Herbal supplements and oral health.

MRS. ROBERTS, AGED 72 YEARS, IS A NEW CLIENT IN your dental hygiene practice. During the intraoral examination, you commend her on the health of the palatal tissue underneath her maxillary partial denture. Mrs. Roberts tells you that "the roof of my mouth used to be red and sore until I started using an oil of oregano mouthrinse." How do you respond to this client? Where do you find reliable information on herbal products? What do you say to another client who is using garlic capsules to treat an ear infection?

The use of herbal products and supplements has become big business. So the Natural Health Products Directorate of Health Canada wanted to find out more about what Canadians knew about these natural health products. The Directorate therefore conducted a survey in 2005 that revealed 71% of Canadians use herbs and other dietary supplements for a wide variety of reasons. (Visit www.hc-sc.gc.ca/dhp-mps/pubs/natur/eng_cons_survey_e.html for more information about the survey.) As a professional, it is critical to obtain scientific data about the safety and efficacy of these products. It is your responsibility as an evidence-based practitioner to provide this information to your clients.

Herbal medicines contain many pharmacologically active chemicals that can potentially raise or lower the levels of prescribed medications to a significant extent. Fortunately, there are a number of reliable sources--both print and electronic--that present current scientific research on medicinal herbs. These resources describe factors such as safety, herb-drug interactions, side effects, and contraindications.

The following texts may be useful for your reference shelf:

Kuhn MA, Winston D. Herbal Therapy & Supplements: A Scientific & Traditional Approach. Philadelphia: Lippincott; 2000. ISBN 0-7817-2643-3.

This book is a joint effort by a registered nurse with a PhD in physiology and a noted herbalist. The introductory chapter reviews the concept of herbal therapy, the issue of standardization, and the research process used to evaluate herbs. Extensive descriptions of the herbs follow in alphabetical order by their common name. There is a comprehensive index that lists herbs by both their botanical and common names.

Nursing Herbal Medicine Handbook. Philadelphia: Springhouse; 2001. ISBN 1-58255-100-6.

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This handbook is designed to give you information on the herbs and dietary products your clients may be using. Facts about which foods and medicines should be avoided when someone is using a certain herb, and potentially harmful ways these products can interact, are provided.

A number of reputable web-based resources are available and a brief description for four of these databases follows:

Memorial Sloan-Kettering Cancer Center provides objective information for health care professionals. The database includes a clinical summary for each agent and details about constituent's adverse effects, interactions, and potential benefits or problems. A consumer version of each monograph is also available. (See www.mskcc.org/mskcc/html/11915.cfm)

International Bibliographic Information on Dietary Supplements (IBIDS) is a collaboration between two government agencies: the Office of Dietary Supplements (of the U.S. National Institutes of Health and Food and Nutrition Information Center) and the National Agricultural Library (of the Agricultural Research Service, U.S. Department of Agriculture). This contains over 730,000 citations regarding dietary supplements from four major database sources: biomedical-related articles from MEDLINE, botanical and agricultural science from AGRICOLA, worldwide agricultural literature through AGRIS, and selected nutrition journals from CAB Abstracts and CAB Health. (See www.ods.od.nih.gov/Health_Information/IBIDS.aspx.)

Health Canada Drugs and Drug Products site contains natural health product information tailored for a wide audience. For the consumer, it includes "Frequently Asked Questions" and "It's Your Health" sections plus a list of licensed natural health products. The Natural Health Products Research Program supports natural health products and knowledge-based development. (See www.hc-sc.gc.ca/dhp-mps/prodnatur/index_e.html.)

The National Center for Complementary and Alternative Medicine of the National Institutes of Health is the lead U.S. agency for scientific research on complementary and alternative medicine. It provides an introduction to dietary supplements, reviews safety factors, and publishes "herbs at a glance" fact sheets. (See http://nccam.nih.gov/.)

In summary, herbal medicines have become a popular way for people to treat their own ailments but with this ability comes the potential for misinformation and problems. We hope that the information in this column will be useful for both you and your clients.

Note: A search for "oregano" on the IBIDS database returned 128 research articles on oregano oil. It appears that Mrs. Roberts may be supported in her use of this aromatic oil as studies have shown it to hold antifungal properties. Garlic is used in naturopathic medicine as an antibacterial agent for the treatment of otitis media.

by CDHA Staff