Clinical Considerations
➤ General comments: Mouth and throat diseases can be caused by bacteria, (e. g., Streptococcus or Staphylococcus species), viruses, mycoses (e. g., Candida albicans), allergies, pseudoallergies, and autoimmune diseases.
➤ Herbal and general treatment measures: Mouth washes and gargles are mechanical measures for cleansing the mouth and increasing the blood flow in the oral mucous membranes. Depending on which secondary herbal substances they contain, they can also relieve pain and speed up the healing process.
➤ Clinical value of herbal medicine
– Herbal preparations are effective in counteracting bacterial, viral or nonspecific mouth and throat diseases. They can be used alone or for adjunctive treatment parallel to established synthetic drugs.
– There are no known herbal remedies for fungal diseases of the mouth and throat.
– Astringents help to clear up drug-related oral eruptions, and bitters are used to counteract dryness of the mouth.
Diseases of the Mouth and Throat Recommended Herbal Remedies (Overview)
Demulcents
➤ Marshmallow root (Althaeae radix); mallow leaf (Malvae folium); ribwort plantain (Plantaginis lanceolatae folium); sage leaf (Salviae folium).
– Action: Antitussive.
– Contraindications: None known.
– Side effects: None known.
Astringents
➤ Myrrh (Myrrhae); dried bilberries (Myrtilli fructus); silverweed (Potentillae anserinae herba); rhatany root (Rhataniae radix); sage
leaf (Salviae officinalis folium); tormentil root (Tormentillae rhizoma).
– Action: Anti-inflammatory, antimicrobial, promotes wound healing.
– Side effects: None known.
Aromatic Herbs
➤ Clove oil (Caryophylli aetheroleum); chamomile flower (Matricariae flos) myrrh; lemon balm leaf (Melissae folium).
– Action: Bacteriostatic, bactericidal, virustatic. Some are antiphlogistic.
– Contraindications: Chamomile: Known allergy to chamomile.
– Side effects: None known.
Bitters
➤ Centaury herb (Centaurii herba); bogbean leaf (Menyanthidis folium); gentian root (Gentianae radix).
– Action: Increases the flow of saliva by stimulating bitter receptors on the tongue.
– Contraindications: Individuals with gastric or duodenal ulcers should not use gentian root.
– Side effects: Although rare, headaches may occur.
Range of Applications in Acute Mouth and Throat Diseases
Acute Stomatitis (with less severe pain)
➤ Mallow leaf, marshmallow root, and sage leaf, either alone or using equal parts of each, as an infusion.
– Dosage and administration: Use as a mouthwash or gargle, 3 to 6 times a day.
– Clinical value: Herbal treatment alone is usually sufficient in mild cases. Otherwise, the herbal remedies can be applied for adjunctive treatment. Acute Stomatitis (painful)
➤ Chamomile flower and sage leaf (1 : 1) for infusions.
– Alternative: Clove oil 5 % in water base.
– Suggested combination: Commercial slippery elm bark (Ulmus rubra) preparations.
– Dosage and administration: Place herbs in water, bring to a boil, then cover and steep for 14 minutes. Rinse mouth or gargle with 1 tablespoon infusion in a cup of warm milk, 3 to 10 times a day as needed.
– Clinical value: Can be used alone to treat mild or moderate disorders. Also combines well with synthetic drugs and chemical remedies (e. g., lidocaine or tetracaine). Isolated Mouth and Throat Ulcers (Aphthae)
➤ Myrrh tincture; sage leaf.
– Dosage and administration
• Apply a few drops of myrrh tincture 1 : 5 to the affected sites, 2 to 3 times a day.
• Gargle: Briefly boil sage leaves in water (1:1) and steep for 14 minutes.
– Clinical value: The effects of these herbs are comparable to those of their active constituents’ synthetic counterparts. Pharyngitis with Dry Cough and Problems in Swallowing
➤ Mallow leaf; sage leaf; marshmallow root.
– Dosage and administration: Prepare an infusion using one or more of these herbs. Gargle with the infusion several times a day.
– Clinical value: The effects of these herbs are comparable to those of their active constituents’ synthetic counterparts. Clinical studies to confirm this are, however, not available. Acute Glossitis and Aphthous Stomatitis
➤ Dried bilberry.
– Dosage and administration: Steep 1 to 3 tablespoons of dried bilberries in 1 liter of water for around 15 minutes. Gargle with the infusion several times a day.
– Clinical value: Studies comparing bilberry to its active constituents’ synthetic counterparts are not available.
• Bitters: Centaury herb, bogbean, and gentian root. Prepare an infusion using one or more of these herbs. Add 1 to 2 teaspoons of the tea mixture to 1 liter of water.
– Clinical value: Comparable treatment regimens with synthetic drugs do not exist. The elimination of harmful factors (e. g., cigarette smoking) can greatly improve the symptoms. Chronic Gingivitis and Periodontal Disease
➤ Undiluted rhatany (Krameria spp.) tincture.
– Tincture Rx: Tinct. Krameriae, Tinct. Arnicae, aa 20.0.
– Dosage and administration: Dilute 1 teaspoon in 1 glass of water and rinse or apply undiluted tincture to gums, 2 to 3 times a day.
– Clinical value: Useful alternative to synthetic drugs. No comparative studies are available. Inflammation and Mild Suppuration of the Gums
➤ Tincture Rx: Tinct. Sanguinariae 3.0,, Tinct. Myrrhae, 20.0.
– Dosage and administration: Apply 1 tsp of the mixture diluted in 4 ounces of water to the gums, 2 to 3 times a day.
– Clinical value: Good alternative to synthetic drugs. Persistent “Lump” in the Throat or Need to Clear the Throat
➤ Centaury herb, bogbean, and gentian root. Prepare an infusion using one or more (equal parts) of these herbal remedies, or use the following tincture. Tincture Rx: Tinct. Resina myrrhae 10.0.
– Dosage and administration: Add 1 teaspoon tincture to a glass of water, or
1 to 2 teaspoons tea mixture to 1 liter of water. Rinse the mouth or gargle, several times a day.
– Clinical value: Comparable treatment regimens with synthetic drugs and/ or chemical remedies do not exist. Dryness of the Mouth and Sicca Syndrome
➤ Same as for lump in throat sensation (above).
– Action: Bitters stimulate the remaining intact mucous glands.
– Clinical value: Alternative to artificial saliva. Herpes Simplex Labialis
➤ Apply externally on the lesions either lemon balm leaf dry extract in creme base, or St. John's wort oil.
– Dosage and administration
• Apply 10–20 mg of the creme per cm2 of affected skin, 2 to 4 times of day.
• St. John's wort oil: Apply 1–2 ml of the oil to the affected area, several times daily.
– Clinical value: Useful alternatives to the synthetic counterparts; however, no convincing clinical studies to test this have been published.
– St. John's wort oil has demonstrated anti-inflammatory and antiviral properties and may help reduce pain and inflammation.
Note: It is important to start treatment early, that is, as soon as the first signs appear.
