Toothache is a commonly encountered problem. Any inflammatory condition affecting the gums and tooth pulp gives rise to pain. Enamel of tooth is insensitive to pain, toothache occurs only when the enamel is eroded. In most cases toothaches are caused by problems in the teeth or gums, such as cavities, gum disease, the emergence of wisdom teeth, a cracked tooth, infected or inflamed dental pulp, jaw disease or exposed tooth root. After having one or more teeth extracted, a condition known as dry socket can develop, leading to extreme pain. The severity of a toothache can range from mild discomfort to excruciating pain, which can be chronic or sporadic.

This pain can often be aggravated by chewing or by hot or cold temperatures. Severe pain may be considered a dental emergency. Toothache is a common symptom of an acute tooth abscess. It is associated with persistent throbbing pain at the site of the infection. Putting pressure or warmth on the tooth may induce extreme pain. In some cases, a tooth abscess may perforate bone and start draining into the surrounding tissues creating local facial swelling. In some cases, the lymph nodes in the neck get swollen and tender in response to the infection.

Though the cause of the toothache should be established before starting the treatment, topical application of clove oil to the affected area can be a first-aid management which is well-documented as an effective remedy in Ayurvedic classics.

Lavanga [Syzygium aromaticum (Linn.) Merr. & Perry]

Lavanga is the dried flower bud of Syzygium aromaticum, a tree cultivated in many parts of the world and also to a considerable extent in South India. Flower buds are collected twice a year, in the months of October and February when they change colour from green to crimson, and are dried carefully and separated from their peduncles. Clove is a fragrant floral bud, black or brown in color, widely used in Indian cuisines. Its pungent aroma and flavour is very familiar from its use as a culinary herb. The oil extracted from cloves is used as a home remedy for toothache. It is an ingredient of tooth powders, gargles and chewing gums. The oil is also used as a local analgesic for hypersensitive dental cavities; a mixture of clove oil and zinc oxide is used in dentistry as a temporary filling for tooth cavities.

Composition

Lavanga oil is extracted from the buds of clove.

English name	Clove
Latin name	Syzygium aromaticum (Linn.) Merr. & Perry
Family	Myrtaceae
Parts used	Flower buds

Main chemical constituents

Eugenol, eugenol acetate and caryophyllene.

Quality standards

The Ayurvedic Pharmacopoeia of India provides quality standards of Lavanga based on the following physical constants:

Foreign matter	Not more than 2%
Total ash	Not more than 7%
Acid insoluble ash	Not more than 1%
Alcohol soluble extractives	Not less than 3%
Water soluble extractives	Not less than 9%
Volatile oil	Not less than 15%

Method of preparation

Clove oil is usually available in grocery and medical shops. It is prepared by water distillation of clove buds containing the desired percentage of eugenol.

Dosage form

Clove oil has a warm, strong, spicy smell and the oil is colourless to pale yellow with a medium to watery viscosity.

Therapeutic properties

Clove oil is analgesic, anaesthetic, antiseptic, refrigerant, digestive, carminative, stomachic, anti-spasmodic and rubefacient.

Dose and mode of use

• (1) Cotton swab soaked in clove oil should be kept on the affected tooth without touching the gums.
• (2) Clove oil-soaked tissue paper can also be applied directly to the affected site of the tooth. It may be used 2 to 3 times a day.
• (3) Gargles with one to two drops of clove oil in a cup of warm water are useful as a mouth wash for toothache and gum problems.

Indications and uses

Clove oil is useful in toothache, halitosis, cephalalgia, dental caries, and painful condition after tooth extraction.

Precautions and safety aspects

• (1) Clove oil is irritant and pungent. Therefore, it is advised to prevent the oil from touching the tongue and gums.
• (2) If topical application of clove oil fails to relieve the pain, take dental consultation.
• (3) Clove oil application in deep dental cavities should be done carefully.
• (4) Clove is toxic, its oral use in large amounts (i.e. more than 3.7 g/kg body weight) may be life threatening.
• (5) Enough information about safety is unavailable for the oral use of cloves and clove supplelments in pregnant and breast feeding women.
• (6) Undiluted clove oil may cause allergic itching, rash and even burns, so its local application should be done carefully.

References

• (1) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part 1. Vol. I. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 2001. p. 81.
• (2) India, Ministry of Health and Family Welfare. The Ayurvedic harmacopoeia of India. Part.1. Vol. I. New Delhi: Department of Indian Systems of Medicine and Homeopathy, 2001. p. 80.
• (3) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 4: New Delhi: Central Council for Research in Ayurveda and Siddha, 2001. p. 359.

Further reading

• (1) India, Ministry of Health and Family Welfare. The Ayurvedic formulary of India. 2nd revised English edition. Part I. New Delhi: Department of Indian Systems of Medicine and Homeopathy 2003.
• (2) Sharma P V. Dravyaguna Vigyana. Vol. II. Varanasi: Chaukahambha Bharati Academy, 1996.
• (3) Chunekar KC. Bhavaprakasha Nighantu. Varanasi: Chaukhamba Bharati Academy, 1982.
• (4) Indian Herbal Pharmacopoeia. Vol. II. A joint publication of Regional Research Laboratory, Jammu Tawi and Indian Drug Manufacturers’ Association, Mumbai, 1999.
• (5) Warrier PK et al. ed. Indian medicinal plants. Vol. 5. Madras: Orient Longman Ltd. 1994.
• (6) Meena MR, Sethi V. Antimicrobial activity of essential oils from spices. J. Food Sci. Technol. 1994.
• (7) Sarin YK. Illustrated manual of herbal drugs used in Ayurveda. New Delhi: Council of Scientific and Industrial Research & Indian Council of Medical Research, 1996.

Source: Traditional Herbal Remedies for Primary Health Care - WHO