Use of Aloe Vera in Dentistry

Journal of Indian Academy of Oral Medicine and Radiology, July-September 2011;23(3):S389-391 S389
JIAOMR
Use of Aloe Vera in Dentistry
1
Pravin Sundarkar,
2
Ravindra Govindwar,
3
Sanjai B Nyamati,
4
Neeraj Alladwar,
5
Vivek Thombre
6
Abhishek Soni,
7
Anand Raj
1
Professor, Department of Prosthodontics, Triveni Dental College, Bilaspur, Chhattisgarh, India
2
Professor and Head, Department of Orthodontics, Guardian College of Dental Sciences, Ambarnath, Maharashtra, India
3
Dean, Department of Oral Medicine and Radiology, Triveni Dental College, Bilaspur, Chhattisgarh, India
4
Professor, Department of Orthodontics, SDKS Dental College, Nagpur, Maharashtra, India
5
Reader, Department of Periodontia, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
6
Reader, Department of Periodontia, Maitri Dental College and Research Institute, Durg, Chhattisgarh, India
7
Reader, Department of Prosthodontia, Kalmagh Dental College and Research Institute, India
Correspondence: Pravin Sundarkar, Professor, Department of Prosthodontics, Triveni Dental College, Bilaspur, Chhattisgarh
India, e-mail: pravinsundarkar@gmail.com
REVIEW ARTICLE
ABSTRACT
The aloe vera plant has a long history of healing power. Recently, aloe vera has gained some popularity as an active natural product used
in the medical and dental field for treating many diseases. It has various miraculous properties like anti-inflammatory, antibacterial, antiviral
and antitumor which accelerates wound healing and helps in treating various lesions in oral cavity. Though, there are various indications for
its use, more clinical research is required to determine its real efficacy in dentistry. The aloe vera plant, its composition, properties,
mechanism of action and clinical uses are briefly reviewed in this article.
Keywords: Aloe vera, Antitumor, Antibacterial, Antifungal, Antiviral, Wound healing, Moisturizing.
INTRODUCTION
The use of natural products in the prevention and treatment of
oral conditions has increased recently and could be of benefit
to low socioeconomic level in urban and rural communities.
1
Among the various currently available herbal agents, aloe vera,
popularly known as babosa, is a plant commonly found in the
Northeast of Brazil. Its foliage, extract and resin present
antimicrobial, anti-inflammatory and healing properties and are
indicated to hepatic and stomach diseases.
2
The plant aloe vera has a history dating back to biblical
time. Aloe vera plant is not a cactus, but a member of the tree
lily family, know as Aloe barbadensis. It produces a tubular
yellow flower in the spring that is typical of the lily family.
There are over 250 species of Aloe grown around the world.
Only two species are grown commercially: Aloe barbadensis
Miller and Aloe aborescens. The aloe plant is grown in warm,
tropical areas and cannot survive freezing temperatures. In the
United States, most of the aloe is grown in the Rio Grande
Valley of South Texas, Florida and Southern California.
Internationally, aloe can be found in Mexico, the Pacific Rim
countries, India, South America, Central America, the
Caribbean, Australia and Africa.
3
COMPOSITION OF ALOE VERA
The aloe barbadensis plant consists of two different parts, each
of which produce substances with completely different
compositions and therapeutic properties. The parenchymal
tissue makes up the inner portion of the aloe leaves and produces
the aloe vera gel (or mucilage), a clear, thin, tasteless, jelly-like
material. This tissue is recovered from the leaf by separating
the gel from the inner cellular debris. The other part of the
plant is a group of specialized cells known as the pericyclic
tubules, which occur just beneath the outer green ring of the
leaf. These cells produce an exudate that consists of a bitter
yellow latex with powerful laxative-like actions. This exudate,
which is not to be confused with the gel/mucilage from the
parenchymal leaf tissue, is available commercially for systemic
ingestion to produce catharsis.
4
The aloe vera is complex. The plant contains vitamins A,
C and F. Vitamin B (thiamine), niacin, vitamin B
2
(riboflavin),
choline and folic acid along with traces of vitamin B
12
. Enzymes
such as acid phosphatase, alkaline phosphatise, amylase, lactic
dehydrogenase and lipase. When taken orally, these biochemical
catalysts, amylase and lipase aid in digestion by breaking down
fats and sugars.
5
It consists of 75 different ingredients, including
vitamins, minerals, enzymes, sugars, anthraquinones or phenolic
compounds, lignin, saponins, sterols, amino acids and salicylic
acid.
6,7
Yamaguchi et al reported the presence of aluminum,
sodium, potassium, calcium, magnesium, manganese, copper,
zinc, chromium and iron in the aloe plant.
8
Polysaccharide Components
The major types of polysaccharides (described by Reynolds
and Dweck) consisted of glucomannans of various compositions
(Long chains of glucose and mannose units hooked together),
10.5005/jp-journals-10011-1177
Pravin Sundarkar et al
S390
JAYPEE
some of which were acetylated. Polymers of galactose and
galacturonic acid also have been found in the aloe vera gel.
9
Different investigators have revealed different polysaccharide
structures within the gel. Yarons 1991 studied regarding the
gels viscosity and rheology, indicated that the glucomannans
in aloe rarely were found in other plants and provided the plastic
properties of the gel that are similar to the properties of human
body fluids.
10
One of the glucomannans in the gel is an
acetylated mannan that is available commercially as a patented
product, Acemannan Hydrogel (Carrasyn, Carrington
Laboratories, Irving, TX; 800.444.2563).
11
ROUTE OF ADMINISTRATION
As an external application, it is currently available in market in
the forms of gel, oil, face powder, face wash and toothpastes.
PROPERTIES
Moisturizing Actions
The moisturizing effect of aloe vera gel appears to be due to
the mix of water and polysaccharide components, creating a
J elly-like consistency that holds the water within the mix and
minimizes its evaporation, providing a sustained moist
environment when applied to drying tissues and humectant
properties that promote retention of moisture in tissues.
12
Wound Healing Effects
Countless studies have demonstrated the healing powers of aloe
vera gel. A 1996 study reported that a high molecular weight
polypeptide constituent from the gel demonstrated a healing
effect on excisional wounds in rats.
13
Yagi et al reported that aloe vera gel contains a glycoprotein
with cell proliferating-promoting activity, while Davis et al noted
that aloe vera gel improved wound healing by increasing blood
supply, which increased oxygenation as a result.
14,15
In 1991, Thompson reported that topical application of the
aloe vera-derived allantoin gel stimulated fibroblast activity and
collagen proliferation.
16
Angiogenesis is the growth of new blood capillaries and is
a part of tissue regeneration. A 1993 study showed that topical
application of aloe vera gel reestablished vascularity of burn
tissue for a guinea pig, although no specific constituents were
identified.
17
The aloe vera gel polysaccharide acemannan was
shown to activate macrophages, an effect that improved wound
healing in a rat model.
18,19
Two years later, Lee et al reported
that the low molecular weight component of freeze-dried aloe
vera gel stimulated blood vessel formation in a chick
chorioallantoic membrane; in addition, a methanol-soluble
fraction of the gel stimulated proliferation of artery endothelial
cells in an in vitro assay and induced them to invade a collage
substrate.
20
Antitumor Effect
An induction of glutathione S-transferase and an inhibition of
tumor promoting effect of phorbol myristic acetate has also
been reported which suggests possible benefit of using aloe gel
in cancer chemotherapy.
21
Antibacterial/Antifungal/Antiviral Effects
Streptococcus pyogenes and Streptococcus faecalis are two
microorganisms that have been inhibited by aloe vera gel.
22,23
Using a rat model, Heggers et al suggested that the antibacterial
effect of the aloe vera gel in vivo could enhance the wound
healing process by eliminating the bacteria that contributed to
inflammation.
24
Aloe vera gel reportedly was bactericidal
against Pseudomonas aeruginosa, while acemannan prevented
it from adhering to human lung epithelial cells in a monolayer
culture.
25,26
A processed aloe vera gel preparation reportedly
inhibited the growth of Candida albicans.
22
Uses of Aloe Vera in Dentistry
Aloe vera has shown antimicrobial effect against resistant
microorganisms found in pulp space. The antimicrobial activity
of alcohol and chloroform extract could be due to the high
solubility of active ingredients in these liquid extract media.
27
The antimicrobial effect of a dentifrice containing aloe vera
has been demonstrated in an in vitro study, in which this
phytotherapic agent inhibited the growth of diverse oral
microorganisms, such as S. mutans, S. sanguis, A. viscosus and
C. albicans.
28
One study available evaluating the clinical effects of aloe
vera showed a significant reduction of gingivitis and plaque
accumulation after use of a mouthrinse containing this natural
product.
29
A study carried out at University of Fortaleza, Cear, Brazil.
In 2007, concluded that the dentifrice containing aloe vera did
not show any additional effect on plaque and gingivitis control
compared with the fluoridated dentifrice.
30
Few article on uses of aloe vera suggested various
applications of it in dentistry:
3,31
1. Applications directly at sites of periodontal surgery.
2. Applications to the gum tissues that have been traumatized
or injured by abrasion brushes, dental floss, toothpicks, etc.
3. Chemical burns caused by accidents with aspirin are quickly
relieved.
4. Extraction sites respond comfortably and empty purses not
develop when aloe vera is applied.
5. Acute lesions of the mouth are improved by direct
application in viral lesions, aphthous ulcers and cracks in
the corners of the lips. Abscesses in the gums are also
reduced with the implementation of the plant.
6. Other oral chronic diseases respond kindly. Even gum
problems associated with tong and burning mouth syndrome
are much improved.
7. Patients with sore gums and teeth with dentures maladaptive
may also benefit.
8. Aloe vera can also be used around dental implants to control
inflammation caused by bacterial contamination. But no
clinical studies are present to support these applications.
Use of Aloe Vera in Dentistry
Journal of Indian Academy of Oral Medicine and Radiology, July-September 2011;23(3):S389-391 S391
JIAOMR
CONCLUSION
Though aloe vera is a promising herb with its various clinical
applications in medicine and dentistry, more clinical research
should be undertaken, so that it can establish in the field of
medicine and dentistry.
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