varanasi: Chaukhamba Sanskrit Series; 2015. [4] Professor sharmapriya vat, editor, charakasamhita, text with english translation, 9th edition, Vol Chaukambhaorientalia 2005;5;43:464 [5] Dash B, Sharma RK. Aggravation of Ama and its Role in Pathogenesis. In: Caraka Samhita. Delhi: Chowkhamba Krishnadas Academy; 2003. [6] Tonetti MS, Van Dyke TE. Periodontitis and atherosclerotic cardiovascular disease: Consensus report of the Joint EFP/AAP Workshop. J Periodontol. 2013;84(4 Suppl): S249. [7] Asokan S, Emmadi P, Chamundeswari R. Effect of oil pulling on plaque-induced gingivitis: A randomized, controlled, triple-blind study. Indian J Dent Res. 2009;20(1):47–51. [8] Peedikayil FC, Sreenivasan P, Narayanan A. Effect of coconut oil in plaque-related gingivitis A preliminary report. Niger Med J. 2015;56(2):143–7. [9] Thaweboon S, Nakaparksin J, Thaweboon B. Effect of oil-pulling on oral microorganisms in biofilm models. Asia J Public Health. 2011;2(2):62–6. [10] Jagdish L, Sridevi V, Kaviyarasan V. Antimicrobial activity of Triphala against dental pathogens. J Ethnopharmacol. 2009;124(2):289–94. [11] Hugar SS, Kukreja P, Hugar SM, Deshmukh MA. Evaluation of the effect of Dashana Samskara Churna on gingivitis: A clinical study. Ayu. 2010;31(2):224–8. [12] Vaidya YadavjiTrikamji Acharya. Charaka Samhita of Agnivesha, Sutrasthana, Chapter 5, Verse 78-88. Reprint ed. Varanasi: ChaukhambaSurbharati Prakashan; 2017. p. 38. [13] Acharya Sushruta. Sushruta Samhita, Sutrasthana, Chapter 45, Verse 13. Edited by Vaidya Yadavji Trikamji. Reprint ed. Varanasi: Chaukhamba Sanskrit Sansthan; 2018. p. 199. [14] Sharma PV. Dravyaguna Vijnana, Vol. 2. Reprint ed. Varanasi: Chaukhamba Bharati Academy; 2013. p. 156–160. [15] Gupta P, et al. Role of traditional chewing sticks in oral hygiene: A review. J Oral Health Comm Dent. 2009;3(1):29–31. [16] Saimbi CS, et al. Antiplaque effect of neem extract. J Indian Dent Assoc. 1994;65(2):49–52. [17] Venugopal T, et al. Effect of neem on dental caries among preschool children. J Indian Soc Pedod Prev Dent. 2001;19(1):19–23. [18] Khalid A. Antimicrobial activity of Azadirachta indica (neem) leaf extract against oral pathogens. Pak J Pharm Sci. 1999;12(1):23–28. [19] Biswas K, et al. biological activities and medicinal properties of neem (Azadirachta indica). Curr Sci. 2002;82(11):1336–1345. [20] Vanka A, et al. antimicrobial efficacy of neem-based mouth rinse: A comparative study. Indian J Dent Res. 2001;12(3):107–112. [21] Baswa M, et al. Bactericidal activity of neem oil. Indian J Exp Biol. 2000;38(7):697–700. [22] Summant R, et al. Comparative evaluation of mango leaf and toothbrush for oral hygiene. JIDA. 1992;63(6):267–70. [23] Muruganandan S, et al. Antimicrobial and anti-inflammatory properties of mangiferin. Indian J Pharmacol. 2005;37(4):239–42. [24] Rai S, et al. Phytochemical analysis of Mangifera indica leaves and their antibacterial activity. J PharmacognPhytochem. 2014;3(6):64–66. [25] Al–Zahrani MS. The effect of chewing stick use on oral health: A review. Saudi Dent J. 2010;22(2):55–59. [26] Pedrazzi V, Sato S, de Mattos Mda G, Lara EH, Panzeri H. Tongue-cleaning methods: A comparative clinical trial employing a toothbrush and a tongue scraper. J Periodontol. 2004;75(7):1009–12. [27] Seemann R, Conceição MD, Filippi A. Tongue coating: Its relationship to oral malodor and microbial composition. Quintessence Int. 2001;32(6):479–91. [28] Chopra R, Mathur S, Sandhu M, Goyal K, Sood S, Sood R. Comparative evaluation of efficacy of different tongue cleaning aids in reducing Streptococcus mutans count and tongue coating among school children. J Indian Soc Pedod Prev Dent. 2013;31(4):242–7. [29] Yaegaki K, Sanada K. Volatile sulfur compounds in mouth air from clinically healthy subjects and patients with periodontal disease. J Periodontal Res. 1992;27(4):233–8. [30] Gilmore J, Augenstein W, Johnson N, et al. Reducing oral malodor by tongue cleaning and its influence on oral health: A review. J Contemp Dent Pract. 2012;13(6):849–56. [31] Hebbar A, Keluskar V, Shetti A. Oil pulling – Unraveling the path to mystic cure. J Int Oral Health. 2010;2(4):11–15. [32] Peedikayil FC, Sreenivasan P, Narayanan A. Effect of coconut oil in plaque related gingivitis – A preliminary report. Niger Med J. 2015;56(2):143–147. [33] Asokan S, Emmadi P, Chamundeswari R. Effect of oil pulling on plaque-induced gingivitis: A randomized, controlled, triple-blind study. Indian J Dent Res. 2009;20(1):47–51. [34] Gupta R, Sharma V, Singh R. Evaluation of the efficacy of Arimedadi Taila in the management of bleeding gums: A clinical study. Ayu. 2012;33(3):399–402. [35] Peedikayil FC, Sreenivasan P, Narayanan A. Effect of coconut oil in plaque-related gingivitis — A preliminary report. Niger Med J. 2015;56(2):143–7. [36] Thaweboon S, Nakaparksin J, Thaweboon B. Effect of oil pulling on oral microorganisms in biofilm models. Asia J Public Health. 2011;2(2):62–6. [37] Prakash S, Shelke AU. Comparative evaluation of efficacy of Triphala mouthwash and chlorhexidine gluconate mouthwash on oral health in school children. J Ayurveda Integr Med. 2014;5(4):229–232. [38] Shastri A. Ayurveda Tattva Sandipika. Commentary on Ashtanga Hridaya. Varanasi: Chaukhambha Publications; 2015. [39] Jagetia GC, Baliga MS. Evaluation of anticancer activity of betel leaf (Piper betle) extract. J Ethnopharmacol. 2004;90(1):107–114. [40] Warnakulasuriya S. Betel quid and oral cancer: A review. J Oral Pathol Med. 2002;31(5):239–246. [41] Vagbhata. Ashtanga Hridaya, Sutrasthana, Ch. 2/9. Edited by Gupta K. Varanasi: Chaukhambha Sanskrit Series; 2010. [42] Bhavamishra. Bhavaprakasha Nighantu, Dantyadi Varga. Varanasi: Chaukhambha Bharati Academy; 2009. [43] Sushruta. Sushruta Samhita, Chikitsasthana, Ch. 24/12. Edited by Acharya YT. Varanasi: Chaukhambha Orientalia; 2014. [44] Sharma S. Kriya Sharira. Varanasi: Chaukhambha Sanskrit Bhawan; 2013. p. 209–211. [45] Suchetha A, Venkat R, Rai K. Clinical evaluation of the efficacy of an Ayurvedic gum massage powder (Periocare®) in oral hygiene. J Ayurveda Integr Med. 2013;4(4):213–219. [46] Rai B, Kharb S, Jain R. Effect of curcumin on clinical and histological parameters of oral submucous fibrosis: A pilot study. J Contemp Dent Pract. 2010;11(4):34–41. [47] Cikrikci S, Mozioglu E, Yilmaz H. Biological activity of curcuminoids isolated from Curcuma longa. Rec Nat Prod. 2008;2(1):19–24. [48] Suhag A, Dixit J, Dhingra K. Comparative evaluation of subgingival irrigation with 1% curcumin solution, 0.2% chlorhexidine, and saline in chronic periodontitis patients: A pilot study. Indian J Dent Res. 2007;18(3):148–151

Copyright

Copyright © 2026 Dr. Ayushi Khandelwal. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.