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Vol 2 | Issue 4 | Oct – Dec 2023                                                                                Indian J Pharm Drug Studies | 156  

Review Article 

Application of Alternative Medicine as a Curative Therapy of Oral Mucosal 

Lesions: A Comprehensive Review 

Annayat Ghuman1, Mehar Ghuman2, Pankaj Gupta3 

From, 1BDS Final Prof, Shaheed Kartar Singh Dental College, 2PG Resident Pathology, DMC Ludhiana, 3Private Dental 

Practitioner at Elite Dental Clinic, Udhampur, India. 

ABSTRACT 

The term Alternative Medicine is used to denote a form of medicine that falls outside the mainstream of western medicine. These 

medicines exist in all cultures to some degrees and terms such as traditional medicines, indigenous medicines, holistic medicines, 

folk medicines and oriental medicines. When such medicines and related therapies are applied in the dental field, the term holistic 

dentistry is used. Alternative medicines or therapy encompasses a variety of disciplines such as acupuncture, chiropractic 

treatment, guided imagery, yoga, biofeedback, hypnosis, aromatherapy, herbal remedies, relaxation, massage etc. There is common 

patient belief that these therapies are safe to use. However, there is lack of sufficient scientifically proven data regarding their 

safety. The emphasis with most alternative therapies is based upon the natural healing capability of the body. This article emphasis 

the use of various alternative therapies, their advantages, mechanism of actions, side effects and implications in dentistry. 

Key words: Alternative Medicine, Anti-oxidant, Herbal Medicines, Holistic, Oral Mucosal Lesions. 

lternative therapy is a generalized term applied to 

all methods of treating a specific disease or 

condition. This therapy aims at co-operating with 

the natural forces and various defensive mechanism of the 

body against pathogens. World health organization (WHO) 

has identified more than 150 systems of alternative 

medicines. Most practiced ones are :Ayurveda, Homeopathy, 

Naturopathy, Unani medicine, Magneto therapy, Aroma 

therapy, Acupuncture, Yoga, Biofeedback Training, Mud 

Therapy, Massage therapy etc. 

Complementary and alternative medicine (CAM), according 

to National Center for Complementary and Alternative 

Medicine (NCCAM), represents a group of diverse medical 

and health care systems, practices, and products that are not 

presently considered to be part of the conventional medicine.  

Access this article online 

Received – 25th Nov 2023 

Initial Review – 15th Dec 2023 

Accepted – 28th Dec 2023 
 

Quick Response Code 

Complementary medicine is the one used together with 

conventional medicine.  Example: Using aromatherapy to 

help reduce patient’s discomfort following surgery.  

Alternative medicine is the one used in place of conventional 

medicine. Example: Using a special diet to treat cancer 

instead of undergoing surgery, radiation, or chemotherapy 

that has been recommended by a conventional doctor.  

NCCAM classifies CAM therapies into five categories [1,2]. 

1. Alternative medical systems: These systems are built as 

a result of various theories and consequently practice and 

expertise. They are evolved apart from and earlier than 

the conventional medical approach in treating various 

diseases. These systems are divided into therapies that 

fall into western culture (Homeopathic and Naturopathic 

medicine) and Non-Western cultures (Traditional 

Chinese medicine and Ayurveda) [1,2]. 

_________________________________________________ 

Correspondence to: Pankaj Gupta, MDS-Oral Medicine 

and Radiology, Shakti Nagar, Udhampur, J&K, India. 

Email: pankajmds2807@gmail.com, Tel.: +91 7006270818 

A 

mailto:pankajmds2807@gmail.com


Ghuman et al.                                                                                                              Alternative medicine in dentistry 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                                Indian J Pharm Drug Studies | 157  

2. Mind-Body Interventions: The connection between the 

mind and the body uses a variety of techniques designed 

to enhance the mind’s capacity to affect bodily function 

and symptoms. Example: Meditation, prayer and 

therapies that use creative outlets such as art, music, or 

dance [2]. 

3. Biologically based therapies: These therapies use 

natural substances such as herbs and vitamins to cure a 

disease. Example: Dietary supplements, herbal products 

and the use of other natural but as yet scientifically 

unproven therapies (Example- Using shark cartilage to 

treat cancer) [2]. 

4. Manipulative and Body-Based Methods: These 

methods are based on manipulation and/or movement of 

one or more parts of the body. Example: Chiropractic or 

osteopathic manipulation and massage [1]. 

5. Energy therapies - Energy therapies involve the use of 

energy fields. They are of two types: 

a) Bio-field therapies: The bio-field therapies are intended 

to affect energy fields that surround and penetrate the 

human body. However, the existence of such fields has 

not yet been scientifically proven. Some forms of energy 

therapy manipulate bio-fields by applying pressure 

and/or manipulating the body by placing the hands in, or 

through, these fields. Examples include qigong, Reiki 

and therapeutic touch [2] 

b) Bio-electromagnetic based therapies: Unconventional 

use of electromagnetic fields such as pulsed fields, 

magnetic fields, or alternating-current or direct-current 

fields [2]. 

The use of alternative medicine aims at prevention of a 

disease whereas traditional medicine tends to intervene once 

disease has occurred. Alternative medicines when compared 

with traditional medicine have lesser side effects and are less 

expensive, since most of them are manufactured using plant 

extracts. However, there is very little scientifically proven 

data regarding their safety when compared to traditional 

medical methods [3]. 

Alternative therapies commonly used in management of 

oral mucosal lesions. 

ALOE VERA 

The name Aloe vera derives from the Arabic word “Alloeh” 

meaning “shining bitter substance,” while “vera” in Latin 

means “true.” The botanical name of Aloe vera is Aloe 

barbadensis miller. It belongs to Liliaceae family. 

Constituents of Aloe vera 

1. Vitamins: It contains antioxidant such as A, C and E. It 

also contains vitamin B12, folic acid, and choline. 

2. Enzymes: It contains enzymes such as: Alkaline 

phosphatase, amylase, bradykinase, carboxypeptidase, 

catalase, cellulase, lipase, and peroxidase. Bradykinase 

helps to reduce excessive inflammation when applied to 

the skin topically, while others help in the breakdown of 

sugars and fats. 

3. Minerals: It contains calcium, chromium, copper, 

selenium, magnesium, manganese, potassium, sodium 

and zinc. They are essential for the proper functioning of 

various enzyme systems in different metabolic pathways. 

4. Sugars: It contains monosaccharides (glucose and 

fructose) and polysaccharides (glucomannans, 

Acemannan). 

5. Anthraquinones: It has12 anthraquinones, which are 

phenolic compounds traditionally known as laxatives. 

Aloin and emodin act as analgesics, antibacterials and 

antivirals [3]. 

6. Fatty acids: It provides 4 plant steroids; cholesterol, 

campesterol, β-sisosterol and lupeol. All these have anti-

inflammatory action and lupeolin addition possesses 

antiseptic and analgesic properties [3] 

Mechanism of action 

a) Healing properties: Glucomannan, a mannose-rich 

polysaccharide, and gibberellin, a growth hormone, 

interacts with growth factor receptors on the fibroblast, 

thereby stimulating its activity and proliferation, which in 

turn significantly increases collagen synthesis [3]. 

b) Effects on skin exposure to UV and gamma radiation: 

Topical application of aloe vera in gel form result in 

generation of metallothionein (Antioxidant) that 

scavenges hydroxyl radicals and prevents suppression of 

glutathione peroxidase and superoxide dismutase. This in 

turn decreases the production and release of IL-10 and 

thus prevents UV-induced suppression of delayed type 

hypersensitivity (Figure 1). 

c) Anti-inflammatory action: Aloe vera inhibits the COX 

pathway and reduces PGE2 production from arachidonic 

acid. 

d) Effects on the immune system: Alprogen inhibits 

calcium influx into mast cells, thereby inhibiting the 

antigen-antibody mediated release of histamine and 

leukotriene from mast cells. 

e) Antiviral and antitumor activity: These actions may be 

due to indirect or direct effects. Direct effect is due to 

anthraquinones. The anthraquinone inactivates various 



Ghuman et al.                                                                                                              Alternative medicine in dentistry 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                                Indian J Pharm Drug Studies | 158  

enveloped viruses such as herpes simplex, varicella 

zoster and influenza while indirect effect is due to 

stimulation of the immune system.3An induction of 

glutathione S-transferase and an inhibition of the tumor-

promoting effects of phorbolmyristic acetate has also 

been reported which suggest a possible benefit of using 

aloe gel in cancer chemoprevention [4]. 

Indications in oral mucosal lesions: Aloe vera may be 

indicated in the management of recurrent aphthous 

stomatitis, Lichen planus, Radiation mucositis, OSMF and 

Leukoplakia. 

a) Oral lichen planus: A randomized controlled trial study 

was conducted to check the efficacy of Aloe vera gel in 

the treatment of oral lichen planus (OLP). The authors 

concluded that Aloe vera gel is statistically more 

effective than placebo in inducing clinical and 

symptomatic improvement of OLP. Therefore, Aloe 

vera gel can be considered as a safe and alternative 

treatment for patients with OLP [5]. 

b) Oral submucous fibrosis: A study was conducted in 

2012 to compare the efficacy of antioxidants and 

aloevera in treatment of OSMF, where the subjects under 

the Aloe vera group showed a better treatment response 

compared to the antioxidants group. It reduced the 

burning sensation and also improved mouth opening [6]. 

c) Recurrent aphthous stomatitis: In a study the authors 

conducted a double-blind clinical trial to evaluate the 

efficacy of topically administered Aloevera gel on minor 

aphthous ulcers. It was concluded that 2% Aloevera oral 

gel was not only effective in decreasing the patient's pain 

score and wound size, but also decreased the wound 

healing period [7]. 

Side effects: Topical application may cause redness, 

burning, stinging sensation and rarely generalized dermatitis 

in sensitive individuals. Allergic reactions are mostly due to 

anthraquinones such as aloin. When administered orally it 

may cause abdominal cramps, diarrhea, constipation, red 

urine and hepatitis. 

 
Figure 1: Showing the possible effects of topical application of aloe vera gel on skin. 

CURCUMIN 

Curcumin (diferuloylmethane) is the chief component of the 

spice turmeric and is derived from the rhizome of the East 

Indian plant Curcuma longa.Turmeric contains a class of 

compounds known as the curcuminoids, comprised of 

curcumin, demethoxycurcumin and bisdemethoxycurcumin. 

Curcumin has anti-oxidant, antiseptic, analgesic, antimalarial 

and anti-inflammatory properties. 

1. Antioxidant Activity: Curcumin has been shown to 

inhibit lipid peroxidation using linoleate, a 

polyunsaturated fatty acid that can be oxidized to form a 

fatty acid radical. It also scavenges various reactive 

oxygen species (ROS) produced by macrophages 

(superoxide anions, hydrogen peroxide and nitrite 

radicals) [8]. It also down regulates the Nitric oxide 

synthase (iNOS) activity in macrophages, thus reducing 

the amount of ROS generated in response to oxidative 

stress [9]. 

2. Anti-inflammatory Activity: Curcumin supresses the 

activation of NF-kB, an inducible transcription factor that 

regulates the expression of a host of genes involved in 

the inflammation such as COX-2, TNF-a, Cyclin –D1, 

ICAM-1 [10]. 

Indications 

a) Recurrent aphthous stomatitis: Eight studies involving 

439 subjects were reviewed. The efficacy of curcumin 



Ghuman et al.                                                                                                              Alternative medicine in dentistry 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                                Indian J Pharm Drug Studies | 159  

was compared with 1% triamcinolone in four studies, 

glycerin vehicle in one study, placebo in one study, and 

honey in one study. Overall, these studies reported a 

good efficacy of curcumin in reducing pain and ulcers 

size in patients with RAS [11]. 

b) Pre- cancerous lesions: Curcumin has a crucial role in 

the management of precancerous conditions like lichen 

planus, oral submucous fibrosis and leukoplakia. Various 

in vitro and in vivo animal experiments activities of 

turmeric extract oil have demonstrated that symptoms of 

pain and burning sensation declined and mouth opening 

was also partially reversed [11]. 

Dosages: Doses of 500-8,000 mg of powdered turmeric per 

day have been used in human studies. Standardized extracts 

are typically used in lower amounts in the 250-2,000 mg 

range [12]. 

Adverse effects: May cause gastric irritation, stomach upset, 

nausea, diarrhea, allergic skin reaction, and anti-thrombosis 

activity interfering with blood-clot formation in some 

patients. 

ALLICIN 

The word Allicin is derived from the Latin name of the 

garlic plant, Allium sativum. 

1. Anti-microbial action: Allicin has been reported to 

inhibit the growth of gram positive, gram-negative, and 

acid-fast bacterium, including multidrug-resistant 

bacterium especially the oral bacteria by its chemical 

reaction on thiol groups of various enzymes in vitro [13]. 

It also possess some degree of immunomodulatory effect 

by increasing the activity of natural killer cell. It inhibits 

TNF-alpha -induced secretion of IL-1, IL-8, IFN-ɣ in a 

dose dependent manner. It also suppresses the expression 

of IL-8 and IL-1 [14]. 

2. Indications 

a) Recurrent apthous ulcer: Oral adhesive tablets (5 mg 

allicin): It adhere to the oral mucosa and release allicin 

slowly at the site of the ulcer in 3 to 4 hours. In this way, 

a higher drug concentration and a longer-lasting release 

period could be achieved at the affected site to increase 

the efficacy [15]. 

Side effects-Increases bleeding- should be stopped 2 weeks 

before surgery. It can irritate GI tract -should be used in 

caution in patients with digestive problem. It was also found 

to decreases Blood pressure in some patients [16]. 

GREEN TEA 

Green tea is made from un-oxidized leaves and is one of the 

less processed types of tea and therefore contains one of the 

most amounts of antioxidants and beneficial polyphenols 

mainly catechins. 

Constituents: Catechins (30 %), Caffeine, Vitamins (A, B2, 

E, Folic acid, B-carotene), Saponins, ɣ- aminobutyric acid, 

Minerals (Potassium, calcium, phosphorus, manganese) and 

Chlorophyll. 

Actions 

1. Antioxidant: It has antioxidant activity either directly by 

scavenging of reactive oxygen and nitrogen species or 

indirectly by inhibition of redox sensitive transcription 

factors, and induction of antioxidant enzymes [17]. 

2. Antitumor effect: EGCG (epigallocatechingallate) has 

shown to induce apoptotic cell death and cell cycle arrest 

in tumor cells [18]. 

3. Antimicrobial activity: Catechins constitute the most 

important antibacterial agents on methicillin resistant 

Staphylococcus aureus, Helicobacter pylori and α-

Hemolytic streptococcus [19]. 

Indications in Dentistry 

a) Oral lichen planus: Green tea, especially 

epigallocatechin-3-gallate, possesses anti-inflammatory 

and chemopreventive properties. It can inhibit antigen 

presentation, T-cell activation, proliferation and 

migration, keratinocyte apoptosis, nuclear factor-kappaB 

(NF-кB) activation and MMP-9 activity and can 

modulate the imbalance between TGF-β and interferon-γ 

signaling, all of which are involved in the pathogenesis 

of OLP [20]. 

b) Candidiasis: These results indicate that EGCG enhances 

the antifungal effect of amphotericin B or fluconazole 

against antimycotic-susceptible and resistant C. albicans. 

Combined treatment with catechin allows the use of 

lower doses of antimycotics and induces multiple 

antifungal effects [21]. 

Side effects: Drinking more than 5 cups a day is unsafe. It 

can cause side effects because of the caffeine. These side 

effects can range from mild to serious and include headache, 

nervousness, sleep problems, vomiting, diarrhea, irritability, 

irregular heartbeat, tremor, heartburn, dizziness, ringing in 



Ghuman et al.                                                                                                              Alternative medicine in dentistry 

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the ears, convulsions, and confusion [22]. It increases the 

excretion of calcium in the urine leading to osteoporosis. 

Caffeine should be limited to less than 300 mg per day (2-3 

cups) [22].  

HONEY 

Honey, a thick sweet liquid made by bees from the nectar of 

flowers, is one of the oldest known medicines. 

Properties  

a) Hygroscopic properties: This effect is based on high 

osmotic properties so it can extract water from bacterial 

cells and cause them to die. It has been shown that 

wounds infected with Staphylococcus aureus are quickly 

rendered sterile by honey 

b) Acidic pH: Honey is characteristically quite acidic, its 

pH being between 3.2 and 4.5, which is low enough to be 

inhibitory to many animal pathogens 

c) Increased lymphocyte and phagocytic activity:  Honey 

(at a concentration of 1%) stimulates monocytes in cell 

culture to release cytokines like tumour Necrosis Factor 

(TNF)-alpha, interleukin (IL)-1 and IL-6, which activate 

the immune response to infection [23].  

USES OF HONEY 

a) Recurrent apthous stomatitis: In a study, honey 

application can significantly reduce inflammation, 

accelerate healing process and increase pain free days in 

those lesions with resolution of the erythema or 

ulceration without need for steroid therapy. The mean 

healing period in RAS was 4 days which is lower than 

the previous reported studies.24In the same study, 

application of honey in the prodromal period, in one 

case, accelerated healing process with resolution of 

erythema and tingling sensation and prevented vesicular 

eruption. When it was applied after eruption of vesicles, 

in other cases, there was rapid resolution of the vesicles 

with no crust formation within 8 days [24]. 

b) Denture stomatitis: A study was conducted to evaluate 

the clinical efficacy of a new Brazilian propolis gel in the 

treatment of denture stomatitis. The results of the study 

showed that all patients treated with Brazilian propolis 

gel and Daktarin had complete clinical remission of 

palatal edema and erythema [25]. 

c) Anti-tumor effects of honey: A study had reported that 

Sangju honey (Simdanjeong, Sangju, Korea) could 

suppress cellular migration, metastasis, and cell 

proliferation in Oral squamous cell carcinoma (OSCC). 

The study results further indicated that Sangju honey 

could also induce apoptosis and suppress OSCC growth 

(Figure 2) [26]. Wang et al. studied the anti-mutagenic 

effects of different types of honey against a commonly 

encountered dietary mutagen Trp-p-1 and found that all 

honeys exhibited significant inhibition of mutagenicity 

against this compound [27]. A study done on tumour 

development and metastasis in murine tumour models 

using various honey-bee products showed an important 

role in controlling tumour growth and metastasis in 

mammary carcinoma and a methylcholanthrene-induced 

fibrosarcoma in mouse [28]. 

 
Figure 2- Proposed mechanisms underlying inhibition of oral cancer cell growth by Sangju honey. 

SPIRULINA 

Spirulina, or Arthrospira platensis, is blue - green algae 

which appear as long, thin, spiral threads. Spirulina contains 

a rich supply of protein (60-70 % dry weight), 

Carbohydrates, Iron, Vitamins (A, K and B complex), 

Carotenoids (β carotene, Zeaxanthin, Cryptoxanthin, 

Phycocyanin, Lutein, Xanthophylls. The nutrients present in 



Ghuman et al.                                                                                                              Alternative medicine in dentistry 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                                Indian J Pharm Drug Studies | 161  

Spirulina boost the immune system and enhance the body's 

ability to generate new blood cells to prevent disease and 

cancer [29]. 

Mechanism of action 

β-carotene has antioxidant and anti-inflammatory activities – 

it inhibits the production of nitric oxide and PGE2 and 

suppresses the expression of COX-2, TNF-α and IL-1. 

Phycocyanin inhibits proinflammatory cytokine formation of 

TNFα, suppresses COX-2 expression and decreases PGE2 

production [30]. 

Indications in dentistry 

a) Oral submucous fibrosis: A study was conducted on a 

group of patients with OSMF. The subjects were given 

spirulina 500 mg along with triamicolone 0.1%.  After 

the end of 3 months the subjects showed significant 

improvement in burning sensations, mouth opening and 

painful ulcerations [31]. 

b) Leukoplakia: The evaluated the chemopreventive 

activity of Spirulina fusiformis (SF) (1 g/day for 12     

mos) in reversing oral leukoplakia in pan tobacco 

chewers in Kerala, India. Complete regression of lesions 

was observed in 20 of 44 (45%) evaluable subjects 

supplemented with SF, as opposed to 3 of 43 (7%) in the 

placebo arm (p < 0.0001) [32]. 

c) Homeopathy: The term homeopathy comes from the 

Greek word homoios, meaning similar, and pathos, 

meaning suffering or sickness. The basic law of 

homeopathy is "The law of similars." The law states that 

disease represents a disturbance in the body’s ability to 

heal itself. “Remedies” are determined by noting the 

symptoms produced by large doses of a substance in a 

healthy individual and applying these substances in 

highly diluted doses to relieve the same symptoms [33]. 

d) Ignatia: It is a homeopathic medicine that is derived 

from the bean of a small tree that is native to the 

Philippine Islands and China. The tree belongs to the 

Loganiaceae family, and has long, twining, smooth 

branches. Ignatia homeopathic 30C in management of 

oral lichen planus (OLP). A Single blind randomized 

control clinical trial was done on 30 consecutive patients 

with oral lesions consistent clinically and histologically 

with erosive and/or atrophic OLP were recruited. The 

patients were randomly divided into two groups to 

receive Ignatia or placebo. They were treated for 4 

months.Mean lesion sizes and mean pain measures 

differed between control and treatment groups 

favouringIgnatia [34]. 

CONCLUSION 

The complementory and alternative medicines along with 

various other extracts from the plants together along with 

main stream of western medicines can be used as preventive 

or treatment modalities for oral mucosal and precancerous 

lesions. The dental health care workers needs to be informed 

regarding the use of herbal products that may have an impact 

the delivery of safe and effective dental treatment. In 

addition, the use of such treatments in dentistry should be 

based on evidence of effectiveness and safety as 

demonstrated in randomized clinical trials. 

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How to cite this article: Annayat Ghuman, Mehar 

Ghuman, Pankaj Gupta. Application of Alternative 

Medicine as a Curative Therapy of Oral Mucosal Lesions: 

A Comprehensive Review. Indian J Pharm Drug Studies. 

2023; 2(4):156-162. 

Funding: None                Conflict of Interest: None Stated 

 


