Alternative medicine isn't so alternative anymore. Once dismissed as a fad or fringe movement, alternative medicine has become an increasingly popular component of mainstream health care, including dentistry.

But patients need to use caution when using any alternative, "natural" treatments, including herbal supplements.

"'Stop, look and listen' applies to the health-food counter as much as the intersection," says Academy of General Dentistry spokesperson Eric Z. Shapira, DDS, MAGD. Most patients neglect to include vitamins and herbal remedies when listing their medications for their dentist or physician. But even the most common herbs, such as St. John's wort and ginkgo biloba, can cause serious health problems if taken in combination with other drugs or taken in extreme dosages.

Dr. Shapira recommends some natural remedies for oral health:

Fluoride ? This naturally occurring mineral has been proven to protect teeth from decay. Many municipal water supplies contain fluoride. Other sources are fluoride toothpaste, mouthwash and topical rinses and pastes applied in the dental office.

Alcohol-free mouthwash ? Some common mouthwashes contain alcohol to cover up the smell of plaque. But alcohol dries out the mouth, which can cause discomfort and create an environment for more plaque to thrive.

Tea ? A folk remedy that works, wet tea bags can provide relief from canker sores, swollen gums and toothache.

Zinc ? This mineral is widely available in lozenges that can relieve the pain of a sore throat. But Dr. Shapira urges patients to use zinc sparingly. As with any herb, vitamin or mineral, patients need to follow directions and inform their dentist of its use.

"People think herbs are harmless because they are considered 'natural,' and they think, if one is good, 10 are better," said Dr. Shapira. But overdoing it with supposedly safe herbs can cause health problems as serious as internal bleeding and heart arrhythmia, Dr. Shapira warns.

He also points out that all drugs are natural. "Almost all medicines start out as plants, but established drugs have the benefit of being standardized and regulated by the Food and Drug Administration," he says. Herbal medications are not standardized or regulated in any way.

Dr. Shapira urges patients to be well informed before taking any herbal concoction or embarking on an alternative therapy such as acupuncture, chiropractic or even aromatherapy. That means more than reading the manufacturers' promotional material or Internet sites.