Introduction:
Ayurveda is the first and the oldest medical science, existing since or before the human creation. It is aimed to -

1. Protect the health by giving the knowledge of preventive health principles.
2. Cure the diseases by explaining the different types of treatment procedures and principles.

Shalakya- Tantra gives the detailed description of the diseases of eyes, ear, nose, oral cavity and shir-rogas.

Mukha word is used both for oral cavity and face. Mukha is one of the nine externally opening srotas. One group of Mukha - rogas known as Dantamulagata rogas upon which the entire oral as well as general health hygiene resolves.

Dantapupputaka:

According to Acharyas by the aggravation of Kapha and Rakta there develops swellings in the gums resembling the seed of a Badar compressing two or three teeths, hard, very painful, getting matured. This disease is called as Dantapupputaka.

Now a days the occurrence of this disease in rural as well as in urban areas is very high. Improper tooth brushing, bad habits like alcohol, pan, tobacco chewing, fast foods, altered foods, bad oral hygiene, lack of cleanness in oral cavity, also lack of proper teeth and gum exercise leads to formation of swelling in the gums and ultimately Dantapupputaka vyadhi.

Sushruta described Chikitsa of Datapupputaka vyadhi before 5000 years which is –

When Dantapupputaka is in tarunavastha [fresh and immature] Rakmokshana [blood letting] should be done.

With successful treatment and good oral hygiene, gingival harmony can be restored.

Bhav Prakasha, Madhav nidana, Sharnagdhar, Yoga Ratnakar, Nimitantra, and Bhaisajya Ratnavali, told the same chikitsa of Dantapupputaka as told by Sushrutacharya.

The modern management of Periodontitis is not satisfactory because of mechanical removal of causes by scaling or use of chemicals i. e. antibiotics, analgesics, mouth washes, irrigations etc, which are costly as well as time consuming and also not completely safe in all cases.

Aims and Objectives:

To evaluate the effect of Raktamokshana in Dantapupputaka Vyadhi.

Materials and methods:

For the present study the patients were selected randomly from the Dental O.P.D. of Shalakya­ - Tantra Department.
The material for study and selection of patients were done irrespective of age, sex, religion, race, occupation etc. fulfilling the criteria of selection and eligibility for the study.

Inclusion Criteria:

1. Patients between 15 to 60 years of age.
2. Patients having normal bleeding and clotting time.
3. Patients having swollen gums. (Upto 3 Dantaveshtha)
4. Patients having Dantapupputaka.

Exclusion Criteria:

1. Patients having Hb% below 7gm%.
2. Patients having diseases of bleeding tendency.
3. Patients having any systemic disease like Diabetes.
4. Uncooprative patients who can not gave proper follow – up.

Investigations:

Blood - Hb%
Bleeding Time and Clotting Time.
Blood sugar level- Random.

Sampling:

Random sampling method was adopted for the selection of the
Patients irrespective of caste, religion, income, sex, occupation etc.
Patients were divided into two groups viz.

1. Trial Group
2. Control Group

1. Trial Group:

Raktamokshana karma was carried out by Pracchana method in tarunavastha of Dantapupputaka Vyadhi under all aseptic precaution with 12 No. sterile surgical blade attached with B. P. Handle (5-7 strait incisions, parallel, not so superficial and not so deep in pratiloma direction were made on affected Dantaveshta) and placebo drug i.e. 250mg sugar powder capsule was given one b.d. for seven days.

On 4th day follow- up Raktamokshana can be done according to the condition of the disease.

2. Control Group:

The modern drugs like,

       Tab. Ciprofloxacin 500 mg bid for 7 days
       Tab. Diclofenac Sodium 50 mg bid for 7 days

was given to relieve infection, pain and inflammation in acute apical Periodontitis (Rapidly Progressive Periodontitis). No Raktamokshana was done in control group.

Total duration of the treatment for both the groups was 7 days and follow – up was on 4th, 7th and on 15th day.

Total effect of the treatment was assessed in both the groups on the basis of clinical assessment of signs and symptoms and statistical analysis in both the groups and then conclusion and results were drawn.

Results and Conclusion:

1. Periodontium is the most important part of the oral cavity. It not only holds and gives support but also give strength to the masticatory apparatus of the body.
2. Periodontal disease affects people of all ages. There is need to early diagnosis and treatment of various forms of periodontitis.Early treatment gives early results and stops further damage of periodontal disease.
3. Raktamokshana (Blood letting) in early cases of Acute localized periodontitis (Rapidly progressive periodontitis) gives wonderful results. It is shodhan chilkitsa and gives prompt relief from pain and swelling seen in Dantapupputaka. The procedure of Raktamokshana is very simple cost effective. No any complications seen, prognosis is almost 100%. No need of any purva-karma and paschat-karma because saliva contains various antiseptic properties. Vitiated kapha and Rakta doshas are removed quickly in Amavastha.
4. After Raktamokshana local defence mechanism, role of saliva heals the periodontal tissue very fast so there is no need of any other medication after Raktamokshana.
5. On the basis of the observations, results and after statistical analysis, it can be concluded that Raktamokshana chikitsa in Tarunavastha of Dantapupputaka (Rapidly progressive periodontitis) gives wonderful results, stops further progression of disease, prompt relief from pain and inflammation, less damages of periodontal tissue.