title: Anti Bacterial Efficacy ofTerminalia Chebula, Terminalia Bellirica, Embilica OfficinalisandTriphalaon SalivaryStreptococcus MutansCount - A Linear Randomized Cross Over Trial.
abstract: BACKGROUND
  From the oral health perspective, it is well established that microorganisms have an important role in caries aetiology. From the dawn of civilization, herbal plants have served an array of roles.Triphalaa tradtional herbal Ayurvedic formula consists of three native fruits of india includingTerminalia Chebula(T. chebula), Terminalia Bellirica(T. bellirica)and Embilica Officinalis(E. officinalis). As per Ayurvedic Formulary of India (AFI)Triphalais prepared by combining a 1:1:1 mixture of ground dry fruits called myrobalans. Till date, an inadequate number of clinical researches on herb based mouth rinses have been reported in Asia, especially in India and other Southeast Asian countries (where these products are most accepted and widely used). The present study was planned to assess the effectiveness ofTriphalawith its three constituents.
  
  
  OBJECTIVE
  The objective of this study was to determine the effect ofTriphala,T. chebula,T. belliricaandE. officinalisaqueous extract rinses separately onStreptococcusmutanscount at various time intervals.
  
  
  METHODS
  This is a double-blind, linear cross over, within group experimental trial conducted among subjects visiting the Department of Public Health Dentistry aged 15 to 40 years. In this design, subjects received all of the treatments sequentially in time. The independent variables to be assessed in this study were all the four interventions of herbal preparations used and the dependent variable assessed is anti bacterial efficacy. Each subject receives two or more different treatments. All the subjects were exposed to all four interventions: 1)T. chebula; 2)T. bellirica; 3)E. officinalis; and 4)Triphalaand were provided 15 ml of the freshly prepared 10% rinse. The subjects were instructed not to eat or drink between salivary samples collection. Post rinse unstimulated salivary samples were collected at five minutes and 60 minutes intervals. All the salivary samples were transferred immediately to microbiological laboratory in sterile containers within one hour for microbiological analysis.
  
  
  RESULTS
  The mean Colony Forming Units (CFUs) ofS. mutanswithTriphalawhen compared to other three intervention was significantly reduced at 5 minutes and 60 minutes (p=0.001).E. officinalisshowed least reduction of mean CFUs when compared to other three groups.
  
  
  CONCLUSIONS
  It can be concluded that all four rinses were effective in reducingS. mutansCFUs, but 10%Triphalahas greater efficacy than its other constituents.
authors.affiliation: Senior Lecturer, Department of Public Health Dentistry, Institute of Dental Sciences , Bareilly, Uttar Pradesh, India .
authors.forename: Smariti
authors.initials: S
authors.lastname: Saxena
authors.affiliation: Professor and Head, Department of Public Health Dentistry, Bapuji Dental College , Davangere, Karnataka, India .
authors.forename: Nagesh
authors.initials: N
authors.lastname: Lakshminarayan
authors.affiliation: Professor, Department of Public Health Dentistry, GSL Dental College , Lakshmipuram, Rajahmundry, Andhra Pradesh, India .
authors.forename: Shanmukha
authors.initials: S
authors.lastname: Gudli
authors.affiliation: Professor and Head, Department of Public Health Dentistry, Anil Neerukonda Institute of Dental Science , Sanghivalasa, Vishakapatnam, Andhra Pradesh, India .
authors.forename: Manish
authors.initials: M
authors.lastname: Kumar
keywords: Colony forming units; Dental caries; Herbal preparations; Mouthrinse