Last Updated on: 04/11/2026
Use of Haritaki (Terminalia Chebula) for Prevention of Caries – A Review of Research Evidence
Out of the 13 studies (Haritaki Review), two have focussed on metabolic syndrome (dyslipidemia and T2DM); three studies have targeted issues associated with oral cavity; and three studies targeted different skin conditions.
Haritaki mouth rinse as an Anticaries Agent
We found two studies targeting to see the anticaries potential of haritaki mouth rinse. One study was a randomized controlled trial and another one was a pre-post study. Both studies were conducted in India.
In the first pre-post study at Chidambaram (Tamil Nadu), Carounanidy U. et al. used 10% aqueous extract of haritaki mouth rinse for 40 seconds among healthy individuals at high risk of dental caries and looked for changes in pH, salivary buffer capacity, and microbial count by having serial assessment for next 90 minutes. Statistically significant increase was observed in pH and buffering capacity. Microbial activity decreased with the intervention, but the change was not statistically significant. Study indicates the potential role of 10% aqueous extract of haritaki as a mouth rinse for prevention of caries among high risk healthy individuals.
In the second study (an RCT), conducted among school children at high risk of caries in Karnataka, India, authors compared 10% aqueous hot and cold extracts of haritaki mouth rinse along with placebo. Both hot and cold aqueous extracts of haritaki showed improvement in comparison to the placebo group and the differences were statistically significant. Differences between hot and cold groups were not statistically significant. Acceptability (for color, odor and taste) was found in the highest for color (approx 90%) and lowest for taste (approx. 50%) for both cold and hot extracts.
Haritaki for issues of Oral Cavities – Characteristics of Included Studies
| Authors/Study Design | Study Title | Diagnosis | Duration/Groups/Numbers | Intervention |
|---|---|---|---|---|
| Mali S., 2018 RCT | Efficacy of Myristica fragrans and Terminalia chebula as Pulpotomy Agents in Primary Teeth: A Clinical Study | Subjects with at least two primary molars requiring pulpotomy | 12 Months 20 Participants (40 primary molars) Data: 0, 3, 6, 12 months | A: Nutmeg 2% gel B: Harad 2% gel C: Formocresol (5 – 8 Minutes procedure at baseline) |
| Carounanidy U., 2007 Pre-post study (serial measures) | Use of an aqueous extract of Terminalia chebula as an anticaries agent: a clinical study | Males and females at high risk of caries | 40 Seconds rinse 50 Salivary Samples Data: At Baseline, 10, 30, 60 & 90 min | 50 subjects 10% Aqueous extract of Haritaki mouth rinse |
| Palit M., 2016 RCT | Effectiveness of Mouthrinse formulated from Aqueous Extract of Terminalia chebula on Salivary Streptococcus mutans Count and pH among 8- to 12-year-old School Children of Karnataka: A Randomized Clinical Trial | Healthy Children with high risk of caries | 1 min rinse A: 20 B: 20 C: 20 Data: At Baseline, 10, 60, & 90 min | A: 5ml of 10% w/v TC hot aqueous extract B: 5ml of 10% w/v TC cold aqueous extracts C: Sterile distilled water (Both extracts were used at normal temperature) |
Potential Clinical Applications:
Both the studies focus on the prevention of caries and have included populations with a high risk of caries. Keeping in mind the biases in the studies, use of 10% extract of haritaki can be used in the high risk population. As there are no such preparations available in the market (to the best of our knowledge), extra effort is needed from the side of the clinician/patient which challenges the feasibility of the treatment like many other treatments in ayurveda. Response rate was not reported in both the studies which makes clinical decisions difficult.
Haritaki for issues of Oral Cavity – Conclusions
| Study Title | Results | Limitations | Take Home Message |
|---|---|---|---|
| Use of an aqueous extract of Terminalia chebula as an anticaries agent: a clinical study | There was an increase in pH, buffer capacity and decrease in microbial count. Changes were statistically significant for pH and buffering capacity, but not for microbial count. Results attained peak for pH and buffer capacity in first 10 to 30 minutes. | 1) A pre-post study 2) Study conducted among healthy individuals at high risk of caries. 3) Lack of robust statistical tests 4) Only Streptococcus mutant and Lactobacillus were studies | Aqueous extract of Terminalia chebula for mouth rinse can be an effective anticaries agent. |
| Effectiveness of Mouthrinse formulated from Aqueous Extract of Terminalia chebula on Salivary Streptococcus mutans Count and pH among 8- to 12-year-old School Children of Karnataka: A Randomized Clinical Trial | Both hot and cold aqueous extracts of haritaki showed improvement in comparison to placebo group and the differences were statistically significant. Differences between hot and cold groups were not statistically significant. Acceptability (color, odor, taste) was highest for color (approx 90%) and lowest for taste (approx 50%) | 1) Study conducted among healthy school children at high risk of caries. 2) Study was single blind (microbiologist) | 10% aqueous extract of Terminalia chebula mouth rinse reduces risk of caries. |
Dosing/Duration/Formulation:
Dosage of the mouth rinse remains unknown for clinical use. Both studies have used 10% aqueous extracts of haritaki mouth rinse. Whether this is the ideal dose or not remains unestablished. Besides, a decision about frequency of mouth rinse cannot be made on the basis of available information in the articles. Clinicians need to rely on their understanding of use of mouth rinse for a clear decision on the same.
Adverse Events/Side Effects:
Both the studies have not specifically mentioned anything about the possible adverse effects of the treatment. No serious adverse events were reported in both the studies, highlighting the safety of the interventions. However, acceptability of treatment was checked in the second by using a tool specifically developed for the study. Authors checked for acceptability of color, odor and taste of haritaki extract. None of the participants considered extracts unacceptable, though acceptability remained relatively lower for taste in comparison to color or odor. Overall the intervention can be considered safe.
There are currently no studies available comparing the efficacy of haritaki mouth rinse with conventional mouth rinse options used for the prevention of caries. A clinical decision about the use of haritaki mouth rinse for a population at high risk of caries can be made by a clinician on the basis of their experience.
More about haritaki:
References:
1) Mali S, Singla S, Sharma A, Gautam A, Niranjan B, Jain S. Efficacy of Myristica fragrans and Terminalia chebula as Pulpotomy Agents in Primary Teeth: A Clinical Study. Int J Clin Pediatr Dent. 2018 Nov-Dec;11(6):505-509. doi: 10.5005/jp-journals-10005-1565. PMID: 31303738; PMCID: PMC6611537.
2) Carounanidy U, Satyanarayanan R, Velmurugan A. Use of an aqueous extract of Terminalia chebula as an anticaries agent: a clinical study. Indian J Dent Res. 2007 Oct-Dec;18(4):152-6. doi: 10.4103/0970-9290.35823. PMID: 17938489.
3) Palit M, Hegde SK, Bhat SS. Effectiveness of Mouthrinse formulated from Aqueous Extract of Terminalia chebula on Salivary Streptococcus mutans Count and pH among 8- to 12-year-old School Children of Karnataka: A Randomized Clinical Trial. Int J Clin Pediatr Dent. 2016 Oct-Dec;9(4):349-354. doi: 10.5005/jp-journals-10005-1390. Epub 2016 Dec 5. PMID: 28127168; PMCID: PMC5233703.