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WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES
Vitthal et al. World Journal of Pharmacy and Pharmaceutical Sciences

SJIF Impact Factor 7.632
Volume 11, Issue 11, 753-765 Review Article ISSN 2278 – 4357
HERBAL REMEDIES USED IN THE TREATMENT OF MOUTH

ULCER: A SYSTEMATIC REVIEW
Ugale Rohit Vitthal* and Deshmukh Krushna Balasaheb
Student of Final Year B.Pharmacy at S.N.D. College of Pharmacy, Babhulgaon, Yeola.
Article Received on
ABSTRACT
17 Sept. 2022, Mouth ulcers are one of the most common diseases of oral mucosa. It
Revised on 07 Oct. 2022,
Accepted on 27 Oct. 2022 is also known as canker sores, RAS (recurrent aphthous stomatitis).
DOI: 10.20959/wjpps202211-23588 Mouth ulcer are open sores appears inside the mouth. They are painful,
white ulcers of inner lips, cheeks and gums. These sores typically heals
*Corresponding Author in 10 to 14 days. Common causes of mouth ulcers include infection,

Dr. Ugale Rohit Vitthal numerous viral, fungi, some hormonal changes, physiological stress
Student of Final Year and some nutritional deficiencies, iron, mechanical injury, food
B.Pharmacy at S.N.D.
allergy, skin disease etc. Herbal medicines is an effective and safer
College of Pharmacy,
alternative to synthetic medication. The purpose of this article is to
Babhulgaon, Yeola.
discuss the effectiveness of most popular herbal remedies in treating
mouth ulcers. This review article involves the information about herbal remedies used in the
treatment of mouth ulcers which includes iscussion about turmeric, aloe vera, guava leaves,
honey, ginger, tulsi, neem along with their family, uses and chemical constituents.
KEYWORDS: Mouth ulcer, RAS, Herbal remedies, turmeric, tulsi.
INTRODUCTION
A mouth ulcer is a pathological condition of the oral cavity in which loss of mucosal
membrane occurs, it is also known as a mucosal ulcer. They are round and painful sores
appear inside the lips and cheeks.[1] Mouth ulcers are common and developed with many
other diseases. The exact causes of mouth ulcer is not known. Common causes of mouth
ulcers include infection, numerous viral, fungi, treponemal, some hormonal changes,
physiological stress and some nutritional deficiencies such as vitamins especially B12 & C,
iron, mechanical injury, food allergy, skin disease etc. It can be painful during eating,
drinking or brushing teeth.[2]
www.wjpps.com │ Vol 11, Issue 11, 2022. │ ISO 9001:2015 Certified Journal │ 753
Treatment of mouth ulcer includes antiseptic mouthwashes, antibiotics like doxycycline

mouthwash, antiviral gels like luliconazole, Benzalkonium chloride. Herbal medicinal plant
such as aloe barbadensis, ocimum tenuiflorum, azadirachta indica, and guava leaves, Indian
cherry leaves, turmeric etc. are also used in the treatment of oral ulcer.[3,4]
Types of mouth ulcer

Minor ulcer
It is a small oval, round having a diameter of 2 to 8 mm, they can heal in two weeks.
Fig. 1: Minor ulcer.
Major ulcer
These are bigger and dipper, they are 1 cm or larger in size with irregular border. It can take
several weeks to heal. It can leave scars in the mouth.
Fig. 2: Major ulcer.
Herpetiform ulcer
It is a very small ulcer which is 2-3 mm in diameter. This is a collection of tiny ulcers. They
can heal within 7 to 10 days without leaving any scars.[5]
Fig. 3: Herpetiform ulcer.
Factors responsible for the mouth ulcer

 Emotional stress
Ulcer is associated with Stress and Physiological instability. It is noted that the patient having
high stress has more chance of causing ulcer. Therefore antidepressant medication lowers the
chances of ulcer.
 Hormonal changes
Due to some hormonal changes during the menstrual cycle, some women can experience oral
changes like canker sores, bleeding gums.
 Drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac can result in oral ulcers.
This type of ulcer appears due to side effects of the drug and disappears when the use of drug
is being stopped.
 Allergies and Sensitivities
Food allergies- it include chocolate, coffee, tomato, almonds, cheese, peanuts can cause
aphthous ulcers.
 Genetic
Serious ulcers are due to genetic susceptibility. About 40% of people have ulcers due to
family background.
 Mechanical injury
Mechanical injury can occur due to local anaesthetic injection, dental procedure, sharp teeth,
brush injuries and these are responsible for aphthous ulcers.
 Mechanical trauma
Due to lack of sufficient saliva and emergence of RAS (recurrent aphthous stomatitis), by
failing to lubricate and shield the mouth mucosa and form trauma.
 Deficiency of vitamin B12

Due to lack of iron, folic acid, vitamin B12 which may result in the occurrence of RAS.
Hematinic deficiency expand the RAS.[1]
Other factors which causes mouth ulcer

 Infections such as bacterial and viral infection.
 Mouthwashes, Toothpastes which have sodium lauryl sulphate.
 Some medical conditions.
 Spicy food and fruits containing citric acid.
 Chewing or biting inside of the cheeks and tongue.
 Use of painkillers[6,7]
Cause of oral ulcer

Microbial disease Malignant neoplasms
 Chickenpox blood disorder
 Hiv infection  Anaemia
 Fungal infection  Leukaemia
 Tuberculosis  Neutropenia
 Syphilis Gastrointestinal disease
 Herpetic stomatitis  Ulcerative colitis
 Herpes zoster  Crohn’s disease
 Hand, foot and mouth  Coeliac disease
disease
Herbal remedies[8]
Herbal remedies which include herbs, herbal material, herbal preparation, finished herbal
preparation contain active ingredients from any part of plants or whole plant.[9] Indian flora
contains a wide range of medicinal plants that have been used to treat mouth ulcers. There are
some side effects associated with allopathic medicines. That’s why there is a need to
investigate or research such herbal medication for better patient acceptance.[10] Herbal
compounds having anti-ulcer activity include saponins (from Panax japonicus, kochia
scoparia), Flavonoids (silymarin, naringin, quercetin, anthocyanosides and sophoradin),
Tannins (from lindera umbellata), Gum guar and myrrh, Liquorice, aloe gel and
capsicum.[11,12]
Advantages of herbal remedies

1) Herbal remedies are safe and effective for use.
2) Herbal remedies are widely accepted by the people or patients.

3) It can be used for a long time.
4) Medicinal plants are widely present in developing countries like India, it has a sufficient
supply.
5) Herbal remedies are environmentally eco-friendly.
6) They are economically cheap and less expensive.[13,14]
1. Turmeric
Common name: Haldi
Scientific name: Curcuma longa
Biological Source: It is the dried rhizome of Curcuma longa Linn.
Family: Zingibereaceae
Chemical constituents: Diarylheptanoids, curcumin, dimethoxycurcumin,
bisdimethoxycurcumin.
Use: Anti-inflammatory, antiulcer, anti-arthritic activity, antioxidant, anticarcinogenic,
antimutagenic, anticoagulant, antifertility, antidiabetic, antiulcer, antibacterial.[15]
Fig. 4: Turmeric.
Turmeric is used in the treatment of RAS. Turmeric helps in reducing the pain of the ulcer.
Curcumin shows wound healing activity, so it also effective in the treatment of mouth ulcer
by increasing cellular proliferation & collagen synthesis at the wound site as evidenced by
increase in DNA and total protein & also shows increase in type-Ⅲ collagen content of
wound tissue, results in faster rate of epithelialization and wound contraction, it also shows
increase in tensile strength.[16]
2. Aloe vera
Common name: Aloe vera
Scientific name: Aloe Barbadensis
Biological source: Aloe is dried latex of leaves of aloe vera.
Family: Liliaceae
Chemical constituents: sterols, amino acids, enzymes, anthraquinones, lignins, vitamins,
minerals, polysaccharides, monosaccharide, saponins, salicylic acid.
Use: antiulcer, anti-inflammatory, anti-diabetic, antioxidant, anticancer, healing.[17]
Fig. 5: Aloe vera.
Aloe Vera is used in the treatment of mouth ulcers, its anti-inflammatory property helps in
reducing the pain of ulcer. Aloe vera shows soothing and wound healing activity on burn.
Through cell proliferation, aloe vera boosts the rate of wound closure and the tensile strength
when applied to wounds this is due to aloe vera. Aloe vera speeds up blood flow to the areas
that have been injured by increasing the amount of collagen and the level of collagen cross
linking therefore promoting wound concentration and breaking of scar tissue. Antibacterial
action of aloe vera helps in wound healing.[18]
3. Guava leaves
Common name: Guava leaves,(Amrood)
Scientific name: Psidium guava-java.
Biological source: Psidium guajava L.
Family: Myrtaceae
Chemical constituents: Flavonoids, (Quercetin and its glycosides), tannis, saponin, oleanolic
acid.
Fruit: Vitamins, iron, phosphorus & calcium.

Use: Antimalarial, antiulcer, anthelmintic, analgesic, antispasmodic.[19]
Fig. 6: Guava leaves.
Guava leaves are used in the treatment of aphthous ulcers. Specificcally it reduces the pain of
ulcer and effectively decreases the size of ulcer. The guava leaves are most frequently used to
treat and disinfect wounds by rinsing affected areas with decoction of the leaves. The
presence of flavonoids extracted from guava leaves, such as quercetin, morin-3-o-lyxoside,
and morin-3-o-arabinoside, may shows a significant reduction in the size of aphthous ulcers.
Antiviral and antibacterial properties were observed for 3-0-arabinoside. One of the potential
causes of the healing of an aphthous ulcer is characterised by hypersensitivity and
inflammation and size of ulcer are reduced by the action of flavonoids.[20]
4. Neem
Common name: Neem
Scientific name: Azadirachta indica
Biological source: It consists of leaves and other aerial parts of Azadirachta indica.
Family: Meliaceae
Use: Anti-inflammatory, Anti ulcer, Anticarcinogenic, Anti oxidant, anti mutagenic, Anti
bacterial, Antiviral, Antifungal, Antihyperglycemic.[21]
Chemical Constituent: Azadiractin, nimbin, DPPH, Azadiradione, salnnin, Azadirone,
gedunin, 2-pentadecanone, methyl starate, phytole, nimbidin, gueraceatin, ascorbic acid,
amino acid, polyphenolic flavonoids.[22]
Fig. 7: Neem.
Neem leaves are rich with antioxidants, they improve the immune response in gum and tissue
of the mouth, which are good remedies for mouth ulcers. Neem leaves act as pain reliever in
mouth ulcer and toothache problems.[23] Neem contain azadirachtin, nimbin, nimbidin,
nimbolide, have antibacterial effect. Neem inhibit the growth of bacteria and fungi Neem
leaves show anti-inflammatory effect. Neem leaves play an important role in wound healing
by tensile strength of the healing tissue. Azadirachta indica leaf extracts stimulates wound
healing by triggering an inflammatory response and neovascularization.[24]
5. Honey
Common name: Madhu, Mel.
Scientific name: Honey.
Biological source: Honey is a sugar secretion deposited in honey comb by the bees.
Family: Apidae
Chemical constituents: Glucose, Fructose, Sucrose, dextrin, formic acid, protins, enzymes,
vitamins.
Uses: Antiseptic, Antibacterial, anti-inflammatory, immune boosting, antifungal.[25]
Fig. 8: Honey.
Honey is used in treatment of minor RAS. The rate of tissue regeneration is accelerated by
honey and inhibition of edema, exudation, malodour, inflammation in wounds. Since honey is
readily available worldwide and is less expensive, it could be used as an alternative treatment
for the patients who have oral ulcers. Honey reduced the severity of the pain, the size of the
ulcer and the erythema in a safe and effective manner.[26]
6. Ginger
Common name: Ginger.
Scientific name: Gingiber officinale
Biological source: Ginger consists of the rhizomes of Zingiber officinale.
Family: Zingiberaceae
Chemical Constituents: Gingerol, shigaol, sesquiterpene, hydrocarbons, oleoresin.
Uses: Anticancer, Antiulcer, Anti-inflammatory, Antioxidant, antimicrobial, anti-diabetic.[27]
Fig. 9: Ginger.
Ginger is used in the treatment of Aphthous ulcers. Anti-inflammatory effect of ginger reduce
the pain of ulcer. With the help of mucoadhesive containing liquorice extract decrease the
size of lesion and also reduce the pain. Yanoacrylate-2-octyle mucoadhesive which help in
wound healing, decrease the time (duration) of healing and also decrease the size of lesion.[28]
7. Tulsi
Common name: tulsi
Scientific name: Ocium sanctum.
Biological source: It consists of fresh and dried leaves of Ocimum sanctum Linn.
Family: Lamiaceae
Chemical Constituents:
Fixed oil: Linoleic acid, Linolenic acid, oleic acid, Palmitic acid.
Essential oil: eugenol, cubenol, Linalial, carinene

Minerals: Vitamin C, Vitamin A, calcium, Zink, iron.
Uses: Anti-cancer, antiulcer, antiarthmitic, antibacterial, antifungal, antioxidant, anti-
inflammatory, anti-helminthic, antispasmodic, imunomodulatory.[29]
Fig. 10: Tulsi.
Tulsi is used in the treatment of different types of ulcers. Due to its anti-inflammatory, anti-
bacterial, anti-oxidant and immuno-modulatory characteristics, tulsi can be promising herb in
the treatment of various oral disorders. Tulsi leaves are effective in oral infection. Tulsi
leaves include antibacterial like carracrol and terpene & sesquiterpene b carbophyline. Tulsi
leaves can be chewed to maintain good dental hygiene. The tulsi has immunomodulatory
properties. Additionally it affects the hemopoetic tissues and skin. Thus, Tulsi can be applied
to oral Lichen planus therapy. Tulsi helps in healing the sores of ulcers. Antiulcer effect of
tulsi is due to cytoprotective effect.[30]
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WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES

Vitthal et al. World Journal of Pharmacy and Pharmaceutical Sciences

HERBAL REMEDIES USED IN THE TREATMENT OF MOUTH

Ugale Rohit Vitthal* and Deshmukh Krushna Balasaheb

Student of Final Year B.Pharmacy at S.N.D. College of Pharmacy, Babhulgaon, Yeola.

*Corresponding Author in 10 to 14 days. Common causes of mouth ulcers include infection,

KEYWORDS: Mouth ulcer, RAS, Herbal remedies, turmeric, tulsi.

Treatment of mouth ulcer includes antiseptic mouthwashes, antibiotics like doxycycline

Types of mouth ulcer

Fig. 1: Minor ulcer.

Fig. 2: Major ulcer.

Fig. 3: Herpetiform ulcer.

Factors responsible for the mouth ulcer

 Deficiency of vitamin B12

Other factors which causes mouth ulcer

Cause of oral ulcer

Advantages of herbal remedies

2) Herbal remedies are widely accepted by the people or patients.

Fig. 5: Aloe vera.

Fruit: Vitamins, iron, phosphorus & calcium.

Fig. 6: Guava leaves.

Essential oil: eugenol, cubenol, Linalial, carinene

Fig. 10: Tulsi.

4. Nikita Shahare, Shailendra Chouhan, G. N. Darwhekar. Herbs Used in treatment of

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