Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited

Department of Pharmacognosy, Faculty of pharmacy, Tishk International University-Erbil, Kurdistan Region, Iraq

The employ of medicinal plants has a long history in therapeutic and dental practice and they have long been used worldwide^1-3. Anti-inflammatory, antidiabetic, Anticancer, Huntington's disease, antibacterial, analgesic, sedative agents, endodontic irrigants and antioxidant properties of plants with their biocompatibility explain the people’s growing attention in the use of herbal medications^4-12.With the knowledge of curative properties of the medicinal plants against oral microorganisms and their incorporation in clinical practice we can aim to reduce if not remove this disease entity. Medicinal plants though produce slow recovery but their therapeutic effect is miraculous¹³. Above the earlier period, pharmaceutical companies have been involved in examined plants as basis for new phytotherapeutic agents with established efficiency, quality and safety^14-16. Dental pathology is a worldwide fitness difficulty, disturbing both undersized and rising or urbanized countries. The most widespread oral pathologies are dental caries and periodontal disease and the gravest oral pathologies are oral and pharyngeal cancer and oral tissue lesions are too of important concern¹⁷. For these causes, the WHO believes that oral health is a right of every people ¹⁸. An additional matter facing oral health is the huge number of children who are pretentious by tooth decay¹⁹. There are presently various treatments for oral pathologies, but these have disagreeable side consequences, such as altered oral microbiota or systemic gastrointestinal symptoms. Above 750 species of bacteria occupy the oral cavity (50% of which are yet to be identified) and a figure of these are concerned in oral diseases²⁰. Therefore, there is a sensitive require for novel options to conservative treatments, medicinal plants being a region of attention. A significant instance in which plants locate their usefulness is the treatment of bacterial infections at the oral height since most conservative antibiotics are unsuccessful because of bacterial resistance and those that are efficient have disagreeable side consequences²¹. Because of this, natural compounds are a safer substitute to antibiotics in the treatment of oral infections and are too an approach in the deterrence and treatment of additional oral diseases, counting dental caries, but also additional grave diseases such as cancer. Consequently, the reason of this review is to present several new examples of customary medicinal plant extracts or phytochemicals that have been exposed to slow down the enlargement of oral pathogens, decrease the development of dental plaque and decrease the indications of oral illness.

The Medline, Pub Med and Google Scholar databases were electronically investigated for pertinent articles and books available in English using the keywords medicinal plant, herb, phytotherapy, dentistry and pediatric.

Medicinal plants are a subject of attention for present investigates in the meadow of medicine, being ever more employed for the treatment of a great number of pathologies. Furthermore, numerous drugs presently employed in allopathic medicine have their source in medicinal plants. So, plants are together basis of conventional medicines and a substitute to them²¹. Medicinal plants are ever more employed in dentistry because of the components they enclose. The plants employed in dental pathology have dissimilar therapeutic actions such as antimicrobial, antifungal, antiviral, anti-inflammatory, analgesic and also as endodontic irrigant Table 1. Based on these manifold remedial actions, natural compounds locate their usefulness in a huge amount of dental pathologies.

Scientific name	Product	Experiment	Ref
Anti-cariogenic properties of herbal agents
Zingiber officinale	n-hexane, ethyl acetate, methanol and aqueous extracts	Antimicrobial analysis such as biofilm inhibition, time-kill kinetics, adherence inhibition was conducted	22
Satureja hortensis	extract and its essential oil	Antibacterial activity against S. mutants was evaluated by the disc diffusion method	23
Salvia officinalis	Glass-ionomer cement (GIC) modified with of S. officinalis extract	Antibacterial activity against S. mutants and L. caseiwas evaluated by agar disc diffusion method	24
Psidium guajava	P. guajava leaf extract used in herbal toothpaste	Herbal toothpaste was studied for its antimicrobial activity against, S.aureus, S. mutants, Bacillus subtilis, S. oralis, and Proteus vulgaris	25
Vaccinium vitis-idaea	Polyphenol-rich fraction	Evaluation of biofilm formation ability and bioactivity of S. mutants, S. sobrinus, and S. sanguinis	26
Tinospora cordifolia	Ethanolic extract	Seven different concentrations were prepared and tested against S. mutans in brain-heart infusion agar medium	27
Glycyrrhizaglabra/ Terminalia chebula	G. glabra and T. chebula extracts	The anti-adherence property of the herbal extract was evaluated using a glass surface adherence test	28
Trachyspermum ammi	T. ammi oil	Serial dilution and disc diffusion method was used for evaluation of T. ammi antibacterial efficacy	29
Mentha piperita	M. piperita leaf extract	Anti-microbial activity of the M. piperita was tested by the disc diffusion method	30
Camellia sinensis	The esterified derivative of EGCG	The number of colony-forming units was assessed for evaluation of EGCG efficiency against cariogenic bacteria	31
Psoraleae semen	P. semen ethanolic extract	Protein leakage evaluation and scanning electron microscopy was conducted to determine the efficacy of P. semen against bacterial cell membrane	32
Punica granatum	P. granatum gel	Agar well diffusion method was used for evaluation of P. granatum against cariogenic bacteria such as S. sanguis, S. mutans, and L. casei	33
Galla chinensis	G. chinensis crude aqueous extract	Anticariogenic efficacy of G. chinensis was evaluated by tests like Keyes’ caries diagnosis and scoring technique and the mineral density analysis on molar animal teeth	34
Rosmarinus officinalis	Alcoholic extract dentifrice	Single-disc diffusion technique was used for evaluation of herbal dentifrice against cariogenic bacteria	35
Aloe vera	Aloe vera leaf extract	Agar and broth microdilution method was used for antibacterial evaluation	36
Houttuynia cordata	H.cordata ethanolic extract	Antibiofilm activity of H. cordata extract was evaluated against oral pathogens	37
Toddalia asiatica/Cortex Lycii/ Cimicifuga foetida/ Toddalia asiatica	Herbal mouthwash (LongZhang Gargle®)	An Agar diffusion test was conducted to determine antibacterial activity against S. mutans	38
Cistus incanus	C. incanus accelerated solvent extract	A live/dead assay was conducted for evaluation of C. incanus herbal extract	39
Camellia sinensi/Alium sativum/Citrus aurantiifolia	Herbal mouthwash	Agar diffusion test was conducted to determine antibacterial activity against S. mutans and C. albicans	40
Anacardium occidentale/ Mangifera indica	Herbal ethanolic extract	An Agar diffusion test was conducted to determine antibacterial activity against S. mutans and E. faecalis	41
Herbal medicine and periodontal health maintenance
Acacia chundra//Adhatoda vasica/Mimusops elengi/ Piper nigrum/Pongamia pinnata/Quercus infectoria/ Syzygium aromaticum/ Terminalia/Zingiber officinale	Ayurvedic herbal extract	ELISA test was conducted for evaluation of IL-8 production by immortalized gingival keratinocytes after herbal extract treatment	42
Hippophae rhamnoides	H. rhamnoides pulp oil mouthwash	Biofilm Ring Test was conducted for evaluation of H. rhamnoides efficacy against P. gingivalis, C. albicans, and S. gordonii	43
Cinnamomum zeylanicum/ Salvadora persica	Herbal ethanolic extracts	Agar diffusion test was performed for evaluation of the antibacterial property of the herbal extract against A. actinomycetemcomitans and T. forsythia	44
Acacia nilotica/Murraya koenigii/Eucalyptus hybrid/ Psidium guajava	Herbal ethanolic extract	An Agar diffusion test was conducted to determine antibacterial activity against P. gingivalis and F. nucleatum	45
Allium sativum/Ziziphora clinopodioides	Z. clinopodioides and A. sativum essential oil	The broth macro dilution method and disk diffusion technique were conducted to evaluate the activity of essential oils on S. aureus and P. aeruginosa.	46
Houttuynia cordata	The decoction of dried H. cordata leaves	The microbial broth dilution method was used for evaluation of H. cordata antibacterial property	47
Polygoni multiflori	2,3,5,4- Tetrahydroxystilbene-2-O-beta-glucoside (THSG)	Evaluation of modulatory property of THSG on inflammatory responses caused by P. gingivalis in gingival fibroblasts	48
Morus alba	ethanolic extract	Antibacterial efficacy of the ethanolic extract was assessed by estimating minimum inhibitory concentration against common periodontal pathogens	49
Amellia sinensis	A. sinensis solution	Expression of interleukin-10, tumor necrosis factor and RANKL in diabetic rats were evaluated after treatment with A. sinnensis solution by immunohistochemistry	50
VitisViniferea	Commercially available grape seed extract	Brekoex Grape seed OPC 30® The modified agar dilution millpore method was conducted for evaluation of seed extract antibacterial property against S. aureus, E. coli, C. albicans, and K. pneumonia	51
Herbal medications and endodontic treatments
Myrtus Communis/Eucalyptus Galbie	Methanolic extracts in combination with calcium hydroxide powder	Agar diffusion technique, tube dilution test, and microtiter plate assay were conducted for evaluation of antibacterial activity against E. faecalis	52
Angelica archanglica/Asurum European	Fufang bing peng irrigant	PCR, high-throughput sequencing analyses, and antibacterial test were conducted to evaluate the efficacy of the herbal irrigant against E. faecalis	53
Emblica officinalis/ Terminalia bellirica/ Terminalia chebula	Triphala extract	Dental canals were examined after rinsing with Triphala extract for evaluation of the smear layer by field emission scanning electron microscope	54
Morinda citrifolia	M. citrifolia juice	Disc and well diffusion tests were conducted for evaluation of M. citrifoliaa gainst intracanal bacteria such as E. faecalis and C. albicans	55
Cymbopogon citratus/ Mentha piperita/ Ocimum sanctum	NaOCl herbal solution (9:1 ratio)	A combination of 6% NaOCl and herbal extracts was tested for pH and chlorine content	56
Psidium guajava/ Anacardium occidentale/ Carica papaya/ Aloe vera	Herbal extracts	An Agar diffusion test was conducted for evaluation of herbal extracts against E. faecalis and C. albicans	57
Morinda citrifolia/ Emblica officinalis/ Terminalia bellirica/ Terminalia chebula	M. citrifolia extract/Triphala juice	Colony-forming units of E. faecalis and C. albicans were evaluated after intracanal irrigation with Triphala juice, M. citrifolia extract and CHX	58
Curcuma longa	C. longa gel	Evaluation of anti-bacterial property of C. longa against E, faecalis infection found in dentinal tubules	59
Cymbopogon citratus/ Ocimum basilicum/ Camellia sinensis	C. citarus oil/O. basilicum oil/obicure tea extract	Broth micro dilution method was used for evaluating the antimicrobial efficacy of herbal extracts against E. faecalis found on gutta-percha cones	60
Emblica officinalis/ Psidium guajava	Alcoholic extracts	The Agar disk-diffusion method was used for evaluating the efficiency of herbal extracts and BioPure MTAD® against E. faecalis	61
Morinda citrifolia,/ Azadirachta indica/ Aloe vera	Aqueous extracts	An Agar diffusion test was conducted for evaluating herbal extract’s efficacy against E. faecalis	62
Allium sativum	Water extract	Fluorescence microscopic analysis and microbial viability assay were used for evaluation of antibacterial efficacy against E. faecalis	63
Ferula gummosa	F. gummosa essential oil	Broth micro-dilution evaluation and disk diffusion test were conducted to evaluate the antibacterial efficacy of F. gummosa oil	64
Herbal medicine and anti-fungal properties
Nigella Sativa	Alcoholic extract	Candida colony count evaluation was conducted after rinsing C. albicans-contaminated acrylic resin specimens with N. sativa extract	65
Equisetum giganteum/ Punica granatum	Combination of herbal ethanolic extracts with denture adhesive	Evaluation of the herbal extracts’ efficacy against C. albicans by confocal laser scanning microscopy analysis, colony-forming units count, cell viability analysis, and scanning electron microscopy	66
Isodon flavidus	Methanolic extract	Evaluation of anti-fungal property of I. flavidus by biofilm breakdown assay against C. albicans and T. rubrum	67
Lippia citriodora	Aqueous and ethanolic extract	Evaluation of anti-fungal property of L. citriodora by the disk and well diffusion tests	68
Centratherum anthelminticum/ Ocimum sanctum	Seed oils	Evaluation of anti-fungal property of herbal oils by disc diffusion and broth micro dilution methods	69
Zataria multiflora	0.5 mg/ml Z. multiflora extract	Evaluation of anti-fungal property of Z. multiflora herbal extract against C. albicans by mean viable microbial count	70
Origanumdubium	Origanum oil combined with tissue conditioner	Evaluation of anti-fungal property of O. dubium herbal extract against C. albicans by agar punch well method	71
Anti-inflammatory and wound healing properties
P. ginseng/G. glabra/Z. jujuba/ P. ternata/Z. officinale/ Scutellaria/Coptis	Hangeshashinto	Evaluation of the effects of Hangeshashinto on scratch induced wound healing in vitro and in vivo	72
Schisandtrin chinensis	Schisandrin C	Evaluation of reactive oxidative stress and nitric oxide production in dental pulp cells by muse cell analysis	72
Camellia sinensis	Herbal extract	Evaluation of inflammatory cell infiltration in oral epithelium after treatment with C. sinensis herbal extract in rats by histological analysis	74
Antineoplastic properties in herbal medications
Geranium thunbergii	Geraniin	Evaluation of anti-neoplastic property of Geraniin against SCC cells by western blot assay	75
Vernonia cinerea	8α-tigloyloxyhirsutinolide- 13-O-acetate	Evaluation of anti-proliferative property of 8αTGH against SCC cells by SRB colorimetric method	76
Syzygium cumini	Herbal extract	Evaluation of anti-proliferative property of S. cumini against SCC cell lines by MTT assay	77
Eclipta prostrata	Herbal extract	Evaluation of E. prostrata property on metastasis promoting proteins production in SCC cell lines	78
Rheum palmatum	Herbal extract	Evaluation of R. palmatum herbal extract against SCC cell metastasis by western blot and gelatin zymography	79
Nigella sativa/Aloe vera/ Salvadora persica	Herbal extracts	Evaluation of anti-neoplastic property of herbal extracts against HeLa cell lines	80
Salvia miltiorrhiza	Herbal extract	property of S. miltorrhiza extracts against oral neoplastic cells by western blotting analysis	81
Gynostemma pentaphyllum	Gypenosides	Evaluation of Gypenosides’s effects on cell viability and apoptosis, and oral neoplastic cell DNA	82
Cudrania tricuspidata	Cudraxanthone H	Evaluation of anti-proliferative property of Cudraxanthone H against SCC cell lines by western blotting and fluorescent nuclear staining	83
Bone regeneration and herbal medicine
G. glabra/V. vinifera/A. officinarum/U. dioica/S. aromaticum/S. vulgaris/ H. perforatum	Mecsinahemostopper	Evaluation of hard tissue regeneration by using histologic and radiologic analyses after treatment with the herbal agent and low-level laser therapy in rats	84
Morinda citrifolia	Aqueous extract	Evaluation of osteogenic differentiation in human periodontal ligament cells after treatment with M. citrifolia	85
Aloe vera	Acemannan	Evaluation of bone formation after tooth extraction by dual-energy X-ray absorptiometry and histologic analysis	86

There are several people which claim herbalmedicines to be devoid of side effects that is amyth. There still are masses which still completelydepend on herbal medicine so much so that havereplaced the daily prescribed dose of allopathicfor diabetes, hypertension, thyroid disease, etc^87-90 with herbal medicines where the patient have pledged to have the medicines lifelong. There are several sites online which are trying to trade herbal medicines under the tag of being free from side effects. In countries like India which are in the race of becoming a developed country no regulations and laws are made against the trade of Ayurveda medicines which use herbs and their extracts. People are drawn to such traders and start using herbal medicines under the notion of them being free from side effects^{91, 92}. However toxicities due to herbalism can be due to improper intake, self-treatment as they are easily available in the market, under qualified practitioners and intake of sub standard products. Herbs manifest their toxicities in the form of nephrotoxicity, cardio toxicity, hepatotoxicity, neurotoxicity and skin toxicity^19-95. Various manifestations of most commonly used herbs are indicated in the Table 2 along with their recommended indications⁹⁶.

Herbal medicine has gained considerable popularity during the past decade. The chief benefits of using natural options are easy accessibility, cost-effectiveness, improved shelf life, low toxicity and lack of microbial confrontation accounted up to now. Herbal agents have been employed in dentistry for plummeting inflammation, as antifungal, antibacterials, antimicrobial plaque agents, antiseptics, antioxidants, antimicrobials, antivirals, and analgesics. They also help in healing and are efficient in scheming microbial plaque in gingivitis and periodontitis and thus improving immunity. Many researchers in the meadow of dentistry and pharmacology have devoted their time and resources to evaluation of natural products, discovering their bioactive compounds and finding applications for them in a variety of features of oral health maintenance. In this paper, we tried to create a complete review of recent scientific studies about medicinal plants and their current status in the meadow of dentistry. The gathered data can be employed as a basis for future endeavors to discover novel natural medicaments with lower costs and side effects for oro-dental pathologies.

Herbal medicine shows assure consequences in almost every aspect of oro-dental treatment plans. Although numerous of the studies with reference to the beneficial properties of herbal medicine in dentistry claim that herbal products can be employed as alternatives for conventional drugs, without bearing common side effects, the majority of them lack proper evidence about their protection and biocompatibility. Most of these researches are conducted at in-vitro and pre-clinical settings. Therefore, there is an urgent need to increase research efforts and funding aimed at clinical trials on efficacy, safety, cost-effectiveness, and characterization of these natural compounds. Alternative and herbal therapy can be helpful for the people all around the earth, especially in resource limited countries. This can support and justify the requirement for upcoming studies with up to date and reliable protocols and techniques.

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Name	Toxicity	Indication	Ref.
Cranberry	Nephrolithiasis	Dietary supplement	97
Willow Bark	Renal Dysfunction	Anti Rheumatic	98
Aconite , Monks Hood	Ventricular Arrhythmia	Pain	99
Black Cohosh	Acute hepatitis	Menopausal symptoms	100
Kava kava	Acute liver failure	Tranquilizer	101
Valerian	Liver toxicity	Sedative	102