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Herbal Medicine: Should The Dentist Know?

What Is Herbal Medicine?

World Health Organisation (WHO) defined herbal medicines as herbs, herbal materials, herbal preparations and finished herbal products that contain as active ingredients parts of plants, or other plant materials, or combinations. Herbal medicine is also known as botanical medicine or phytomedicine.

Why do people use herbal medicines?

  1. Therapeutic (medicinal)
    • Some herbal medicines are proven to treat some medical condition either alone or in combination with conventional medicines
  2. Traditional or folk medical practices
  3. Cheaper and more accessible
    • Herbal medicines are believed to be cheaper than conventional medicines
    • Herbal medicines are easy to find
  4. “Miracle drug” beliefs
    • People believed herbal medicines can cure any disease including cancers and AIDS (Acquired Immune Deficiency Syndrome)
    • People believed herbal medicines are less toxic than conventional medicines
  5. Self-medication
    • People believed herbal medicines are useful for disease preventions
    • People believed herbal medicines are natural and safe
    • Disappointed with the effectiveness of conventional medicines for chronic diseases

Should the patients inform their dentists if they are taking herbal medicines?

The dentist should be made aware of any intake of herbal medicines.

  • This is due to the potential side effects of the herbal medicines and possible drug interactions with conventional medicines.
  • Some herbal medicines may have adverse effects to the tissues in the mouth.
  • The dentist may consider prescribing a different type of medication to the patients to avoid drug interactions
  • The dentist may recommend patients with impaired immunity system to seek medical advice from their physician if they are taking herbal medicines.

Potential Drug Interactions of Herbal Medicines with Conventional Medicines

Listed here are the few examples of drug interactions between herbal medicines (available in Malaysia) and conventional medicines (adapted from Abebe, 2003):

Herbal medicines (Scientific names)

Commonly reported uses

Dental medicines

Effects of interactions

Aloe latex (Aloe vera, Aloe ferox) Laxative, topical applications for wound healing, burns, skin conditions Steroid medicines

Multiple oral medicines

Cardiovascular hyperactivity (abnormal rhythm, hypertension)

Reduced effects of drugs

Chamomile (Matricaria recutita, Chamaemelum nobile) Used to relieve muscle spasms, mild sedative, wound healing Aspirin


Increased risk of bleeding

Increased sedative effect

Echinacea (Echinacea angustifolia) Antimicrobial, immune stimulant, for colds, flu, eczema and upper respiratory infections Ketoconazole, acetaminophen Liver toxicity
Evening primrose (Oenothera biennis)3 Used for the treatment of premenstrual syndrome and symptoms of menopause Aspirin


Increased risk of bleeding

Increases steroid activity/toxicity

Garlic (Allium sativum) Antihypertensive, antioxidant, for people with high cholesterol, antimicrobial, for cancer prevention, colds, flu and diabetes Aspirin

General anaesthetic

Increased risk of bleeding

Increased risk of bleeding (after surgical procedures)

Ginger (Zingiber officinale) Control vomiting, for sore throat, migraine, antioxidant, anti-inflammatory, for indigestion Aspirin Increased risk of bleeding
Ginkgo (Ginkgo biloba) To improve memory and brain function, for general cardiovascular health, antioxidant Aspirin

Acetaminophen plus caffeine plus enfotamine

Increased risk of bleeding

Brain hemorrhage

Ginseng (Asian and/or American ginseng) (Panax spp.) To enhance endurance, vitality, adaptation and immune system; for stress
Used to treat diabetes (type 2)
Steroid medicines


Increases steroid activity/toxicity

Increased drug effect

Green Tea (Camellia sinesis) Laxative, for cancer prevention, for heart, liver and dental health Atropine (taken orally) Decreased drug effect
Senna (Cassia senna) Laxative Steroid medicines (taken orally) Decreased drug effect

Increased cardiovascular hyperactivity/toxicity

St. John’s wort (Hypericum perforatum) For mild to moderate depression, insomnia, for wound healing, bruises and anti-inflammatory Tetracycline


Increased sensitivity to light (photosensitivity)

Increased sedative effect

Oral Effects of Herbal Medicines1

Herbal medicines
(Scientific names)

Oral Effects

Image of the herb
(Source: Google image)

Echinacea (Echinacea angustifolia) Tongue numbness

Feverfew (Tanacetum parthenium) Oral/aphtous ulcers, lip and tongue irritation and swelling

Increased gingival bleeding time

Ginkgo (Ginkgo biloba) Prolonged bleeding during gingival injury

St. John’s wort (Hypericum perforatum) Dry mouth

Health Hazards from Using Herbal Medicines

Some people think herbal medicines are safe because they come from natural sources. However, some of the herbal medicines are adulterated to increase their effectiveness. Some of the herbal preparations are contaminated with corticosteroids during its handling.

Some topical herbal creams for example containing 0.75mg dexamethasone acetate (a corticosteroid) would lead to suppression of the adrenal glands and steroid toxicity. Adrenal glands produce most of the hormones in the body including steroid hormones, mineralocorticoids, glucocorticoids and androgens.

Some herbal preparations containing estrogen-like (a female hormone) substances may lead to enlarged man’s breasts (gynaecomastia). Some herbal medicines containing steroids may suppress the immune system, causing recurrent infections2.

In conclusion, it is important to let your dentists know that you are taking herbal medicines or any supplements. The dentists will be able to check for the drug interactions and watch for any adverse effects to your oral tissues.


  1. Abebe W. (2003). An Overview of Herbal Supplement Utilization with Particular Emphasis on Possible Interactions with Dental Drugs and Oral Manifestations. The Journal of Dental Hygiene,77(1),37-46
  2. Little JW. (2004). Complementary and alternative medicine: Impact on dentistry. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 98(2), 137-145
  3. Niggeman B. and Grüber C. (2003). Side-effects of Complementary and Alternative Medicine. Allergy, 58, 707-716
Last Reviewed : 11 August 2016
Writer : Dr. Wan Syasliza bt. Mohamed Thani
Accreditor : Dr. Norjehan bt. Yahaya