Efficacy and safety of plant-based therapy on recurrent aphthous stomatitis and oral mucositis in the past decade: a systematic review

Abstract

Oral mucosal inflammation is one of the oral diseases causing pain and reducing the quality of human life. The types of oral mucosal inflammation that commonly found were recurrent aphthous stomatitis (RAS) and oral mucositis (OM). Anti-inflammatory drugs, both synthetic and plant-based, have been used to treat RAS and OM. Plant-based drugs have been attracted the attention of some researchers to minimize the side effects of synthetic drugs. However, a comprehensive review addressing the use of plant-based drugs for RAS and OM therapy, including drug formulation and species of plant, has not yet been reported. Here, we reported the article review of 9 publications derived from the databases of PubMed, ScienceDirect, Cochrane Library, and other additional relevant works, in order to find the effectiveness and safety of plant-based drugs for RAS and OM therapy. This review was written by following the PRISMA guidelines, and the risk of bias of the articles was evaluated using the Oxford Quality Scoring System. It was found that the effective and safe drugs for RAS therapy contained acemannan from Aloe vera and curcumin from Curcuma longa, both in an oral gel formulation. For OM therapy, drugs contained curcumin from Curcuma longa; licorice from Glycyrrhiza glabra; Aloe vera and black mulberry from Morus nigra, in soft tablet, mouthwash solution or mucoadhesive film formulation. In conclusion, the most effective and safest plant-based therapy for RAS is Acemannan 0.5% in oral gel, whereas for OM is Licorice root extract 0.18 mg in mucoadhesive film.

Effectiveness of the Natural-Based Products and Mucoadhesive for Recurrent Aphthous Stomatitis Therapy: A Systematic Review

“…Previous published systematic review articles [6,8], stated that several herbal medicines and natural products for the RAS therapy in various formulas were effective and safe; however, both of them did not discuss the regarding the mucoadhesive vehicles and its effects in RAS therapy. Many studies only explored herbal or natural products for RAS therapy but did not consider the of mucoadhesive as a vehicle.…”

“…This was related to the geographical condition and climates of the countries in Asia to grow the plants, so that can produce various herbal or natural products as basic ingredients in drugs manufacture. In several Asia countries such as Indonesia, Malaysia, Thailand, India, China, Iran, Saudi Arabia, and others, herbal medicines have been used as a traditional medicine for years [6].…”

“…Natural-Based Products (NBP) was used in several countries in Asia for traditional medicine for several diseases since a very long time ago [6][7][8]. However, it was only in the last few decades that its scientific research for medical treatment has begun.…”

“…Even though NBP was proven to be effective and safe for RAS therapy [6][7][8], the challenge in RAS therapy was the oral mucosa which is always wet and moist so that reducing the drug penetration. Mucoadhesive as a vehicle can prolong the contact time between the drug and mucous surface and increase the therapeutic effectiveness of therapy [10].…”

Clinical Efficacy and Safety of Herbal Medicine Therapy in Recurrent Aphthous Stomatitis: A Systematic Review

“…Li et al conducted a systematic review on the efficacy and safety of topical herbal medicine treatment on recurrent aphthous stomatitis based on the studies published from 1996 to 2015 [14]. Meanwhile, Wahyuni et al conducted a systematic review on the efficacy and safety of plant-based therapy on recurrent aphthous stomatitis and oral mucositis in the past decade [15].…”