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REVIEW ARTICLE
Year : 2013  |  Volume : 4  |  Issue : 1  |  Page : 3-7  

Role of curcumin in systemic and oral health: An overview


1 Department of Oral Pathology, Dr. H.S. Judge Institute of Dental Sciences and Hospital, Punjab University, Chandigarh, India
2 Department of Periodontology, Dr. H.S. Judge Institute of Dental Sciences and Hospital, Punjab University, Chandigarh, India

Date of Web Publication20-Feb-2013

Correspondence Address:
Shaveta Sood
Department of Periodontology, Dr. H.S. Judge Institute of Dental Sciences and Hospital, Punjab University, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-9668.107253

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   Abstract 

Various modalities of treatment are available for different dental diseases, but the major drawback of these conventional drug therapies is the numerous side effects associated with their use. This has led to renewed interest in the discovery of novel anti-infective natural compounds derived from plants. Plants have been the major source of medicine since the time immemorial. Turmeric has been attributed a number of medicinal properties in the traditional system of medicine. The objective of this article is to review the efficacy of turmeric herb in maintenance of oral health, in particular, and overall health, in general. Turmeric, a rhizome of Curcuma longa, is a herb known for its medicinal properties and is a more acceptable and viable option for a common man. It has proven properties like anti-inflammatory, antioxidant, antimicrobial, hepatoprotective, immunostimulant, antiseptic, and antimutagenic. Due to these properties, it is quite useful in dentistry as well. It has a role in the treatment of periodontal diseases and oral cancers. Turmeric can also be used as a pit and fissure sealant, mouth wash, and subgingival irrigant in different preparations. It can also be used as a component in local drug delivery system in gel form.

Keywords: Antimicrobial, medicine, mouthwash, oral health, turmeric


How to cite this article:
Nagpal M, Sood S. Role of curcumin in systemic and oral health: An overview. J Nat Sc Biol Med 2013;4:3-7

How to cite this URL:
Nagpal M, Sood S. Role of curcumin in systemic and oral health: An overview. J Nat Sc Biol Med [serial online] 2013 [cited 2015 May 23];4:3-7. Available from: http://www.jnsbm.org/text.asp?2013/4/1/3/107253


   Introduction Top


Medicinal plants have been used as a traditional treatment agent for numerous human diseases since ages in many parts of the world. In rural areas of the developing countries, they continue to be used as the primary source of medicine. About 80% of the people in developing countries use traditional medicines for their health care. The frequent use and misuse of the currently used therapeutic agents has led to the evolution of resistant strains of common pathogens as well as increased incidence of adverse effects associated with their usage. Hence, the search for alternative products continues, and natural phytochemicals isolated from plants used as traditional medicines are considered as a good alternative source. As only 1% of approximately 5,00,000 plant species worldwide has been phytochemically investigated until date, there is great potential for discovering novel bioactive compounds.

Turmeric (haldi), a rhizome of Curcuma longa, is a flavourful yellow-orange spice. Its plant is 3 feet in height and has lance-shaped leaves and spikes of yellow flowers that grow in a fleshy rhizome or in underground stem. An orange pulp contained inside the rhizome constitutes the source of turmeric medicinal powder. [1] Components of tumeric are named curcuminoids, which include mainly curcumin (diferuloyl methane), demethoxycurcumin, and bisdemethoxycurcumin. Curcumin (diferuloylmethane) is a polyphenol derived from Curcuma longa plant, commonly known as turmeric. The active constituents of turmeric are the flavonoid curcumin (diferuloylmethane) and various volatile oils including tumerone, atlantone, and zingiberone. Other constituents include sugars, proteins, and resins. The best-researched active constituent is curcumin, which comprises 0.3-5.4% of raw turmeric. Curcumin has been used extensively in ayurvedic medicine for centuries, as it is nontoxic and has a variety of therapeutic properties including antioxidant, analgesic, anti-inflammatory, antiseptic activity, and anticarcinogenic activity. [2]

As a natural product, turmeric (curcumin) is nontoxic and has diversified effects in various oral diseases. About 40-85% of an oral dose of curcumin passes through the gastrointestinal tract unchanged, with most of the absorbed flavonoid being metabolized in the intestinal mucosa and liver. Due to its low rate of absorption, curcumin is often formulated with bromelain for increased absorption and enhanced anti-inflammatory effect. [3],[4]


   Applications of Curcumin Top


Therapeutic applications of turmeric

The active constituent of turmeric is known as curcumin, which has been shown to have a wide range of therapeutic effects. [5]

Antioxidant

Curcumin protects against free radical damage because it is a strong antioxidant. [6] Water- and fat-soluble extracts of turmeric and its curcumin component exhibit strong antioxidant activity, comparable to that of vitamins C and E. [7] An in vitro study measuring the effect of curcumin on endothelial heme oxygenase-1, an inducible stress protein, was conducted utilizing bovine aortic endothelial cells. Incubation (for 18 hours) with curcumin resulted in enhanced cellular resistance to oxidative damage. [8]

Anti-inflammatory

It reduces inflammation by lowering histamine levels and possibly by increasing the production of natural cortisone by the adrenal glands. [9] Oral administration of curcumin in instances of acute inflammation was found to be as effective as cortisone or phenylbutazone, and half as effective in cases of chronic inflammation. [10] Its anti-inflammatory properties may be attributed to its ability to inhibit both biosyntheis of inflammatory prostaglandins from arachidonic acid and neutrophil function during inflammatory states. [10]

Hepatoprotective

It protects the liver from a number of toxic compounds such as carbon tetrachloride (CCl4), [11],[12] galactosamine, [13] acetaminophen (paracetamol), [14] and Aspergillus aflatoxin. [15] Turmeric's hepatoprotective effect is mainly a result of its antioxidant properties as well as its ability to decrease the formation of proinflammatory cytokines. Sodium curcuminate, a salt of curcumin, also exerts choleretic effects by increasing biliary excretion of bile salts, cholesterol, and bilirubin as well as by increasing bile solubility, therefore, possibly preventing and treating cholelithiasis. Curcumin has choleretic activity that increases bile output and solubility, which may be helpful in treating gallstones. [16]

Antiplatelet aggregation

It has been shown to prevent platelets from clumping together, which in turn improves circulation. [17] Inhibition of platelet aggregation by curcumin constituents is thought to be via potentiation of prostacyclin synthesis and inhibition of thromboxane synthesis. [17]

Antimutagenic

Curcumin is antimutagenic as it potentially helps to prevent new cancers that are caused by chemotherapy or radiation therapy used to treat existing cancers. It effectively inhibits metastasis (uncontrolled spread) of melanoma (skin cancer) cells and may be especially useful in deactivating the carcinogens in cigarette smoke and chewing tobacco. [18],[19] Animal studies involving rats and mice as well as in vitro studies utilizing human cell lines have demonstrated curcumin's ability to inhibit carcinogenesis at three stages: Tumor promotion, [20] angiogenesis, [21] and tumor growth. [22] In two studies of colon and prostate cancer, curcumin inhibited cell proliferation and tumor growth. The anticarcinogenic effects of turmeric and curcumin are due to direct antioxidant and free-radical scavenging effects and their ability to indirectly increase glutathione levels, thereby aiding in hepatic detoxification of mutagens and carcinogens and in inhibiting nitrosamine formation. [23],[24]

Antimicrobial

Turmeric extract and the essential oil of Curcuma longa inhibits the growth of a variety of bacteria, parasites, and pathogenic fungi. Improvements in lesions were observed in the dermatophyte- and fungi-infected guinea pigs, as at 7 days post-turmeric application, the lesions disappeared. [25] Curcumin has also been found to have moderate activity against Plasmodium falciparum and Leishmania major. [26]

Cardiovascular effects

Turmeric's protective effects on the cardiovascular system include lowering cholesterol and triglyceride levels, decreasing susceptibility of low density lipoprotein (LDL) to lipid peroxidation, [27] and inhibiting platelet aggregation. [17] These effects have been noted even with low doses of turmeric. A study of 18 atherosclerotic rabbits administered low-dose (1.6-3.2 mg/kg body weight, daily) turmeric extract demonstrated decreased susceptibility of LDL to lipid peroxidation in addition to lower plasma cholesterol and triglyceride levels. Higher dose did not decrease lipid peroxidation of LDL, but cholesterol and triglyceride level decreases were noted, although to a lesser degree than with lower dose. Turmeric extract's effect on cholesterol levels may be due to decreased cholesterol uptake in the intestines and increase conversion of cholesterol to bile acids in the liver. [16]

Local effects

Fresh juice from the rhizome or a paste prepared from turmeric or decoction is often used as a local application as well as internally in the treatment of leprosy, snake bites, and vomiting associated with pregnancy. [28]

Gastric effects

Curcumin has a significant role in cases of gastric ulcers. An open, phase II trial was performed on 25 patients with endoscopically diagnosed gastric ulcer. Participants were provided 600 mg powdered turmeric, five times daily. After 4 weeks, ulcers had completely healed in 48% patients. The success rate increased over time, with 76% being ulcer free after 12 weeks of treatment. No significant adverse reactions or blood abnormalities were noted. [29]

Chronic anterior uveitis

Thirty-two patients with chronic anterior uveitis were provided 375 mg curcumin, three times daily for 12 weeks. Curcumin was effective in 86% patients and was as effective as corticosteroid therapy, the only available standard treatment. [30]

Dental applications of turmeric

Turmeric can be used in following ways to offer relief from dental problems.

Dental pain

Massaging the aching teeth with roasted, ground turmeric eliminates pain and swelling. [2]

Periodontal problems

Topical application
Applying a paste made from 1 tsp of turmeric with ½ tsp of salt and ½ tsp of mustard oil provides relief from gingivitis and periodontitis. It is recommended to rub the teeth and gums with this paste twice daily. [2]

Mouth wash In a study by Waghmare et al. about 100 subjects were randomly selected. Both gingival index and plaque index were recorded at 0, 14, and 21 days. It was concluded that chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control methods in prevention of plaque and gingivitis. Turmeric mouthwash prepared by dissolving 10 mg of curcumin extract in 100 ml of distilled water and 0.005% of flavouring agent peppermint oil with pH adjusted to 4 is found to be as effective as most widely used chlorhexidine mouthwash. Though chlorhexidine gluconate has been found to be more effective when antiplaque property was considered. The effect of turmeric observed may be because of its anti-inflammatory action. Reduction in total microbial count was observed in both the groups. [31]

Local drug delivery system

In a study conducted by Behal et al., 30 subjects with chronic localized or generalized periodontitis with pocket depth of 5-7 mm were enrolled in a split-mouth study design. Control sites received Scaling and Root Planing [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. [32]

Subgingival irrigant

In a study conducted by Suhag et al., periodontal sites were treated on day 0 (baseline) by a single episode of scaling and root planing. Subsequently selected sites were irrigated (triple irrigation regimen) with either saline (0.9%), chlorhexidine (0.2%), curcumin (1%), or served as nonirrigated control sites on day 0 (baseline) immediately following instrumentation. Triple irrigation regimen was repeated for the next 5 consecutive days and on days 15 and 21. Clinical parameters recorded were probing pocket depth (PPD), bleeding on probing (BOP), and redness for 200 sites in 20 patients with chronic periodontitis. The results indicated that the irrigated sites had significant improvement in all 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 compared with the chlorhexidine group and saline group on day 5. However, the difference between groups was not significant at the next recall visits. Mean PPD reduction was significantly greater for the curcumin group than all other groups on all post-treatment days. Thus, 1% curcumin solution can cause better resolution of inflammatory signs than chlorhexidine and saline irrigation as a subgingival irrigant. [33]

Pit and fissure sealant

This sealant can be produced from a composition comprising a polymerizable resin system containing acrylic monomer and at least one colorant selected from the group consisting of annatto extract, turmeric extract, and β-Apo-8′-Carotenal. [2]

Anticancer properties

Curcumin has been found to possess anticancer activities because of its effect on a variety of biological pathways involved in mutagenesis, oncogene expression, cell cycle regulation, apoptosis, tumorigenesis, and metastasis. It potentiates the effect of chemotherapy and acts as an enhancer of radiotherapy. Also, it is found to arrest carcinomatous cells in the G2/M phase of cell cycle, in which cells are more susceptible to cytotoxic effects of radiotherapy. [34]

Precancerous lesions

Its role in the treatment of various precancerous conditions like oral submucous fibrosis, leukoplakia, and lichen planus has also been studied. Turmeric extract and turmeric oil have demonstrated oncopreventive 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 also observed. [35]

Adverse effects

Generally considered safe, but may cause gastric irritation, stomach upset, nausea, diarrhoea, allergic skin reaction, and antithrombosis activity interfering with blood-clot formation.

Future challenges

One of the major concerns with developing curcumin for clinical efficacy is its low oral bioavailability that can be attributed to its poor absorption, high rate of metabolism in the intestines, and rapid elimination from the body. Also, little information is available to determine its safety in higher doses. Nanotechnology-based novel strategies are being aggressively explored worldwide to enhance curcumin's bioavailability and reduce perceived toxicity. [36]


   Conclusion Top


Turmeric is considered a safe, nontoxic, and effective alternative for many conventional drugs due to its distinguished therapeutic properties and multiple effects on various systems of the body. Its role in the treatment of cancers is very promising. However, there is scarcity of information and research in this field. Therefore, further research is required to determine the optimal dosage, bioavailability, and bio-efficacy of curcumin-based drugs.

 
   References Top

1.Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: A component of turmeric (Curcuma longa). J Altern Complement Med 2003;9:161-8.  Back to cited text no. 1
[PUBMED]    
2.Çýkrýkçý S, Mozioglu E, Yýlmaz H. Biological activity of curcuminoids isolated from Curcuma longa. Rec Nat Prod 2008;2:19-24.  Back to cited text no. 2
    
3.Wahlstrom B, Blennow G. A study on the fate of curcumin in the rat. Acta Pharmacol Toxicol 1978;43:86-92.  Back to cited text no. 3
    
4.Ravindranath V, Chandrasekhara N. Absorption and tissue distribution of curcumin in rats. Toxicology 1980;16:259-65.  Back to cited text no. 4
    
5.Chaturvedi TP. Uses of turmeric in dentistry: An update. Indian J Dent Res 2009;20:107-9.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.Ramirez-Boscα A, Soler A, Gutierrez MA. Antioxidant curcuma extracts decrease the blood lipid peroxide levels of human subjects. Age 1995;18:167-9.  Back to cited text no. 6
    
7.Toda S, Miyase T, Arich H. Natural antioxidants. Antioxidative compounds isolated from rhizome of Curcuma longa L. Chem Pharmacol Bul 1985;33:1725-28.  Back to cited text no. 7
    
8.Mortellini R, Foresti R, Bassi R, Green CJ. Curcumin, an antioxidant and anti-inflammatory agent, induces heme oxygenase-1 and protects endothelial cells against oxidative stress. Free Radic Biol Med 2000;28:1303-12.  Back to cited text no. 8
    
9.Ammon HP, Safayhi H, Mack T, Sabieraj J. Mechanism of anti-inflammatory actions of curcumin and boswellic acids. J Ethnopharmacol 1993;38:113-9.  Back to cited text no. 9
    
10.Mukhopadhyay A, Basu N, Ghatak N. Anti-inflammatory and irritant activities of curcumin analogues in rats. Agents Actions 1982;12:508-15.  Back to cited text no. 10
    
11.Deshpande UR, Gadre SG, Raste AS. Protective effect of turmeric (Curcuma longa L.) extract on carbon tetrachloride-induced liver damage in rats. Indian J Exp Biol 1998;36:573-7.  Back to cited text no. 11
    
12.Park EJ, Jeon CH, Ko G, Kim J, Sohn DH. Protective effect of curcumin in rat liver injury induced by carbon tetrachloride. J Pharm Pharmacol 2000;52:437-40.  Back to cited text no. 12
    
13.Kiso Y, Suzuki Y, Watanabe N, Oshima Y, Hikino H. Antihepatotoxic principles of Curcuma longa rhizomes. Planta Med 1983;49:185-87.  Back to cited text no. 13
    
14.Donatus IA, Sardjoko, Vermeulen NP. Cytotoxic and cytoprotective activities of curcumin. Effects on paracetamol-induced cytotoxicity, lipid peroxidation and glutathione depletion in rat hepatocytes. Biochem Pharmacol 1990;39:1869-75.  Back to cited text no. 14
    
15.Soni KB, Rajan A, Kuttan R. Reversal of aflatoxin induced liver damage by turmeric and curcumin. Cancer Lett 1992;66:115-21.  Back to cited text no. 15
    
16.Ramprasad C, Sirsi M. Curcuma longa and bile secretion. Quantitative changes in the bile constituents induced by sodium curcuminate. J Sci Ind Res 1957;16:108-10.  Back to cited text no. 16
    
17.Srivastava R, Puri V, Srimal RC, Dhawan BN. Effect of curcumin on platelet aggregation and vascular prostacyclin synthesis. Arzneimittelforschung 1986;36:715-7.  Back to cited text no. 17
    
18.Mehta K, Pantazis P, McQueen T, Aggarwal BB. Antiproliferative effect of curcumin (diferuloylmethane) against human breast tumor cell line. Anticancer Drugs 1997;8:470-81.  Back to cited text no. 18
    
19.Menon LG, Kuttan R, Kuttan G. Anti-metastatic activity of curcumin and catechin. Cancer Lett 1991;141:159-65.  Back to cited text no. 19
    
20.Kawamori T, Lubet R, Steele VE. Chemopreventative effect of curcumin, a naturally occurring anti-inflammatory agent, during the promotion/progression stages of colon cancer. Cancer Res 1999;59:597-01.  Back to cited text no. 20
    
21.Thaloor D, Singh AK, Sidhu GS, Prasad PV, Kleinman HK, Maheshwari RK. Inhibition of angiogenic differentiation of human umbilical vein endothelial cells by curcumin. Cell Growth Differ 1998;9:305-12.  Back to cited text no. 21
    
22.Limtrakul P, Lipigorngoson S, Namwong O, Apisariyakul A, Dunn FW. Inhibitory effect of dietary curcumin on skin carcinogenesis in mice. Cancer Lett 1997;116:197-203.  Back to cited text no. 22
    
23.Hanif R, Qiao L, Shiff SJ, Rigas B. Curcumin, a natural plant phenolic food additive, inhibits cell proliferation and induces cell cycle changes in colon adenocarcinoma cell lines by a prostaglandin-independent pathway. J Lab Clin Med 1997;130:576-84.  Back to cited text no. 23
    
24.Dorai T, Cao YC, Dorai B, Buttyan R, Katz AE. Therapeutic potential of curcumin in human prostate cancer. III. Curcumin inhibits proliferation, induces apoptosis, and inhibits angiogenesis of LNCaP prostate cancer cells in vivo. Prostate 2001;47:293-303.  Back to cited text no. 24
    
25.Apisariyakul A, Vanittanakom N, Buddhasukh D. Antifungal activity of turmeric oil extracted from Curcuma longa (Zingiberaceae). J Ethnopharmacol 1995;49:163-9.  Back to cited text no. 25
    
26.Rasmussen HB, Christensen SB, Kvist LP, Karazami A. A simple and efficient separation of the curcumins, the antiprotozoal constituents of Curcuma longa. Planta Med 2000;66:396-8.  Back to cited text no. 26
    
27.Ramirez-Tortosa MC, Mesa MD, Aguilera MC. Oral administration of a turmeric extract inhibits LDL oxidation and has hypocholesterolemic effects in rabbits with experimental atherosclerosis. Atherosclerosis 1999;147:371-8.  Back to cited text no. 27
    
28.Snow JM. Curcuma longa L (Zingiberaceae). Protocol J Botan Med 1995;1:43-6.  Back to cited text no. 28
    
29.Prucksunand C, Indrasukhsri B, Leethochawalit M, Hungspreugs K. Phase II clinical trial on effect of the long turmeric (Curcuma longa Linn) on healing of peptic ulcer. The Southeast Asian J Tropl Med Public Health 2001;32:208-15.  Back to cited text no. 29
    
30.Lal B, Kapoor AK, Asthana OP. Efficacy of curcumin in the management of chronic anterior uveitis. Phytothery Res 1999;13:318-22.  Back to cited text no. 30
    
31.Waghmare PF, Chaudhary AU, Karhadkar VM, Jamkhande AS. Comparative evaluation of turmeric and chlorhexidine gluconate mouthwash in prevention of plaque formation and gingivitis: A clinical and microbiological study. J Contemp Dent Pract 2011;12:221-2.  Back to cited text no. 31
    
32.Behal R, Mali MA, Gilda SS, Paradkar AR. Evaluation of local drug delivery system containing 2% whole turmeric gel used as an adjunct to scaling and root planning in chronic periodontitis: A clinical and microbiological study. J Indian Soc Periodontol 2011;15:35-8.  Back to cited text no. 32
[PUBMED]  Medknow Journal  
33.Suhag A, Dixit J, Dhan P. Role of curcumin as a subgingival irrigant: A pilot study. PERIO: Periodontal Pract Today 2007;2:115-21.  Back to cited text no. 33
    
34.Wilken R, Veena MS, Wang MB, Srivatsan ES. Curcumin: A review of anti-cancer properties and therapeutic activity in head and neck squamous cell carcinoma. Mol Cancer 2011;10:12-9.  Back to cited text no. 34
    
35.Deepa DA, Anita B, Sreelatha KT. Comparative study of the efficacy of curcumin and turmeric oil as chemoprotective agents in oral submucous fibrosis: A clinical and histopathological evaluation. JIAOMR 2010;22:88-92.  Back to cited text no. 35
    
36.Bisht S, Feldman G, Soni S, Ravi R, Karikar C, Maitra A, et al. Polymeric nanoparticle-encapsulated curcumin ("Nanocurcumin"): A novel strategy for human cancer therapy. J Nanobiotechnology 2007;5:1-18.  Back to cited text no. 36
    



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