Keywords
Therapeutics
Honey
How to Cite
Abstract
Recurrent aphthous stomatitis (RAS) is recurrent and painful diseases of the oral mucosa that can be very painful and annoying despite their small size. There is no definitive cure for this disease and the usual treatments are mainly based on pain control. The aim of this study was to investigate the effect of honey-lemon spray (mucotin) in the treatment of recurrent aphthous stomatitis. Methods: This study is a randomized controlled clinical trial conducted in 2020 at Zahedan University of Medical Sciences on 46 RAS patients. The participants were randomly assigned to the intervention (mucotin) or control groups (Triamcinolone ointment) equally (23 patients in each group). Patients were evaluated for the severity of pain and ulcer size. Evaluations were performed on days 0, 2, 7 of the treatment using VAS. Data were analyzed using ANOVA statistical test. Results: The inner aspect of the lower lip was the most common site of RAS in the participants (48.8%) and the lowest site went for hard palate (2.4%). Four items including pain, burning sensation, necrosis area, and erythematous area were evaluated in both groups. There was no significant difference in all parameters before the treatment period (day 0). The mean pain score, burning sensation, necrosis, erythematous areas were not different in days 0, 2 and 7 between groups respectively (p=0.849, p=0.105, p=0.917, p=0.442). Conclusion: Honey-lemon spray (Mucotin) and topical corticosteroid have similar effects in RAS treating, So Mucotin can be used as the first line of treatment for RAS lesions. This herbal medicine has no side effects.
References
Krawiecka E, Ślebioda Z, Szponar E, Kowalska A, Dorocka-Bobkowska B. Vitamin D status in recurrent aphthous stomatitis. Postepy Dermatol Alergol. 2017 Dec;34(6):612-17. doi: 10.5114/pdia.2017.69683.
Cui RZ, Bruce AJ, Rogers RS 3rd. Recurrent aphthous stomatitis. Clin Dermatol. 2016 Jul-Aug;34(4):475-81. doi: 10.1016/j.clindermatol.2016.02.020.
Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg. 2008 Apr;46(3):198-206. doi: 10.1016/j.bjoms.2007.07.201.
Edgar NR, Saleh D, Miller RA. Recurrent Aphthous Stomatitis: A Review. J Clin Aesthet Dermatol. 2017 Mar;10(3):26-36.
Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Wu YC, Sun A. Recurrent aphthous stomatitis - Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management. J Formos Med Assoc. 2019 Sep;118(9):1279-89. doi: 10.1016/j.jfma.2018.10.023.
El-Haddad SA, Asiri FY, Al-Qahtani HH, Al-Ghmlas AS. Efficacy of honey in comparison to topical corticosteroid for treatment of recurrent minor aphthous ulceration: a randomized, blind, controlled, parallel, double-center clinical trial. Quintessence Int. 2014 Sep;45(8):691-701. doi: 10.3290/j.qi.a32241.
Zeini Jahromi N, Ghapanchi J, Pourshahidi S, Zahed M, Ebrahimi H. Clinical Evaluation of High and Low-Level Laser Treatment (CO2vsInGaAlP Diode Laser) for Recurrent Aphthous Stomatitis. J Dent (Shiraz). 2017 Mar;18(1):17-23.
Bardellini E, Amadori F, Conti G, Majorana A. Clinical efficacy of a solution composed by sodium bicarbonate and alginate, aloe vera, propoli, chamomile, calendula and honey, in the treatment of minor recurrent aphthous stomatitis in children. Minerva Pediatr. 2016 Dec;68(6):507-9.
Heydarirad G, Choopani R. "Dry mouth" from the perspective of traditional Persian medicine and comparison with current management. J Evid Based Complementary Altern Med. 2015 Apr;20(2):137-42. doi: 10.1177/2156587214558596.
Aghamohamamdi A, Hosseinimehr SJ. Natural Products for Management of Oral Mucositis Induced by Radiotherapy and Chemotherapy. Integr Cancer Ther. 2016 Mar;15(1):60-8. doi: 10.1177/1534735415596570.
Ahmed S, Othman NH. The anti-cancer effects of Tualang honey in modulating breast carcinogenesis: an experimental animal study. BMC Complement Altern Med. 2017 Apr;17(1):208. doi: 10.1186/s12906-017-1721-4.
Almasaudi SB, Al-Nahari AAM, Abd El-Ghany ESM, Barbour E, Al Muhayawi SM, Al-Jaouni S, et al. Antimicrobial effect of different types of honey on Staphylococcus aureus. Saudi J Biol Sci. 2017 Sep;24(6):1255-61. doi: 10.1016/j.sjbs.2016.08.007.
Sarkar R, Ghosh A, Barui A, Datta P. Repositing honey incorporated electrospun nanofiber membranes to provide anti-oxidant, anti-bacterial and anti-inflammatory microenvironment for wound regeneration. J Mater Sci Mater Med. 2018 Mar;29(3):31. doi: 10.1007/s10856-018-6038-4.
Fazalda A, Quraisiah A, Nur Azlina MF. Antiulcer effect of honey in nonsteroidal anti-inflammatory drugs induced gastric ulcer model in rats: a systematic review. Evid Based Complement Alternat Med. 2018 Jul;2018:7515692. doi: 10.1155/2018/7515692.
Khanal B, Baliga M, Uppal N. Effect of topical honey on limitation of radiation-induced oral mucositis: an intervention study. Int J Oral Maxillofac Surg. 2010 Dec;39(12):1181-5. doi: 10.1016/j.ijom.2010.05.014.
Halim DS, Mahanani ES, Saini R, Marzuki Omar, bt Ibrahi NR, Alam MK. A comparison study on the effectiveness of local honey and salicylate gel for treatment of minor recurrent aphtous stomatitis. Int Med J. 2013;20(6):770-2.
Vissink A, Mitchell JB, Baum BJ, Limesand KH, Jensen SB, Fox PC, et al. Clinical management of salivary gland hypofunction and xerostomia in head-and-neck cancer patients: successes and barriers. Int J Radiat Oncol Biol Phys. 2010 Nov;78(4):983-91. doi: 10.1016/j.ijrobp.2010.06.052.
Dongmo PMJ, Tchoumbougnang FT, Boyom FF, Sonwa ET, Zollo PA, Menut C. Antiradical, antioxidant activities and anti-inflammatory potential of the essential oils of the varieties of Citrus limon and Citrus aurantifolia growing in Cameroon. J Asian Scient Res. 2013;3(10):1046-57.
Hamdan D, Ashour ML, Mulyaningsih S, El-Shazly A, Wink M. Chemical composition of the essential oils of variegated pink-fleshed lemon (Citrus x limon L. Burm. f.) and their anti-inflammatory and antimicrobial activities. Z Naturforsch C J Biosci. 2013 Jul-Aug;68(7-8):275-84.
Ameri A, Poshtmahi S, Heydarirad G, Cramer H, Choopani R, Hajimehdipoor H, et al. Effect of Honey-Lemon Spray Versus Benzydamine Hydrochloride Spray on Radiation-Induced Acute Oral Mucositis in Head and Neck Cancer Patients: A Pilot, Randomized, Double-Blind, Active-Controlled Clinical Trial. J Altern Complement Med. 2021 Mar;27(3):255-62. doi: 10.1089/acm.2020.0468.
Ghalayani P, Zolfaghary B, Farhad AR, Tavangar A, Soleymani B. The efficacy of Punica granatum extract in the management of recurrent aphthous stomatitis. J Res Pharm Pract. 2013 Apr;2(2):88-92. doi: 10.4103/2279-042X.117389.
Li CL, Huang HL, Wang WC, Hua H. Efficacy and safety of topical herbal medicine treatment on recurrent aphthous stomatitis: a systemic review. Drug Des Devel Ther. 2015 Dec 31;10:107-15. doi: 10.2147/DDDT.S96589.
Shavakhi M, Sahebkar A, Shirban F, Bagherniya M. The efficacy of herbal medicine in the treatment of recurrent aphthous stomatitis: A systematic review of randomized clinical trials. Phytother Res. 2022 Feb;36(2):672-85. doi: 10.1002/ptr.7332.
Tugrul S, Koçyiğit A, Doğan R, Eren SB, Senturk E, Ozturan O, et al. Total antioxidant status and oxidative stress in recurrent aphthous stomatitis. Int J Dermatol. 2016 Mar;55(3):e130-5. doi: 10.1111/ijd.13101.
Yaghoobi R, Kazerouni A, Kazerouni O. Evidence for Clinical use of honey in wound healing as an anti-bacterial, anti-inflammatory anti-oxidant and anti-viral agent: a review. Jundishapur J Nat Pharm Prod. 2013 Aug;8(3):100-4. doi: 10.17795/jjnpp-9487.
Klimek-Szczykutowicz M, Szopa A, Ekiert H. Citrus limon (Lemon) Phenomenon-A review of the chemistry, pharmacological properties, applications in the modern pharmaceutical, food, and cosmetics industries, and biotechnological studies. Plants (Basel). 2020 Jan;9(1):119. doi: 10.3390/plants9010119.
Kia SJ, Mansourian A, Basirat M, Akhavan M, Mohtasham-Amiri Z, Moosavi M-S. New concentration of curcumin orabase in recurrent aphthous stomatitis: A randomized, controlled clinical trial. J Herbal Med. 2020;22(2):100336. doi: 10.1016/j.hermed.2020.100336.
Giroh VR, Hebbale M, Mhapuskar A, Hiremutt D, Agarwal P. Efficacy of aloe vera and triamcinolone acetonide 0.1% in recurrent aphthous stomatitis: A preliminary comparative study. J Indian Acad Oral Med Radiol 2019 Jan-Mar;31(1):45-50. doi: 10.4103/jiaomr.jiaomr_203_18.
Deshmukh RA, Bagewadi AS. Comparison of effectiveness of curcumin with triamcinolone acetonide in the gel form in treatment of minor recurrent aphthous stomatitis: A randomized clinical trial. Int J Pharm Investig. 2014 Jul;4(3):138-41. doi: 10.4103/2230-973X.138346.
Babaee N, Zabihi E, Mohseni S, Moghadamnia AA. Evaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitis. Dent Res J (Isfahan). 2012 Jul;9(4):381-5.
Samet N, Laurent C, Susarla SM, Samet-Rubinsteen N. The effect of bee propolis on recurrent aphthous stomatitis: a pilot study. Clin Oral Investig. 2007 Jun;11(2):143-7. doi: 10.1007/s00784-006-0090-z.
Saleh MF, Othman A, Ibrahim A. The Efficacy of essential oils (lavender oil and flaxseed oil) in treatment of recurrent aphthous ulceration. Indian J Public Health Res Devel. 2019;10(5):1325-9. doi: 10.5958/0976-5506.2019.01180.x.
Queiroz SIML, Silva MVAD, Medeiros AMC, Oliveira PT, Gurgel BCV, Silveira ÉJDD. Recurrent aphthous ulceration: an epidemiological study of etiological factors, treatment and differential diagnosis. An Bras Dermatol. 2018 Jun;93(3):341-6. doi: 10.1590/abd1806-4841.20186228.
Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, et al. Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev. 2012 Sep 12;(9):CD005411. doi: 10.1002/14651858.CD005411.pub2.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Masoomeh Shirzaiy; Ghazaleh Heydarirad; Samaneh Bakhshipour
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