CRITICAL ANALYSIS ON AYURVEDIC

DENTISTRY

DR.SYAM CHANDRAN.C

INTRODUCTION

Food - the basic necessity of mankind.

Among the Astanga of Ayurveda, Shalakya tantra holds an important role.

Dentistry and oral surgery forms a subsection of Shalakya Tantra.

• It was Susrutha who could, for the first time differentiated between the various diseases of oral cavity in general and of gums and teeth in particular.

• In Ayurvedic Samhitas emphasized on oral hygienic measures like दन्तधा�वन , जिह्वा� निनर्ले�खन, गण्डू�ष, कवर्ले, त�म्बू�र्ले से�वन and other oral hygienic measures.

HISTORICAL REVIEW

Vedic period

• In Rig Veda the word “Danta” is used.

• Ashwini Kumaras the God physicians and surgeons given a new teeth to pushanva is mentioned by the author of Shatapatha Brahmana

(a commentary on Shukla Yajurveda).

• In Atharva Veda also we will find the references of danta rogas

The procedures for controlling gingival diseases are as old as recorded history. In 3000 B.C. itself gold and silver toothpicks were buried by the Sumerians with their dead bodies.

• By the 18th century, modern dentistry developed but 19th century witnessed several developments that revolutionized the field.

• Mukha roga prakaran

– Dantamula rogas (gingival and periodontal diseases)– Danta rogas (dental diseases)

• The seven subsites of mukha according to Susrutha are

(1) Oshta(Lips)

(2) Dantamula (Gums)

(3) Danta (Teeth)

(4) Jihva (Tongue)

(5) Talu (Palate)

(6) Kantha (Throat)

(7) Sarvani (Entire oral cavity mucosa).

THE ORIGIN AND NATURE OF DANTA

• The origin of teeth is from Pitrujabhava since it is Composing of Asthi and Majja.

• Acharya Susrutha has defined the teeth as ‘Ruchakasthi’

• Teeth - Asthi and Majja dhatu

• Synonyms - dashana, Radana, Rada, Dwija

• According to ancient Acharyas, the humans have 32 teeth.

permanent - (Sakrijjata)

deciduous - (Dwija).

• Rajadanta (रा�दन्त) - Middle Incisors

• Vasta (वस्त) – Canines

• Damshtra (द�ष्ट्र) - Pre molars

• Hanavya (हा�नव्य) - Molars

रा�जदन्त रा�जदन्त वस्तवस्त दष्ट्रदष्ट्रदष्ट्र

दष्ट्र

हा�नव्यहा�नव्य

DANTAMOOLADANTAMOOLA

Acharya Kashyapa in the Kashyapa Samhita has mentioned, Dantamula are developed from Rakta Dhatu in the womb of mother and later grow in shape and becomes firm.

Synonyms -दन्तमां��से, दन्तव�ष्टक�,

दन्त�व�ष्ट, दन्तबून्दन

In Ayurvedic Classical texts the term Dantaveshta posses two meanings: - A structure in mukha refers to the tissue surrounding the danta.- As a disease > Dantaveshtaka is one among the

Dantamula roga’s.

The Sandhi between the Danta and Dantamula is called the उल्र्ले$कर्ले सेन्धि&.

दन्त रा�ग

DANTA ROGAS

द�लन - Odontina

दन्तहार्ष� - Hypersensitivity

दन्तशर्क� रा� - Dental Calculus

र्कपा�लिलर्क� - Enamel separation

र्क� मि�दन्त - Dental carries

श्या�वदन्त - Tooth Discoloration

भन्ज�नर्क - fissured tooth

हान���क्ष - Dislocation of mandible

• uÉÉiÉÉiÉç EwhÉxÉWûÉ SliÉÉ

• vÉÏiÉxmÉvÉåï AÍkÉMü urÉjÉÉ

• SÏrÉïqÉÉlÉåwÉÑ CuÉ ÂeÉÉ

vÉÏiÉSliÉ/SÉsÉlÉ

“ द�ल्यन्त� बूहुधा� दन्त....” (सु�.निन १६/२८)

• uÉÉiÉ mÉëMüÉãmÉ

• vÉÏiÉ EwhÉ AqsÉ AxÉÌWûwhÉÑiÉÉ

SliÉWûwÉï

» Acute pulpitis-piercing pain

» Tooth attrition

Definition : Pain arising from exposed dentin typically in response to thermal, chemical stimuli, osmotic

etc…

C/F : Sudden pain

Generalized hypersensitivity

Diagnosis : Measuring of sensitivity-

Stimulate the area with compressed air

Hypersensitivity

Attrition : Loss of dental tissue caused by tooth to tooth

contact during mastication.

Tooth Wear

Abrasion : Loss of dental tissue caused from abrasion by a foreign substance.

ErosionProgressive loss of hard dental tissue by chemical processes

Eg: Tooth contact with acidsRegurgitation of HCl

Management of vÉÏiÉSliÉ

• xuÉåSlÉ and sÉåZÉlÉ of SliÉmÉÉÍsÉ

• SWûlÉ with iÉæsÉ

• mÉëÌiÉxÉÉUhÉ with SÉÌQûqÉ iuÉMç ,नि*फर्ले, vÉÑÇÌP

• aÉhQÕûwÉ with ¤ÉÏUÏव,क्ष MüwÉÉrÉ

• xÉÑZÉÉåwhÉ xlÉãWû MüuÉsÉ• ÎxlÉakÉ lÉxrÉ • qÉÉÇxÉUxÉ rÉuÉÉaÉÑ ¤ÉÏU• uÉÉiÉWûU MüwÉÉrÉ• ÌiÉsÉ rÉ̹qÉkÉÑ ¤ÉÏU

aÉÇQÕûwÉ kÉÉUhÉ

Management of SliÉWûwÉï

SliÉ qÉsÉ AkÉÉuÉlÉÉiÉçMüTüvÉÉãwÉhÉ by uÉÉiÉ

ÎxjÉUÏpÉÔiÉÈ

vÉMïüUÉ

mÉÔÌiÉaÉÇkÉiÉÉ

SliÉ

aÉÑhÉWûÉÌlÉ

ZÉUxmÉvÉï

SliÉvÉMïüUÉ

Dental calculus is an adherent calcified or calcifying mass that forms on the surface of teeth and dental appliances.

PLAQUE/ CALCULUS

Stages of plaque formation

Formation of dental pellicle

Colonization of plaque microorganisms

Maturation

Calculus : Mineralized dental plaque.

Scaling

Manual scaler

Ultrasonic scaler

Management of SliÉvÉMïüUÉ

• vÉMïüUÉ

ÌlÉWïûUhÉ

• mÉëÌiÉxÉÉUhÉ

ÌlÉSÉlÉ: xÉÉ AÌmÉ EmÉåͤÉiÉÉ

sɤÉhÉ: vÉÉiÉrÉÌiÉ AhÉÑvÉÉå SliÉÉiÉç MümÉÉsÉÉÌlÉ

rÉSÉ vÉMïüUrÉÉ xÉWû

“दलन्तिन्त दन्त वल्र्क�निन...........

..................................... दशन�न निवन�शिशन* ” (सु�.निन

१६/३३)

MümÉÉÍsÉMüÉ

Enamel hypoplasia

» Congenital type

» Environmental type

» Dental flurosis

Management of Kapalika

• क, cNíûûxÉÉkrÉ

• SliÉWûwÉÉåï£ü ÍcÉÌMüixÉÉ

MüÄTüuÉÉiÉM urÉÉÍkÉ

sɤÉhÉ:

uÉY§ÉÇ uÉ¢üÇ

pÉuÉåiÉç

SliÉpÉÇaÉ

iÉÏuÉëÂeÉÉ

xÄTÑüOûlÉ

pÉgeÉlÉMü

Management of Bhanjanaka

• AÌSïiÉuÉiÉç

र्क� ष्णÈ ÍNûÌSì cÉsÉÈ xÉëÉÌuÉ xÉÇUÇpÉÉå qÉWûÉÂeÉÈ

क, मिमांदन्त

Acc. to Vagbhata ;

xÉqÉÔsÉÇ SliÉqÉÉÌwÉëirÉ SÉãwÉæÈ EsoÉhÉ qÉÂiÉæÈ

xÉÑÍvÉUå vÉÉãÌwÉiÉå �ज्ज

SliÉ A³É qÉsÉ mÉÔËUiÉåmÉÔÌiÉiuÉÉiÉç Ì¢üqÉrÉÈ xÉÔ¤qÉÉ eÉÉrÉiÉå

xÉÇUÇpÉÉå AWåûiÉÑ iÉÏuÉë AÌiÉï vÉqÉÈ

AÍxÉiÉÈ cÉsÉÈ

mÉëpÉÔiÉÈ mÉÔrÉU£üxÉëÑiÉç

Management of र्क� मि�दन्त

• xuÉåSlÉ• U£üÌuÉxÉëÉuÉhÉ• ÎxlÉakÉ uÉÉiÉWûU SìurÉ AÉsÉåmÉ,

aÉlQÕûwÉ, lÉxrÉ

• aÉÑQû qÉkÉÑÍcɹ mÉÔUhÉ SWûlÉ• xÉmiÉcNûS AMïü ¤ÉÏU mÉÔUhÉ• MüÉåwhÉ ÌWÇaÉÑû

• SliÉ ÌlÉWïûUhÉ

REQUIREMENTS

» Inspection

Exploration

Diagnosis of dental caries

» Radiographs

Pit and fissure caries Buccal and lingual surface caries

Occlusal surface caries

Hidden caries Root surface caries

Types1. Intra oral-X-ray film is inside the mouth.

Bite-wingPeriapicalOcclusal

2. Extra oral- film is outside the mouth.

Radiographs

» Highlight the crown of the teeth.» Reduction in radiopacity of the enamel.

Indication:» To find cavities between the teeth» To see tartar on the root.

Bitewing X-rays

Periapical X-ray

The teeth from either the upper or lower jaw in one portion of the mouth are shown.

Occlusal X-ray

» Larger

» Full arch of the teeth in either the upper or lower jaw is shown.

» Highlight tooth development and placement

Panaromic x-ray (OPG)

Show the entire mouth area-all teeth on the upper and lower jaws-on a single X-rays.

» x-ray of the entire side of the head.

» Used to look at the teeth in relation to the jaw for teeth alignment.

Cephalometric projections

» Removing the caries and replacing the lost substance of the tooth with a filling.

Types of restoration:» Direct restorations: Filling is placed directly into

the prepared cavity.» Requires a single visit

Materials usedDental amalgam, GIC ,composite fillings.

Treatment of caries

Amalgam Glass ionomer cement Composites

INDIRECT RESTORATIONS

Requires two or more visits

It includes,

» Crowns

» Bridges.

Crowns» These are the coverings that fit over teeth.» Made of porcelain.

Indications: Broken down old fillings.

Sensitive tooth

Malformed or discolored teeth.

Extensive damage by decay

Bridges

ROOT CANAL TREATMENT

The process of removing

diseased or damaged pulp

from the tooth, then filling and

sealing the pulp chamber and

root canals.

Creating an abscess Cleaning the cavity Measuring the cavity

U£üÍqÉÍ´ÉiÉ ÌmɨÉ

दग्धात�

vrÉÉuÉiÉÉ/lÉÏsÉiÉÉ

ÍcÉÌMüixÉÉ: AxÉÉkrÉ

vrÉÉuÉSliÉ

Cause:When the total intake of fluoride is high

Diagnosis:

Mild

Dental flurosis

Moderate Severe

Traumatogenic discoloration

» Discoloration of single tooth.

Trauma

extra vessation of blood components

necrotization of pulp

Bluish or blackish discoloration

Tetracycline staining

Yellow or grey horizontal bands on tooth.

Treatment :» Bleaching» Restoration

Aim- Entirely cosmetic

ÌlÉSÉlÉ: pÉÉUuÉWûlÉAÍpÉbÉÉiÉ

sɤÉhÉ: ÌlÉUxiÉ ÎeÉÀûM×Níû pÉÉwÉhÉ

ÍcÉÌMüixÉÉ: AÌSïiÉuÉiÉç

WlÉÑqÉÉå¤Éû

cÉsÉÌ°È SvÉlÉæÈ

pɤÉhÉÉiÉç AÍkÉMü urÉjÉÉ

ÍcÉÌMüixÉÉ:

xÉxlÉåWû

SvÉqÉÔsÉÉqoÉÑaÉlQÕûwÉ

xlÉåWû lÉxrÉ

mÉëÌiÉxÉÉUhÉ

दन्तचा�र्ले

» Loss of tooth support» Inflammation

Class O Complete tooth stability.Class I Tooth moves 1/2 mm buccally and 1/2 mm

lingually.Class II All degrees between Class I and Class III

mobility of up to 1mm in any direction.Class III Tooth is terminally mobile. Greater than 1 mm

in any direction and is depressible in the socket.

Tooth Mobility

JalandharabandhamA position of the body maintained, which constricts the nerve plexuses situated in the kantha , thereby blocking the impulses carried in them from reaching their destined centres of perception and transiently/ temporarily controlling the sensation of pain.

MüUÉsÉxiÉÑ MüUÉsÉÉlÉÉÇ SvÉlÉÉlÉÉÇ xÉqÉѪqÉÈ

• ÍcÉÌMüixÉÉ : AxÉÉkrÉ

• Overbite• Underbite• Crossbite• Spacing• Crowding • Treatment : Appliances are used

MüUÉsÉ

OVERBITE CROSSBITE

UNDERBITE

दन्त�0लगतरा�ग

शी2त�दVitiation of कफ राक्त

दुग5&

मां,दुत� , क, ष्णा�त� of दन्त मां�र्ले

रु�

श*त�द

राक्त स्रा�व from दन्तमां�र्ले�

Bleeding gumsCauses of bleeding gums include:

• Any bleeding disorder• Hormonal changes during pregnancy• Leukemia• Scurvy• Vitamin K deficiency

Chikitsa

• Raktamookshana• Gandusha - Shunti, Sarshapa, Triphala,

Musta, Rasanjana.• Lepa – Priyangu, Tagara, Musta, Triphala.• Nasya – Triphala, Madhuka, Padhyaka, Sidha Taila

Karanja

दन्त पु$प्पु$टक

Vitiation of राक्त कफ

सेरु

दन्तय=न्धिस्*ष$ व� यस्य श्वयथु$

दन्त पा�प्पा�टर्क

• Rakta mokshana• Pratisarana – Panchalavana,

Yavakshara, madhu.• Shirovirechana, Nasya, Snigdha Bhoojana

Nimba

दन्तव�ष्ट

दुष्ट शी=णिणात

पु�य स्रा�वन्तिन्त , राक्त स्रा�व

चार्ले� दन्त

दन्त व3ष्टर्क

Chronic periodontitis

• Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque.

• Rakta mokshana• Pratisarana – Lodhra, Patanga,

Madhuka, Laksha, Madhu.• Gandusha – Ksheeri vriksha kwatha.

Madhu, gritha, sharkara.• Nasya – kakolyadi siddha ksheera.

Asana

शीBनिषरा

Vitiation of कफ राक्त

श्वयथु$ दन्त मां�र्ले�ष$

रु

र्ले�र्ले�स्रा�निव

कण्डू$

शीBनिषरा

Chronic gingivitis

• Chronic gingivitis is a persistent inflammation of the gingiva, the soft tissues surrounding the teeth.

• Rakta mokshana• Lepa – Lodhra, Musta, Rasanjan.• Gandusha – Ksheeri kwatha• Nasya – Sariva, utpala, Yastimadhu, Lodhra, Agaru, Chandana siddha ksheera and gritha.

Karaveera

Vitiation of नि*द=ष

व�ष्ट�भ्यस्त�र्ले$

दन्त मां��से�निन पुच्यन्त�

मां$ख� चा पुरिरापु2डूयत�

�हा�श5निर्षरा

मांहा�शीBनिषरा

पुरिरादरा

Vitiation of निपुत्त राक्त कफ

मिष्टवनित चाव्यस्रा$कG

दन्त मां��से�निन शी2य5न्त�

पुरिरादरा

Gangrenous stomatitis

• Gangrenous stomatitis (cancrum oris) is a lesion involving the orofacial structures that is primarily seen in areas where the socioeconomic standards are low and there is poor hygiene

उपुक$ शी

Vitiation of निपुत्त, राक्त

व�ष्ट�ष$ द�हा पु�कश्च

दन्त चार्ले�

प्रस्रा�वन्तिन्त शी=णिणात�

मांन्द व�दन�

मां$ख� पु�नित चा �यत�

उपुक$ शी

Stomatitis

• Stomatitis is inflammation of the mucosa. The term refers to any inflammatory process affecting the mucous membranes of the mouth and lips, with or without oral ulceration

• Shodana• Raktamokshana – Rubbing with

leaves of Gojiwaha.• Pratisarana – madhu, Panchalavana,

Trikatu.• Kavala – Pippali, Sarshapa, nagara.• Nasya - Kakolyadi gana siddha

gritha.

दन्त वJदर्भ5 घृ,ष्ट�ष$ दन्तमां�र्ले�ष$ ( दन्त क�ष्ट )

से�राम्बू= �यत� मांहा�न

चार्ले� दन्त

दन्त वJदर्भ5

• Shodana of danta moola and application of Kshara and Sheetal upachara.

Arjuna

वधा5न

Vitiation of vata

अमिधाक= दन्त

त2व्र व�दन

व्य�मिधा �त� रुकG चा प्रशी�म्यनित

वधा5न

• Extraction of tooth• Agnikarma

Lavanga

अमिधामां��से

कफ�

हा�नव्य� पुणिश्चमां� दन्त�

मांहा� शी=थु

मांहा� रु�

र्ले�र्ले�स्रानिव

अमिधामां��से

Perichoronitis

• Also known as operculitis, is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva (gums) and the dental follicle.

• Caused by an accumulation of bacteria and debris beneath the operculum, or by mechanical trauma (e.g. biting the operculum with the opposing tooth)

• Chedhana of Adhimamsa• Lepa – Vacha, Tejovati, Patha,

Sarjikshara, yavakshara and madhu.• Kavala – Pippali and madhu• Vrana dhavana – Patola, Triphala, Nimba Kashaya• Shirovirechana and Dhooma

Apamarga

दन्त न�डू2

5 types - व�त, निपुत्त , कफ, नि*द=ष , शील्य

पुक्वमां$पु�क्षत�

शी=फ� न पुक्वमिमांनित

अभ्यन्तरा� प्रनिवशीनित

Vitiate त्वकG , राक्त, मां��से अस्थिR

दन्त न�डू2

• Chedana – Dusta mamsa• Kshara/Agnikarma• Dhavana of danta nadi –

Jati,Madanaphala,Katuki, Gokshura. • Vranaropana – Jati, Yasti madhu, Lodhra, Khadira siddha taila.

Irimeda

Conclusion

• Ethics of ideal dentistry is to prevent the dental disorders and restore the dentures in its native form.

• The proper application of Dincharya explained in Ayurvedic classics plays a major role in preventing oral cavity diseases.

• Lack of anesthetic agents is a major lacuna in executing surgical procedures in danta and danta moolagata rogas explained in classics.

Thank you…