|Year : 2014 | Volume
| Issue : 1 | Page : 5-9
The role of Aloe vera in various fields of medicine and dentistry
Andey Venkata Subhash1, S. Suneela1, Ch. Anuradha1, S. N. Bhavani2, M. Srinivas Minor Babu3
1 Department of Oral & Maxillofacial Pathology, Sree Sai Dental College, Srikakulam, Andhra Pradesh, India
2 Department of Oral & Maxillofacial Pathology, S.V.S Dental College, Mahaboobnagar, Andhra Pradesh, India
3 Department of Pedodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
|Date of Web Publication||15-May-2014|
Andey Venkata Subhash
Department of Oral & Maxillofacial Pathology, Sree Sai Dental College, Srikakulam, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Aloe vera is a cactus like plant that actually is part of the lily family. There are more than 300 varieties of the Aloe plant, but the Aloe barbadensis variety exhibits the best medicinal properties. It has strong antiseptic, antibacterial, fungicidal and virucidal properties. It promotes cell growth and is neurologically calming and acts as a detoxifying agent. Others provide nutritional support and some increase the regenerative potential of tissues while others act with anti-inflammatory responses. This article reviews the uses of the plant in different fields of medicine and dentistry.
Keywords: Aloe vera , diabetes, gingivitis, healing, inflammation
|How to cite this article:|
Subhash AV, Suneela S, Anuradha C, Bhavani SN, Minor Babu MS. The role of Aloe vera in various fields of medicine and dentistry. J Orofac Sci 2014;6:5-9
|How to cite this URL:|
Subhash AV, Suneela S, Anuradha C, Bhavani SN, Minor Babu MS. The role of Aloe vera in various fields of medicine and dentistry. J Orofac Sci [serial online] 2014 [cited 2017 Mar 23];6:5-9. Available from: http://www.jofs.in/text.asp?2014/6/1/5/132564
| Introduction|| |
Aloe vera is a tropical or sub-tropical plant of genus Aloe, species Barbadensis belonging to the family Liliaceace. There are about 240 species of Aloe. It is succulent, perennial, evergreen having lance shaped leaves which are very hard with jagged edges and sharp points containing a viscous but an essentially clear gel. , It is known as the "lily of the desert" and is considered the "plant of immortality."
It is native to Africa but is now widespread. It is a bitter herb with a wide range of medicinal properties. It contains over 75 compounds, many of which are biologically active. A. vera has been used medicinally for thousands of years.  A. vera has been shown to enhance defensive function and it has a variety of components to combat in dental diseases.
| History|| |
In 2200 B.C., it has been mentioned on Sumerian clay tablets. Ebers Papyrus in 1550 B.C. stated that 12 recipes for mixing Aloe with other agents were used to treat human disorders in Egyptian queens Cleopatra and Nefertiti. Both gave importance to A. vera as being an important contributor to their beauty.  It was extensively traded in the Near East and Asia in 400 B.C. In 333 B.C. the Island of Socotra was captured by Alexander the great because of its Aloe supplies. Later in 68 A.D. Dioscorides wrote a detailed description of A. vera and all of its uses. In 200 A.D. A. vera became an important part of Roman medicine and became extremely popular in Europe in the centuries to come. In 1500 A.D. it was introduced to the new world by the conquistadors. In 1655 A.D. John Goodyew mentioned about A. vera in his book "Dioscorides Medical treatise De Materia Medic."
In 1934, A. vera was published in the modern medical paper. It describes how the whole leaf was used to treat radiation dermatitis. Many papers were published in the 20 th century describing a wide range of medicinal properties [Table 1]. Reports have mainly focused on the anti-diabetic, anticancer and antimicrobial properties of the whole leaf, gel, or juice of the plant.  Many species of Aloe have been studied.
| Method of obtaining gel|| |
The cut leaves are washed carefully under tap water then soaked in suitable bactericide and fungicide such as microphene for 5 to 10 min and then the leaves are washed with sterile water and dried with a cloth so as not to leave any lint on the plant. Then the gel is separated from the leaf by peeling away the outer green cortex of the leaf carefully. Finally, the separated gel matrix is prepared for solution treatment by homogenizing it to break up the interstitial fibers running through it.
| Stabilization of the prepared gel|| |
The first step in stabilizing gel is to add catalytic proportions of a non-toxic oxidant in necessary amounts just before the gel is brought to a temperature within a range from about 350c-800c. The non-toxic oxidant is added by stirring and heating for about 30 min until the solution assumes a lighter appearance indicating that oxidation is complete. The preferred material for catalytic oxidation is hydrogen peroxide, which is non-toxic, readily available and relatively inexpensive.
| Products|| |
Gel and latex
- Gel: Leaf pulp or mucilage obtained from the parenchymal tissue.
- Latex: Bitter, yellow substance obtained from pericyclic tubules just beneath the outer skin of the leaves (otherwise called "A. vera").
Route of administration
As an external application, it is currently available in the market in the form of gels, extracts, hair oils, deodorant sticks, face powders and tooth pastes. Among all of these external uses, the most widely and commonly used form is A. vera gel. As an ingestible natural medicine, A. vera can be taken in the form of juice, capsules, powders, granules, sap, yoghurt, desserts, herbal tea and tablets.
| USES OF A. VERA|| |
The comparative antimicrobial activities of the gel and leaf of A. vera were tested against Staphylococcus aureus, Pseudomonas aeruginosa, Trichophyton mentagraphytes, Trichophyton schoeleinii, Microsporium canis and Candida albicans. Ethanol was used for the extraction of the leaf after obtaining the gel from it. Antimicrobial effect was measured by the appearance of zones of inhibition.
Studies using A. vera tooth pastes have shown that A. vera tooth gel and the toothpastes were equally effective against C. albicans, Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis, Prevotella intermedia and Peptostreptococcus anaerobicus. A. vera tooth gel demonstrated enhanced antibacterial effect against S. mutans. ,, The anthraquinone inactivates various viruses such as herpes simplex, varicella zoster and influenza.
Role in wound healing
When Aloe is combined with other antimicrobials, a wound heals faster than with the anti-microbial alone, possibly due to its moisturizing capability. , Glucomannan, a mannose rich polysaccharide and gibberellins, a growth hormone, interacts with growth factor receptors on the fibroblast, thereby stimulating its activity and proliferation which forms increased collagen synthesis after topical and oral A. vera administration. This causes accelerated wound contraction leading to increased breaking strength of resulting scar tissue.
It may have a direct inhibitory effect on microbes and also selectively modulates cells of the immune system. , A. vera contains antiseptic agents such as lupeol, salicylic acid, urea nitrogen, cinnamonic acid, phenols and sulfur. They all have inhibitory action on fungi, bacteria and viruses. Cellular cytotoxicity: Human embryonic kidney cells were utilized to determine the effectiveness of A. vera gel on cellular longevity. The cellular death rate was found to be reduced by 2/3 rd when cultured with A. vera gel.
Dry socket (Third molar extraction)
Acemannan hydro gel (from clear inner gel of A. vera) is used in the treatment procedure. In normal treatment 7.6% develop AO, with Acemannan 1.1% develop AO. ,,
Davis evaluated the topical anti-inflammatory activity of A. vera using croton oil induced edema assay and concluded that small amounts of A. vera given topically will inhibit inflammation. ,, A. vera inhibits the cyclogenase pathway and reduces prostaglandin E2 production from arachidonic acid. Recently, the novel anti-inflammatory compound called C-glucosylchromone was isolated from gel extracts.
Aloe-emodin induces apoptosis in T24 human bladder cancer cells.
Investigated anticancer effect of AE (1,8-dihydroy-3-[hydroxymethyl]-anthraquione) in the T24 human bladder cancer cell line by studying apoptosis regulation. Aloe-emodin is purified from A. vera leaves, has been reported to have antitumor activity. ,,,, An induction of glutathione S-transferase and an inhibition of the tumor promoting effects of phorbol myristic acetate has also been reported which suggest a possible benefit of using Aloe gel in cancer treatment.
Gingivitis and periodontitis
A. vera tooth gel provides preventive and curative measures against gingivitis and periodontitis. Applications directly to the site of periodontal surgery along with periodontal dressing or to gum tissues when they have been traumatized with a tooth brush dentifrice abrasion, sharp foods, dental floss and toothpick injuries have shown improved healing properties.  A. vera gel at optimum concentrations in toothpastes or mouthwashes could be useful for prevention of dental caries and periodontal diseases.
A. vera when added to toothpaste has bleaching property for the teeth. Denture patients with sore ridges and ill-fitting dentures can benefit as fungus and bacterial decontamination reduce the inflammatory irritations. Saponins which contain glycoside, are soapy substances that have both cleansing and antiseptic properties. 
Oral lichen planus
Hayes described first case of treatment of oral lichen planus using A. vera juice and A. vera gel for 3 months. Choonhakarn et al. carried out a double blind study to explore the efficacy of A. vera gel in management of oral lichen planus and found that A. vera gel is more effective than placebo. As indicated by other studies, A. vera can be used in dosages of two ounces A. vera juice 3 times a day for 3 months and for local application A. vera gel can be used. ,,
Irritable bowel syndrome (IBS)
Normal: Bacteria help breakdown food so it can be absorbed but also produces a controlled level of toxins. IBS: toxin levels are too high either from bad diet or stress and so toxins can be absorbed as well and cause insufficient absorption of other nutrients leading to the nutrient deficiency which leads to lethargy and exhaustion and affects colon leading to diarrhea and indigestion and lower back pain. Daily A. vera Juice helps facilitate this irrigation by breaking up residue naturally and also detoxifies the colon so can actually enjoy the wider range of food. It works gradually and gently, so no real side-effects and blood conditions are improved due to detoxification. 
Aloe and rheumatoid arthritis
The pressure of gravity causes physical damage to the joints and surrounding tissues and the risk increases with age, obesity and repetitive joint use. Rheumatoid: Immune system mistakenly attacks the lining inside a joint, cause unknown but thought to be genetic. Pain caused by nerve damage and the pressure in the swollen joints gives a red color due to increased blood supply to the area. Traditional: do help with pain but do not repair damage and can also cause thinning of skin and osteoporosis.
relieves pain and helps disperse damaged tissue because it works as an immune system stimulant and anti-inflammatory and also speeds up cell growth. Cytokines are the messengers of the immune system that activate the neutrophils and lymphocytes to attack their targets. They are stimulated by the polysaccharide of Aloe. Sometimes works immediately whereas others take longtime or degree of success is not of much benefit. ,
Moisturizing and anti-aging effect
A. vera has rejuvenating action. The mode of action of polysaccharide is that they act as moisturizers, stimulates the fibroblasts to replicate faster and smoothens skin. Fibroblasts produce collagen and elastin fibers, so the skin becomes more elastic and less wrinkled. Its moisturizing effects have also been studied in the treatment of dry skin associated with occupational exposure. The study concluded that A. vera gel gloves improved the skin integrity, decreased appearance of fine wrinkles and decreased erythema. 
Aloe and diabetics
Characterized by hyperglycemia and alterations of glucose and lipid metabolism. It leads to cell damage and elevation of reactive oxygen species. A. vera helps in the stimulation of insulin secretion, thereby decrease blood glucose levels. It decreases cholesterol, triglycerides, phospholipids and free fatty acids from increased clearance and decreased transporters. ,
Shows increased healing effects on 2 nd degree burns. Vessels return to normal size quicker than with untreated burns. ,, It reduces the production and release of skin keratinocyte-derived immunosuppressive cytokines such as interleukin-10 and hence prevents ultraviolet-induced suppression of delayed type hypersensitivity.
| Contraindications|| |
Side-effects may be categorized into topical and systemic routes as follows.
Redness, burning and stinging sensation. Allergic reactions are mostly due to anthraquinones, such as aloin and barbalion. It is best to apply it on a small area first to test for possible reaction.
Abdominal cramps, diarrhea, red urine, hepatitis, dependency of worsening of constipation. Prolonged use has been reported to increase the risk of colorectal cancer. Laxative effect may cause electrolyte imbalances (low potassium levels). 
| Conclusion|| |
A. vera considered the "plant of immortality" has been used medically for thousands of years. Aloe is thus a powerful nutritional supplement and antioxidant. It also protects and promotes wound healing. A. vera, a promising herb with its various clinical applications in dentistry, more clinical research should be undertaken and hence that it can establish itself in this field and mankind can be benefitted with its wide range of properties.
| References|| |
|1.||Surjushe A, Vasani R, Saple DG. Aloe vera: A short review. Indian J Dermatol 2008;53:163-6. |
|2.||Atherton P. Aloe vera revisited. Br J Phytother 1998;4:76-83. |
|3.||Kumar KP, Bhowmik D, Chiranjib L, Biswajit M. Aloe vera: A potential herb and its medicinal importance. J Chem Pharm Res 2010;2:21-9. |
|4.||Sikarwar MS, Patil MB, Shalini S, Vishnu B. Aloe vera: Plant of immortality. Int J Pharma Sci Res 2010;1:7-10. |
|5.||Wynn RL. Aloe vera gel: Update for dentistry. Pharmacol Today 2005;53:6-9. Gen Dent. 2005;53:6-9 |
|6.||Smitasingh, Jindal R, Singh S. Aloe Vera: Boon to Dentistry. Indian Dent Res Rev 2010;4:138-41. |
|7.||Ro JY, Lee BC, Kim JY, Chung YJ, Chung MH, Lee SK, et al. Inhibitory mechanism of aloe single component (alprogen) on mediator release in guinea pig lung mast cells activated with specific antigen-antibody reactions. J Pharmacol Exp Ther 2000;292:114-21. |
|8.||Agarry OO, Olaleye MT, Bella-Michael CO. Comparative antimicrobial activities of Aloe vera gel and leaf. Afr J Biotechnol 2005;4:1413-4. |
|9.||'t Hart LA, Nibbering PH, van den Barselaar MT, van Dijk H, van den Berg AJ, Labadie RP. Effects of low molecular constituents from Aloe vera gel on oxidative metabolism and cytotoxic and bactericidal activities of human neutrophils. Int J Immunopharmacol 1990;12:427-34. |
|10.||Tan BK, Vanitha J. Immunomodulatory and antimicrobial effects of some traditional Chinese medicinal herbs: A review. Curr Med Chem 2004;11:1423-30. |
|11.||Chithra P, Sajithlal GB, Chandrakasan G. Influence of Aloe vera on collagen characteristics in healing dermal wounds in rats. Mol Cell Biochem 1998;181:71-6. |
|12.||Chithra P, Sajithlal GB, Chandrakasan G. Influence of Aloe vera on the glycosaminoglycans in the matrix of healing dermal wounds in rats. J Ethnopharmacol 1998;59:179-86. |
|13.||Garnick JJ, Singh B, Winkley G. Effectiveness of a medicament containing silicon dioxide, aloe, and allantoin on aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:550-6. |
|14.||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. |
|15.||Davis RH. Aloe vera: A Scientific Approach. New York: Vantage Press; 1989.1997 |
|16.||Heggers JP, Kucukcelebi A, Listengarten D, Stabenau J, Ko F, Broemeling LD, et al. Beneficial effect of Aloe on wound healing in an excisional wound model. J Altern Complement Med 1996;2:271-7. |
|17.||Joeng HY, Kim JH, Hwang SJ, Rhee DK. Anticancer effects of aloe on sarcoma 180 in ICR mouse and on human cancer cell lines. Coll Pharmacol 1994;38:311-21. |
|18.||Kim HS, Lee BM. Inhibition of benzo[a]pyrene-DNA adduct formation by Aloe barbadensis Miller. Carcinogenesis 1997;18:771-6. |
|19.||Kim HS, Kacew S, Lee BM. In vitro chemopreventive effects of plant polysaccharides (Aloe barbadensis miller, Lentinus edodes, Ganoderma lucidum and Coriolus versicolor). Carcinogenesis 1999;20:1637-40. |
|20.||Kuo PL, Lin TC, Lin CC. The antiproliferative activity of aloe-emodin is through p53-dependent and p21-dependent apoptotic pathway in human hepatoma cell lines. Life Sci 2002;71:1879-92. |
|21.||Pecere T, Gazzola MV, Mucignat C, Parolin C, Vecchia FD, Cavaggioni A, et al. Aloe-emodin is a new type of anticancer agent with selective activity against neuroectodermal tumors. Cancer Res 2000;60:2800-4. |
|22.||Wynn RL. Aloe vera gel: Update for dentistry. Gen Dent 2005;53:6-9. |
|23.||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. |
|24.||Hayes SM. Lichen planus - Report of successful treatment with Aloe vera. Gen Dent 1999;47:268-72. |
|25.||Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. The efficacy of Aloe vera gel in the treatment of oral lichen planus: A randomized controlled trial. Br J Dermatol 2008;158:573-7. |
|26.||Thongprasom K, Carrozzo M, Furness S, Lodi G. Interventions for treating oral lichen planus. Cochrane Database Syst Rev 2011; Jul 6;(7):CD001168. |
|27.||Aloe vera and digestion, irritable bowel syndrome and arthritis. Available from: http://www.positivehealth.com/Permit/Articles/Aloe%20Vera/aloinf20.htm. |
|28.||West DP, Zhu YF. Evaluation of Aloe vera gel gloves in the treatment of dry skin associated with occupational exposure. Am J Infect Control 2003;31:40-2. |
|29.||Aloevera:Mythormedicine? http://www.positivehealth.com/Permit/Articles/Aloe%20Vera/atherton.htm. |
|30.||Rajasekaran S, Ravi K, Sivagnanam K, Subramanian S. Beneficial effects of Aloe vera leaf gel extract on lipid profile status in rats with streptozotocin diabetes. Clin Exp Pharmacol Physiol 2006;33:232-7. |
|31.||Roberts DB, Travis EL. Acemannan-containing wound dressing gel reduces radiation-induced skin reactions in C3H mice. Int J Radiat Oncol Biol Phys 1995;32:1047-52. |
|32.||Visuthikosol V, Chowchuen B, Sukwanarat Y, Sriurairatana S, Boonpucknavig V. Effect of Aloe vera gel to healing of burn wound a clinical and histologic study. J Med Assoc Thai 1995;78:403-9. |
|33.||Moore TE. The M and M's of Aloe vera - is it for dentistry? J Okla Dent Assoc 2001;91:30-1, 36. |