Aloe vera is as Good as Conventional Mouthwash in Protecting from Radiation Induced Mouth Ulcers

Lungs, mouth, throat, nose and other sinuses are generally lined with a gelatinous and sticky material known as mucus. Mucus is secreted by mucous membrane. The lining that particularly covers the mouth region is called oral mucosa. Mucus helps us in various ways:

Preventing lungs, throat, mouth, nasal and sinus passages from drying. If the membranes of these parts dried out, then they can’t function properly.

It has an antibiotic and enzymatic activity that kill or neutralize the harmful bacteria or pathogen.

It also has anti-allergic properties i.e. prevents from allergy by trapping the allergens (allergy causing agents).

According to researchers, our body secretes about 1.5 liters mucus/day. It is found that when a person is sick or having any allergic problem then the consistency of mucus changes. For example, during cold, the mucus becomes thicker and sticky.

Mucositis is a disease that is caused by the rapid damaging of the mucosal lining of the alimentary canal. The main cause of this disease is the cancer treatment in which mucosal membrane is exposed to chemotherapy and number of radiations, which will break down the mucosal tissue and make it pronounced for ulceration and infection.

Oral mucosa is the most sensitive part as it directly affected by chemotherapy and radiations and is a most common part for mucositis.

Due to mucositis, patients have to suffer from many discomforts like pain, weight loss, the problem in swallowing also affect the treatment of the tumor. It can also lead to candidiasis.

Aloe vera gel can be used to cure mucositis. This is due to its anti-inflammatory, antiproliferative and analgesic properties. The nutritional profile of aloe vera gel is rich in lectin, polysaccharides, superoxide dismutase, vitamin C and E and minerals.

What happened in the study?

The study was conducted in head and neck cancer patients to compare the efficiency of aloe vera mouthwash with benzydamine mouthwash in preventing the radiation induced mucositis.

In the study, aloe vera mouth wash or benzydamine mouthwash was given randomly to 26 eligible head and neck cancer patient who was going to have their radiation therapy.

WHO grading system was used to measure the mucositis severity.

The goal of the study is to determine the grades of mucositis severity at different intervals between the two random groups.

What were the results of the study?

In the result, we find that the grades for mucositis severity at different intervals between the two random groups are similar (for both aloe vera mouthwash and benzydamine mouthwash) i.e.

In the initial state: grades are equally distributed between both groups i.e. there is no distributional difference.

The interval between radiation therapy and the onset of mucositis: similar grades for both the group (For aloe vera 15.69±7.77 days and for benzydamine 15.85±12.96 days).

The interval between starting of radiation therapy and maximum level of mucositis severity: similar grades for both the groups (for aloe vera 23.38±10.75 days and for benzydamine 23.54±15.45 days).

After mucositis severity: also similar for both the groups.

Therefore both the aloe vera and benzydamine mouthwash have similar efficiency to prevent mucositis. Thus, for the patients suffering from head and neck cancers, aloe vera mouthwash is an alternative agent to prevent radiation induced mucositis.

In nutshell, the result shows that aloe vera can be efficiently used in the treatment of mucositis as it has no toxic effect; also it is a natural product rather than any chemical derivative.

How does this occur?

Aloe vera is an efficient mouthwash to cure the mucositis. This efficiency of aloe vera is mainly due to its anti-inflammatory, antiproliferative and analgesic property. Aloe vera also exhibits antiviral and anticancer property. Several experiments on animals show that aloe vera also provide protection from sun burn or U.V. damages.

The above properties of aloe vera are the result of cyclooxygenase-2 suppression, high antioxidant and immunomodulatory mechanism of it.

The proper reason for the anti-inflammatory property of aloe vera is yet not known but it is considered that is due to the inhibition of cyclooxygenase, an enzyme which induces inflammation (i.e. cyclooxygenase-2 suppression mechanism).

Aloe vera also exerts wound healing capacity, ulcers treatment, and mucous membrane protection. Wound healing capacity is exhibited by reducing vasoconstriction and aggregation of platelet at the injured site. This will further enhance the oxygenation of the wound and scavenging free radical activity.

By inhibiting the collagenase (collagen breaking enzyme, collagen is the most abundant structural protein found in the human body) and metalloproteinase (an enzyme having the metal ion which catalyzes the breakdown of proteins), collagen formation activity is increased, which heal the wound. It also activates immune cells.

Thus in this way, the wound is healed by it.

Mannose-6-phosphate serves as the important constituent of aloe vera. This helps in the fibroblast proliferation and collagen proliferation. Some researchers consider mannose-6-phosphate as the key enzyme for healing.

In the immunomodulatory mechanism, aloe vera increases the production of antibodies and growth factors which further increases its wound healing and anti- inflammatory property.

Antioxidant substances in aloe vera also help to eliminate the free radical production and show healing properties.

Presence of antraquinones such as barbaloin and iso-barbaloin in aloe vera confers its antibacterial action. Polysaccharides in Aleo vera exhibit the antifungal property.

What does this mean?

This implies that the various properties (like anti-inflammatory, antibacterial, healing, immunomodulation, and antioxidant) of aloe vera helps not only to prevent mucositis but also prevent from other diseases like candidiasis. This also balances the nutritional profile of the patient.

As the efficiency of aloe vera mouthwash and benzydamine mouthwash have no significant difference, so aloe vera mouthwash should be preferred for the treatment of radiation induced mucositis.