Aloe Vera’s Impact on Oral Health
In many parts of the world, herbal and natural remedies are commonly used to treat injuries and illnesses.
In many parts of the world, herbal and natural remedies are commonly used to treat injuries and illnesses. Similarly, some United States patients gravitate toward natural, homeopathic, and holistic medicaments as part of their health care regimens. In addition, the use of antibiotics to treat infections has contributed to an increase in bacterial resistance and the rise of so-called superbugs. As a result, alternative medicine has been a popular topic of interest, as researchers investigate ways to incorporate natural products into therapeutic treatments. With a historical reputation in holistic healing, aloe vera is one of the most popular medicinal plants. Due to the naturally occurring chemical compounds, it has been shown to demonstrate beneficial inhibitory effects on gram-positive and gram-negative bacteria, such as Staphylococcus aureus, Pseudomonas aeruginosa, and Porphyromonas gingivalis. Besides its antimicrobial effects, aloe vera’s antioxidant and anti-inflammatory action can also aid the healing process following dental treatment.
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The aloe vera plant has been found to contain anti-inflammatory properties.6 Research shows it inhibits histamine and leukotrienes released by mast cells and can cause macrophages to release nitric oxide and cytokines. It also has been shown to inhibit the cyclooxygenase pathway, which reduces prostaglandin E2 (PGE2) and breaks down bradykinin to decrease pain. There is a reduction of leukocyte adherence and tumor necrosis factor-α (TNF-α), which, in turn, blocks the inflammatory process. Each of the pathways deals with the immune system, which helps explain its method of action. Additionally, the anti-inflammatory fatty acids in aloe vera juice, such as β-sitosterol and campesterol, can help with a variety of immune system diseases.
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The viscous secretion in aloe vera, known as mucilage, contains various vitamins and amino acids. Specifically, vitamins A, C and E are antioxidant compounds that contribute to ridding potentially damaging oxidative agents and carcinogens. Additionally, the mucilage contains antioxidant enzymes, such as glutathione peroxidase and superoxide dismutase, that work to counteract free radicals produced from the site of infection. The plant’s antioxidant properties work synergistically with the anti-inflammatory components to expedite wound healing. Daily consumption of aloe vera gel extract was found to reduce the amount of Lactobacillus spp. and Streptococcus mutans in saliva, which are oral pathogenic bacteria. In addition, the gel extract helps increase plasma total antioxidant capacity, with no clinical adverse effects.
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The antimicrobial effect of aloe vera is mainly due to the anthraquinones found in the sap, which are associated with inhibiting bacterial protein synthesis. The plant contains an antibacterial agent called acemannan that plays an indirect role in its therapeutic activities through phagocytosis. Studies completed in vitro and in vivo contribute to scientific understanding of how it fights pathogens by reducing secondary infections, increasing the activity of T-lymphocytes, and increasing the activity of macrophages, thus promoting wound healing.
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Aloe vera possesses several beneficial properties, as noted above; together the anti-inflammatory, antioxidant, and antimicrobial properties work simultaneously to aid wound healing. Takzaree et al demonstrated its ability to expedite wound healing. Specifically, this study showed the increase of transforming growth factor-β (TGF-β) gene expression with aloe vera application to wounds on rat subjects. TGF-β is known to be one of the most important factors in wound healing; this is due to the gene stimulating epithelialization and angiogenesis, which is critical to healing. Although the discussion of aloe vera’s wound-healing properties is dependent on this one study and more research is needed, these findings underscore its potential benefits as an alternative therapy in the dental and medical fields.
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Prevention is a key element of sustaining optimal oral health. Prabhakar et al conducted a randomized clinical trial in vivo using a split-mouth design to determine aloe vera’s efficacy as a potential cavity-disinfecting agent following minimally invasive hand excavation of caries. Three solutions (distilled water, aloe vera extract, and propolis extract) were compared with a control, and the results showed significant amounts of cariogenic bacteria remained following hand excavation alone. In addition, bacterial counts were statistically significant in post-cavity disinfection. Compared to distilled water, disinfecting caries sites with propolis and aloe vera extract resulted in a statistically significant reduction in bacterial counts. The two extracts had similar disinfecting potential, but aloe vera was marginally more efficacious and the authors reported no adverse effects. This suggests using aloe vera as an alternative cavity-disinfecting agent may aid in the prevention of secondary caries and contribute to the long-term success of restorative procedures.
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Additional Research Needed
Further studies are needed to evaluate the use of aloe vera in dentistry as an alternative therapeutic agent. Future research should include larger sample sizes and longer time intervals to follow-up as longitudinal studies. Another interesting prospect includes using aloe vera in conjunction with other herbal, natural and homeopathic products. For example, Sahgal et al showed pomegranate (Punica granatum) offers similar effects to chlorhexidine in eliminating periodontal pathogens. Future studies might include the combination of aloe vera and pomegranate to evaluate if the two yield enhanced antimicrobial effects..