Journal of Advanced Oral Research / May-Aug 2016 / Vol. 7 No. 2
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. 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.
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.
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
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 scientic literature concerning the salutary properties of ginger and its efcacy in treating
a variety of diseases of the oral cavity.
Method: A review was performed based on the available scientic literature concerning the salutary properties of ginger and its
efciency 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
Keywords: Antimicrobial, antioxidant, complementary and alternative medicine, oral diseases, Zingiber ofcinale
Address for correspondence: Dr. K. J. Rashmi, #49/C, Hesgal Road, Vidhyanagar, Mudigere, Chickmagalur, Karnataka, India.
Phone: +91-7760077928. E-mail: firstname.lastname@example.org
Received: 24-02-2016 Revised: 13-03-2016 Accepted: 22-03-2016
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Rashmi and Tiwari: Ginger in dentistry
2Journal of Advanced Oral Research / May-Aug 2015 / Vol. 7 No. 2
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. 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.
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.
PHARMACOLOGICAL ACTION OF GINGER AND
Ginger has been used for its anti-inflammatory
properties for centuries although it was only
scientifically discovered and proven in the early
1970s. It inhibits the synthesis of inflammatory
mediators such as prostaglandins by acting on
enzymes cyclooxygenase-1 and cyclooxygenase-2. It
also inhibits 5-lipoxygenase enzyme which is involved
in the biosynthesis of leukotrienes. 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. 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
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. 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. 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. 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)
Diarylheptanoids (gingerenones, A and B)
Figure 1: Ginger with thick lobes and ring-like scars
Rashmi and Tiwari: Ginger in dentistry
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.
Tumorigenesis and progression is a multi-step process
controlled by genetic and environmental factors.
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). 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. Gingerol activity has been found to be
effective against breast, colon, prostate cancer, and
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. 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. 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
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
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. 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. 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. 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.
USES OF GINGER IN DENTISTRY
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. 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). Hasan et al.
(2012) showed that ethanol extract is effective against
C. albicans and its effectiveness varied with increased
concentrations. Supreetha et al. (2011) substantiated
by conclusively proving the pronounced antifungal
effects of ethanolic extract of ginger.
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). Species
of Zingiberaceae family make excellent candidates
for antifungal phytomedicines and are considered
relatively safe for human consumption.
Rashmi and Tiwari: Ginger in dentistry
4Journal of Advanced Oral Research / May-Aug 2015 / Vol. 7 No. 2
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.
Xerostomia refers to a subjective dry mouth sensation
which is frequently, but not always, associated with
hypoactivity of salivary glands. Xerostomia is a
common complaint often found among the geriatric
population, affecting approximately 20% of the
people. Chamani et al. (2011) suggested that the
systemic ginger extract application can increase the rate
of salivation. 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.
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. 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. Similar results
were obtained by several other studies.[37,38]
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. 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. 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.
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.
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.
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
Journal of Advanced Oral Research / May-Aug 2016 / Vol. 7 No. 2
status, the pharmacokinetics or pharmacodynamics
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.
1. Atanasov AG, Waltenberger B, Pferschy-Wenzig EM, Linder T,
Wawrosch C, Uhrin P, et al. Discovery and resupply of
pharmacologically active plant-derived natural products: A review.
Biotechnol Adv 2015;33:1582-614.
2. Chan EW, Wong SK. Phytochemistry and pharmacology of
ornamental gingers, Hedychium coronarium and Alpinia purpurata:
A review. J Integr Med 2015;13:368-79.
3. Bhakru HK. Ginger. Herbs that Heal. Natural Remedies for Good
Health. 1st ed. New Delhi: Orient Paperbacks Publishers, A Division
of Vision Books Pvt., Ltd.; 2008. p. 91.
4. Bode AM, Dong Z. The amazing and mighty ginger. In: Benzie IF,
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Aspects. 2nd ed. Ch. 7. Boca Raton, FL: CRC Press/Taylor & Francis;
5. Jung HW, Yoon CH, Park KM, Han HS, Park YK. Hexane fraction of
Zingiberis Rhizoma crudus extract inhibits the production of nitric oxide
and proinflammatory cytokines in LPS-stimulated BV2 microglial cells
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7. Aktan F, Henness S, Tran VH, Duke CC, Roufogalis BD, Ammit AJ.
Gingerol metabolite and a synthetic analogue Capsarol inhibit
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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
Author Year Type of study Uses in dentistry
Giriraju and Yunus 2013 In vitro study Antibacterial activity against S. mutans, C. albicans, E. feacalis
Park et al. 2008 In vitro study Antibacterial activity against periodontal pathogens
Atai et al. 2009 In vitro study Against C. albicans
Haghpanah et al. 2015 Randomized clinical trial As a muco-bioadhesive for RAS
Patel et al.  2011 In vitro study Dental caries
Jain et al. 2015 In vitro study Against S. mutans
Maekawa et al. 2015 In vitro study Intracanal medicament
Mahyari et al. 2016 randomized double-blind
Treatment of gingivitis
Cojocaru et al. 2015 In vitro study Cytotoxic effect against Amelanotic melanoma
Valera et al. 2015 In vitro study Intracanal medicament
Jayashankar et al. 2011 Randomized clinical trial As one of the compositions in herbal toothpaste
Lakhan et al. 2015 Systematic review and meta-analysis As hypoalgesic agent
Khandouzi et al. 2015 Randomized clinical trial Glycemic marker Type 2 DM
Kim et al. 2007 In vitro and in vivo study Against UVB-induced ROS
Wang et al. 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
aeruginosa. Res J Biol Sci 2011;6:37-9.
16. Park M, Bae J, Lee DS. Antibacterial activity of -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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23. Montazeri AS, Hamidzadeh A, Raei M, Mohammadiun M,
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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
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27. Hasan HA, Rasheed Raauf AM, Abd Razik BM, Rasool Hassan BA.
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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)
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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
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35. Loesche WJ. Role of Streptococcus mutans in human dental decay.
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36. Patel RV, Thaker VT, Patel VK. Antimicrobial activity of ginger and
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37. Premkumar K, Umapati T, Kathariya MD, Agrawal A, Kumar PS,
Kallampilli G. Effect of honey and aqueous ginger against
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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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42. Maekawa LE, Valera MC, Oliveira LD, Carvalho CA, Camargo CH,
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46. Jayashankar S, Panagoda GJ, Amaratunga EA, Perera K,
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47. Lakhan SE, Ford CT, Tepper D. Zingiberaceae extracts for pain: A
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in vivo. Free Radic Res 2007;41:603-14.
49. Wang CZ, Qi LW, Yuan CS. Cancer chemoprevention effects of
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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. Conict of Interest: None delcared.