Curcumin shows surprising efficacy in various oral treatment

Anisha Hall Hoppe, Dental Tribune International

Thu. 6. June 2024

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BARI, Italy: An increasing number of products are appearing on the market aimed at replacing toothpastes and mouthrinses containing synthetic constituents with less-processed alternatives. One of these ingredients in alternative oral care products is curcumin, and researchers in Italy have recently conducted a systematic review of studies investigating whether it is able to provide the same control of plaque and gingivitis. They determined that, not only did the curcumin-based products result in fewer side effects, but the results were similar to that of 0.2% chlorhexidine and had the added benefit of nearly no toxicity.

A power plant

Derived from the turmeric plant, curcumin is a polyphenol with well-documented anti-inflammatory, antioxidant, antibacterial and neuroprotective properties that are beneficial in managing the chronic inflammation and oxidative stress characteristic of periodontal disease. Curcumin has been found to inhibit the growth of common oral pathogens such as Streptococcus mutans and Porphyromonas gingivalis. Some of the studies included in the review showed that curcumin-based mouthwashes and gels effectively reduce gingival inflammation and plaque, making them viable alternatives to products containing chlorhexidine, which can cause adverse effects such as tooth staining and altered taste sensation.

Use in cancer treatment and pain management

The systematic review also highlighted curcumin’s role in oral cancer prevention and treatment. Its antioxidant properties help in neutralising free radicals, reducing oxidative stress, which is a known factor in carcinogenesis. Curcumin induces death of cancer cells and inhibits tumour growth, making it a potential adjunct in oral cancer therapy. Some of the clinical studies included demonstrated that curcumin can enhance the effects of conventional chemotherapeutic agents while minimising their side effects.

Another significant area of interest is curcumin’s effect on oral mucositis, a common complication of cancer treatment. Curcumin’s anti-inflammatory and wound healing properties help in reducing the severity of mucositis and promote faster healing of oral ulcers in some cases. Topical application of curcumin-based formulations has shown promising results in alleviating pain and inflammation associated with mucositis.

For non-cancerous ulcers, one study noted no difference between a curcumin gel treatment and a triamcinolone acetonide gel, as both patient groups had reduced pain and number and duration of ulcers.

As far as cancerous lesions, according to the authors, “Studies conducted recently have demonstrated the ability of natural compounds, such as curcumin and green tea, to lower the chance of precancerous lesions progressing.” One study cited showed that patients with precancerous lesions showed a significant improvement in their pain and the size of their lesion when taking curcumin. Additionally, serum and salivary markers of oxidative stress were reduced.

These same anti-inflammatory effects can help in reducing pain and inflammation associated with conditions like pulpitis and periapical periodontitis. Curcumin’s ability to modulate pain pathways and its synergistic effect with analgesics make it a valuable adjunct in pain management protocols.

Limitations of this “wonder plant”

Despite its promising therapeutic potential, curcumin’s clinical application is limited by its poor bioavailability. Curcumin is poorly soluble in water and is rapidly metabolised and eliminated from the body. Strategies to enhance its bioavailability, such as the use of nanoparticle forms of curcumin, lipo-soluble substances such as olive oil and compounds like piperine, have shown to improve its absorption and efficacy.

“Curcumin, lycopene, and piperine together have shown promise in treating precancerous diseases, offering chemopreventive options for oral cancer and enhancing the quality of life of patients,” the authors wrote. Although the cited research identified curcumin as useful for chemoprevention of head and neck squamous cell carcinoma, its poor bioavailability was problematic. Thus, a chewing gum formulation was developed with the aim of improving mucosal absorption, and it demonstrated that bioavailability increased with direct contact with the gingivae. The researchers noted these discoveries were a solid foundation for further research into “more targeted and less invasive potential therapeutic approaches”.

The most stressful side effect for patients is the potential for mouth and tooth staining from prolonged or high-dose use. The researchers suggested the use of a white metabolite of curcumin, tetrahydrocurcumin.

Playing it safe

Curcumin’s negligible toxicity makes it a safe alternative for long-term use in dental care. Unlike synthetic chemicals, natural curcumin does not cause significant adverse effects, making it suitable for a wide range of patients, including those with chronic conditions and the elderly. Its natural origin also aligns with the growing trend towards the use of natural and holistic approaches in healthcare.

Clinicians who want to use curcumin should not only strive to learn more about it medically and its implications aesthetically, but should also be prepared to test their patients to ensure no allergies to curcumin are present.

The study, titled “The role of curcumin in oral health and diseases: A systematic review”, was published online on 28 May 2024 in Antioxidants.

Editorial note: