Spilanthes acmella, commonly known as toothache plant, is an important medicinal plant belonging to family Asteraceae. It has been reported to possess various biological activities like anti-pyretic, antidiuretic, anti-inflammatory, anti-oxidant, immunomodulatory, hepatoprotective, anticancer and antitoothache etc. The bioactive chemical component is spilanthol, an alkamide which is present in roots and all aerial parts of the plant. Spilanthol has high industrial demand for its use in pharmaceutical, cosmetic and toothpaste industry. S.acmella is quickly getting depleted from its natural habitat, because of its wider applications for commercial use

Dr. Anitha C

Dr. Manjushree R

Dr. Nandan N

Dr. Soundarya Vishwanathan

Dr. Sunil Raj N

English

Journal of Ayurveda and Integrated Medical Sciences (JAIMS)

                                                     REVIEW ARTICLE Mar-Apr 2021  Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2021 | Vol. 6 | Issue 2 77  The Buzz Button to your Toothache – Spilanthes acmella : A Review Dr. Soundarya Vishwanathan1, Dr. Nandan N2, Dr. Anitha C3, Dr. Manjushree R4, Dr. Sunil Raj N5. 1Senior Lecturer, 2Reader, 3Reader, 4Senior Lecturer, 5Professor and Head, Bangalore Institute of Dental Sciences, Bangalore, Karnataka, INDIA.                INTRODUCTION Phytotherapy, the use of herbal agents as medicines has become the focus of research in the recent years.[1] Herbal medicines are the oldest remedies known to mankind and have been used by all cultures to treat injuries or illness. A medicinal plant is any plant in which one or more of its organ, contains substances that can be used for therapeutic purposes, or which are precursors for chemical, pharmaceutical and semi-synthetic materials.[2] Spilanthes acmella refers to the important medicinal plant distributed in the tropical and sub-tropical regions around the world with rich source of therapeutic and medicinal constituents.[3]  Spilanthes  acmella  commonly known  Address for correspondence:  Dr. Soundarya Vishwanathan Senior Lecturer, Bangalore Institute of Dental Sciences, Bangalore, Karnataka, INDIA. E-mail: drsoundarya13@gmail.com  Submission Date: 17/03/2021 Accepted Date: 11/04/2021 Access this article online Quick Response Code Website: www.jaims.in  Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CC-by-NC-SA as toothache plant or Paracress or Eyeball plant is an important medicinal plant belonging to family Asteraceae.[4] The main constituents, namely, “spilanthol” and “acmellonate”, are sometimes used to reduce the pain associated with toothaches and can induce saliva secretion.[5,6] The leaves and flower heads of S. acmella have analgesic, anti-fungal, anti-helminthic, anti-bacterial, immunomodulatory, adaptogenic, lithotriptic, anti-scorbitic, sialagogine, local astringency and digestive property. The plant also has vasorelaxant and antioxidant and local anaesthetic and antipyretic activities due to presence of spilanthol which have been substantiated by lab and animal studies.[7] In particular, this plant is famous as a folklore remedy for toothache and for throat and gum infections. The flowers are crushed and applied at the site of toothache, particularly in “Irula tribe of Hasanur hills in Erode district of Tamil Nadu” where it is known by the local name “Mandal Poo Chedi”.[8] Apart from Tami Nadu, root paste of the plant is used in throat problems in Chindwara and Betul district of Madhya Pradesh.[9]  The recent past has witnessed a tremendous revival of interest in the use of medicinal plant products due to the various drawbacks associated with synthetic medicines. However, efforts are needed to explore, A B S T R A C T  Spilanthes acmella, commonly known as toothache plant, is an important medicinal plant belonging to family Asteraceae. It has been reported to possess various biological activities like anti-pyretic, anti-diuretic, anti-inflammatory, anti-oxidant, immunomodulatory, hepatoprotective, anticancer and anti-toothache etc. The bioactive chemical component is spilanthol, an alkamide which is present in roots and all aerial parts of the plant. Spilanthol has high industrial demand for its use in pharmaceutical, cosmetic and toothpaste industry. S.acmella is quickly getting depleted from its natural habitat, because of its wider applications for commercial use.  Key words: Anti - toothache plant, Dentistry, medicinal plants, Spilanthes acmella. Dr. Soundarya Vishwanathan et al. The Buzz Button to Your Toothache – Spilanthes acmella ISSN: 2456-3110                                                       REVIEW ARTICLE Mar-Apr 2021  Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2021 | Vol. 6 | Issue 2 78  standardise, and validate Ayurvedic medicines for their potency, safety, and efficacy in order to bring them to market as main line therapeutics. This article reviews the botanical description and the outline of therapeutic potential of S.acmella in dentistry. Description Spilanthes as a genus is composed of 60 species is very popular among the ancient tribal community. S. acmella is native to Brazil and is cultivated throughout the year as ornamental or medicinal plant. S. acmella is a very beautiful, erect herb that and flourishes with gold and red floral inflorescences.  It is an annual or short-lived herb that is 40-60 centimetres tall. The plant grows naturally in damp areas or as a potted herb in a rich soil with compost.[10] The plant has striking yellow/red cone-like flowers. Leaves are opposite, acute or obtuse at apex, petiolate, broadly ovate, narrowed at base, flowering and fruiting in March-April.[11] Its flowers and leaves have pungent taste and when touched it is accompanied by tingling sensation and numbness[12] but when cooked, the plants lose their strong flavour and may be used as a green leafy vegetable. Spilanthes acmella is commonly known as Toothache plant and its various synonyms are Bidens acmella, Bidens ocymifolia, Pyrethrum acmella, Spilanthes ocymifolia, Verbesina acmella, and Blainvillea acmella.  Classification[2,10] Table 1: Classification of the plant. Kingdom : Plantae Subkingdom : Tracheobionta Phylum : Tracheophyta Division : Magnoliophyta Super division : Spermatophyte Class : Magnoliopsida Sub Class : Asteridae Order : Asterales Family : Asteraceae Subfamily : Mimosoideae Genus : Spilanthes  Species : Acmella Other Names[13,2] Jambu, Toothache plant, Electric daisy, Buzz buttons, Schezuan buttons, Jotang, jocong and Dung getang, Akarkara, Jotang, jocong and Xiao tong chui, Tian wen cao, Bian di hong. Distribution S.acmella is widely distributed in the tropical and sub-tropical regions of the world including America, North Australia, Africa, Malaya, Borneo, India and Sri Lanka.[14]  The plants of this genus are reported in some regions of India such as South India, Chhattisgarh and Jharkhand.  Bio Active Compounds Phytochemicals are active components present in plants that have protective or disease preventive properties. The most common alkamide present in Spillanthes acmella is called Spilanthol. More than 45 other compounds have been isolated, the dominating ones being hexanol, tridecanone, germacrene, hexanol, caryophyllene and Sequesterpenes.[15] Medicinal Uses Chakraborty et al.[16] studied the antipyretic activity of S.acmella which was carried out by yeast induced method. The antipyretic activity of S.acmella demonstrated in the study is attributed to the presence of flavonoids which are predominant inhibitors of either cyclo-oxygenase or lipo-oxygenase. The anti-inflammatory activity of S.acmella has been carried out by the researchers. The activity was attributed to the presence of flavonoids which are potent inhibitors of prostaglandins at later stages of acute inflammation.[4] Noor Jahan et al.[17] demonstrated that the ethanolic extract of S.acmella Dr. Soundarya Vishwanathan et al. The Buzz Button to Your Toothache – Spilanthes acmella ISSN: 2456-3110                                                       REVIEW ARTICLE Mar-Apr 2021  Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2021 | Vol. 6 | Issue 2 79  showed antimicrobial activity against Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Salmonella typhi. Shigella dysenteriae the extracts also showed activity against resistant bacteria harbouring Blagene. The diuretic potential of whole plant of S. acmella as well as fresh flowers, showed strong diuretic activity when given orally in a single dose diuretic potential of whole plant of S. acmella as well as fresh flowers, showed strong diuretic activity when given orally in a single dose.[18] The diuresis induced by the S.acmella flowers was found to be strong with intensity similar to that of furosemide and accompanied by marked increases in both urinary Na+ and K+ levels. The onset of the diuretic action of the aqueous extract was extremely rapid, and it also had a fairly long duration of action.[4] The flower heads of S.acmella are used to prevent scurvy and aid digestion. The roots of the plants are chewed to treat GIT disturbances.[10] The leaves are used as immunomodulatory, adaptogenic, lithotriptic, anti-scorbitic and digestive. Extract of S. Acmllea contains an active component used in beauty care cosmetics as a fast-acting muscle relaxant to accelerate repair of functional wrinkles. The plant extract was also used for stimulating, reorganizing and strengthening the collagen network in anti-age applications, e.g. in anti-wrinkle cream formulations. An Indian tribe uses S. Acmella to treat fungal skin conditions, such as athletes’ foot, ringworm and nail infections.[19]  In India, S. Acemella flower heads are used to treat stammering in children. Leaves and flowers of the plant are also used to treat leucorrhoea in females among people of tribes in Bangladesh[20] The whole plant paste of Spilanthes acmella is also used as “poisonous sting” in Chittagong hill tracts of Bangladesh where the plant is also known as Jhummosak.[21] It protects the individual from colds and flu. An extract of the leaves and flowers is traditionally used for the stomatitis, flu, cough, rabies diseases and tuberculosis, throat complaints, headache and fever.[10]  Dental Uses Toothache Traditionally, S. Acmella is called as anti-toothache plant. The pungent flower heads and/or leaves is chewed or placed in tooth cavities to relieve pain.[22] The flower heads also provide relief to throat problems or paralysis of the tongue. The component responsible for this is Spilanthol.[19]  Local Anaesthetic Activity Local anaesthesia is the loss of sensation in a circumscribed area of the body caused by depression of excitation in nerve endings or inhibition of the conduction process. The local anaesthetic activity of S.acmella has been carried out using two different animal models. The mean onset of local anaesthetic action was very potent which could be attributed to the presence of alkyl amides. Studies by Chakraborthy et al.[23] showed the local anaesthetic property of S. acmella in rats in comparison with xylocaine. The well-recognized local anaesthetics are comprised of mostly amide compounds such as xylocaine (lidocaine). Its mechanism of action involves the blockage of voltage-gated Na+ channels. By the same analogy, the alkamides of S. acmella extracts produced local anaesthetic action presumably through the blockage of Na+ channels.[19] Extracts from the plant is used as a pain relieving oral gel with no known side-effects described, S.acmella having a hot burning taste which causes salivation.[24]  Dentifrice Spilanthol has been incorporated in tooth pastes and mouth rinses. The objective is to provide a lasting fresh minty flavour; it also increases salivation, which improves appetite. The spilanthol present also has a mild anaesthetic effect thus enabling people with toothache to brush comfortably.[10]  Anti-Fungal Agent S. acmella shows only minimal antifungal activity. However, they are proven to have activity against the fungi Cryptococcus neoformans and Microsporum Dr. Soundarya Vishwanathan et al. The Buzz Button to Your Toothache – Spilanthes acmella ISSN: 2456-3110                                                       REVIEW ARTICLE Mar-Apr 2021  Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2021 | Vol. 6 | Issue 2 80  gypseum which are common opportunistic pathogens in AIDS patient.[25]  Periodontitis Periodontitis is due to inflammation of gums. Chewing on the flower heads and roots has shown to decrease gum inflammation and have been used in the treatment of periodontitis.[10]  Recurrent Apthous Stomatitis Recurrent apthous stomatitis is a disease characterized by multiple ulcerations on the mucosal tissue. It is commonly precipitated by stress, hormonal changes in women, trauma and chemical irritants. The leaves of S. Acmella have shown to be effective on treating recurrent aphthous stomatitis.[10]  Intra - Canal Medicament The effect of   S. acmella on C. albicans was studied at various concentrations and compared with the anti-fungal property of calcium hydroxide. The results showed S.acmella was effective against C.albicans in all concentrations and compared with the anti-fungal property of calcium hydroxide. The results showed S. Acmella possesses remarkable antibacterial and antifungal activity against common root canal pathogens which are responsible for repeated endodontic failures such as E. faecalis and C. albicans when compared with medicaments like calcium hydroxide.[26]  CONCLUSION The main gaps in knowledge about of the plant are mainly related to its use in treating certain conditions and the risks associated with very high levels of consumption. S.acmella is one of such important medicinal plants that is quickly getting depleted from its natural habitat, because of its wider applications the plant is not meeting the demand due to less cultivation. It is, therefore, imperative to develop more efficient methods for its conservation and large-scale propagation.   REFERENCES 1. Vinod A, Nandan N, Raj N S, Vishwanathan S. Turmeric - The Serendipitous Herb : A Review. J Ayurveda Integr Med Sci. 2018;3(6):114–24.  2. Arif M, Juyal D, Joshi A. A review on pharmacognostic and phytochemical study of a plant Spilanthes acmella Murr. 2017;6(5):172–7.  3. Dubey S, Maity S, Singh M, Saraf SA, Saha S. Phytochemistry, Pharmacology and Toxicology of Spilanthes acmella : A Review. Adv Pharmacol Sci. 2013;2013.  4. Rani AS, Sana H, Sulakshana G, Puri ES, Keerti M. Spilanthes acmella- an important medicinal plant. Int J Minor Fruits, Med Aromat Plants. 2019;5(December):15–26.  5. 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This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  

The Buzz Button to your Toothache – Spilanthes acmella : A Review

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The Buzz Button to your Toothache – Spilanthes acmella : A Review

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