Why Turmeric is Fantastic for Oral Health and Hygiene

Study 1: Turmeric Gel Aids In Treatment of Gingivitis

This study was conducted to assess the efficacy of Curcuma gel in gingivitis. This study was conducted on 10 patients suffering from severe gingivitis.

It was primarily done on those patients who did not receive any kind of periodontal therapy in the last six months.

The 10 selected patients with a papillary index score of 3 (higher bleeding) were asked to apply Curcuma gel after brushing twice a day regularly for three weeks. They were also asked to leave the gel in the mouth for 10 minutes before rinsing with water.

The results were recorded in the form of tables in a proforma sheet at different time intervals like 0, 7, 14, 21 days.

The aim of the study was to analyze the parameters like papillary bleeding index and gingival index with the help of a visual analog scale.

The papillary bleeding index is used to assess the overall health of gingiva mainly the bleeding tendency of gingiva while Gingival index is used to analyze the gingival condition along with the qualitative changes like change in color of gingiva or swelling of gingiva.

What were the results of the study?

Initially (day 0) the bleeding was very high. On day 7 the bleeding was considerably less and with time the bleeding got significantly reduced. On day 21 the papillary bleeding score was reduced to as low as 1.25.

The application of Curcuma gel didn’t show any adverse allergic reaction or ulceration.

There was a drastic decrease in inflammation when Curcuma gel was applied thrice daily for three weeks continuously. The color of the gingiva also improved significantly from reddish pink to pale pink.

At last, the study shows that the Curcuma gel is a potent herb in treating gingivitis due to its anti-inflammatory and anti-microbial properties.

How does this occur?

Curcumin is a hydrophobic polyphenol and an active constituent of Curcuma longa (turmeric). It posses many properties of which anti-inflammatory and anti-bacterial activity is of paramount importance in gingivitis.

Curcumin exerts its effect as an anti-inflammatory agent by inhibiting the activation of nuclear factor kappa-B (a transcription factor) as well as by inhibiting the activity of pro-inflammatory enzyme cyclooxygenase-2 which in turn reduces the inflammatory mediators involved in arachidonic acid metabolism.

It is also better than other anti-inflammatory drugs like aspirin as it does not affect the synthesis of prostacyclin which is responsible for inhibiting the platelet aggregation that leads to the formation of dental plaque but selectively inhibits thromboxane which facilitates platelet aggregation thus forming dental plaque.

Another potent mechanism of curcumin in gingivitis is its antimicrobial activity. The major microorganism which plays a key role in the progression of gingivitis is P.gingivalis.

It possesses a spectrum of proteases including trypsin-like enzymes. These enzymes enhance the ability of P.gingivalis to destruct the periodontal ligaments and tissues.

The possible mechanism by which curcumin exhibits its antibacterial activity against P.gingivalis and other pathogenic microorganisms is by blocking the assembly dynamics of FtsZ in the Z-ring .

You might be wondering what this FtsZ is and what is its role here? FtsZ is an essential bacterial protein which assembles by itself at a particular site called “Z-ring”.

This ring plays an important role in bacterial proliferation as it provides energy for it.

Curcumin is also a powerful anti-oxidant. It reduces oxidative stress which occurs due to the imbalance between body’s own antioxidant defense system and reactive oxygen species (ROS).

This ROS plays a major role in periodontal tissue destruction.

What does this mean?

As we can see from the above study and its results that a daily application of Curcumin gel for three weeks continuously can significantly improve the symptoms of gingivitis like inflammation, bleeding and reddening of gums.

This proves that Curcuma (Turmeric) is an effective adjunct that can be used in the treatment of gingivitis and plaque removal.

The turmeric gel showed no visible side-effects and was biocompatible in nature.

Study 2: Turmeric More Effective than Commonly Used Germicidal Mouthwash for Plaque and Gingivitis 

A research published in 2012 in the Journal of Indian Society of Periodontology aimed at comparing the ability of turmeric and chlorhexidine gluconate mouthwashes in intercepting the development of bacterial infections like gingivitis and plaque.

The study comprised of 60 patients suffering from gingivitis.

Half of them were asked to use 0.1% turmeric mouthwash and the other half was given 0.2% chlorhexidine gluconate mouthwash for 21 days.

Changes in the severity of plaque and gingivitis after 0, 14 and 21 days were analyzed.

After 21 days, the researchers deduced that the severity of plaque and gingivitis reduced significantly in both groups.

Both turmeric and chlorhexidine were nearly equally efficient.

Turmeric reduced plaque by 69.072% and gingivitis by 62.545%. Chlorhexidine, on the other hand, reduced plaque by 64.207% and gingivitis by 61.150%. 

Turmeric was found to be more effective on both counts if we consider the exact percentages!

Summary

From these facts, we can infer that both turmeric mouthwash and chlorhexidine mouthwash are efficient in preventing and reducing the severity of oral infections like plaque and gingivitis owing to their anti-inflammatory and anti-bacterial characteristics.

But considering the facts that concentration of chlorhexidine mouthwash was twice that of turmeric mouthwash;, and that continuous chlorhexidine usage can produce various adverse effects, it would not be wrong to say that turmeric, in the end ,may be better than chlorhexidine in maintaining good oral health.

Study 3: Curcumin Fares Better Than Steroids In Treatment Of Oral Submucous Fibrosis

This study elucidates the extent of effectiveness of curcumin in case of Oral Submucous Fibrosis (OSF).

This was a clinical trial conducted on 30 OSF patients. They were assigned into 2 groups, with 15 people in each group. One group was tested group and another one was the control group.

The test group was put on a regime of commercially available Curcuminoids named Longvida(400mg lozenges, daily intake of 2gm lozenges).

The control group was under the steroid tenovate (0.05% of clobetasol propionate)ointment regime. This ointment had to be applied thrice a day.

Both these regimes lasted for 3 months and follow-up analysis was done at the end of 6months. Both groups were advised to regularly perform some physiotherapy exercises involving the movement of the mouth and the jaws.

This mouth exercise device (MED) based had to be done for 20 min, 10 min for each side. This is done thrice a day.
OSF is diagnosed based on the reduction of the interincisal distance (distance between your 2 jaws at mouth opening) in mouth opening and fibrous bands found in the oral mucosa.

Patients were asked to forego the use of tobacco 1 month prior to the start of the drug regime.

The baseline for mouth opening and the fibrous bands were noted for each group at the start of the experiment. This was then compared with the results after the 3months trial and the 6-month follow-up.

Visual Analogue Scale (VAS) measurements were also monitored.

This is to check the burning sensation caused by the intake of hot & spicy food. This is another parameter to monitor OSF and common tooth sensitivity.

Keeping all these parameters in mind the results were analyzed.

What were the results?

The results showed some drastic changes. There was a 5.93mm increase in mouth opening in the test group. This is 2.37mm deviation from the baseline. In case of the control group, the increase in the mouth opening is of 2.66mm.  A meagre 1.76mm deviation from the baseline.

Burning sensation on an intake of spicy food reduced in the treatment group but this was not observed in the control group.

The results of the test group showcased a sustained outcome, even 6months after withdrawal of the treatment. On the other hand, the control group had a relapse of disease parameters 6 months after treatment withdrawal.

Thus, it is clearly illustrated in this study that curcumin had a far more sustained effect than conventionally applied steroids used in OSF.

How did this occur?

The anti-inflammatory and anti-oxidant effects of curcumin are the chief mechanism of action against Oral Submucous Fibrosis.

Curcumin inhibits NF-κB activation pathway.  The level expression of this pathway is very high in OSF patients. It is one of the essential cell signaling pathways for the disease to occur.

The inhibition of COX-2,lipoxygenase and inducible nitric oxide synthase (iNOS) enzymes by curcumin plays a major role in this.

Also, the blocking of certain pro-inflammatory cytokines like IL-12, IL- 8, IL-6, TNFα reduces inflammation in the mouth. Thus affecting OSF patients by relieving the pain and burning sensation.

The anti-oxidant property of curcumin causes a scavenging effect on superoxide and hydroxyl radicals. This results in a reduction of oxidative stress (imbalance between prooxidant and antioxidant agents).

It reduces lipid peroxidation (degradation of lipids which damages tissue).

All these factors are responsible for the reduction in the burning sensation caused due to intake of spicy foods.

What does this mean?

Overall, this study reveals the efficacy of curcumin as an alternative cure for Oral Submucous Fibrosis. The lack of any side effects and the relative sustained effect of curcumin makes it a far better cure than conventional steroids.

Read the full study at http://www.ncbi.nlm.nih.gov/pubmed/26604488

Study 4: Curcumin Fares Better Than Steroids In Treating Oral Ulcers

The study was a randomized, double blind, clinical trial and was carried out for a period of 6 months.Detailed case history was made.

60 patients diagnosed with recurrent aphthous stomatitis were selected for the clinical trial based on various inclusion and exclusion criteria. Group I had 30 participants. They were given curcumin gel for the treatment of RAS. The other group was given a standard treatment of Triamcinolone Acetonide gel.

The size of ulcer was measured by a sterile Vernier Caliper. The number of ulcers was also noted down. The pain score was measured for each participant in the study and noted down.

A strict uniform protocol for administration of gel was followed. Patients were asked to apply the gels thrice a day on each of the ulcer post their meal.

They were asked to not consume food or water for at least half an hour.

The same type of applicator was provided to everyone and the quantity of application was also fixed.

Patients were examined on alternate days and the following parameters were noted down.
• Size of the ulcers
• Number of ulcers
• Pain score

The curcumin gel used was Curenext oral gel that contained 10mg of Curcuma longa extract per gram of gel. Triamcinolone Acetonide gel used for the study was Kenacort oral paste that contained 0.1% triamcinolone acetonide.

What were the results of the study?

60 patients were involved in the study. They were randomly assigned in groups of 30.

There was no significant variation in the demographic data of the patients in the two groups.

The pain scores were compared. The pain score of group I from day 0 to day 7 was calculated to be 4.7±1.53. The means that the average level of pain on a scale of 10 was found to be 4.7.

The pain score for group II patients was found to be 4.5±1.43. Group II patients on an average rated their pain from day 0 to day 7 as 4.5.

The result implies that there was a notable reduction in pain in 7 days in both groups.

Statistically, there was no significant difference in pain scores between the groups.

Another parameter that was recorded was the number and size of ulcers. The results show that over the period of 7 days the size and number reduced remarkably for both groups of people.

There was no considerable difference in the parameter result between Group I and Group II.

This study showed that curcumin is effective in reducing pain and healing the ulcer. It effectively reduces the size and number of ulcers.

How does this occur?

Treatment of oral ulcer aims at relieving pain, reduce inflammation and promote healing.

Curcumin downregulates the expression of interleukin (IL)-6 protein, TNF, and various other chemokines. This leads to suppression of inflammation.

One such mechanism is by decreasing the rate of release and metabolism of arachidonic acid.

Arachidonic acid is a polyunsaturated fatty acid present in the cell membrane. It is an intermediate in the inflammation pathway.

Also, it is a vasodilator that is responsible for the redness of the affected site.

Oxygenation of arachidonic acid produces prostaglandins by cyclooxygenase pathway and leukotrienes from lipoxygenase pathway.

A decrease in arachidonic acid metabolism reduces the activity of cyclooxygenase and lipoxygenase, which are inflammatory enzymes.

This, therefore, reduces inflammation.

Curcumin possesses anti-oxidant properties.

It prevents oxidative damage of the cells. Curcumin decreases the level of lipid peroxides. This prevents Oxidative degradation of lipids which in turn reduces tissue damage.

Curcumin elevates the level of superoxide dismutase (SOD) that breaks down potentially harmful oxygen molecules. Catalase (CAT), glutathione peroxidase (GPx) levels also increase due to curcumin.

This prevents the cells against oxidative stress. Oxidative stress is the imbalance between the production of free radicals and the ability of the body to neutralize the harmful effect of free radicals by antioxidants. This leads to aggressive cellular damage.

Reduction in oxidative stress initiates wound healing. It improves collagen synthesis and maturation, wound contraction and finally epithelialisation.

The wound is covered by a new layer after it is filled with well vascularised healthy tissues.

Curcumin increases the activity of transforming growth factor-beta1 and fibronectin which is responsible for the enhancement of wound healing.

What does this mean?

This implies that curcumin can heal oral ulcer and relieve the pain as effectively as a steroid.

Steroids have unwanted and non-reversible side effects.

Turmeric has a pharmacological activity that is similar to steroids.

Turmeric, if taken in required dosage, can be a safer, economical and effective alternative to steroids.

Read the full study at: http://www.ncbi.nlm.nih.gov/pubmed/25126527