E-ISSN:2456-3110

Case Report

Ayurvedic management

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 1 January
Publisherwww.maharshicharaka.in

A case report of Ayurvedic management on Dantavidradhi w.s.r. to periodontal Abscess

Dhara M. M1*, Vaghela D2
DOI:10.21760/jaims.9.1.50

1* Makwana Dhara M., Phd Ayu Scholar, Department of Shalakya Tantra, Institute of Teaching and Research, Jamnagar, Gujarat, India.

2 DB Vaghela, Head of Department Professor, Department of Shalakya Tantra, Institute of Teaching and Research, Jamnagar, Gujarat, India.

Background: Aacharya Vagbhatta has described seventy five Mukhroga; among them Dantamooolgat Roga are thirteen. Dantavridradhi (Periodontal Abscess) is one of the Dantamulagata Roga can be correlated with periodontal Abscess. Dantavridhi (Periodontal Abscess) is Tridoshaja, Sadhya Vyadhi as swelling develops on gums and accomplished with pain, burning sensation, pus discharge and sometimes with blood stains. Materials and Methods: A 47 year old normal and oriented female patient attended Shalakya Tantra OPD at ITRA Hospital with complains of swelling on upper jaw gums (gingiva) as chief complain associated with pain during chewing, mild pus discharge since 12 days. She was diagnosed with Dantavridradhi (Periodontal Abscess) and treated by Ayurvedic management as orally Triphala Guggulu, Gandusha and Kavala with Panchtiktak Kwatha, Pratisarana/Lepa of Katuki Churna mixed with Gomutra locally and adviced to maintain oral hygiene properly. Observation and Result: Considerable reduction of swelling is observed on the upper jaw gums (gingiva) within 8 days. Pain and pus discharge were relieved after 5 days. Complete relief in symptoms were noticed after 10 days. Conclusion: Ayurveda line of treatment approach is helpful in the management of Dantavridradhi (Periodontal Abscess).

Keywords: Dantamoolgat Roga, Dantavidradhi, Periodontal Abscess

Corresponding Author How to Cite this Article To Browse
Makwana Dhara M., Phd Ayu Scholar, Department of Shalakya Tantra, Institute of Teaching and Research, Jamnagar, Gujarat, India.
Email: 		Dhara M. M, Vaghela D, A case report of Ayurvedic management on Dantavidradhi w.s.r. to periodontal Abscess. J Ayu Int Med Sci. 2024;9(1):313-318.
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https://jaims.in/jaims/article/view/2918

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-11-09 2023-11-18 2023-11-28 2023-12-08 2023-12-18
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared. NIL YES 13.83 NONE

© 2024by Dhara M. M, Vaghela Dand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Dhara M. Makwana et al. Ayurvedic management on Dantavidradhi

Introduction

As per modern science this stream can be correlated with E.N.T., Ophthalmology and Oro-Dentistry.

Aacharya Vagbhatta has described 75 (seventy-five) Mukhroga, among them Dantamooolgat Roga are (13) thirteen.[1] Dantavridradhi (Periodontal Abscess) is of the Dantamulagata Roga can be correlated with periodontal Abscess.

Dantavridradhi (Periodontal Abscess) is aswelling develops on gums and accomplished with pain, burning sensation and heaviness. if ruptured after suppuration, it presents with pus discharge and sometimes with blood stains.[2] It has two types: 2 (acc. to stages) i.e. Ama & Pakwa Avastha. Aacharya Vagbhatta has described treatments according to their stages in details. He had narrated about Kaval, Lepa and Pratisarana for Amavastha wherelse Shastrakarma advised in Pakvavastaha with Gandusha and Nasya.

Periodontal Abscess is a localized accumulation of pus within the gingival wall of a periodontal pocket.[3] Periodontal therapy divided in Non-Surgical[4] and surgical Therapy[5] The treatment of periodontal abscesses includes drainage, mechanical debridement, and mouth rinses, reserving antibiotic with anti-inflammatory therapy.

Nowadays Patients are going to aware about traditional medicines. The main aim of this case study to evaluate the efficacy of non-evasive ayurvedic treatment of periodontal disease.

Case History

A 47 year old well-oriented female patient attended Shalakya Tantra OPD at ITRA Hospital. Patient was healthy before 12 days, after that gradually she felt swelling over the upper jaw gums. on after 2-3 days, she felt pain during chewing and burning sensation. Gradually symptoms increase and she had mild pus discharge since 5 days. With the chief complains of Swelling on upper jaw gums (maxillary gingiva) since 12 days. Her associated complains were pain during chewing with mild pus discharge. After the complete examination of oral cavity she was diagnosed with Dantavridradhi (Periodontal Abscess)

Materials and Methods

History

Past History: Covid-19 Positive 3 year ago

Systemic diseases: None

Medicinal History: Patient didn’t take any medicines for current condition as she wanted ayurvedic treatment. No any current medication since 1 year.

Surgical History: None

Family History: None

Personal History:

  • Aahar/Diet: Non Vegitarian
  • Agani/Appetite: Samyak/ Normal
  • Nindra/Sleep: sound sleep 6-7 hours
  • Mutra/Urine: 5-6 t/D, 0-1 t/N
  • Mala/Stool: satisfactory, 1 t/day
  • Jihva: Nirama
  • Shabda: Prakrut
  • Druka: Prakrut
  • Akruti: Krish/Avar Prama

Addiction: tea 2-3 t/d

Menstrual cycle: irregular (every 2-3 months), Scanty (1 pad/day, 3 days)

Samanya Parikasha / Vitals

  • BP: 110/70 mmhg
  • Pulse: 76/min
  • RR: 20/min
  • Temp: 97.2°F

On examination

Intra Oral Examination

Oral hygiene: Fair

Halitosis: present

Labial Mucosa: NAD

Buccal Mucosa: NAD

Tongue: NAD

Palate: NAD


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Tooth examination

Saucer shaped abfraction of teeth

Missing teeth present at lower central incisors and right maxillary both premolars

Tooth mobility was absent

Gingiva examination (Figure no. 1)

Generalised Gum Recession

Swelling over gingiva i.r.t. 1st and 2nd incisors 1st quadrant (right upper maxillary)

Suppuration - Present

Pain on percussion,

No bleeding on probing

JAIMS 2918 01
Figure 1: Before treatment

JAIMS 2918 02
Figure 2: After treatment

Laboratory Investigations

Haematological investigations carried out for any other disease.

Result: Within normal limit

Therapeutic Intervention

1. Triphala Guggulu was advised orally 2 BD after meal with warm water

2. Katuki Churna for Ptatisarana/Lepa (Locally), 10-15 gms mixed with Gomutra

3. Panchtiktak Kwatha for Kaval and Gandusha BD before meal

Patient was also advice to maintain oral hygiene properly and follow the Pathapathya.

Pathya:

Aahar: Laghu, Ushna, Tikta Katu Aahar Sevana, Mrudag, Shashishali etc.

Vihara: Dantadhana, Jihvanirlekhana, Kaval, Gandish etc.

Apathya:

Aahar: Madhur, Amla Rasasevan, Paya, Dadhi, Matsya Sevana etc.

Vihara: Dantadhavanadhesh, Anuchit Kaval and Gandush etc

Follow up: Patient was under observation for next 10 days

Observation and Results

Reduction of swelling is observed on the upper jaw gums (gingiva) within 8 days. Pain and pus discharge were relieved after 5 days. Burning sensation and Heaviness subsided within 2 and 3 days respectively. Complete relief in symptoms were noticed after 10 days. (Figure no. 2)

Discussion

Dosha are involved in Dantavridradhi are Tridoshaja with Rakta and Mansa Dhatu are vitiated. According to Sadhyasadhyata it is included in Sadhya Vyadhi. Aacharya Vagbhatta has described two types of treatment according to Avastha.[6]

Amavastha

  • Kavala - A warm decoction of drugs of Katu (pungent), Tikta (bitter) and Kashaya (astringent) properties mixed with Go-Mutra (cow's urine) is used for Kavala (gargling).
  • Lepa - with above mentioned ingredients.
  • Pratisarana

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  • - Paste of Katuka, Kushtha, Meshashrungi, Yavakshara is applied on swelling.
  • For preventing suppuration - Ruksha and Sheeta drug properties should be used systemically whereas Sheeta Lepa is applied externally/locally.

Pakvavastha

  • Shastrakarma - Abscess, if develops, should be incised, and drained followed by cauterization if deeply seated.
  • Gandush should be performed with decoction of Triphala, Tulsi and Nimbi (Arishta).
  • Nasya should be performed with Ghrutamanda processed with Yashtimadhu.

Treatment given in the present study was prescribed according to their reference in the Ayurveda classics in Astang Sangaha Samhita. Triphala Guggulu has Haritaki, Bibhitaki, Aamlaki and Guggulu as the main ingredient of the classical formulation. It is best effective in inflammatory conditions.

It has the ability to inhibit cellular accumulation and fluid exudation. Triphala has Tridosha Shamak and Rasayana (rejuvenating) properties as well. Panchtiktak Kwatha has been used for Kaval & Gandusha. i.e., group of barks of five trees - Vata (Ficus bengalensis L.), Ashwatha (Ficus religiosa L.), Udumbara (Ficus glomerata Roxb.), Plaksha (Ficus lacor Buch-Ham.), Parish (Thespesia populenea Soland. ex corea.).

It is a drug with Kashaya Rasa (astringent taste) and by the action of the Rasa; it acts as a Stambhaka (arresting) and Grahi (that holds). It is Kashaya Pradhana Rasa, it also act as Pitta Shamana and Rakta Shodhaka (blood purifier).

It’s a good Shothahara (that which reduces swelling), due to the Kashaya Rasa of the drug it acts with Peedana (act of squeezing), Ropana (heal) and Shodhana (curative effect) property. Due to these properties, it destroys or liquefies the accumulated substances and hence minimizes the swelling.

Furthermore, the drug is Rooksha (dry) and Kaphahara. Even due to this, Shopha, which is Kaphaja, gets reduced. Moreover, the Lekhana (scraping), Kledahara (arresting Dampness), Chedana (destroying/removing) and Raktashodhaka (blood purifier) properties of Kashaya Rasa

also will facilitate the debridement of the slough. Which work as antimicrobial, and wound healing properties also.

Katuki Churna mixed with Gomutra Ptatisarana/Lepa (Locally) gave Sodhana effect which eliminate of sticky bio-film over gums and tooth area.

And increase anti-oxidants activities. With this treatment protocol was helpful in Samprapti Vighatna of Dantavridradhi (Periodontal Abscess).

Conclusion

The entire Ayurvedic treatment selected for this case indicated Kapha-Pitta Shamaka, Anti-inflammatory, Antioxidant, and gingiva rehabilitation properties. Where no invasive strategy was utilized and in short period marked improvement was achieved.

Thus, we can conclude that Ayurveda Chikitsa is helpful in the management of Dantavridradhi (Periodontal Abscess).

References

1. Astang Hridayam, dr. Bramhanand Tripathi, Edited with Nirmala hindi commentary, Published by Chaukhambha Sanskrit Pratishthan, Reprint Edition – 2013, Uttar Tantra 21/65, page no 1033

2. Astang Hridayam, dr. Bramhanand Tripathi, Edited with Nirmala hindi commentary, Published by Chaukhambha Sanskrit Pratishthan, Reprint Edition – 2013, Uttar Tantra 221/24, page no 1025

3. Shantipriya Reddy, Essentials of Clinical Periodontology and Periodontics, 2nd edition, New Delhi Jaypee Brothers Medical Publishers, 2008, Chapter 19: Gingival Enlargements, page no 153

4. Shantipriya Reddy, Essentials of Clinical Periodontology and Periodontics, 2nd edition, New Delhi Jaypee Brothers Medical Publishers, 2008, Chapter 36 periodontal therapy, Non-Surgical Therapy page no 269

5. Shantipriya Reddy, Essentials of Clinical Periodontology and Periodontics, 2nd edition, New Delhi Jaypee Brothers Medical Publishers, 2008, Chapter 38 periodontal therapy, Surgical Therapy page no 291


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6. Astang Sangarha, Kaviraj Atrideva Gupt vyakhyakar, Published by Chaukambha Krushnadas academy, Varanasi, Reprint Edition - 2005 Uttar Tantra 26/26, page no 282


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