Mangaiyarkarasi
SP, Manigandan T, Elumalai M, Cholan PK, Kaur RP. Benefits of Aloe vera in dentistry. J Pharm Bioallied Sci. 2015;7(Suppl 1):S255-S259.
The
succulent leaves of the aloe vera (Aloe vera
syn. A. barbadensis, Xanthorrhoeaceae) plant have
been used medicinally for hundreds of years. The yellow leaf sap or latex is
rich in 12 different anthraquinones, which are strong laxatives. The clear gel,
or mucilage, found inside the leaves, is a well-known treatment for burns and
has wound-healing, anti-inflammatory, and analgesic properties. The gel is
composed primarily of polysaccharides and contains 75 nutrients including vitamins
A, C, E, B1, B2, B3 (niacin), B6, choline, folic acid, alpha-tocopherol, and beta-carotene,
and 19 of the 20 required amino acids. Aloe vera also contains enzymes that aid
in digestion and are anti-inflammatory (e.g., bradykinase). Other components
that are anti-inflammatory are acemannan, fatty acids, hormones (auxins and
gibberellins), salicylic acid (also an analgesic), and sterols. The sterol lupeol
also has antiseptic and analgesic properties. The polysaccharide acemannan is
an antiviral and has immunomodulating properties; it has been shown to reduce
secondary infections and increase the activity of T-lymphocytes and
macrophages. This review article provides very brief summaries of the
experimental and clinical evidence supporting the use of aloe vera in
dentistry.
Patients
with oral submucous fibrosis (n = 20) receiving 5 mg of topical aloe vera gel three
times per day for three months had reduced burning and enhanced mouth opening
compared to patients treated with antioxidant capsules two times per day for three
months. Oral aloe gel was also clinically more effective than placebo in the
treatment of oral lichen planus and minor aphthous stomatitis. In the latter
study, 2% gel decreased patient pain scores, reduced wound size, and increased
the rate of healing.
Patients
undergoing head and neck radiotherapy who used an oral aloe vera mouthwash had
reduced oral candidiasis and radiation-induced mucositis.
Patients
(n = 15) with plaque-induced gingivitis treated with 10 mL aloe vera mouthwash two
times per day for three months plus scaling had reduced gingival inflammation
compared to patients treated with the mouthwash alone (n = 15) or scaling alone
(n = 15).
Adults
(n = 15) with periodontitis and
mechanical debridement (scaling plus root planing) treated with intra-pocket
placement of aloe vera in one site of the mouth or no aloe vera in another site
had improved periodontal condition in the aloe vera site.
Several
studies demonstrate the antimicrobial activity of aloe vera. In an in vitro
study, aloe vera toothpaste was more effective than two popular commercial
toothpastes (The Colgate-Palmolive Company; New York, New York) in destroying seven
microbes commonly found in the mouth despite the absence of additional fluoride
in the aloe vera toothpaste. It is noted that aloe vera does not contain the
abrasives found in commercial toothpastes and hence is less harsh on teeth and
a good alternative for patients with sensitive teeth. Aloe vera also controlled
bacteria-induced inflammation around dental implants. Aloe vera was an
effective antimicrobial for disinfecting gutta percha cones (used for root
canals). Also, aloe vera plus sterile water had superior antimicrobial activity
against 18 strains of microorganisms isolated from infected root canals. A patch
containing acemannan hydrogel derived from aloe vera was found to significantly
reduce the incidence of alveolar osteitis following molar extraction compared
to clindamycin (n = 607). Acemannan has also been formulated as a denture
adhesive with minimal cytotoxicity.
Aloe
vera is not recommended during pregnancy or lactation because theoretically it
can stimulate the uterus of pregnant women, and it could cause gastrointestinal
distress in nursing infants. Other side effects include transient redness, burning,
or stinging after topical use and have been reported in a few cases. Oral aloe
vera containing high levels of latex-derived anthraquinones can cause cramps,
diarrhea, red urine, hepatitis, and dependency or worsening of constipation.
Prolonged use of anthraquinone-rich latex as a purgative may increase the risk
of colorectal cancer. The laxative effect may cause electrolyte imbalances (low
potassium levels).
The
authors conclude that for the purposes of dentistry, aloe vera has the
advantage of being easily available, inexpensive, easy to apply orally, and has
no adverse effects. The authors caution that it should not be used in people
allergic to plants in the Liliaceae family, or by pregnant or lactating women.
[Note: Formerly classified as a member of the Liliaceae family, aloe vera is
now placed in the Xanthorrhoeaceae
family.] The authors acknowledge that long-term studies with larger populations
are needed.
—Heather S. Oliff,
PhD
