Even with a long list of dentifrices, rinses, antibiotics and drugs to combat gingivitis and periodontitis, the battle continues. If you are in despair for what to prescribe next, don’t worry; there may be an answer from our botany-oriented colleagues. There is a growing wave of research being done that turns to nature to help fight our war against inflammation in the oral cavity. Many of these research projects focus on the main culprit of oral inflammation – the dreaded lipopolysaccharide (LPS). LPS is the byproduct of many periodontal pathogens, and it wreaks havoc on the supporting tissues comprising the periodontium. Researchers believe that if natural agents can mediate the inflammatory reaction of the host cells, then destruction of the gingiva and alveolar bone can be slowed or halted.
Which natural agents are being studied?
One earthy remedy being investigated is a compound called farrerol. This compound is derived from the plant Rhododendron, also known as “rhodies” and the state flower of West Virginia. In China, Wang, et al. reported that farrerol was shown to lower the inflammatory response in human gingival fibroblasts after being assaulted with LPS. Interesting, right?
Another study in China by Jian, et al. focused on tormentic acid, found in the Japanese rose (Rosa rugosa). This group also found their non-pharmacological, plant-derived intervention lessened the amount of inflammatory signals in human gingival fibroblasts after stimulation with LPS.
Furthermore, Lombardo et al. in Brazil investigated green tea and cranberry components that worked in concert with cathelicidins. Cathelicidins are innate immune proteins that puncture bacterial cell walls. Interestingly, they found each substance alone did not significantly protect oral epithelial cells and fibroblasts from large inflammatory reactions when introduced to LPS. When added together, though, they were able to work together to significantly reduce the inflammatory response in these tissues.
While these inflammatory fighters are yielding good results, don’t tell your patients to chew on rose petals just yet. Bear in mind that these are in vitro studies that will have to climb up the ladder to animal models and then human trials. Once they do reach that level, there will have to be research done to determine an effective delivery method. Even though it may take a bit longer to see these natural medicaments in the clinical realm, it is a step in the right direction to lessen our dependence on pharmacological interventions for resolving oral inflammation.
~ Austin Shackelford, Arizona ’18