TURMERIC (Curcuma longa) - A TRADITIONAL MEDICINE IN THE MODERN DENTISTRY

    INTRODUCTION 

    Medicinal plants are used as a conventional treatment agent for various human diseases since ages in several parts of the globe. In rural areas of the developing countries, they still be used because the primary source of medication. concerning 80% of the folks in developing countries use ancient medicines for his or her health care.

    Turmeric has been used historically in Asian cuisines for each its flavor and color. within the Chinese and Ayurvedic medication, it's been preponderantly used as an anti-inflammatory agent and conjointly for the treatment of jaundice, menstrual difficulties, hematuria, hemorrhage, and colic. 

    It is official within the accumulation of China moreover as in alternative Asian countries such as Japan and peninsula and its usage covers a large range of health indications. 


    OVERVIEW OF TURMERIC 

    Kingdom: Plantae

    Clade: Tracheophytes

    Clade: Angiosperms

    Clade: Monocots

    Clade: Commelinids

    Order: Zingiberales

    Family: Zingiberaceae

    Genus: Curcuma

    Species: C. longa 

    Turmeric, a rhizome of herb, could be a flavoursome yellow-orange spice. Its plant is three feet tall and has lance-shaped leaves and spikes of yellow flowers that grow in a very fleshy rhizome or in underground stem. 

    An orange pulp contained within the rhizome constitutes the supply of turmeric medicative powder.
    Components of tumeric are named curcuminoids, that embody in the main curcumin (diferuloyl methane), demethoxycurcumin, and bisdemethoxycurcumin. 

    Curcumin (diferuloylmethane) could be a polyphenol derived from herb plant, usually called turmeric. 
    The active constituents of turmeric are the flavonoid curcumin (diferuloylmethane) and numerous volatile oils together with tumerone, atlantone, and zingiberone. different constituents embody sugars, proteins, and resins. 

    The turmeric plant is distinctive by each its characteristic stem root and also the leaves that extend upward from erect, thick stems arising from the foundation. herb is really a fleshy oblong tuber 2–3 in (5–10 cm) long, and shut to one in (2.54 cm) wide.

    When eaten, it colours the spit yellow and leaves a warm sensation within the mouth.

    They are about to two linear unit (61 cm), lustrous and deep green. The flowers arise from those leaves, and are a yellow color, growing in groupings of 3 to 5.

    The best-researched active constituent is curcumin, that includes zero.3-5.4% of raw turmeric. 

    Curcumin has been used extensively in ayurvedic drugs for hundreds of years, because it is nontoxic and contains a form of therapeutic properties together with antioxidant, analgesic, anti-inflammatory, antiseptic activity, and anticarcinogenic activity.

    As a natural product, turmeric (curcumin) is nontoxic and has distributed effects in numerous oral diseases. 

    About 40-85% of associate oral dose of curcumin passes through the gastrointestinal tract unchanged, with most of the absorbed flavonoid being metabolized within the viscus tissue layer and liver. 

    Due to its low rate of absorption, curcumin is usually developed with bromelain for accumulated absorption and enhanced anti-inflammatory result. 

    SELF MEDICATION IN COMMON DENTAL PROBLEMS

    Rinsing the mouth with turmeric water (boil 5 g of turmeric powder, two cloves, and 2 dried leaves of guava in two hundred g water) provides instant relief.

    Massaging the aching teeth with roast, ground turmeric eliminates pain and swelling.

    Applying the powder of burnt turmeric pieces and bishop's weed seed on teeth and cleanup them makes the gums and teeth sturdy.

    Applying a paste made of one tsp of turmeric with ½ tsp of salt and ½ tsp of mustard oil provides relief from gingivitis and periodontal disease. Rub the teeth and gums with this paste double daily. 

    MOUTHWASH

    In a study by Waghmare et al. concerning one hundred subjects were randomly chosen. 

    Both gingival index and plaque index were recorded at 0, 14, and 21 days. it absolutely was ended that chlorhexidine gluconate additionally as turmeric solution is effectively used as associate adjunct to 
    mechanical plaque management strategies in hindrance of plaque and periodontitis. 

    Turmeric solution ready by dissolving ten mg of curcumin extract in one hundred milliliter of water and 0.005% of flavoring agent flavoring with pH scale adjusted to four is found to be as effective as most generally used chlorhexidine solution,though, chlorhexidine gluconate has been found to be simpler once antiplaque property was thought-about. 

    The impact of turmeric determined is also because of its anti-inflammatory action. Reduction in total microbic count was determined in each the teams.

    Turmeric mouth wash


    ORAL LICHEN PLANUS

    The Cell mediate immunity to secondary antigenic modification in oral mucous membrane is assumed to play a significant role in its pathological process of oral lichen planus modified keratocyte surface antigens are the first target for cytotoxic cellular response. 

    Curcumin additionally been shown to own immune modulatory result involving activation of host macrophages and natural killer cells and modulation of lymphocytes mediate function.

    Steroids are the medicine of alternative within the treatment of lichen planus whether or not topical or general. 

    Their hazards and side effects and contraindications are well known .

    Vibha Singh and his Co researcher's tried to search out out herbal modalities (curcumin) for oral lichen planus with no or least side effects. 


    ANTIOXIDANT PROPERTY 

    Oxidative damage to soft oral tissues could result from exposure to the chemicals or biochemicals found in teeth-whitening products, dental restorations, tobacco and alcohol. 

    Antioxidants are the primary line of defense against free radical injury and are crucial for maintaining optimum health and well-being. 

    The need for antioxidants becomes even a lot of crucial with increased exposure to free radicals generated by pollution, roll of tobacco smoke, drugs, illness, stress and exercise. 

    Antioxidant supplementation is a wonderful way of up free protection. 

    San Miguel et al investigated specific polyphenols and turmeric derivative antioxidants in mixtures that counteracted the consequences of stressors similar to hydrogen peroxide, ethanol, and nicotine by decreasing total reactive oxygen species and increasing cell viability and DNA synthesis. 

    PITS AND FISSURE SEALANT 

    It has been found that tinted pit and fissure sealant is helpful for applying to tooth surfaces for the hindrance or reduction of tooth decay. 

    This sealer may be created from a composition comprising a polymerizable resin system containing acrylic monomer and a minimum of one colorant chosen from the cluster consisting of Annatto extract, turmeric extract, and β-Apo-8.-Carotenal.

    PERIODONTAL PROBLEM

    Topical application Applying a paste made of one tsp of turmeric with ½ tsp of salt and ½ tsp of mustard oil provides relief from gingivitis and periodontal disease. it's counseled to rub the teeth and gums with this paste twice daily.

    ROLE IN PRECANCEROUS LESION

    Its role within the treatment of varied precancerous conditions like oral submucous fibrosis, leukoplakia, and lichen planus has conjointly been studied. 

    Turmeric extract and turmeric oil have in contestible 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 conjointly determined.

    Anti cancer effect of curcumin 

    Photo credit: https://www.frontiersin.org/files/Articles/439562/fgene-10-00514-HTML/image_m/fgene-10-00514-g002.jpg (cited at 11 June 2020)



    ANTI CANCER PROPERTIES

    Curcumin has been found to possess antineoplastic activities due to its impact on a range of biological pathways concerned in mutagenesis, oncogene expression, cell cycle regulation, apoptosis, tumorigenesis, and metastasis.

    It potentiates the impact of therapy and acts as an enhancer of radiation therapy. Also, it's found to arrest cancer cells within the G2/M part of cell cycle, during which cells are additional vulnerable to cytotoxic effects of radiotherapy.

    EPIGENETICS 

    Epigenetics is that the study of genetic phenotype changes that don't involve alterations within the desoxyribonucleic acid sequence. 

    Mechanisms of epigenetics embody changes in 
    • DNA methylation
    • Histone modification 
    • Alteration within the expression of miRNAs 
    The active biological activity of curcumin at slightly low concentrations in humans may well be because of epigenetic modulation of various pathways. 

    Curcumin will provoke the programmed cell death however slow down the proliferation of neoplastic cell lines.

    Curcumin is renowned for its potent metastatic tumor activities that are consistently examined through elucidation of variety of potential mechanisms of actions 

    summary of biological activities of curcumin in epigenetic modulator(accessed on 11 June 2020)


    DENTAL PLAQUE DETECTION SYSTEM

    Caries or periodontics diseases are thought to be infectious diseases caused by bacterium present in dental plaques and it's celebrated that the removal of dental plaques is very vital for the health of oral cavities. 

    However, dental plaques don't seem to be simple to spot by the naked eye and it's troublesome to verify their attachment site and extent precisely. 

    Accordingly, dental plaques are typically stained with dental-plaque staining agents, that contain dyes, to reveal their locations so as to uncover the attached dental plaques.

    The dental-plaque detection system includes a dental-plaque staining agent, that contains at least one designated from the yellow pigment of beni-koji( it's a bright reddish purple soured rice, that acquires its color from being cultivated with the mould Monascus purpureus), turmeric extracts, and curcumin; and a light-emitting equipment, that outputs light having a wavelength among a spread of 250 to 500 nm to an object within the mouth wherever the dental-plaque staining agent is connected. 

    A yellow pigment of beni-koji and turmeric are referred to as staining agents conjointly used for alternative functions

    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.

    INFLUENCE OF HUMAN GINGIVAL FIBROBLAST 

    Several studies have additionally disclosed programmed cell death of human primary gingival fibroblast (hPGF) cells at lower doses like 1, 10, and 25 µM of curcumin however at higher doses like 50, 60, 75, and 100 µM, statically important high programmed cell death was noted. 

    They have additionally found that the effect of curcumin treated traditional human fibroblasts and microvascular endothelial cells (MVED) exploitation MTT assay and determined that lower doses of curcumin stimulated the proliferation of normal human fibroblasts and hMVED, whereas higher doses reserved it.

    According to other authors curcumin treated hPGF cells exhibited most and important programmed cell death at seventy five µM and showed decrease in cell population and shrinkage of cell size and morphologic alterations in 

    Basal cell cancer cells when treatment with 50 nM curcumin and located cell shrinkage disappearance of microvilli and look of membrane blebbing. 

    DENTAL PAIN

    Dental pain Massaging the aching teeth with roasted, ground turmeric eliminates pain and swelling

    SUBGINGIVAL IRRIGATION

    In a study conducted by Suhag et al., periodontal sites were treated on day zero (baseline) by one episode of scaling and root planing. 

    Subsequently elite sites were irrigated (triple irrigation regimen) with either saline (0.9%), chlorhexidine (0.2%), curcumin (1%), or served as nonirrigated management sites on day zero (baseline) at once following instrumentation. 

    Triple irrigation plan was perennial for succeeding five consecutive days and on days fifteen and twenty one. 

    Clinical parameters recorded were probing pocket depth (PPD), injury on probing (BOP), and redness for two hundred sites in twenty patients with chronic periodontitis. 

    The results indicated that the irrigated sites had significant improvement altogether parameters as compared with the nonirrigated sites on days 2, 3, 4, and 5. The curcumin group showed significant reduction in BOP (100%) and redness (96%) when put next with the antiseptic group and saline group on day five. 

    However, the distinction between teams wasn't vital at succeeding recall visits. Mean PPD reduction was considerably larger for the curcumin group than all different teams on all post-treatment days. 

    Thus, 1% curcumin solution will cause higher resolution of inflammatory signs than chlorhexidine and saline irrigation as a subgingival irrigant 

    RECURRENT APTHOUS STOMATITIS 

    RAS is an inflammatory condition of unknown etiology affecting the oral mucous membrane. 

    Approximately 20% of the population suffers from RAS a while in their lives. 

    The unwellness primarily involves non-keratinized mucosal surfaces and is characterised by single or multiple painful ulcers with periodic recurrence and healing. 

    The appearance of ulcers is preceded by a prodroma of localized burning or pain that lasts for around 24-48 hr.

    The peak of onset is between ten and nineteen years and will continue throughout life. 
    Reports have shown that in patients who used standard antiseptic gel, the lesion well solely when the periods of your time as previous attacks. 

    They experienced  no early reduction in pain or frequency of return. 

    The patients who used the curcumin oil reported  that ulcers started healing earlier than in previous attacks; there was conjointly early reduction in pain. 

    A follow-up for annual has shown no recurrence in these patients. 

    Photo credit: www.wikipedia.com 


    WOUND HEALING

    Habiboallah et al.15 performed a study to match the results of turmeric ghee formulation and hyaluronic acid on gingival wound-healing following surgery in hound dog dogs. 

    A significant distinction within the inflammatory and repair parameters of the healing method as regards to cases treated with Curcuma longa was determined. The results advised a positive Potential therapeutic impact on surgical wound healing, particularly improvement of periodontic treatment consequences after surgery. 


    CONCLUSION

    Turmeric is taken into account a secure, nontoxic, and effective different for several typical medication because of its distinguished therapeutic properties and multiple effects on various systems of the body.

    The benefits of turmeric include: analgesic, antibacterial drug, anti-inflammatory drug, anti-tumor, anti-allergic, antioxidant, antiseptic, antispasmodic, appetizer, astringent, cardiovascular, carminative, cholagogue, digestive, and diuretic. 

    There are several uses of turmeric in medicine. 

    The use of plants and herbs for dental care could be a quite common indigenous system of drugs and that we should embody it in our daily life. 

    However, there's insufficiency of knowledge and research during this field.

    Therefore, more analysis is needed to see the best dosage, bioavailability, and bio-efficacy of curcumin-based medication.

    Further research is required for the correct use of turmeric in medicine Its role within the treatment of cancers is incredibly promising. 

    REFERENCE 


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