Sharma B. Apthous ulcer treatment with homeopathy Doi:10.21276/ledent.18.02.02.05 Original Article ROLE OF HOMEOPATHY MEDICINE IN TREATMENT OF APTHOUS ULCER: A RANDOMIZED STUDY Bhasker Sharma1 1 M.D. (Homoeopathy), Ph.D. Scholar (Homoeopathy), Tantia University, Sriganganagar, Rajasthan. Abstract Background: Dental treatment can be challenging sometimes in managing acute or chronic conditions due to side effects of treatment regimens. Homeopathy has recently gained importance as an alternative medicine for salivary pathology, apthous ulcers etc. However there is lack of sufficient evidence which shows that homeopathy may be beneficial in dentistry. Aim: The objective of this study is to clinically determine the role of homeopathy in treatment of apthous ulcer. Material and Methods: A cross sectional study was planned. A total of 150 patients aged above 18 years of age were selected for the study. Patients were divided into two group, study group and control group. Study group were treated with homeopathic medicine and patients were followed up for 7 days. Results: Of the 75 cases in study group 80% cases were healed completely on 7th day whereas only 26.6% ulcers were healed in control group. Pain intensity in study group was very less (2.6%) while it was 40% in control group. Conclusion: Based on the result of present study it was found that homeopathy can be considered as an alternative for allopathy. It is safe and without side effects. Keywords: Apthous ulcer, Homeopathy, Natural alternative. Corresponding Author: Dr. Bhaskar Sharma. M.D. (Homoeopathy), Ph.D. Scholar (Homoeopathy), Tantia University, Sriganganagar, Rajasthan. How to Cite: Sharma B. Role of Homeopathy Medicine in Treatment of Apthous Ulcer: A Randomized Study. Ida Lud J Le Dent 18;2(2):24-30. INTRODUCTION Apthous ulcer is one of the most common oral conditions frequently encountered by IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 patients as well as doctors. Approx 70-87% population are affected by minor recurrent apthous ulcer and it is considered to be the most common form. Minor apthous ulcers 24
are usually less than 1 cm in diameter and are self-limiting and can resolve in 7 to 10 days. 1,2 However, major apthous ulcer is bigger in size than minor and is painful in nature. 3 Various treatment modalities are available for painful ulcers like triamcinolone acetonide, colchicine, pentoxifylline, prednisolone, dapsone, levamisol, thalidomide, azathioprine, methotrexate. 4,5 Homeopathy is been used for years for treatment of various diseases and recently it has gained importance in dentistry as well. Few authors have reported that Belladonna is useful for toothache, early dental abscess. Arsenicum album is considered useful in pulp pathologies and Kreosotum is used for treatment of primary teeth. 6,7 Homeopathy is natural alternative to allopathic treatment and has no side effect. So we made an attempt to emphasize the importance of herbal medicine in treatment of apthous ulcer. MATERIAL AND METHODS A cross sectional study was planned and a total of 150 patients aged above 18 years was selected for the present study. Both males and females were included in the study. Inclusion criteria involved: All the patients presenting with apthous ulcer. There was no difference in sex and age distribution among different groups. Ethical clearance was obtained at the beginning. A detailed description regarding the investing procedures was explained to patients and attends. A written informed consent was obtained from patients. After selection of patients, size of ulcer was observed and pain intensity was recorded. All the patients were divided in two groups. Group 1 (study group) those receiving homeopathic treatment and group 2 (control group) those who will receive placebo. Group 1-75 patients Group 2-75 patients After initiation of treatment patients were monitored on 3 rd, 5 th and 7 th day. Size of ulcer was observed and pain intensity was recorded. RESULTS A total of 150 patients were selected for the study. Out of 150 patients 40% were males and 60% were females (Table 1). Patients were divided in two groups. Group 1 consisted of 75 patients; all 75 patients were given homeopathic medicines. Group 2 also consisted of 75 patients i.e. control group (Table 2). Of the 75 patient in study group, 26.6% ulcers showed mild improvement, 46.6% moderate, 24% were healed completely whereas.6% and no healing was seen in.6% patients on 3 rd day follow up. Where as in control group 25.3% ulcers showed mild improvement, 32% moderate, 6.6% ulcers were healed completely and 36% patients showed no sign of healing. 5 th day follow up showed following results; 24% mild improvement, 42.6% moderate improvement was evident and 33.3% were healed completely i.e. 25/75 patients in group 1. Whereas in group 2 mild improvement was observed in 29.3%, moderate in 25.3%, complete healing in % and 25.3% showed no healing i.e. 19/75. Overall improvement was found to be more in study group than control group (Table 3). 7 th day in study group 60/75 patients were healed completely i.e. 80%, 13.3% showed moderate improvement and 6.6% showed mild improvement. However in study group only 26.6% showed complete healing and no healing was evident in 16% cases (Table 3). Overall improvement was found to be greater in group 1. When intensity of pain was examined it was found that in study group 48% cases complaint of IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 25
moderate pain, 37.3% mild, 9.3% severe pain and 5.3% said they don t experience any pain. Whereas in control 50.6% complaint of moderate pain, 32% mild, and 13.3% suffered from severe pain only 4% had no pain on 3 rd day. 5 th day in study group 26.6% cases reported mild pain, 29.3% moderate, 4% severe and 40% said no pain. Whereas in control group 36% suffered from mild pain, 26.6% moderate, 10.6% severe and only 26.6% had no pain. On 7th day 90.6% cases in study group had no pain whereas in control group only 33.3% had no pain. Overall pain intensity was found to be more in control group. The difference in pain intensity was found to be significant. (p<0.001) Graph 1:: Patients demographic details PATIENTS 100 90 80 70 60 50 40 30 10 0 MALE FEMALE PATIENTS Table 1: DISTRIBUTION OF GROUPS Groups Number Percentage Group 1 (study group) Group 2 (control group) 75 50% 75 50% IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 26
TABLE 2: OBSERVATION OF ULCER SIZE ULCER HEALING DAY 3 DAY 5 DAY 7 Homeo Ctrl MILD 19 (25.3%) 18 (24%) 22 (29.3%) 5 (6.6%) 18 (24%) MODERATE 35 (46.6%) 24 (32%) 32 (42.6%) 19 (25.3%) 0 25 (33.3%) SEEVERE 2 (.6%) 27 (36%) 0 19 (25.3%) 0 12 (16%) HEALED 18 (24%) 5 (6.6%) 25 (33.3%) 15 (%) 60 (80%) TABLE 3: INTENSITY OF PAIN PAIN INTENSITY DAY 3 MILD 28 24 (37.3%) (32%) DAY 5 27 (36%) DAY 7 5 30 (6.6%) (40%) MODERATE 36 (48%) 38 (50.6%) 22 (29.3%) 2 (2.6%) 15 (%) SEEVERE 7 (9.3%) 10 (13.3%) 3 (4%) 8 (10.6%) 0 5 (6.6%) HEALED 4 (5.3%) 3 (4%) 30 (40%) 68 (90.6%) 25 (33.3%) IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 27
DISCUSSION Apthous ulcer is an inflammatory condition of mouth. Apthous ulcers can be single as well as multiple. These recurrent apthous ulcers can affect patient s speech, chewing and swallowing of food. Corticosteroids are considered to be gold standard treatment for apthous ulcers and other oral condition for years. 8 However these medicines have certain side effects. There comes the need of an alternative medicine. Homeopathy cannot replace the skills of a dentist but it can be vital adjunct for many cases. Based on the result of present study it was found that homeopathy is efficient in reducing the pain intensity as well as size of ulcer. 5 th day follow up showed following results; 24% mild improvement, 42.6% moderate improvement was evident and 33.3% were healed completely i.e. 25/75 patients in group 1. Whereas in group 2 mild improvements was observed in 29.3%, moderate in 25.3%, complete healing in % and 25.3% sowed no healing. 80% cases were healed completely on 7 th day in study group. A significant difference was found in pain instensity of both groups. On 7th day 90.6% cases in study group had no pain whereas in control group only 33.3% had no pain. FahimehMousavi et al reported that pain intensity and ulcer size were statistically significant at day 4 and at day 6 (P < 0.05) in their study and no adverse effects were observed. The authors recommended that homeopathy can be used in treatment of apthous ulcer. 2 our study is in agreement with the authors.study conducted by Fontes et al. reported that colchicine improved pain and size of ulcer RAS in 63% of cases. 9 various other authors have reported that Pentoxifylline reduces the symptom of apthous ulcer from 36% to 63% and is often associated with recurrence. 10,11 Though there is lack of evidence in the literature based on our study we found homeopathy to be effective in treatment of apthous ulcer. CONCLUSION Within the limits of our study we conclude that homeopathy is a safer alternative to allopathic used in treatment of apthous ulcer. It effectively reduces patient discomfort by reducing the pain. Marked improved is evident in size of ulcer. More research with a greater sample size is warranted for the same. REFERENCES 1. Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am 05; 49(1): 31 47, vii viii. 2. Fahimeh Mousavi et al. Homeopathic treatment of minor aphthous ulcer: a randomized, placebo-controlled clinical trial. Homeopathy 09:98, 137 14. 3. Rogers RS 3rd. Recurrent aphthous stomatitis, clinical characteristics and associated system disorders. Semin Cutan Med Surg 1997; 16(4): 278 283. 4. Aguirre JM, Bagan JV, Rodriguez C, et al. Efficacy of mometasonefuroate micro emulsion in the treatment of erosiveulcerative oral lichen planus: pilot study. J Oral Pathol Med 04; 33: 381 5. 5. Altenburg A, Abdel-Naser MB, Seeber H. Practical aspects of management of recurrent aphthous stomatitis. JEADV 07; 21:1019 1026. 6. Goel P, Torwane N, Hongal S, Chandrashekhar B. Homeopathic medicine An adjuvant for dentistry. IAMJ. 14;2:3 10. 7. Bhateja S, Arora G, Mahna R. Complementary & alternative therapy in dentistry: Homeopathy A review. Ann Essenses Dent. 13;5:36 40. IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 28
8. Lee Y, Chien YW. Oral mucosa controlled delivery of LHRH by bilayer mucoadhesive polymer systems. J Control Release 1995;37(3):251-61. doi: 10.1016/0168-3659(95)00082-8 9. Fontes V, Machet L, Huttenberger B, Lorette G, Vaillant L. Recurrent aphthous stomatitis: treatment with colchicine. An open trial of 54 cases. Ann Dermatol Venereol 02; 129: 1365 1369. 10. Garcia Callejo FJ, Orts Alborch MH, Molrant Ventura A, Segarra Cortes P, Marco Algarra J. Recurrent aphthous stomatitis and clinical response to pentoxifylline. Acta Otorrinolaringol Esp 1999; 50: 671 673. 11. Chandrasekhar J, Liem AA, Cox NH, Paterson AW. Oxypentoxifylline in the management of recurrent aphthous oral ulcers: an open clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87: 564 567 Conflict of Interest:NoneSource of Support: NiL This work is licensed under a Creative Commons Attribution 4.0 International License IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 29
IDA Ludhiana s Journal ledentistryvol.2 issue 2 18 30