Herbal Therapeutics for Oral Bacterial Infections: Mechanisms, Clinical Applications and Challenges

Abstract

Oral bacterial infections, including dental caries, gingivitis, periodontitis, and endodontic infections, remain among the most
prevalent oral health problems worldwide and significantly impact quality of life. Conventional antimicrobial therapies have
been widely used for their management; however, concerns regarding antimicrobial resistance, adverse effects, disruption of
the oral microbiome, and limited long-term efficacy have encouraged the exploration of alternative therapeutic approaches.
Herbal medicines have gained increasing attention due to their rich phytochemical composition and broad spectrum of
biological activities. This review summarizes the current evidence regarding the role of herbal therapies in the prevention and
treatment of oral bacterial infections. Various medicinal plants, including Azadirachta indica (Neem), Curcuma longa
(Turmeric), Camellia sinensis (Green Tea), Punica granatum (Pomegranate), Salvadora persica (Miswak), Syzygium
aromaticum (Clove), Glycyrrhiza glabra (Licorice), and Allium sativum (Garlic), have demonstrated significant antimicrobial
activity against major oral pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Aggregatibacter
actinomycetemcomitans, and Enterococcus faecalis. The review discusses their active phytoconstituents, mechanisms of
antimicrobial action, and clinical applications in oral healthcare. Additionally, recent advances in herbal formulations,
including mouthwashes, gels, dentifrices, mucoadhesive systems, and nanotechnology-based delivery platforms, are
highlighted for their potential to enhance therapeutic efficacy and patient compliance. Clinical studies indicate that several
herbal products exhibit effectiveness comparable to conventional oral care agents while demonstrating favorable safety
profiles. Nevertheless, challenges related to standardization, quality control, regulatory approval, and limited large-scale
clinical evidence continue to restrict their widespread clinical adoption. Overall, herbal therapeutics represent a promising and
rapidly evolving approach for the management of oral bacterial infections and may serve as valuable adjuncts or alternatives to
conventional antimicrobial therapies.