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Pharmacotherapeutic Properties of Ginger and its use in Diseases of the Oral Cavity: A Narrative Review

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Journal of Advanced Oral Research / May-Aug 2016 / Vol. 7 No. 2
INTRODUCTION
Healing with medicinal plants is as old as humankind
itself. The indigenous plants with known medicinal value
have long been in use for their definite physiological
actions on the human body. These properties are
attributed to specific bioactive constituents of plants
namely alkaloids, flavonoids, tannins, and phenolic
products.[1] Ginger, scientifically known as Zingiber
officinale Roscoe (family Zingiberaceae), is a vital
plant with several remedial and nutritional principles.
It is used predominantly as a spice, natural additive,
and in herbal remedies. Customarily, ginger is used
in complementary and alternative medicine (CAM) of
different countries such as Africa, China, India, and
Arabian ethnomedicine to cure various ailments such
as nausea, vomiting, headache, allergies, asthma, cough,
and pain, to name a few.[2]
The use of CAM dates back to hundred or even
thousands of years depending on the country and culture
concerned. However, its popularity has increased in
general medicine and dentistry to treat various oral
diseases enormously among the young as well as the
geriatric population over the last few years mainly
because of fewer adverse effects and also increased
a number of patients developing bacterial resistance
because of antibiotic overload or improper dosage.
Review Article
Pharmacotherapeutic Properties of Ginger
and its use in Diseases of the Oral Cavity:
A Narrative Review
K. J. Rashmi1, Ritu Tiwari2
1Dental Connect, Bengaluru, Karnataka, India, 2Denty’s Oral Care and Cure, Bengaluru, Karnataka, India
ABSTRACT
Aims and objective: The traditional system of medicine has been practiced successfully in countries such as India and China, for
almost 3000 years and witnessed an exponential growth in recent times. These systems deal with preparations that are derivatives
of medicinal plants and are a rich source of phytonutrients. Ginger is one such herb of considerable importance. This paper primarily
aims to exhaustively review the available scientic literature concerning the salutary properties of ginger and its efcacy in treating
a variety of diseases of the oral cavity.
Method: A review was performed based on the available scientic literature concerning the salutary properties of ginger and its
efciency in treating oral diseases. Studies conducted in the last 10 years (2005-2016) were included in the review. Moreover, a
book-based and literature-based review was performed from PubMed electronic database using the keywords “properties of ginger,”
“uses of ginger in dentistry,” and “ginger extract in oral diseases.”
Result: Ginger has remarkable pharmacologic and physiologic actions on the human body which is thought to exert therapeutic effects.
Its medicinal properties are used in the eld of Medicine as well as in dentistry for the treatment of several oral lesions.
Conclusion: Ginger can be used for the management of several oral diseases yet more clinical trials are required to optimize its
effects.
Keywords: Antimicrobial, antioxidant, complementary and alternative medicine, oral diseases, Zingiber ofcinale
Address for correspondence: Dr. K. J. Rashmi, #49/C, Hesgal Road, Vidhyanagar, Mudigere, Chickmagalur, Karnataka, India.
Phone: +91-7760077928. E-mail: rashmikj25@gmail.com
Received: 24-02-2016 Revised: 13-03-2016 Accepted: 22-03-2016
Access this article online
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Website:
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DOI:
10.2047/joaor-07-02-001
Rashmi and Tiwari: Ginger in dentistry
2Journal of Advanced Oral Research / May-Aug 2015 / Vol. 7 No. 2
ABOUT GINGER
Ginger is believed to be a native of south-eastern
Asia and belongs to the family Zingiberaceae. It
is cultivated through rhizomes and grows well in
tropical and subtropical areas, perennially. The
rhizomes are full of aroma and have thick lobes with
ring-like scars, growing up to a size of 30-90 cm
[Figure 1]. Origin of the word “ginger” can be traced
back to the Sanskrit/Pali word “singabera,” meaning
“shaped-like a horn” based on its appearance. It was
well known to the Indian and Chinese medicine
and was referred to as “maha aushadhi” (the great
medicine) in Vedic literature. The trade of ginger
was extended widely by 1st century A.D. making it a
popular spice in the Mediterranean region, England,
Spain, Greece, and Rome. The Greek physician Galen
believed ginger was a purificant of the body and can
treat diseases caused by bodily imbalances.[3] It was
used primarily as a condiment, however, slowly the
medicinal usages of ginger were recognized, and
formulations were prepared to treat symptoms of
nausea, vomiting motion sickness, and to stimulate
the appetite as well.
CHEMICAL COMPOSITION
Phytonutrients are the active principles of the plants.
Although they are not established as essential nutrients
provided by the plants, they do have biological
significance. Ginger is a renowned source of these
chemicals, which have well-documented therapeutic
properties. The main active ingredient present in ginger
includes phenolic compounds (gingerol and shogaol)
sesquiterpene hydrocarbons and oleoresins [Table 1].
However, the composition of active principles is not
uniform and depends on the native region of the plant
species. Multiple analytical processes have proven the
presence of at least 115 separate chemical constituents
in diverse ginger varieties.[4]
PHARMACOLOGICAL ACTION OF GINGER AND
ITS CONSTITUENTS
Anti-inammatory
Ginger has been used for its anti-inflammatory
properties for centuries although it was only
scientifically discovered and proven in the early
1970s.[2] It inhibits the synthesis of inflammatory
mediators such as prostaglandins by acting on
enzymes cyclooxygenase-1 and cyclooxygenase-2.[5] It
also inhibits 5-lipoxygenase enzyme which is involved
in the biosynthesis of leukotrienes.[6] The study of
Aktan et al. (2006) revealed that ginger partially
inhibits nitric oxide synthase (iNOS) activity and
reduces the production of NO in macrophages via
attenuation of NF-kappa-B mediated iNOS gene
expression.[7] Srivastava et al. (1992) studied effects
of ginger on rheumatism or musculoskeletal disorders
and suggested that the anti-inflammatory activity
can be ascribed to prostaglandin and leukotriene
suppression as well as dual inhibition of eicosanoid
biosynthesis.[8]
Antioxidant activity
Antioxidants help in the neutralization of oxidative
stress created by an excess of free radicals that can
lead to DNA damage. Ginger is a rich source of
antioxidants which act by scavenging superoxide anion,
hydroperoxide, and hydroxyl free radicals. It also
prevents lipid peroxidation (LPO) and inhibits NO
synthesis.[9] Compounds, such as 6 dehydroshogaol,
6-shogaol, and 1-dehydro-6-gingerdione, are the active
ingredients implicated as potent antioxidants due to
the presence of unsaturated ketone moiety in their
structures.[9] Shirin Adel and Prakash (2010) observed
the antioxidant activity of ginger root by analyzing its
components such as vitamin C, β carotene, flavonoids,
polyphenols, and tannins and concluded that maximum
antioxidant activity is present in the alcoholic
(methanolic) extracts.[10] Hence, ginger can be considered
as a functional food which has bioactive principles to
protect against cell oxidation. Its pharmacologic action
Table 1: Active ingredients of ginger
Volatile oils (zingiberene, zingiberol, D-camphor)
Shogaols
Diarylheptanoids (gingerenones, A and B)
Gingerols
Figure 1: Ginger with thick lobes and ring-like scars
Rashmi and Tiwari: Ginger in dentistry
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Journal of Advanced Oral Research / May-Aug 2016 / Vol. 7 No. 2
fulfills basic nutritional requirements as well as delays
the onset of chronic diseases.[10]
Anticancer activity
Tumorigenesis and progression is a multi-step process
controlled by genetic and environmental factors.[11]
Ginger can play an important role in the control of
tumor growth and proliferation by inducing apoptosis,
upregulation of tumor suppressor genes, and inhibition
of angiogenic factors (vascular endothelial growth
factor).[4] Investigations have shown that constituents,
such 6-gingerol, 6-shogaol, 6-paradol, zingerone,
and zerumbone, have major antitumor properties.
6-shogaol causes apoptotic death in human prostate
cancer lines, whereas 6-gingerol inhibits NF-κB
activation, Bcl-2 and surviving and activates p53,
Bax, and G0-G1 cycle through downregulation of
cyclin D1.[11] Gingerol activity has been found to be
effective against breast, colon, prostate cancer, and
promyelocytic leukemia.[12,13]
Antimicrobial activity
Antibiotics are a major asset in combating
microorganisms and their associated infections
but unfortunately are also associated with adverse
effects. An in vitro study has shown the antimicrobial
activity of 10% ethanolic ginger extract against oral
microorganisms which were resistant to routinely
used antimicrobials.[14] Another study showed that
ginger in concentration 20 mg/mL is efficient against
Pseudomonas aeruginosa, and the antibacterial
activity was directly proportional to the concentration
of extract.[15] A research done by Park et al. (2008)
showed its effectiveness against pathogens routinely
encountered in periodontal infections such as
Prevotella intermedia, Porphyromonas gingivalis, and
Porphyromonas endodontalis.[16]
Anti diabetic activity
Diabetes mellitus (DM) is a metabolic disorder
characterized by impaired insulin secretion or action.
Other than the conventional modes of treatment, medicinal
plants, and alternative therapies are also being tried to
maintain glucose homeostasis. Various studies have
shown that ginger has a pronounced antihyperglycemic
effect. It reduces the fasting blood sugar, hemoglobin
A1c in Type 2 DM, and also promotes insulin dependent
uptake of glucose by increasing GLUT4 expression. The
hypoglycemic effect of ginger is considered to be based on
the inhibition of oxidative stress and anti-inflammatory
processes.[17-19]
Other effects
Ginger contains phenolic and flavonoid compounds,
which are considered neuroprotective. 6-shogaol was
shown to be neuroprotective in transient global ischemia
by causing inhibition of microglial matter.[20] Ginger and
its constituents tend to increase mucin secretion which
in turn helps in ulcer prevention. Animal studies have
shown that ginger extract can prevent gastric ulcers
caused by stress or non-steroidal anti-inflammatory
drugs.[21] Due to constituents such as gingerols, shogaols,
and galanolactone, and diterpenoid, ginger antagonizes
5-HT3 receptor and shows antiserotonergic effect. This
could be imperative in control of post-operative nausea
and vomiting.[22,23] Montazeri et al. (2013) observed that
250 mg of ginger powder given 1 h before surgery was
an effective antiemetic.[23] The study of Mustafa et al.
(1990) concluded that administration of ginger powder
(500-600 mg) six times a day for 3-4 days provided relief
from migraine attack.[24]
USES OF GINGER IN DENTISTRY
Oral candidiasis
Yeast of the genus Candida, particularly Candida
albicans species are the most common agents involved
in oral infections. These infections could prove life-
threatening in immunocompromised patients. Treatment
of these infections in some cases is unduly challenging
because of the potential toxicity of regular antifungal
agents against host cells or due to the development of
resistance.[25] An in vitro study evaluated the antifungal
activity of ethanolic extract of ginger rhizomes on
C. albicans and observed that the minimum inhibitory
concentration was 2 mg/mL (1:5 dilution).[26] Hasan et al.
(2012) showed that ethanol extract is effective against
C. albicans and its effectiveness varied with increased
concentrations.[27] Supreetha et al. (2011) substantiated
by conclusively proving the pronounced antifungal
effects of ethanolic extract of ginger.[28]
Denture stomatitis is the most common type of oral
candidiasis caused mostly by C. albicans. Eslami
et al. (2015) in their study observed improvement of
symptoms of denture stomatitis with the use of ginger
mouthwash (20 ml, 3 times a day for 20 days).[29] Species
of Zingiberaceae family make excellent candidates
for antifungal phytomedicines and are considered
relatively safe for human consumption.
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Recurrent apthous stomatitis (RAS)
RAS is the most common oral mucosal lesion. Exact
etiology of the lesion is unknown, and treatment is
usually palliative. The anti-inflammatory action of ginger
improves the clinical symptoms of RAS. Haghpanah
et al. (2015) instituted mucoadhesives containing
ginger extract in the treatment of RAS and a significant
reduction in the intensity of pain was observed in the
treatment group, based on the visual analog scale.[30]
Xerostomia
Xerostomia refers to a subjective dry mouth sensation
which is frequently, but not always, associated with
hypoactivity of salivary glands.[31] Xerostomia is a
common complaint often found among the geriatric
population, affecting approximately 20% of the
people.[32] Chamani et al. (2011) suggested that the
systemic ginger extract application can increase the rate
of salivation.[33] Increased salivation may be due to direct
parasympathomimetics effect on the post-synaptic
M3 receptors and also a possible repressive effect on
presynaptic muscarinic autoreceptors.[34]
Dental caries
Dental caries is one of the universally prevalent
problems of the modern society. Studies have revealed
that Streptococcus mutans average from 20 to 40% of
the cultivable flora in biofilms removed from carious
lesions.[35] Patel et al. (2011) established considerable
antibacterial activity of ginger against S. mutans and
Lactobacillus acidophilus. Moreover, a combination of
extracts of ginger and honey was found to be effective
against Staphylococcus aureus. They also suggested that
a paste of ginger and honey can be effective in dental
caries, mouth ulcers, and sore throat.[36] Similar results
were obtained by several other studies.[37,38]
Radioprotector
One of the important modality of treating cancers is
radiation therapy. However, radiation is a double-
edged sword; it compromises normal tissue along
with the cancerous tissue thereby compromising the
treatment results. This has led to the introduction of
radioprotective compounds, which not only selectively
protects the normal tissues but also enables higher doses
of radiation to be used for the treatment.[39] Dietary
ginger offers radioprotection at the biochemical level.
This was investigated on albino rats, subjected to whole
body exposure to fast neutrons of fluence 105 n/cm.
Pre-treatment with ginger extract before radiotherapy
found to decrease glutathione reductase, glutathione
peroxidase enzyme activities, and also LPO.[40] Similarly,
alcoholic extracts of ginger (250 mg/kg) orally, once
daily for 5 consecutive days before exposure to gamma
radiation has been found to reduce the severity of
radiation sickness symptoms.[41]
Intracanal dressing
Endodontic infection is polymicrobial in nature
involving numerous organisms such as C. albicans,
Enterococcus faecalis, Escherichia coli, and endotoxins.
Maekawa et al. (2013) observed that the extract of
dehydrated rhizome of Z. officinale Roscoe can be used
as an intracanal medicament, whereas a combination
with calcium hydroxide acts as an efficient alternative.[42]
Gingivitis
Gingival disease is defined as inflammation of the
gingival tissues caused by accumulation of dental plaque
and is characterized clinically by redness, swelling, and
bleeding of the tissues.Treatment involves proper oral
hygiene and oral prophylaxis. Chlorhexidine gluconate
mouthwash is used to treat gingivitis in most of the cases.
Recently, Mahyari et al. (2016) studied and compared the
efficacy of herbal mouthwash containing hydroalcoholic
extracts of Z. officinale, Rosmarinus officinalis, and
Calendula officinalis (5% v/w) with chlorhexidine.
Moreover, the efficacy of polyherbal mouthwash was
comparable to that of chlorhexidine mouthwash.[43]
Quite a few studies have been conducted so far to assess
the role of ginger and its extracts in diseases of the oral
cavity with positive results. PubMed-based survey of
studies [Table 2] conducted in the last 10 years (2005-
2016) using the keywords “properties of ginger,” “uses of
ginger in dentistry,” and “ginger extract in oral diseases”
yielded 15 favorable results which establishes the
antibacterial, antifungal, antineoplastic, antioxidant,
and anti-inflammatory property of ginger in dentistry.
SIDE EFFECTS AND INTERACTIONS
It might cause mild gastrointestinal effects such as
irritation, heartburn, or diarrhea. Physicians should
monitor international normalized ratio status before
prescribing higher doses of ginger in patients who are
on warfarin. Because several in vitro studies proposed
that ginger extracts inhibit platelet aggregation.[50-53]
In a study on 12 healthy subjects at recommended
doses, ginger did not significantly affect the clotting
Rashmi and Tiwari: Ginger in dentistry
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Journal of Advanced Oral Research / May-Aug 2016 / Vol. 7 No. 2
status, the pharmacokinetics or pharmacodynamics
of warfarin.[54]
CONCLUSION
Ginger is not only an exceptionally favored dietary
condiment but also the most widely cultivated herb
globally. India is one of the largest producers of ginger
in the world. Since thousands of years, it has been
used for its medicinal properties to treat a variety of
diseases. Owing to its easy availability in the Indian
subcontinent coupled with limited side effects and
good patient compliance, the pharmaceutical principles
of this ancient plant should be exploited judiciously.
One of the main issues with herbal formulations is
that their active ingredients and molecular interactions
are not well defined, and thus standardization of the
product becomes difficult. Although the current data
to establish its efficacy and dosages in the management
of oral diseases is inadequate, there is a huge scope for
large-scale clinical trials to demonstrate its efficiency
and safety in medicine as well as in dentistry.
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Table 2: PubMed‑based survey reporting the studies conducted in the last 10 years (2005‑2016) on ginger and its uses in
oral diseases
Author Year Type of study Uses in dentistry
Giriraju and Yunus[14] 2013 In vitro study Antibacterial activity against S. mutans, C. albicans, E. feacalis
Park et al.[16] 2008 In vitro study Antibacterial activity against periodontal pathogens
Atai et al.[26] 2009 In vitro study Against C. albicans
Haghpanah et al.[30] 2015 Randomized clinical trial As a muco-bioadhesive for RAS
Patel et al. [36] 2011 In vitro study Dental caries
Jain et al.[38] 2015 In vitro study Against S. mutans
Maekawa et al.[42] 2015 In vitro study Intracanal medicament
Mahyari et al.[43] 2016 randomized double-blind
placebo-controlled trial
Treatment of gingivitis
Cojocaru et al.[44] 2015 In vitro study Cytotoxic effect against Amelanotic melanoma
Valera et al.[45] 2015 In vitro study Intracanal medicament
Jayashankar et al.[46] 2011 Randomized clinical trial As one of the compositions in herbal toothpaste
Lakhan et al.[47] 2015 Systematic review and meta-analysis As hypoalgesic agent
Khandouzi et al.[17] 2015 Randomized clinical trial Glycemic marker Type 2 DM
Kim et al.[48] 2007 In vitro and in vivo study Against UVB-induced ROS
Wang et al.[49] 2013 In vitro study Antineoplastic effect against head and neck SCC (HN4 cell line)
S. mutans: Streptococcus mutans, C. albicans: Candida albicans, E. feacalis: Enterococcus faecalis, RAS: Recurrent aphthous stomatitis, DM : Diabetes mellitus,
UVB: Ultraviolet B, ROS: Reactive oxygen species, SCC: Squamous cell carcinoma
Rashmi and Tiwari: Ginger in dentistry
6Journal of Advanced Oral Research / May-Aug 2015 / Vol. 7 No. 2
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16. Park M, Bae J, Lee DS. Antibacterial activity of [10]-gingerol and
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17. Khandouzi N, Shidfar F, Rajab A, Rahideh T, Hosseini P, Mir Taheri M.
The effects of ginger on fasting blood sugar, hemoglobin a1c,
apolipoprotein B, apolipoprotein a-I and malondialdehyde in type 2
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18. Medagama AB, Bandara R. The use of complementary and
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22. Huang QR, Iwamoto M, Aoki S, Tanaka N, Tajima K, Yamahara J,
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23. Montazeri AS, Hamidzadeh A, Raei M, Mohammadiun M,
Montazeri AS, Mirshahi R, et al. Evaluation of oral ginger efficacy against
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24. Mustafa T, Srivastava KC. Ginger (Zingiber officinale) in migraine
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25. Garcia-Cuesta C, Sarrion-Pérez MG, Bagán JV. Current treatment of
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26. Atai Z, Atapour M, Mohseni M. Inhibitory effect of ginger extract on
Candida albicans. Am J Appl Sci 2009;6:1067-9.
27. Hasan HA, Rasheed Raauf AM, Abd Razik BM, Rasool Hassan BA.
Chemical composition and antimicrobial activity of the crude extracts
isolated FROM Zingiber officinale by different solvents. Pharmaceut
Anal Acta 2012;3:184.
28. Supreetha S, Mannur S, Simon SP. Antifungal activity of ginger extract
on Candida albicans: An in-vitro study. J Dent Sci Res 2011;2:1-5.
29. Eslami H, Pakroo S, Maleki TE. Is ginger (Zingiber officinale)
mouthwash a convenient therapeutic for denture stomatitis? Adv
Biosci Clin Med 2015;3:17-23.
30. Haghpanah P, Moghadamnia AA, Zarghami A, Motallebnejad M.
Muco-bioadhesive containing ginger officinal e extract in the
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study. Caspian J Intern Med 2015;6:3-8.
31. Greenberg MS, Glick M, Ship JA. Salivary gland diseases. Burket’s
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32. Astor FC, Hanft KL, Ciocon JO. Xerostomia: A prevalent condition
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33. Chamani G, Zarei MR, Mehrabani M, Taghiabadi Y. Evaluation
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34. Ghayur MN, Khan AH, Gilani AH. Ginger facilitates cholinergic
activity possibly due to blockade of muscarinic autoreceptors in rat
stomach fundus. Pak J Pharm Sci 2007;20:231-5.
35. Loesche WJ. Role of Streptococcus mutans in human dental decay.
Microbiol Rev 1986;50:353-80.
36. Patel RV, Thaker VT, Patel VK. Antimicrobial activity of ginger and
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treatment. Asian Pac J Trop Biomed 2011;1:S58-61.
37. Premkumar K, Umapati T, Kathariya MD, Agrawal A, Kumar PS,
Kallampilli G. Effect of honey and aqueous ginger against
Streptococcus mutans isolated from extracted carious deciduous
teeth. JIOMR 2013;25:265-7.
38. Jain I, Jain P, Bisht D, Sharma A, Srivastava B, Gupta N. Use
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39. Baliga MS, Haniadka R, Pereira MM, Thilakchand KR, Rao S,
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40. Nabil, GM, Attia AM, Elhag MA. Radioprotective effects of dietary
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41. Jagetia G, Baliga M, Venkatesh P. Ginger (Zingiber officinale Rosc.), A
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Mechanism of action. Cancer Biother Radiopharm 2004;19:422-35.
42. Maekawa LE, Valera MC, Oliveira LD, Carvalho CA, Camargo CH,
Jorge AO. Effect of Zingiber officinale and propolis on microorganisms
and endotoxins in root canals. J Appl Oral Sci 2013;21:25-31.
43. Mahyari S, Mahyari B, Emami SA, Malaekeh-Nikouei B,
Jahanbakhsh SP, Sahebkar A, et al. Evaluation of the efficacy of a
polyherbal mouthwash containing Zingiber officinale, Rosmarinus
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A randomized double-blind placebo-controlled trial. Complement
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44. Cojocaru SI, Stan M, Stoian G, Dinischiotu A. Effects OF. Zingiber
officinale Roscoe fresh extract on amelanotic melanoma and normal
skin fibrobla STS. Rev Med Chir Soc Med Nat Iasi 2015;119:592-6.
45. Valera MC, Cardoso FG, Maekawa LE, Camargo CH, de Oliveira LD,
Carvalho CA. In vitro antimicrobial and anti-endotoxin action of
Zingiber officinale as auxiliary chemical and medicament combined
to calcium hydroxide and chlorhexidine. Acta Odontol Scand
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How to cite the article: Rashmi KJ, Tiwari R. Pharmacotherapeutic properties
of ginger and its use in diseases of the oral cavity: A narrative review. J Adv
Oral Res 2016;7(2):1-6.
Source of Support: Nil. Conict of Interest: None delcared.
... By triggering apoptosis, upregulating tumor suppressor genes, and inhibiting angiogenic factors (vascular endothelial growth factor), ginger can Complimentary Contributor Copy help to limit tumor development and proliferation. Components such as 6gingerol, 6-shogaol, 6-paradol, zingerone, and zerumbone have been found to have significant anticancer effects through various studies [20,21]. In a dosedependent way, ginger essential oil suppressed mutagenicity produced by direct-acting mutagens. ...
... The phytochemical action of ginger substitutes like dehydrogingerone and zingerone protects normal tissues from tumoricidal effects and prevents gamma radiation-induced illness [20]. This property is also confirmed in a study done by Rashmi et al., where ginger extracts if given before radiotherapy reduced glutathione reductase, glutathione peroxidase enzyme activities, and also lipid peroxidation thus leading to radio-protective action [21]. Different types of medication formulations can be administered to a patient in various forms, including solids such as tablets, capsules, powders, and controlled-release tablets; semisolids such as gels, creams, lotions, and suppositories; and liquids such as drops, syrups, oils, and parenteral nutrition ( Figure 4). ...
... Ginger antagonizes the 5-HT3 receptor and has an antiserotonergic action because of components like gingerols, shogaols, and galanolactone, as well as diterpenoid. This might be crucial for preventing nausea and vomiting after surgery [20,21]. Ginger's antioxidant properties combat aging in people [12]. ...
Chapter
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Potential Benefits of Ginger in Maintenance of Oral Health
... Some evidence shows several pharmacological effects of ginger powder, extract, or its bioactive components including anti diabetic activity, anti-inflammatory, antioxidant, anti-cancer, anti-obesity effects and lipid lowering properties (Srinivasan, 2017). In addition, it has been shown that ginger may be used for the management of several oral diseases (Rashmi and Tiwari, 2016). Ginger is generally used as a safe herbal medicine according to the FDA's report (Brown, 2016). ...
... They also prevent lipid peroxidation (LPO) and inhibits NO synthesis (Rahmani, 2014). Previous studies claimed that ginger may be beneficial in the management of several oral diseases and may improve oral health with its antimicrobial, antibacterial, antifungal, antioxidant and antiinflammatory properties (Rashmi and Tiwari, 2016). Our study confirms the beneficial effects of ginger supplementation on periodontal indices such as plaque, BOP, PD and CAL. ...
... Some evidence shows several pharmacological effects of ginger powder, extract, or its bioactive components including anti diabetic activity, anti-inflammatory, antioxidant, anti-cancer, anti-obesity effects and lipid lowering properties (Srinivasan, 2017). In addition, it has been shown that ginger may be used for the management of several oral diseases (Rashmi and Tiwari, 2016). Ginger is generally used as a safe herbal medicine according to the FDA's report (Brown, 2016). ...
... They also prevent lipid peroxidation (LPO) and inhibits NO synthesis (Rahmani, 2014). Previous studies claimed that ginger may be beneficial in the management of several oral diseases and may improve oral health with its antimicrobial, antibacterial, antifungal, antioxidant and antiinflammatory properties (Rashmi and Tiwari, 2016). Our study confirms the beneficial effects of ginger supplementation on periodontal indices such as plaque, BOP, PD and CAL. ...
... Some evidence showed several pharmacological effects of ginger powder, extract, or its bioactive components including anti diabetic activity, anti-inflammatory, antioxidant, anti-cancer, anti-obesity effects, and lipid lowering properties (Srinivasan, 2017). In addition, it has been shown that ginger may be used for the management of several oral diseases (Rashmi and Tiwari, 2016). Ginger is generally used as a safe herbal medicine according to the FDA's report (Brown, 2016). ...
... They also prevent lipid peroxidation (LPO) and inhibit NO synthesis (Rahmani, 2014). Previous studies claimed that ginger may be beneficial in the management of several oral diseases and may improve oral health with its antimicrobial, antibacterial, antifungal, antioxidant, and anti-inflammatory properties (Rashmi and Tiwari, 2016). This study confirms the beneficial effects of ginger supplementation on periodontal indices such as plaque, BOP, PD, and CAL. ...
Article
Background The objective of this study was to investigate the effects of ginger supplementation in adjunct with non-surgical periodontal therapy (NSPT) on metabolic and periodontal parameters in patients with type 2 DM (T2DM) and chronic periodontitis (CP). Material and methods In this double-blind clinical trial study, 50 T2DM patients with CP were randomly allocated to intervention and control groups and received either 2 g ginger or placebo (4 tablets) twice a day for 8 weeks. All subjects underwent NSPT during the intervention period. Fasting blood glucose (FBG), glycosylated hemoglobin levels (HbA1c), triglyceride (TG), total cholesterol (CHOL), high-density (HDL-c) and low-density lipoprotein (LDL-c) cholesterol, very low-density lipoprotein (VLDL-c), total antioxidant capacity (TAC), malondialdehyde (MDA), clinical attachment loss (CAL), pocket depth (PD), plaque index and bleeding on probing (BOP) were measured in all subjects at baseline and post-intervention Results A significant reduction (P < 0.05) was observed in the mean levels of HbA1c, FBG, MDA, CAL, and PD in the intervention group post-intervention. There were no significant differences found in the mean levels of TG, CHOL, LDL-C, VLDL, TAC, plaque, and BOP in intervention group post-intervention. The mean serum levels of HDL was significantly increased in the intervention group post-intervention (P < 0.05). There were significant differences observed in the mean changes of HbA1c (-0.75 ± 1.17 vs -0.16 ± 0.44; P = 0.04), HDL (3.95 ± 8.54 vs -0.76 ± 5.04; P = 0.03), CAL (-0.57 ± 0.50 vs -0.14 ± 0.35; P = 0.003) and PD (-0.52 ± 0.51 vs - 0.19 ± 0.51; P = 0.04) between intervention and control groups after the intervention. Conclusion It is recommended that ginger supplementation together with NSPT may be effective in control of the glycemic, lipid, antioxidant and periodontal status in T2DM with CP.
... Anti-inflammatory activity [41,43] Gingerol Anti-inflamatory activity Antioxidant activity Antimicrobial activity against P. gingivalis and P. endodontalis Treatment of recurrent apthous stomatitis, xerostomia, dental caries and gingivitis [44] Linalool ...
Article
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Dental pathology remains a global health problem affecting both children and adults. The most important dental diseases are dental caries and periodontal pathologies. The main cause of oral health problems is overpopulation with pathogenic bacteria and for this reason, conventional therapy can often be ineffective due to bacterial resistance or may have unpleasant side effects. For that reason, studies in the field have focused on finding new therapeutic alternatives. Special attention is paid to the plant kingdom, which offers a wide range of plants and active compounds in various pathologies. This review focused on the most used plants in the dental field, especially on active phytocompounds, both in terms of chemical structure and in terms of mechanism of action. It also approached the in vitro study of active compounds and the main types of cell lines used to elucidate the effect and mechanism of action. Thus, medicinal plants and their compounds represent a promising and interesting alternative to conventional therapy.
... These compounds contribute to its anti-inflammatory, anti-bacterial, and anti-oxidant property and help to combat with oral micro-organisms, thereby preventing oral diseases. [11] Hence, the present study aimed to compare the anti-plaque and anti-gingivitis effects of three mouthwashes containing GT, GT plus ginger (GT + G), and CHX mouthwash in 10-14 years' old children. ...
Article
Full-text available
Background: Dental plaque, a microbial biofilm, is the primary etiological factor leading to the initiation of gingivitis and dental caries. It is therefore important to prevent it by taking effective plaque control measures. This research aimed at comparing the anti-plaque and anti-gingivitis effects of green tea (GT), GT plus ginger (GT + G), and chlorhexidine mouthwash (CHX) in children. Materials and methods: This was a randomized clinical trial, with a sample size of 60 children between the age group of 10-14 years with plaque and gingivitis. They were randomly allocated in three different groups, depending upon the mouthwash used: Group A (GT mouthwash), Group B (GT plus ginger mouthwash), and Group C (CHX mouthwash). Plaque index and gingival index were recorded at baseline, then at interval of 15 days and 30 days after using mouthwash. Results: The mean gingival score and plaque showed a significant reduction from the baseline among all the three groups when compared with subsequent recall visits (15 days after using mouth-rinse and 30 days after using mouthwash) with P < 0.05. Conclusion: It can be concluded that the results of all three groups are comparable and hence herbal mouthwash can be used effectively as an alternative to CHX and as an adjunct to mechanical plaque control.
... 41 According to previous studies, ginger may improve oral health and be beneficial in the management of several oral diseases because of its several properties, such as antioxidant, anti-inflammatory antimicrobial, antibacterial, and antifungal. 42 Similar to this study, it was reported that gingerol-related components may prevent the growth of oral bacteria related to CP in the human oral cavity. 40 One clinical trial study indicated that NSPT for 3 months could significantly reduce periodontal status in patients with T2DM and CP. ...
Article
Full-text available
Background: The aim of this study was to evaluate the effects of ginger supplementation on inflammatory, antioxidant, and periodontal parameters in type 2 diabetes mellitus (T2DM) patients with chronic periodontitis (CP) under non-surgical periodontal therapy (NSPT). Material and methods: In this double-blind clinical trial study, 46 T2DM patients with CP were randomly allocated to intervention and control groups and received either 4 tablets 500 mg (2 g) ginger or placebo twice a day for 8 weeks. All patients were treated with NSPT during the intervention period. Serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), hs-C-reactive protein (hs-CRP), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), periodontal indices including clinical attachment loss (CAL), bleeding on probing (BOP), pocket depth (PD), and plaque index were evaluated in all subjects pre- and post-intervention. Results: Following 8 weeks of ginger treatment with NSPT, significant reductions were observed in the mean levels of IL-6 (p=0.001), hs-CRP (p=0.03), TNF-α (p=0.007), CAL, and PD (p<0.001) in the intervention group. The mean serum levels of SOD and GPx were significantly increased in the intervention group after the intervention (p=0.001 and 0.002, respectively). At the end of the study, the mean changes of GPx were significantly higher in the intervention group compared with the control group (p=0.04). Also, after the administration of the ginger with NSPT, significant decrease occurred in the mean change of IL-6 (p=0.009), hs-CRP (p=0.049), TNF-α (p=0.049), CAL (p=0.003), and PD (p=0.04) compared with the control group. Conclusion: It is recommended that ginger supplementation along with NSPT may be effective in the improvement of inflammation, oxidative, and periodontal status in T2DM with CP.
... Its components of gingerdiol, gingerol, quercetin and zingiberene makes it a powerful antioxidant because of their scavenging effect on hydroperoxide, superoxide anion and hydroxyl free radicals. Also they inhibit both (NO) synthesis and lipid peroxidation (LPO) [10,11] . It is used as a herbal treatment in many medical cases as; sprains, arthritis, muscular aches, rheumatism, vomiting, indigestion, infectious diseases, hypertension and many other conditions. ...
... Traditionally, ginger has been the most popular plant material in China, and has been used not only as a condiment for food processing, but also as a medicinal food for gastrointestinal symptoms, such as nausea and vomiting related to pregnancy (Rashmi & Tiwari, 2016). In addition, Shen Nong's Herbal Classic, originating more than 2000 years ago, documented the use of ginger for treatment of bacillary dysentery. ...
Article
Gastrointestinal mucosal damage is a catastrophic effect of abdominal or pelvic radiation used in cancer therapy or pretreatment for hematopoietic stem cell transplantation. 6-Shogaol is the constituent of ginger biophenolic, possesses both anti-inflammatory and antioxidant effects. We therefore investigated 6-shogaol’s candidacy as a protector against radiation-induced intestinal injury. Herein, we found that pretreatment with 6-shogaol improved animal survival and intestinal function following irradiation injury. Furthermore, the potential radioprotective role of 6-shogaol may be partially attributed to its antioxidant and anti-inflammatory properties, which alleviated radiation toxicity to the gastrointestinal tract. Additionally, we observed that 6-shogaol might reduce bacterial translocation and endotoxin levels following abdominal irradiation, and thereby protect against radiation-induced intestinal injury. Our results show a potential role for 6-shogaol as a protective agent to obviate the treatment-limiting intestinal side-effects and thereby may be useful in radiotherapy of patients.
Chapter
Herbal medicine has long been used to prevent and control disease, and it can minimize the potential side effects of chemical products. However, side effects from herbs do exist. Most of the challenges with herbal medicine revolves around inadequate information about the effect of herbs in the oral cavity, the mechanism of action, and potential side effects. There are several herbs described in this chapter have anti-inflammatory, anti-bacterial, anti-viral, anti-fungal in oral micro-organisms. It includes aloe vera, ginger, clove, cinnamon, garlic, neem, miswak, turmeric, tulsi, green tea, chamomile, fenugreek, anise plant, peppermint, bloodroot, caraway, eucalyptus, phyllanthus emblica, black seed, myrrh, rosemary, sage, and thyme; some may act as an alternative management option to current treatments for oral conditions such as caries prevention, gingivitis, periodontitis, oral burn, ulcers and inflammation, after extraction, dry mouth, pain reduction, anesthesia, intracanal medications, ill-fitting dentures, peri-implant mucositis and peri-implantitis. It can be used in several forms such as mouthwashes, toothpastes, topical agents or local drug delivery devices. However, more research is needed to understand their mechanisms and potential side effects.
Article
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In this review, the phytochemistry and pharmacology of two ornamental gingers, Hedychium coronarium (butterfly ginger) and Alpinia purpurata (red ginger), are updated, and their botany and uses are described. Flowers of H. coronarium are large, showy, white, yellow or white with a yellow centre and highly fragrant. Inflorescences of A. purpurata are erect spikes with attractive red or pink bracts. Phytochemical investigations on the rhizomes of H. coronarium generated research interest globally. This resulted in the isolation of 53 labdane-type diterpenes, with little work done on the leaves and flowers. Pharmacological properties of H. coronarium included antioxidant, antibacterial, antifungal, cytotoxic, chemopreventive, anti-allergic, larvicidal, anthelminthic, analgesic, anti-inflammatory, anti-urolithiatic, anti-angiogenic, neuro-pharmacological, fibrinogenolytic, coagulant and hepatoprotective activities. On the contrary, little is known on the phytochemistry of A. purpurata with pharmacological properties of antioxidant, antibacterial, larvicidal, cytotoxic and vasodilator activities reported in the leaves and rhizomes. There is much disparity in terms of research effort within and between these two ornamental gingers.
Article
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Background: Since primitive times, man has gone in different ways to search for cures and relief from various diseases by using several plants, plant products and plant-derived products. Recently, there is a scientific curiosity and certain popularity with regard to screening essential oils and extracts from plants used medicinally all over the world. Objective: This study design to evaluate the component of ginger extracts in different solvents by HPLC in addition to evaluate the in vitro effects of it on micro-organisms, especially the plant is used in Iraqi folk medicine as anti-inflammatory, antipyretic, anti-diabetic, relieving rheumatic pains and for treating stomach discomfort. Methods: The extraction of soluble compounds from ginger by the soxhlet method was performed by using methanol and n-hexane as solvents and the main composition of ginger extracts were analyzed by HPLC. Agar – well diffusion method tested antimicrobial activities of two crud extracts in different concentrations of plant on seven types of bacteria strains and one fungus. Results: Seven components were identified from the separation of ginger extracts by HPLC. The two extracts had antimicrobial activity, methanol extract was superior than n-hexane extract against the same tested microorganisms. Conclusion: The results of this study revealed that this plant possesses some antimicrobial properties as antibiotics and antifungal, therefore they can be used as a potential source of active ingredients for food, pharmaceutical industry or preservatives.
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Medicinal plants have historically proven their value as a source of molecules with therapeutic potential, and nowadays still represent an important pool for the identification of novel drug leads. In the past decades, pharmaceutical industry focused mainly on libraries of synthetic compounds as drug discovery source. They are comparably easy to produce and resupply, and demonstrate good compatibility with established high throughput screening (HTS) platforms. However, at the same time there has been a declining trend in the number of new drugs reaching the market, raising renewed scientific interest in drug discovery from natural sources, despite of its known challenges. In this survey, a brief outline of historical development is provided together with a comprehensive overview of used approaches and recent developments relevant to plant-derived natural product drug discovery. Associated challenges and major strengths of natural product-based drug discovery are critically discussed. A snapshot of the advanced plant-derived natural products that are currently in actively recruiting clinical trials is also presented. Importantly, the transition of a natural compound from a "screening hit" through a "drug lead" to a "marketed drug" is associated with increasingly challenging demands for compound amount, which often cannot be met by re-isolation from the respective plant sources. In this regard, existing alternatives for resupply are also discussed, including different biotechnology approaches and total organic synthesis. While the intrinsic complexity of natural product-based drug discovery necessitates highly integrated interdisciplinary approaches, the reviewed scientific developments, recent technological advances, and research trends clearly indicate that natural products will be among the most important sources of new drugs also in the future. Copyright © 2015. Published by Elsevier Inc.
Article
Background: Gingivitis is a highly prevalent periodontal disease resulting from microbial infection and subsequent inflammation. The efficacy of herbal preparations in subjects with gingivitis has been reported in some previous studies. Objective: To investigate the efficacy of a polyherbal mouthwash containing hydroalcoholic extracts of Zingiber officinale, Rosmarinus officinalis and Calendula officinalis (5% v/w) compared with chlorhexidine and placebo mouthwashes in subjects with gingivitis. Methods: Sixty patients participated in this randomized double-blind placebo-controlled trial and were randomly assigned to the polyherbal mouthwash (n = 20), chlorhexidine mouthwash (n = 20) or placebo mouthwash (n = 20). Participants were instructed to use the mouthwash twice a day (after breakfast and dinner) for 30 s for a period of two weeks. Gingival and plaque indices were assessed using MGI, GBI and MQH scales at baseline, day 7 and day 14 of the trial. Results: There were significant improvements in all assessed efficacy measures i.e. MGI, GBI and MQH scores from baseline to the end of trial in both polyherbal and chlorhexidine mouthwash groups; however, the scores remained statistically unchanged in the placebo group. MGI, BGI and MQH scores in the treatment groups were significantly lower compared with those of the control group at both day 7 and day 14 of the trial. However, there was no significant difference between the polyherbal and chlorhexidine groups, neither at day 7 nor day 14 of the trial. Polyherbal mouthwash was safe and there was neither report of adverse reactions, nor any drop-out during the course of study. Conclusion: Polyherbal mouthwash containing hydroalcoholic extracts of Z. officinale, R. officinalis and C. officinalis (5%) was effective in the treatment of gingivitis and its efficacy was comparable to that of chlorhexidine mouthwash.
Article
Ginger (Zingiber officinale Roscoe) contains the biological properties of the major standard non-volatile pungent compounds of ginger, namely, [6]-, [8]-, and [10]- gingerols, as well as [6]-, [8]-, and [10]-shogaols. So far, the comparative antioxidant potencies among shogaols and gingerols have not been studied in detail and reported. Accordingly, this study aimed to examine and compare the antioxidant abilities of the six main compounds. Results showed that [6]-, [8]-, and [10]-gingerols, as well as [6]-, [8]-, and [10]-shogaols exhibited substantial in vitro antioxidant activities. The DPPH•, ABTS•+, and FRAP assays results showed that the antioxidant abilities of [6]-shogaol were greatest among the six gingerols and shogaols studied (P<0.05), and those of [6]-, [8]-, and [10]- shogaols were greater than those of [6]-, [8]-, and [10]-gingerols, respectively, which can be attributed to the presence of α, β-unsaturated ketones moieties. Moreover, the observation that the antioxidant abilities of [6]-gingerol were greater than those of [8]- and [10]-gingerols (P< 0.05) indicated that the short carbon chains of [6]-gingerol and [6]-shogaol played a significant role in making them more potent antioxidants than the other four longer carbon chain compounds. This finding can be attributed to gingerols undergoing dehydration transformations into shogaols during oven drying. Our results provided some new information on the antioxidant abilities of gingerols and shogaols.
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Ginger is a commonly used spice and herbal medicine worldwide. Besides its extensive use as a condiment, ginger has been used in traditional Chinese medicine for the management of various medical conditions. In recent years, ginger has received wide attention due to its observed antiemetic and anticancer activities. This paper reviews the potential role of ginger and its active constituents in cancer chemoprevention. The phytochemistry, bioactivity, and molecular targets of ginger constituents, especially 6-shogaol, are discussed. The content of 6-shogaol is very low in fresh ginger, but significantly higher after steaming. With reported anti-cancer activities, 6-shogaol can be served as a lead compound for new drug discovery. The lead compound derivative synthesis, bioactivity evaluation, and computational docking provide a promising opportunity to identify novel anticancer compounds originating from ginger.