Are herbal remedies safe for your teeth? A dentist's perspective for Saudi patients

Herbal agents such as miswak (Salvadora persica), clove (Syzygium aromaticum) and neem (Azadirachta indica) are the key pillars of oral health in Saudi Arabia, with strong Islamic roots, and can be found readily in the souks such as the Souq Al-Zal in Riyadh and the Al-Balad in Jeddah. The current study evaluates their safety and efficacy in Saudi dental patients and evaluates the study outcome, which involved 350 patients and 70 dentists in Riyadh, Jeddah, and Dammam, as well as the review of 65 studies. Miswak also decreased plaque by 33 percent in 150 patients as compared to tooth brushing (27%). Toxicity rate was 13 percent with clove, which relieved toothache in 89 out of 120 with a 13 percent cytotoxicity rate, resulting in mild burning. Neem reduced bacterial count by 28% in 90 patients, 7 percent of whom developed allergic reactions to it such as itching. A survey of Saudi patients found that 87 % of them use herbs because of their affordability (miswak: 58 SAR), and according to their religious beliefs, but 19 percent reported side effects, with clove being the most frequent. The dangers, such as the cytotoxicity of cloves and allergies to neem, add to the importance of the professional control. The article gives evidence-based advice to Saudi dentists to adopt these remedies in a safe way, in line with the holistic healthcare objectives of Vision 2030, and in consideration of cultural practice. Balancing tradition and safety must be done by using standardized protocol, and patient education; this guarantees effective oral care in the Kingdom.