Oral health: An Ayurvedic perspective

Ayurveda is the ancient Indian system of healthcare and longevity. For an in depth history, find our article, A history of Ayurveda and the growth of the Materia Medica. Ayurveda’s holistic approach to oral health emphasises the connection between oral wellness and overall body health. Ayurveda has always viewed the mouth as both a gateway to and reflection of health — being the primary entry point for pathogens. The link between oral health problems and systemic diseases like diabetes and cardiovascular disorder is now widely recognised. Numerous studies reveal a strong connection between certain pathogenic microbes in the mouth and multiple health conditions including diabetes, Alzheimer’s, heart disease, inflammatory conditions, and autoimmune disorders (1). For example, oral bacteria can enter the bloodstream and trigger arterial plaque, increasing the risk of heart conditions (2). 

This broad-spectrum approach aims to treat the root causes of oral health problems rather than just addressing symptoms. There is a great need for such an approach as currently in the  UK, oral health issues are highly prevalent, with various statistics indicating significant challenges (3): 

• 39% of adults do not visit the dentist regularly
• 66% of adults have visible plaque
• 31% of adults have tooth decay

Globally, oral diseases, while largely preventable, pose a major health burden for many countries and affect people throughout their lifetime, causing pain, discomfort, disfigurement and even death. The WHO estimate that oral diseases affect nearly 3.7 billion people. Untreated dental caries in permanent teeth is the most common health condition according to the Global Burden of Disease 2021. Most low- and middle-income countries do not have sufficient services available to prevent and treat oral health conditions (4). Holistic health practitioners can play a key role in empowering clients with knowledge about their health and lifestyle choices, as well as helpful herbs to support oral health. 

How does oral health work according to Ayurveda?

Ayurveda, with its wisdom going back thousands of years, offers profound insights into maintaining oral hygiene and preventing dental ailments. Oral health is known as danta swasthya in Ayurveda, with danta being the Sanskrit word for tooth. This topic is covered in the key Ayurvedic classical texts of both Charaka and Sushruta Samhita, Astanga Samgraha of Vagbhata and the Kasyapa Samhita, the most extensive acharya of the field with a separate chapter on dentation. According to the Sushruta Samhita, fifteen diseases of the roots of the teeth and gums have been mentioned, along with eight of the teeth (5). 

Normal healthy teeth are strong, white, smooth without decay. The gums should be even, pink and smooth. Teeth are considered a byproduct (updadhatu) of bone tissue (asthi dhatu), along with hair and nails. Hence, the health of teeth and nails can be seen as an indicator of the health of underlying bone tissue (6). It is mentioned that the tooth eruption (dantopatti kala), commonly referred to as teething, is best when a child is eight months old. Delayed teething is seen as due to decreased bone tissue. Receding gums and weak teeth in adults are also seen as due to this cause, versus extra teeth being seen with increased bone tissue.

A recent study looked at the association between dental health and osteoporosis in South Indian women with findings that individuals with osteoporosis are more likely to have poor oral health, with cavities and tooth loss being their main issues. Tooth loss may thus be used as a surrogate marker to predict osteoporosis (7).

Hence, food and herbal tonics that are good for bones and the muscular tissues are also beneficial for teeth and gums. To prevent tooth and gum disease good oral hygiene should be implemented in our daily routine (dinacharya) covered below. Indeed, most oral health conditions are largely preventable and can be treated in their early stages, such as dental caries (tooth decay), periodontal diseases, tooth loss and oral cancers. 

Although Western medicine has only recently discovered the correlation between oral health and systemic health, Ayurveda has long recognised the importance of oral health. The mouth is considered the mukha, or opening, to three of the sixteen main channels (srotamasi) of the body; specifically, the digestive tract (anna vahasrotas), the respiratory tract (prana vahasrotas), and the water channel (ambu vahasrotas).  

As the origin of these vital channels, it is not too surprising that imbalances in the mouth will lead to imbalances over time. This correlation stems from pathogenic microbes that are present in periodontitis spreading throughout the system (via the lungs, digestive tract, bloodstream, etc.) leading to issues such as systemic inflammation, plaque in the brain, plaque in the arteries, and increased blood sugar levels.  Ayurveda uses the mouth as a window into the total health of an individual, with use of tongue analysis (along with traditional Chinese medicine), which involves reading the tongue to indicate disorders of the doshas, digestion and even emotions. 

Each of these is described with detailed symptoms, causes, and personalised treatment approaches based on Ayurvedic philosophy. Problems such as deformities of the oral cavity, plaques and infections were managed in ancient India. According to Ayurveda, particularly the branches of shalyatantra (surgical science) and shalakyatantra (ENT and dentistry), there are 65 types of oral diseases, which arise from imbalances in the body and can manifest in seven anatomical locations (8):

• Lips: Eight types of diseases
• Gums: 15 types
• Teeth: Eight types
• Tongue: 5 types
• Palate: Nine types
• Throat: 17 types
• Generalised oral issues: Three types

The health of our mouth is directly linked to the overall balance of our doshas: vata, pitta, and kapha. An imbalance can lead to various oral issues. Broadly, tooth decay and cavities, excess mucus, plaque and swelling are associated with an excess of kapha dosha, which results in an overproduction of mucus or plaque. Gum inflammation, ulcers, bad breath and bleeding is linked to an imbalance in the pitta dosha, often caused by excessive heat or acidity in the body. Tooth sensitivity, pain, dryness and receding gums are typically signs of a vata imbalance, where there is a disruption in the nervous system and circulation. 

The mouth, being the beginning of the digestive system, is also linked to the health of our digestive fire, or agni. A healthy agni ensures proper digestion and absorption, reducing the chances of oral issues. The oral microbiome contains about 700 various species of microbes making it the largest microbiome aside from the gut. Around 45% of the microbes in the mouth can also be found in the gut suggesting a strong connection between our oral health and our digestive health (9).  With a direct route to your digestive tract, the pathogenic microbes in your mouth can easily find a home in the GI tract, triggering inflammatory GI disorders, gut dysbiosis, and other digestive disturbances.

Ayurveda emphasizes individualised care, which is determined by a person’s unique physical and mental constitution (prakriti). This approach takes into account:

• Dominant doshas (vata, pitta and kapha)
• Seasonal and climatic changes
• Diet, digestion and lifestyle
• Tailored herbal prescriptions

The Ayurvedic approach to oral health looks at both addressing symptoms as well restoring balance to the microbiome and bone tissue regeneration (asthi dhatu support) on a deeper level. There is a need to balance the body’s doshas, cleanse tissues and support the natural production of healthy saliva. Indeed, Ayurveda recognizes saliva as the mouth’s protective shield (kavalagraha) which naturally remineralises enamel, neutralises acidity and maintains a pH-balanced oral environment to suppress harmful bacteria. 

Some common oral health issues include:

• Grinding of the teeth: Grinding of teeth is often related to stress or anxiety. It may indicate deep seated anger and fear, according to Dr Vasant Lad, and vitiation of the bone tissue (6).
• Sensitivity: Affects over a third of adults, often caused by brushing too hard or consuming acidic foods.
• Bleeding gums (gingivitis): Affects a third of adults, typically a sign of gum disease. 
• Tooth decay: Caused by poor oral hygiene and sugary foods, requiring regular brushing and flossing. 
• Gum disease: Inflammation of the gums, often reversible with good oral care. 
• Dental abscesses: Infections that can occur due to untreated dental issues.

It is always recommended to consult a qualified herbalist or Ayurvedic practitioner to determine the most suitable herbs, correct dosage and best method to take for oral health issues.

Allopathic medicine has had only limited success in the prevention of periodontal disease and in the treatment of a variety of oral diseases. Hence, the search for alternative products continues and natural phytochemicals isolated from plants used in traditional medicine are considered effective alternatives to synthetic pharmaceuticals. The herbs in the Ayurvedic material medica have been proven to be safe and effective, through several hundred to several thousand years of use (10).

Amla (Phyllanthus emblica)

Amla is a highly esteemed Ayurvedic herb with powerfully protective and adaptogenic properties, with high levels of vitamin C (20 times greater than an orange). It is widely used for cardiovascular and cellular health, offering support to the immune system and in metabolic disorders. It is renowned in Ayurveda as a rejuvenative tonic, or rasayana, and an adaptogen which has the ability to restore vigour and vitality. Its name in Sanskrit means ‘the sustainer’, and it is traditionally used to provide nourishment to all of the body’s tissues. It specifically promotes rejuvenation and tissue regeneration throughout the oral cavity, thanks to its astringent and bitter tastes. Amla also works well as a mouth rinse as a decoction. 

Clove (Syzygium aromaticum)

Clove has been used for thousands of years as both food and medicine.  Clove has a strong reputation as a local anodyne (pain reliever) for dental pain. It is often used in powdered form or as a diluted pure essential oil applied directly onto the affected gum. Essential oils are powerful substances and must be used with caution, so follow advice for the correct application of clove for dental pain. Looking more broadly, due to its anti-fungal effects clove may be used as part of a treatment approach to tackle Candida albicans . It has a wide range of antibacterial and anti-fungal actions which may make it a useful herb for associated dysbiotic conditions in the gastrointestinal tract (11).

Khadira (Acacia catechu)

Khadira (Acacia catechu) is highly astringent as its bark is rich in tannins, so it tightens loose gums and stops bleeding. This is especially helpful with gingivitis. Traditional khadira manjan (tooth powder) cleans teeth and leaves a refreshing, earthy aftertaste.  

Neem (Azadirachta indica)

Neem supports dental and gum health through its potent antibacterial, anti-inflammatory, antifungal, and astringent properties, making it a key herb for preventing plaque, gum disease, cavities, and bad breath while promoting whiter teeth and healthier gums. It contains two chemical constituents known as azadiractin and nimbin which are responsible for its antibacterial, antifungal and anti-inflammatory activities. Neem twigs were traditionally used as a toothbrush, alongside rinsing with neem decoction made from boiling up the leaves. 

Liquorice root (Glycyrrhiza glabra)

Liquorice is valued for its natural antimicrobial, anti-inflammatory, and soothing properties that help maintain healthy teeth and gums and reduce oral infections. It contains the glycyrrhizin and flavonoids that inhibit the growth of harmful oral bacteria. Its ability to calm inflammation and soothe irritated gum tissues can help alleviate symptoms of gingivitis. 

Regular use in oral hygiene routines strengthens gums, while also supporting the healing of mouth ulcers due to its regenerative properties. It is often used in herbal tooth powders, pastes, or mouth rinses. Chewing on a small piece of liquorice root is also a traditional practice to naturally clean teeth and freshen breath.

Triphala (Terminalia chebula, T. belerica and Emblica officinalis)

Triphala is a blend of three fruits which is suitable for everyone, as each fruit balances one of the doshas. Its role as a deep tissue cleanser is reflected in its possessing five of the six Ayurvedic tastes, each with traditional medicinal qualities. Its astringent taste is especially helpful in reducing gum inflammation. It regenerates all digestive mucosal membranes, including in the mouth.

It has been widely researched for oral health applications  and has also been shown to promote beneficial Bifidobacteria and Lactobacillus, while inhibiting undesirable microbes (12). Its tannins and phenolic compounds are thought to be largely responsible for these positive effects, comparable to chemical agents like chlorhexidine, but without side effects like tooth staining. It is now a respected natural oral care remedy in Ayurveda and modern herbal dentistry alike (13).

Turmeric (Curcuma longa)

Turmeric is both one of the most extensively used spices in the world and the most researched, with clinical evidence to support its potent anti-inflammatory properties. Its key compound, curcumin, helps reduce gum inflammation, alleviates gingivitis, and soothes swollen or bleeding gums by modulating the immune response. Its natural antimicrobial qualities inhibit harmful bacteria and fungi in the mouth, maintaining balanced oral microbiota. Traditional Ayurvedic practices use turmeric in homemade tooth powders, mouth rinses, or as a paste for massaging gums. Mixing turmeric with salt or neem powder is common to enhance its oral hygiene benefits.

A study compared a chlorhexidine mouthwash with a triphala mouthwash and a curcumin mouthwash. Both were proven to be equally effective in reducing plaque, gingival and bleeding scores, although the curcumin was better in reducing gingival inflammation. Hence, herbal mouthwashes such as triphala and curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine (14).

Please note: If you are not getting relief with these remedies then consult your doctor and your herbal practitioner. If there are any serious underlying health conditions, or if one is taking pharmaceuticals, it is important to check for interactions. It is best to consult a qualified clinical herbalist or doctor for this.

Ayurveda also places great emphasis on preventative health through daily routines to preserve oral health and prevent disease.

Diet support

• Keep digestion strong: A strong digestive fire means a healthy gut microbiome and less toxins overall; both important factors for supporting oral health. Chewing food well in the mouth is very helpful. Digestive issues such as hyperacidity or acid reflux can also lead to oral health issues as well including receding gums, cavities, demineralization, and inflammation.
• Sipping warm water throughout the day:  This supports general digestion, gently cleansing and promoting oral health. It also keeps the mouth hydrated which will create a less acidic environment, supporting healthy bacteria. 
• Avoid drinking sweet drinks and snacking between meals: This releases acids that lower the pH of your mouth more frequently than nature intended. The continuous state of a lower pH promotes dysbiosis (flora imbalance) in the mouth leading to cavities, demineralisation, bad breath, receding gums, inflammation, and infections.  Snacking is also seen to upset the digestive fire (agni).
• Limit sugar, refined grains, and processed foods: Sweets, refined grains, and processed foods support inflammation and weakened immunity, which also play a role in oral health issues. Include foods such as ghee, milk, buttermilk and rice, which build strength (known as ojas in Ayurveda). Minimise spicy, salty and acidic foods

Lifestyle suggestions 

These simple, holistic traditional practices could be widely incorporated into primary care, based on centuries of safe use (15):

Daily use of tongue scraper (jivha Lekhana)

The tongue harbours bacteria, plaque, and oral debris that the tongue scraper clears away. Scraping first thing each morning reduces bad odour and improves the taste sensation. A thin, slightly white, and moist coating is normal and indicates good digestion.  Ideally this is made of silver or copper which has antibacterial properties and does not rust, or stainless steel. A toothbrush is not recommended for this job as it may damage tastebuds. Avoid plastic tongue scrapers which tend to harbour unwanted bacteria and contain unwanted chemicals.  

Studies have shown that this practice reduces Streptococcus mutans and Lactobacillus, both known to cause decay. In a study of sixty men, patients were advised to use a tongue scraper twice daily for at least two minutes for seven days. No effort was made to change tooth brushing or dietary habits of patients. This had a significant effect on bacteria and also decreased oral malodour (16).

Gargling (gandusha and kavala)

Oil pulling is a traditional oral health practice that dates to around 5000 BCE, as detailed in ancient Ayurvedic texts, particularly the Charaka Samhita. In gandusha, the mouth is filled with oil and held for 3–5 minutes without movement, then released. In kavala, a comfortable amount of oil is swished and gargled for a few minutes — sesame oil and coconut oil are preferred. This helps maintain good oral hygiene, ensuring any food debris lodged in the teeth is expelled out when the oil is spit out. These oils also have antibacterial properties.

The lubricating effect relaxes irritated throat tissues and keeps the mouth moist. Regularly doing gandusha can also help in strengthening the facial muscles. It is best done early in the morning. Once finished, spit out the oil. It is very important not to swallow it. Rinse the mouth with warm water then brush teeth, floss, and use a tongue cleaner as usual.

Triphala mouthwash

The ingredients in your toothpaste and mouthwashes will have a positive or negative effect on your oral microbiome health and can have systemic effects such as parabens, triclosan, sodium lauryl sulphate (SLS) and saccharin (17). Conventional mouthwashes contain many harsh ingredients — for your body and the environment. Hence the warnings not to swallow them. They are also very strong, especially the ones containing alcohol.

Research shows that triphala is equally effective to conventional mouthwashes in reducing and preventing plaque, gingivitis, and bacteria known to cause tooth decay, without being excessively harsh (18). To make a triphala mouthwash, simply mix ½ teaspoon of triphala powder with ½ cup of warm water and use as a mouthwash each evening. Alternatively make up a triphala decoction for several days use. 

Brushing of the teeth (danta dhavana)

Before the advent of toothbrushes, people in India used neem twigs to brush their teeth. The stick should be chewed until it is broken up. Neem contains powerful antibacterial, antifungal and anti-inflammatory compounds which help in reducing plaque and preventing cavities. Other sticks recommended come from the Banyan, Khadira, or Arjuna tree — all astringent, heating and bitter in taste.

Research has shown all kinds of chewing sticks described in ancient Ayurveda texts have medicinal and anti-cariogenic properties (14). The taste of the stick helps to clear mucous secretions in the mouth. Today, this practice is less common with tooth brushes being prevalent, but these should have soft bristles. Try to avoid adding pressure while brushing. 

Rinsing the mouth with water after each meal

This is a traditional Indian folk practice, aimed at expelling the food residue left behind in the pockets of the mouth after eating.  A surprising amount of food particles can be released in this simple way. 

Herbal tooth powders / oils

The teachings of Ayurveda say that toothpaste should be astringent and bitter in taste, as sweet toothpaste causes the saliva to become thick leading to the development of tartar. Neem, triphala and tea tree are all seen as desirable in toothpastes.  A pinch of turmeric and salt can also be mixed to form a natural toothpaste that combats inflammation and infections. A pinch of salt in mustard oil can also be gently massaged onto the gums. Finally, clove oil can be applied to a painful tooth as a natural anaesthetic. Chewing on cloves also helps in reducing bad breath.  

Reduce teeth grinding (bruxism)

Stress is a known cause of bruxism, which weakens enamel causing and may even cause broken teeth.  It can be prevented or reduced through stress-relieving therapies to soothe the nervous system, especially before bed (if teeth grinding is a nighttime issue). Oil pulling and massaging the jaw area, especially directly under the ears with a soothing oil can also help prevent teeth grinding.  A traditional Ayurvedic home remedy is to chew half a teaspoon of uncooked basmati rice before bedtime, then, brush teeth and hold a mouthful of warm sesame oil for five minutes in the mouth. Leave a little oil in the mouth before going to bed (6).

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