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Review Article

Review Article Turmeric - Its Applications in Dentistry Amita Sharma , Babita Ahlawat , Sonam Sharma
 
 

Turmeric - Its Applications in Dentistry

Amita Sharma 1 , Babita Ahlawat 2 , Sonam Sharma 3

Abstract

1 Professor & Head, 2 Senior Resident, Department of Dentistry, SHKM Government Medical College, Mewat, Haryana, India.

Turmeric is known to be one of the oldest spices that have been used for thousands of years and is a major part of Ayurvedic medicine. Curcumin, which comprises 0.3-5.4% of raw turmeric, is its best researched active constituent which is nontoxic and has a variety of therapeutic applications including its usage in dentistry. The aim of this article is to explore various dental applications of turmeric as there is scarcity of information and research in this field.

3 Senior Resident,

Correspondence to: Dr.

Keywords: Turmeric, Curcumin, Curcuma longa, Dentistry.

Department of Pathology, Vardhman Mahavir

Introduction

Medical College & Safdarjung Hospital, New Delhi, India.

Sonam Sharma, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.

Turmeric has been used traditionally in Asian cuisines for both its flavor and color. In the Chinese and Ayurvedic medicine, it has been predominantly used as an anti- inflammatory agent and also for the treatment of jaundice, menstrual difficulties, hematuria, hemorrhage, and colic. It is official in the Pharmacopoeia of China as well as in other Asian countries such as Japan and Korea and its usage covers a wide range of health indications. 1 It is acknowledged to be one of the oldest spices that have been used in western and southern parts of India for thousands of years and is a major part of Ayurvedic medicine. That is why it is also affirmed that this spice belongs to India indigenously and is also referred to as ‘Indian saffron.’ Originating in India, turmeric had

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reached China by 700 AD, East Africa by 800 AD and West Africa by 1200 AD, and also had begun to become popular all over the world. It is also known that the Arab traders

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had carried with them turmeric to Europe in the 13th century. Marco Polo, while on his

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numerous legendary voyages to India via the Silk Route, was so mesmerized by turmeric that he had stated it as a vegetable that possesses properties of saffron, but actually is not saffron. 2

Turmeric is popularly known as haldi in India. It is a rhizome of Curcuma longa, a flavorful yellow orange spice. Its plant is 3 ft. in height and has lance-shaped leaves and spikes of yellow flowers that grow in a fleshy rhizome or in underground stem. An orange pulp contained inside the rhizome constitutes the source of turmeric medicinal powder. 3 Curcumin is the best researched active constituent which comprises 0.3-5.4% of raw turmeric. It has been used widely in Ayurvedic medicine for centuries, as it is nontoxic and has a variety of therapeutic properties including antioxidant, analgesic, anti-inflammatory, antiseptic activity, and anticarcinogenic activity. 4 About 40-85% of an oral dose of curcumin passes through the gastrointestinal tract unchanged, with most of the absorbed flavonoid being metabolized in the intestinal mucosa and liver. Due to its low rate of absorption, curcumin is often formulated with bromelain for increased absorption and enhanced anti-inflammatory effect. 5,6

How to cite this article:

Sharma A, Ahlawat B, Sharma S. Turmeric - Its

27-30.

Turmeric is a nontoxic natural product and has diversified effects in several oral diseases.

Applications in Dentistry. J Adv Res Med 2016; 3(1):

Dental Applications

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Dental Pain

Turmeric can be used in following ways to offer relief from dental problems: 7

© ADR Journals 2016. All Rights Reserved.

Sharma A et al.

J. Adv. Res. Med. 2016; 3(1)

Rinsing the mouth with turmeric water (boil 5 g of turmeric powder, two cloves, and two dried leaves of guava in 200 g water) gives instant relief. Massaging the aching teeth with roasted, ground turmeric eliminates pain and swelling. Applying the powder of burnt turmeric pieces and bishops weed seed on teeth and cleaning them makes gums and teeth strong. Applying a paste made from 1 tsp. of turmeric with ½ tsp. of salt and ½ tsp. of mustard oil provides relief from gingivitis and periodontitis. Rub the teeth and gums with this paste twice daily.

Dental Plaque Detection System

Caries is thought to be an infectious disease caused by microbes present in dental plaque, and it is known that the removal of dental plaque is highly important for the health of oral cavity. However, dental plaques are not easy to identify by naked eye. Hence, plaques are generally stained with dental-plaque detection system that includes a dental-plaque staining agent, which contains turmeric extracts and curcumin; and a light- emitting apparatus, which gives out light having a wavelength within a range of 250-500 nm to an object in the oral cavity where the dental-plaque staining agent is attached. 4,8

Pit and Fissure Sealant

It has been found that tinted pit and fissure sealant is useful for applying to tooth surfaces for the prevention or reduction of dental caries. This sealant can be produced from a composition comprising a polymerizable resin system containing acrylic monomer and at least one colorant selected from the group consisting of Annatto extract, turmeric extract, and β- Apo-8.-Carotenal. 9

Subgingival Irrigation

In a study conducted by Suhag et al., periodontal sites were treated on day 0 (baseline) by a single episode of scaling and root planning. Subsequently, selected sites were irrigated (triple-irrigation regimen) with either saline (0.9%), chlorhexidine (0.2%), curcumin (1%), or served as non-irrigated control sites on day 0 (baseline) immediately following instrumentation. Triple-irrigation regimen was repeated for the next five consecutive days and on days 15 and 21 clinical parameters recorded were probing pocket depth (PPD), bleeding on probing, and redness for 200 sites in 20 patients with chronic periodontitis. The results indicated that the irrigated sites had significant improvement in all parameters as compared with the non-irrigated sites on day 2-5. The

curcumin group showed a significant reduction in benzoyl peroxide (100%) and redness (96%) when compared with the chlorhexidine group and the saline group on day 5. However, the difference between groups was not significant at next recall visits mean PPD reduction was significantly greater for the curcumin group than all other groups on all post-treatment days. Thus, 1% curcumin solution can cause better resolution of inflammatory signs than chlorhexidine and saline irrigation as a subgingival irrigant. 10

Mouthwash

In a study by Waghmare et al. about 100 subjects were randomly selected. Both gingival index and plaque index were recorded at 0, 14, and 21 days. It was concluded that chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control methods in prevention of plaque and gingivitis. Turmeric mouthwash prepared by dissolving 10 mg of curcumin extract in 100 mL of distilled water and 0.005% of flavoring agent peppermint oil with pH adjusted to 4 is found to be as effective as most widely used chlorhexidine mouthwash, though, chlorhexidine gluconate has been found to be more effective when antiplaque property was considered. The effect of turmeric observed may be because of its anti-inflammatory action. Reduction in total microbial count was observed in both the groups. 11

Precancerous Lesions

Its role in the treatment of various precancerous conditions like oral submucous fibrosis, leukoplakia, and lichen planus has also been studied. Turmeric extract and turmeric oil have demonstrated co-preventive activity in in vitro and in vivo animal experiments. The local symptoms of burning sensation and pain were reduced and partial reversal of opening of the mouth was also observed. 12

Recurrent Apthous Stomatitis (RAS)

RAS is an inflammatory condition of unknown etiology affecting the oral mucosa. Approximately 20% of the population suffers from RAS some time in their lives. The disease mainly involves non-keratinized mucosal surfaces and is characterized by single or multiple painful ulcers with periodic recurrence and healing. The appearance of ulcers is preceded by a prodrome of localized burning or pain which lasts for around 24-48 hr. The peak of onset is between 10 and 19 years and may continue throughout life. Reports have shown that in patients who used conventional antiseptic gel, the lesion healed only after the periods of time as in

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Sharma A et al.

previous attacks. They experienced no early reduction in pain or frequency of recurrence. The patients who used the curcumin oil reported that ulcers started healing earlier than in previous attacks; there was also early reduction in pain. A follow-up for one-year has shown no recurrence in these patients. 12

Influence on Human Gingival Fibroblasts

Several studies have also revealed apoptosis of human primary gingival fibroblast (hPGF) cells at lower doses like 1, 10, and 25 µM of curcumin but at higher doses like 50, 60, 75, and 100 µM, statically significant high apoptosis was noted. They have also found that the effect of curcumin treated normal human fibroblasts and microvascular endothelial cells (MVED) using MTT assay and observed that lower doses of curcumin stimulated the proliferation of normal human fibroblasts and hMVED, whereas higher doses inhibited it. 10 According to other authors curcumin-treated hPGF cells exhibited maximum and significant apoptosis at 75 µM and showed decrease in cell population and shrinkage of cell size and morphologic alterations in basal cell carcinoma cells after treatment with 50 nM curcumin and found cell shrinkage disappearance of microvilli and appearance of membrane blebbing. 13

Local Drug Delivery System

In a study conducted by Behal et al., 30 subjects with chronic localized or generalized periodontitis with pocket depth of 57 mm were enrolled in a split-mouth study design. Control sites received scaling and root planning (SRP) alone, while experimental sites received SRP plus 2% whole turmeric gel. Both groups demonstrated statistically significant reduction in plaque index, gingival index, sulcus bleeding index, probing pocket depth, and gain in relative attachment loss. There was a significant reduction in the trypsin-like

enzyme activity of “red complex” microorganisms. Greater reduction was observed in all parameters in the experimental group in comparison to those in the control group. Thus, the local drug delivery system containing 2% whole turmeric gel can be used as an adjunct to scaling and root planning. 14

Surgical Wound Healing

Habiboallah et al. 15 performed a study to compare the effects of Curcuma longa ghee formulation and hyaluronic acid on gingival wound-healing following surgery in beagle dogs. A significant difference in the inflammatory and repair parameters of the healing process as regards to cases treated with Curcuma longa was observed. The results suggested a positive potential

therapeutic effect on surgical wound healing, particularly improvement of periodontal treatment consequences after surgery.

Antioxidant Property

Oxidative damage to soft oral tissues may result from exposure to the chemicals or biochemicals found in teeth-whitening products, dental restorations, tobacco and alcohol. Antioxidants are the first line of defense against free radical damage and are critical for maintaining optimum health and wellbeing. The need for antioxidants becomes even more critical with increased exposure to free radicals generated by pollution, cigarette smoke, drugs, illness, stress and exercise. Antioxidant supplementation is an excellent way of improving free protection. 16 San Miguel et al. 17 investigated specific polyphenols and turmeric derivative antioxidants in combinations that counteracted the effects of stressors such as hydrogen peroxide, ethanol, and nicotine by decreasing total reactive oxygen species and increasing cell viability and DNA synthesis.

Safety Facets

Turmeric is known to offer many health benefits, cost- effective and has been considered to be pharmacologically safe. Although human consumption of curcumin as a dietary spice ranges up to 100 mg/day, it has been indicated that humans can tolerate a dose of curcumin up to 12 gm/day, without any toxic side effects. 18,19

Conclusion

Turmeric is one of the most treasurable and potent plant on earth and is being used as a natural wonder traditionally in India. Turmeric has many roles to offer in dentistry. However, there is scarcity of information and research in this field. Therefore, further research is required as turmeric appears to hold a promising future in dentistry.

Conflict of Interest: None References

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Date of Submission: 04 th May 2016 Date of Acceptance: 09 th May 2016

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