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Year : 2022  |  Volume : 49  |  Issue : 2  |  Page : 103-105

Role of Aloe vera in the management of oral submucous fibrosis

Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India

Date of Submission22-Mar-2022
Date of Acceptance12-May-2022
Date of Web Publication23-Aug-2022

Correspondence Address:
Palak H Shah
Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Piparia, Vadodara, Gujarat
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jss.jss_49_22

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Oral submucous fibrosis (OSMF) is a potentially malignant disorder of the oral cavity commonly prevalent in India and other southeastern countries where consumption of areca nut is predominated. As it has significant morbidity and mortality, early diagnosis and prompt treatment are essential. At present, none of the treatment modalities offers a complete cure for the diseases. Thus, in the search of newer treatment modalities, various Ayurvedic medicines have been studied in recent years. The present review aims to summarize the role of Aloe vera for the treatment of OSMF.

Keywords: Aloe vera, anticancer, antioxidant, medical management, oral submucous fibrosis

How to cite this article:
Shah PH, Venkatesh R. Role of Aloe vera in the management of oral submucous fibrosis. J Sci Soc 2022;49:103-5

How to cite this URL:
Shah PH, Venkatesh R. Role of Aloe vera in the management of oral submucous fibrosis. J Sci Soc [serial online] 2022 [cited 2022 Dec 1];49:103-5. Available from: https://www.jscisociety.com/text.asp?2022/49/2/103/354275

  Introduction Top

Oral submucous fibrosis (OSMF) is a chronic, debilitating potentially malignant condition of the oral cavity characterized by progressive inability to open the mouth due to the loss of elasticity and development of vertical fibrous bands in labial and buccal tissue. The etiology is mainly associated with the consumption of areca nut and related products.[1],[2] It was first described in the literature by Schwartz in 1952.[3] Joshi subsequently coined the term oral submucous fibrosis (OSMF) for the condition in 1953.[4] The premalignant nature of this condition was described by Pindborg and Sirsat four decades ago.[3],[4],[5]

Unlike other precancerous lesions and conditions, OSMF is insidious in origin and does not regress, either spontaneously or with cessation of the habit. Various medicinal and surgical treatment modalities are used with different degrees of effectiveness, but none offers a complete cure.[3] Hence, the search for effective treatment modalities is still continued. Since centuries, the usefulness of various Ayurvedic medicines for various diseases is well established. The effectiveness of certain Ayurvedic medicines has also been proposed for oral precancerous and cancerous lesions.[6] Aloe vera is one such Ayurvedic medicine.

  Aloe vera Top

The name Aloe vera is derived from the Arabic word “Alloeh” meaning “shining bitter substance,” and “vera” in Latin means “true.” The botanical name of Aloe vera is Aloe barbadensis Miller. It belongs to the Liliaceae family.[7] It is a cactus-like plant which grows in dry and hot climates. Aloe vera mainly grows in Africa, Northern America, India, Egypt, and Sudan.[8] Aloe vera gel is rich in various vitamins, enzymes, minerals, sugars, fatty acids, and anthraquinones. It has various pharmacological actions such as antibacterial, antifungal, anti-inflammatory, antioxidant, antitumor, immunomodulatory, and hypoglycemic.[7],[8] These properties make Aloe vera useful for various therapeutic indications.

  Aloe vera in Oral Mucosal Lesions Top

Due to its pharmacological and biological properties, Aloe vera has been used for various dental and oral applications. Aloe vera has given promising therapeutic outcomes as an endodontic medicament and treatment overextraction socket.[9],[10] It has been used as a component of various dentifrices too.[11] Previous studies have demonstrated the use of Aloe vera has been used in the treatment of various oral mucosal lesions such as oral lichen planus,[12],[13] Recurrent aphthous ulcers,[14],[15] herpes simplex and herpes zoster infections,[16] radiation-induced mucositis,[17] burning mouth syndrome,[18] xerostomia,[19] candidal denture stomatitis,[20] and periodontitis[21] due to its excellent medicinal properties.

  Aloe vera in Oral Submucous Fibrosis Top

Aloe vera contains several vitamins, i.e., Vitamin A, C, and E, antioxidant properties of which help to combat destructive free radicals. These vitamins also have wound healing properties and they boost the immune system. The fatty acids, salicylic acid, and hormones such as auxins and Gibberellins have anti-inflammatory properties. Aloe vera increases blood supply and speeds up healing. It is a mannoprotein, containing many amino acids which are called “wound-healing hormones.” The polysaccharides contained in the Aloe vera gel also have wound healing, immunomodulatory, and anticancer properties. The sterols in Aloe vera have antiseptic, analgesic, and anti-inflammatory properties. All these properties of Aloe vera are thought to be useful in the treatment of OSMF.[8],[22]

Sudarshan et al.[22] conducted a comparative study between Aloe vera and other antioxidants for the treatment of OSMF. In results, they observed significant improvement in mouth opening and cheek flexibility and reduction in burning sensation with Aloe vera gel.

Patil et al.[23] compared efficacy of Aloe vera gel with oxitard tablets for OMSF treatment. Positive results were found with Aloe vera but oxitard showed superior results. However, the authors mentioned that Aloe vera has the advantage of being economical as compared to oxitard tablets.

Patil et al.[24] compared therapeutic efficacy of Aloe vera and spirulina for treatment of OMSF. In both groups, a significant increase in mouth opening and reduction of symptoms were noted. The authors mentioned that both medicines were equally effective.

Singh et al.[6] compared effectiveness of Aloe vera gel plus physiotherapy to antoxid tablets plus physiotherapy. Both the groups exhibited therapeutic benefits but the Aloe vera group was found to be better in terms of treatment outcomes.

Alam et al.[25] studied the beneficial effects of Aloe vera gel in medically and surgically treated OSMF patients. They found Aloe vera has beneficial effects in reduction of burning sensation, improvement in tongue protrusion and cheek flexibility and maintenance of mouth opening.

Anuradha et al.[26] compared efficacy of Aloe vera gel plus juice to intralesional injection of hydrocortisone and hyaluronidase. Both the groups showed positive results and therapeutic efficacy of both the groups was comparable.

  Conclusion Top

Aloe vera has a numerous unique properties which are of therapeutic benefit for various conditions. From the abovementioned studies, it is evident that Aloe vera has promising results for the treatment of OSMF. When combined with complete discontinuation of habit and other modalities such as physiotherapy, Aloe vera can provide excellent results.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Auluck A, Rosin MP, Zhang L, Sumanth KN. Oral submucous fibrosis, a clinically benign but potentially malignant disease: Report of 3 cases and review of the literature. J Can Dent Assoc 2008;74:735-40.  Back to cited text no. 1
Murti PR, Bhonsle RB, Gupta PC, Daftary DK, Pindborg JJ, Mehta FS. Etiology of oral submucous fibrosis with special reference to the role of areca nut chewing. J Oral Pathol Med 1995;24:145-52.  Back to cited text no. 2
More CB, Shah PH, Rao NR, Pawar RK. Oral submucous fibrosis: An overview with evidence based management. Int J Oral Health Sci Adv 2015;3:40-9.  Back to cited text no. 3
Joshi SG. Fibrosis of the palate and pillars. Indian J Otolaryngol 1952;4:1-4.  Back to cited text no. 4
Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 1966;22:764-79.  Back to cited text no. 5
Singh N, Hebbale M, Mhapuskar A, Ul Nisa S, Thopte S, Singh S. Effectiveness of Aloe vera and antioxidant along with physiotherapy in the management of oral submucous fibrosis. J Contemp Dent Pract 2016;17:78-84.  Back to cited text no. 6
Gupta P, Alekhya K. Alternative medicine in the management of oral mucosal lesions – A review. IOSR J Pharm 2018;8:47-53.  Back to cited text no. 7
Shanbhag VL. Aloe vera in the management of oral submucous fibrosis. Oncobiol Targets 2017;4:13.  Back to cited text no. 8
Poor MR, Hall JE, Poor AS. Reduction in the incidence of alveolar osteitis in patients treated with the SaliCept patch, containing Acemannan hydrogel. J Oral Maxillofac Surg 2002;60:374-9.  Back to cited text no. 9
Nair GR, Naidu GS, Jain S, Nagi R, Makkad RS, Jha A. Clinical effectiveness of Aloe vera in the management of oral mucosal diseases – A systematic review. J Clin Diagn Res 2016;10:E01-7.  Back to cited text no. 10
George D, Bhat SS, Antony B. Comparative evaluation of the antimicrobial efficacy of Aloe vera tooth gel and two popular commercial toothpastes: An in vitro study. Gen Dent 2009;57:238-41.  Back to cited text no. 11
Choonhakarn C, Busaracome P, Sripanikulchai B, Sarakarn P. The effiacy of Aloe vera gel in the treatment of oral lichen planus: A randomized controlled trial. Br J Dermatol 2008;158:5737.  Back to cited text no. 12
Ahmed SS, Gadalla LM, Elmeadawy SH, Badria F. The efficacy of Aloe vera gel in treatment of Oral Lichen Planus. Int Dent Med J Adv Res 2018;4:1-6.  Back to cited text no. 13
Mansour G, Ouda S, Shaker A, Abdallah HM. Clinical effiacy of new Aloe vera- and myrrhbased oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: A randomized, doubleblind, vehiclecontrolled study. J Oral Pathol Med 2014;43:4059.  Back to cited text no. 14
Lalthlamuanpuii, Fahima I, Prabu, Manipal S, Rajmohan, Bharathwaj. A systematic review of Aloe vera in treating recurrent aphthous stomatitis. J Pharm Sci Res 2019;11:3223-6.  Back to cited text no. 15
Giroh VR, Hebbale M, Mhapuskar A, Hiremutt D, Agarwal P. Effiacy of Aloe vera and triamcinolone acetonide 0.1% in recurrent aphthous stomatitis: A preliminary comparative study. J Indian Acad Oral Med Radiol 2019;31:4550.  Back to cited text no. 16
Su CK, Mehta V, Ravi Kumar L, Shah R, Pinto H, Halpern J, et al. Phase II doubleblind randomized study comparing oral Aloe vera versus placebo to prevent radiationrelated mucositis in patients with headandneck neoplasms. Int J Radiat Oncol Biol Phys 2004;60:1717.  Back to cited text no. 17
López-Jornet P, Camacho-Alonso F, Molino-Pagan D. Prospective, randomized, double-blind, clinical evaluation of Aloe vera Barbadensis, applied in combination with a tongue protector to treat burning mouth syndrome. J Oral Pathol Med 2013;42:295-301.  Back to cited text no. 18
MoralesBozo I, Rojas G, OrtegaPinto A, Espinoza I, Soto L, Plaza A, et al. Evaluation of the effiacy of two mouth rinses formulated for the relief of xerostomia of diverse origin in adult subjects. Gerodontology 2012;29:e110312.  Back to cited text no. 19
Shetty PJ, Hegde V, Gomes L. Anti-candidal effiacy of denture cleansing tablet, triphala, Aloe vera, and cashew leaf on complete dentures of institutionalized elderly. J Ayurveda Integr Med 2014;5:114.  Back to cited text no. 20
[PUBMED]  [Full text]  
Bhat G, Kudva P, Dodwad V. Aloe vera: Nature's soothing healer to periodontal disease. J Indian Soc Periodontol 2011;15:205-9.  Back to cited text no. 21
[PUBMED]  [Full text]  
Sudarshan R, Annigeri RG, Sree Vijayabala G. Aloe vera in the treatment for oral submucous fibrosis – A preliminary study. J Oral Pathol Med 2012;41:755-61.  Back to cited text no. 22
Patil S, Halgatti V, Maheshwari S, Santosh BS. Comparative study of the efficacy of herbal antioxdants oxitard and Aloe vera in the treatment of oral submucous fibrosis. J Clin Exp Dent 2014;6:e265-70.  Back to cited text no. 23
Patil S, Al-Zarea BK, Maheshwari S, Sahu R. Comparative evaluation of natural antioxidants spirulina and Aloe vera for the treatment of oral submucous fibrosis. J Oral Biol Craniofac Res 2015;5:11-5.  Back to cited text no. 24
Alam S, Ali I, Giri KY, Gokkulakrishnan S, Natu SS, Faisal M, et al. Efficacy of Aloe vera gel as an adjuvant treatment of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116:717-24.  Back to cited text no. 25
Anuradha A, Patil B, Asha VR. Evaluation of efficacy of Aloe vera in the treatment of oral submucous fibrosis – A clinical study. J Oral Pathol Med 2017;46:50-5.  Back to cited text no. 26


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