Oral ulcers are one of the most prevalent oral mucosal diseases. The etiology of oral mucosal ulcers still has to be discerned as a variety of precipitating factors and causes have been implicated. Unless associated with some underlying systemic component, the condition generally takes 10 to 14 days to resolve, sometimes to recur soon. During the active disease phase, it affects eating, drinking and swallowing, thus affecting the quality of life. The treatment is generally symptomatic and is limited to the use of analgesics, antibiotics and topical application of steroids. The use of these over-the-counter drugs can sometimes lead to severe adverse effects. Herbal medicaments provide a safer and efficacious alternative to synthetic drugs. This article aims to review the most commonly used herbal medicines and investigate their efficacy in treating oral ulcers.
Review article: oral ulcers and its relevance to systemic disorders. Aliment Pharmacol Ther 2005;21(4):295–306
Various remedies for recurrent aphthous ulcer - a review. J Pharm Sci Res 2014;6(6):251–253
Aspirin burn of the oral cavity. Ann Pharmacother 1998;32(10):1107
Mucosal lesions due to oral cocaine use. Br Dent J 1996;180(12):462–464
Clinical practice. Aphthous ulceration. N Engl J Med 2006;355(2):165–172
Recurrent aphthous stomatitis. Otolaryngol Clin North Am 2011;44(1):79–88
Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg 2004;33(3):221–234
The plant kingdom as a source of anti-ulcer remedies. Phytother Res 2000;14(8):581–591
Recurrent aphthous stomatitis. An update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;81(2):141–147
The effect of extract of Punica granatum var. pleniflora for treatment of minor recurrent aphthous stomatitis. Integr Med Res 2014;3(2):83–90
Effects of berberine gelatin on recurrent aphthous stomatitis: a randomized, placebo-controlled, double-blind trial in a Chinese cohort. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115(2):212–217
Formulation development and evaluation of unit moulded herbal semisolid jelly useful in treatment of mouth ulcer. Int J Pharm Tech Res 2011;3(3):1705–1713
Mucoadhesive drug delivery systems. J Pharm Bioallied Sci 2011;3(1):89–100
Lanjekar A, Gaikwad R, Khandelwal V, Kurawar K. To evaluate efficiency of curcumin and honey in patients with recurrent aphthous stomatitis: a randomized clinical controlled trial. Int J Res Rev 2019;6(12):449–455
Novel material in the treatment of minor oral recurrent aphthous stomatitis. Int Med J 2013;20:392–394
Curcumin gel in the treatment of minor Aphthous ulcer: a randomized, placebo-controlled trial. Faslnamah-i Giyahan-i Daruyi 2012;11:1–6
Role of turmeric extract in minimising mucositis in patients receiving radiotherapy for head and neck squamous cell cancer: a randomised, placebo-controlled trial. J Laryngol Otol 2020:1-6. Doi: 10.1017/S0022215120000316
The Indian spice turmeric delays and mitigates radiation-induced oral mucositis in patients undergoing treatment for head and neck cancer: an investigational study. Integr Cancer Ther 2014;13(3):201–210
Acemannan, a polysaccharide extracted from Aloe vera, is effective in the treatment of oral aphthous ulceration. J Altern Complement Med 2013;19(5):429–434
Evaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitis. Dent Res J (Isfahan) 2012;9(4):381–385
Efficacy of aloe vera and triamcinolone acetonide 0.1% in recurrent aphthous stomatitis: a preliminary comparative study. J Indian Acad Oral Med Radiol 2019;31:45–50
Clinical efficacy of new aloe vera- and myrrh-based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: a randomized, double-blind, vehicle-controlled study. J Oral Pathol Med 2014;43(6):405–409
A controlled trial of a dissolving oral patch concerning glycyrrhiza (licorice) herbal extract for the treatment of aphthous ulcers. Gen Dent 2008;56(2):206–210
A comparison study on the effectiveness of local honey and salicylate gel for treatment of minor recurrent aphthous stomatitis. Int Med J 2013;20:770–772
Efficacy of honey in comparison to topical corticosteroid for treatment of recurrent minor aphthous ulceration: a randomized, blind, controlled, parallel, double-center clinical trial. Quintessence Int 2014;45(8):691–701
Effect of flavored (honey and tulsi) ice chips on reduction of oral mucositis among children receiving chemotherapy. Int J Pharm Sci Rev Res 2017;43(1):25–28
The effect of honey on the healing of oral ulcers (clinical study)Al– Rafidain. Dent J 2008;8(2):157–160
The effect of topical application of pure honey on radiation-induced mucositis: a randomized clinical trial. J Contemp Dent Pract 2008;9(3):40–47
Propolisbased niosomes as oromuco-adhesive films: a randomized clinical trial of a therapeutic drug delivery platform for the treatment of oral recurrent aphthous ulcers. Sci Rep 2018;8(1):18056
The effect of bee propolis on recurrent aphthous stomatitis: a pilot study. Clin Oral Investig 2007;11(2):143–147
Treatment of aphthous stomatitis with topical alchemilla vulgaris in glycerine. Clin Drug Investig 2006;26(10):567–573
Effect of herbal Echinacea on recurrent minor oral aphthous ulcer. Open Dent J 2018;12:567–571
Effectivity of guava leaves (Psidium guajava) as mouthwash for patients with aphthous ulcers. Philipp J Otolaryngol Head Neck Surg. 2013;28(2):8–13
The therapeutic effects of chamomilla tincture mouthwash on oral aphthae: a randomized clinical trial. J Clin Exp Dent 2014;6(5):e535–e538
Muco-bioadhesive containing ginger officinal e extract in the management of recurrent aphthous stomatitis: a randomized clinical study. Caspian J Intern Med 2015;6(1):3–8
Triphala: A Boon in Oral and Systemic Health. J Dent Oral Biol. 2017; 2(1): 1024. Subapriya R, Nagini S. Medicinal properties of neem leaves: A Review. Curr Med Chem Anticancer Agents 2005;5(2):149:14–6
Management of ‘Mukhapaka’ by ‘Haridradi Tail’ w.s.r. to recurrent aphthous ulcer. Int J AYUSH 2013;2(1):119–124
Dietary supplements and herbal medicine toxicities-when to anticipate them and how to manage them. Int J Emerg Med 2009;2(2):69–76
Formulation and evaluation pharmaceutical aqueous gel of powdered guava leaves for mouth ulcer treatment. Pharma Tutor 2018;6(4):32–38
Propolis buccal paste in treatment of aphthous ulceration: formulation and clinical evaluation. Asian J Pharm Clin Res. 2011;4(4):29–33
Treatment of mouth ulcer by Curcumin loaded thermoreversible mucoadhesive gel. Int J Pharm Pharm Sci 2015;7(10):399–402
Comparison of effectiveness of curcumin with triamcinolone acetonide in the gel form in treatment of minor recurrent aphthous stomatitis: a randomized clinical trial. Int J Pharm Investig 2014;4(3):138–141
Effectiveness of Indian turmeric powder with honey as complementary therapy on oral mucositis: a nursing perspective among cancer patients in Mysore. Nurs J India 2014;105(6):258–260
Effects of turmeric and curcumin on oral mucositis: a systematic review. Phytother Res 2019;33(5):1318–1329
Aloe vera leaf gel: a review update. J Ethnopharmacol 1999;68(1-3):3–37
Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49(447):823–828
Assessment of anti HSV-1 activity of aloe vera gel extract: An in vitro study. J Dent (Shiraz) 2016;17(1):49–54
Clinical efficacy of an Aloe Vera gel versus a 0.12% chlorhexidine gel in preventing traumatic ulcers in patients with fixed orthodontic appliances: a double-blind randomized clinical trial. Odontology 2020;108(3):470–478
Review of over-the-counter treatments for aphthous ulceration and results from use of a dissolving oral patch containing glycyrrhiza complex herbal extract. J Contemp Dent Pract 2008;9(3):88–98
Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: a randomized double-blinded clinical trial. Asia Pac J Clin Oncol 2017;13(2):e48–e56
Design, formulation, and evaluation of a herbal gel contains melissa, sumac, licorice, rosemary, and geranium for treatment of recurrent labial herpes infections. Dent Res J (Isfahan) 2018;15(3):191–200
Licorice and its potential beneficial effects in common oro-dental diseases. Oral Dis 2012;18(1):32–39
The efficacy of the bioadhesive patches containing licorice extract in the management of recurrent aphthous stomatitis. Phytother Res 2009;23(2):246–250
Effect of methanol and ethanol application on yield of Echinacea purpurea L. in Karaj region. J Herb Drugs 2011;2:121–128
Herbal immunostimulants for the prophylaxis and therapy of colds and influenza. Eur J Herb Med. 1997;3:22–30
Safety and efficacy profile of Echinacea purpurea to prevent common cold episodes: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med 2012;2012:841315
Anti-inflammatory effects of essential oil in Echinacea purpurea L. Pak J Pharm Sci 2013; 26(2):403–408
Healing effects of natural honey on oral minor aphthous ulcers among dental patients in Quetta. PODJ 2012;32(3):412–415
Preparative separation of polyphenols from water-soluble fraction of Chinese propolis using macroporous absorptive resin coupled with preparative high performance liquid chromatography. J Chromatogr B Analyt Technol Biomed Life Sci 2016;1012-1013:42–49
Bee products and the treatment of blister-like lesions around the mouth, skin and genitalia caused by herpes viruses-a systematic review. Complement Ther Med 2019;43:81–84
Anticough and antimicrobial activities of Psidium guajava Linn. leaf extract. J Ethnopharmacol 1999;67(2):203–212
Formulation and evaluation pharmaceutical aqueous gel of powdered Cordia dichotoma leaves with guava leaves. Am J Pharm Res. 2018;8(2):268–277
Chamomile: a herbal medicine of the past with bright future. Mol Med Rep 2010; 3(6):895–901
Clinical evaluation of fluid extract of Chamomilla recutita for oral aphthae. J Drugs Dermatol 2006;5(7):612–617
Ginger: an overview. Am Fam Physician 2007; 75(11):1689–1691
A randomized, placebo- controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthritis Cartilage 2000;8(1):9–12
Suppressive effects of eugenol and ginger oil on arthritic rats. Pharmacology 1994; 49(5):314–318
Amla - the wonder of Ayurvedic medicine. Int J Ayu Herb Med. 2012;2:828–834
Review on Neem (Azadirachta indica): thousand problem one solution. Int Res J Pharm 2011;2:97–102
