Upakusha is one among the dantamoolagata roga, caused by pitta and rakta dushti characterized by paaka, raktasraava, shotha, daaha, manda vedana, poothi mukha. The samanya chikitsa includes Vamana, Virechana, Shirovirechan, Raktamokshana, Pratisarana, Kavala and Raktapitta chikitsa. If left untreated, it may leads to Saushira, Mahasaushira . Upakusha can be correlated with Periodontitis.

Periodontitis is an inflammatory disease of supporting tissues of the tooth, caused by single or multiple microorganisms resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation. It is characterized by redness, swollen gums, bleeding gums, burning sensation; foul smell from mouth. The prevalence of chronic periodontitis in the urban population was found to be 42.3% (localized form - 29.3% and generalized form - 13%).

The management includes cleaning the pockets around the tooth, the teeth involved by periodontal disease can be saved if the bone loss has not been too extreme, irritants are removed by scaling and curettage and pocket are eliminated by gingival recession or by surgical removal of gingiva; osseous deformities are eliminated and tooth supporting tissues are recontoured to a normal physiologic architecture; occlusal force are balanced; and systemic factors are corrected. Finally gingivectomy and gingivoplasty, which are quite expensive and cause lot of inconvenience to the patients.

To develop a cost effective and safe Ayurveda treatment protocol for management of Upakusha (periodontitis) this clinical study of lekhana (scaling), dasanasamskara choorna  pratiasarana and yashtimadhu ghrita kavala is being taken up.

Lekhana (scaling), laakshadi choorna  pratiasarana and yashtimadhu ghrita kavala is taken as control.  

Lekhana (scaling) does rakta shodhana by causing raktamokshana. Pratisarana of laakshaadi churna and dashana samskaara churna helps in alleviating the symptoms as their ingredients have shodhana, lekhana and ropana properties.