Review Article

Aged Garlic Extract as a Wonder Herb in Medicine and Oral

Care: A Comprehensive Review
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Sakshi Kataria, Swatishree Sahoo, Charu Mohan Marya, Ruchi Nagpal, Pratibha Taneja
Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
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Abstract
There has been a sudden high demand of the population for herbal products in the current scenario. Plant‑derived various natural products
have been utilized in the treatment of various diseases since ancient times. The constituents of these products are mostly herbal extracts, such
as polyphenols, garlic, turmeric, aloe vera, green tea, neem, fenugreek, and basil leaves. The most active and beneficial component of garlic is
considered allicin. It has the following properties such as antibiotic effect, antioxidant effect, cholesterol biosynthesis inhibition, antineoplastic
activity, and anti‑inflammatory effect. A wide range of beneficial effects of garlic extracts has been seen to have on oral health. Garlic extracts
have proven to be a potential agent for reducing gingival and periodontal diseases in many studies. In an in vitro study, aged garlic extract (AGE)
showed gingival wound healing. AGE has proved to be effective against chlorhexidine gluconate in inhibiting plaque bacteria in vitro as well
as in vivo. Garlic extracts have antimycotic activity toward a group of fungal agents which also includes its role in denture stomatitis. Due to
its role in inhibiting carcinogenesis, AGE is shown to improve the signs and symptoms of stage II oral submucous fibrosis patients. Despite
all the beneficial effects, it has a potential risk factor for postsurgical bleeding, chemical burn in oral mucosa, malodor, and mucosal irritation.
With all the health benefits, AGE can be used as an alternate to other antibiotics and a potential agent for many oral diseases.

Keywords: Aged garlic extract, garlic extract, herbal extract, oral diseases, oral health, oral pathogens

Introduction with their adverse effects on individuals and the resistance of

the concerned microbes to react.[4,5] The herbal products have
The oral cavity is a useful marker of health and disease
recently come to light as a result of their limited availability or
in humans. The interactions between oral diseases and a
supply during the pandemic. Herbal extracts and polyphenols
person’s overall health are varied and complex.[1] Oral health
derived from herbs constitute a variety of ingredients,
is influenced by systemic diseases, either by the directly
exhibiting anti‑inflammatory, antioxidative, and antimicrobial
approachable pathological pathways or by the indirectly
properties.[5] Plant‑derived and various natural products have
approachable diseases that are related to behavioral changes.
been utilized in the treatment of various diseases since ancient
Approximately 80% of adults worldwide suffer from oral
times. These products consist of herbal extracts, polyphenols,
diseases.[2] Major oral diseases are caused by inflammatory
garlic, turmeric, aloe vera, green tea, neem, fenugreek, basil
changes in the oral cavity, which are aggravated by the
leaves, etc.[6] Because of their ease of availability, lack of
accumulation of reactive oxygen species (ROS). As a potential
or minor adverse effects, lack of product resistance for
site for investigation, remedial access, and discovery, the oral
individuals, and greater efficacy of plant medicines than
cavity also offers newer methods for the local administration
current medicinal products, the general population is more
of remedies for both oral and systemic diseases.[3]
Prevention and cure for oral diseases are done through Address for correspondence: Dr. Swatishree Sahoo,
pharmacological or surgical therapy.[4] The pharmacological Department of Public Health Dentistry, Sudha Rustagi College of Dental
sources can further be classified as chemical products and Sciences and Research, Faridabad, Haryana, India.
herbal products. The chemical products are mainly concerned E‑mail: sahoo.swatishree7@gmail.com

Received: 24‑11‑2022 Revised: 14‑03‑2023 Accepted: 18‑07‑2023 Published: 20-12-2023 This is an open access journal, and articles are distributed under the terms of the Creative
Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to
Access this article online remix, tweak, and build upon the work non‑commercially, as long as appropriate credit
Quick Response Code: is given and the new creations are licensed under the identical terms.
Website: For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com
www.jiaphd.org

How to cite this article: Kataria S, Sahoo S, Marya CM, Nagpal R,

DOI: Taneja P. Aged garlic extract as a wonder herb in medicine and oral
10.4103/jiaphd.jiaphd_241_22 care: A comprehensive review. J Indian Assoc Public Health Dent
2023;21:288-93.

288 © 2023 Journal of Indian Association of Public Health Dentistry | Published by Wolters Kluwer - Medknow
 Kataria, et al.: Aged garlic extract as a wonder herb in medicine
inclined toward herbal products.[5,6] There have been sudden
high demands from the population for herbal products in the
current scenario.
The therapeutic uses of garlic, i.e., Allium sativum, are
ancient.[7] The Egyptian tombs were engraved with drawings
and carvings of garlic dating back to 3700 BC. It is used for
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heart disease, tumors, and headaches as therapeutic purposes,
which have been well documented since 1550 BC in the
Egyptian Codex Ebers. Garlic is also cited in the Holy Bible
and in many countries, as a conventional treatment, primarily
in the Near East, China, and India. The garlic products being
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marketed are divided into two categories: allicin‑potential
products and nonallicin‑potential products. The former
products originate from raw garlic, while the latter products
are derived from processed garlic. Out of all the constituents
of garlic, the most therapeutic agent is allicin.[6,8]
The garlic preparations that contain pharmacologic activities
are mostly seen in raw garlic juice, heated garlic juice,
dehydrated garlic powder, and aged garlic extract (AGE).[9]
These garlic extracts have also recently been utilized as a
source of therapeutic ingredients for various oral diseases. As
a potential antioxidant, anti‑inflammatory, and antimicrobial
agent, AGE has all of the positive effects for oral diseases.
Several in vitro and in vivo studies have revealed promising
results for garlic extracts as a potent herbal agent in the defense
of oral diseases. Hence, this review article summarizes all the
beneficial effects of AGE not only on the whole system but
also on the oral cavity.
Literature Search
Searches were made from the following sources without any
restriction on date but only in English. Searches were made
in the following databases: PubMed, EMBASE, Web of
Sciences, EBSCO, Google Scholar, and by hand. A total of
914 articles were retrieved. A total of 52 articles were found to
be relevant according to the aim of the present review. Out of
52, 6 articles were excluded because the full text could not be
retrieved. Hence, a total of 43 full‑text articles were included
for the present review, among which 9 were randomized
controlled trials, 20 were in vitro studies, 11 were review
articles, 2 were systematic reviews, and 1 was a case report
study [Figures 1 and 2].
Mechanism of Action of Aged Garlic Extract
Allicin is the most active and beneficial component of garlic. It
has the following properties: antibiotic effect, antioxidant effect,
cholesterol biosynthesis inhibition, antineoplastic activity, and
anti‑inflammatory effect.[8,9] The major organosulfur compounds
in raw garlic include water‑soluble S‑allylcysteine (SAC) and
S‑allylmercaptocysteine. Lipid‑soluble compounds include
diallyl sulfide, triallyl sulfide, diallyl disulfide (DADS),
diallyl polysulfides, and others. Allicin has poor stability
and is of a transient nature with oxidant activity. As a result,
after ingestion, garlic decomposes into other forms of
Journal of Indian Association of Public Health Dentistry ¦ Volume 21 ¦ Issue 4 ¦ October-December 2023
EBSCO – 13 EMBASE – 45
Total – 914
PUBMED – 494 Google scholar – 346
Relevant articles – 51
Web of science – 10 (abstracts)
Hand search – 6
Relevant articles – 40
(full texts)
Review articles – 11 Randomized
In vitro studies – 20
controlled trials – 9
Figure 1: Search results
organosulfur compounds that are virtually undetectable in
blood circulation.[10]
Allicin’s main antimicrobial mechanism is that it reacts very
quickly with free thiol groups through thiol‑disulfide exchange.
It interacts with thiol‑containing enzymes, including cysteine
proteases and alcohol dehydrogenases. Recently, a study by
Kodera et al.[8] on the chemistry of AGE has shown that ATrSA
is present in AGE but not in raw garlic.
Pharmacokinetics
The pharmacokinetic properties of garlic are determined by
its components and formulations. The physiological functions
of the body, such as oral absorption, tissue distribution,
metabolism, and excretion, are associated with these properties.
The pharmacologic effect is established by sufficient absorption
of each active constituent to reach the target organs or tissues.[8]
Various authors such as Lachmann et al.,[11] Pushpendran
et al.,[12] and Wang et al.[13] evaluated the pharmacokinetics of
hydrophobic sulfur components from garlic preparations, such
as allicin, vinyldithiins, and allylpolysulfides, in mice and rats
after oral administration. The following results of the studies
were that those hydrophobic compounds, due to their metabolic
instability, were not identified in rodent urine samples,
though they were absorbed in the gastrointestinal tract. In
a study reported by Guo et al.,[14] the oral bioavailability of
alliin (a prototype of allicin) in rats was 16.5%. Matsutomo
et al.[15] in their study, experimented on the pharmacokinetics of
cycloalliin in rats, and the results showed its absorption with a
relatively low bioavailability. In addition to that, a deoxidized
form of cycloalliin has better absorption than cycloalliin,
which was also reported. Nagae et al.[16] in their study on mice,
rats, and dogs for the pharmacokinetics of SAC, a deoxidized
form of alliin, showed that SAC has high absorption with oral
bioavailabilities ranging between 87% and 102%. Kodera
et al.[8] evaluated the pharmacokinetics of SAC in humans and
suggested that after ingestion of AGE, blood concentrations
of SAC lasted long (t1/2, >10 h). Recently, Amano et al.[17]
reported on the metabolism and pharmacokinetics, of three
S‑alk(en)yl‑L‑cysteines in AGE, S‑allylmercaptocysteine
(SAMC), SAC, and S1PC, which are deoxidized forms of
methiin, alliin, and isoalliin, respectively. Results were good
oral absorption in rats and dogs with bioavailabilities of
88%–100%.
289
 Kataria, et al.: Aged garlic extract as a wonder herb in medicine
EBSCO – 13 PubMed – 494 Web of science – 10
Records identified through all the
database searches (n = 914)
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Records screened for title
(n = 427)
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 05/06/2024
Records screened
for abstract (n = 51)
Full text articles included
in the review (n = 40)
Figure 2: Flowchart for the included and excluded studies
Effects on Systemic Health
Effect on the cardiovascular system
A randomized controlled trial by Ried et al.[18] suggested
that daily consumption of two capsules of 1.2 g of AGE
and 1.2 mg of SAC significantly lowered systolic blood
pressure (SBP) by 5 mmHg compared with placebo.
Polysulfides (garlic‑derived) also manipulate blood
pressure (BP) through the nitric oxide‑and hydrogen
sulfide‑signaling pathways.[18] The results of a meta‑analysis
of 20 clinical trials performed from 1988 to 2013 showed
that garlic supplements decreased the BP of 970 participants
with a mean ± SE (standard error) decrease in SBP of
5.1 ± 2.2 mmHg (P = 0.001) and a mean ± SE decrease
in diastolic BP of 2.5 ± 1.6 mmHg (P = 0.002).[8,18] Ried[19]
performed a double‑blind, randomized, placebo‑controlled
parallel trial on adult patients with uncontrolled hypertension.
Results reported that AGE consumption may be used
as a conventional antihypertensive therapy. Matsutomo
et al.[15] evaluated the effects of AGE and its two major
sulfur‑containing constituents, SAC and S1PC, on
spontaneously hypertensive rats in their study. They found
out that the development of hypertension was delayed in the
SAC‑treated animals but was not significantly different from
the vehicle‑treated controls.
Effect on the hemopoietic system
A wide range of patients with a variety of medical problems,
including hypercholesterolemia and hypertension, are on
AGE extract or other garlic‑based agents.[20,21] These patients
can also have comorbidities such as deep vein thrombosis,
which requires anticoagulation therapy. Garlic has potential
antiplatelet properties.[22]
Macan et al.’s[22] randomized controlled trial suggested that
there was no increase in bleeding with the collateral use of
290 Journal of Indian Association of Public Health Dentistry ¦ Volume 21 ¦ Issue 4 ¦ October-December 2023
Google scholar – 346 Hand search – 6
Duplicate removed (n = 487)
Records excluded after
screening for title (n = 376)
Records excluded after
screening for abstract (n = 6)
AGE in patients on oral anticoagulation (warfarin) therapy.
The results suggest that AGE may be carefully administered
along with anticoagulation therapy. Malhotra et al.[23] showed
in their study that garlic consumption causes inhibition of
platelet aggregation. As a result, there is an increased risk of
pathological bleeding following surgical procedures.
Effect on the neurological and hepatic systems
Garlic has been shown in animal studies to have potential
protective effects against the damage caused by methotrexate
and 5‑fluorouracil in colorectal therapy.[7] Evidence from
both in vitro and animal studies states that AGE has a
protective action against the hepatic damage caused by
environmental compounds such as bromobenzene and against
cardiotoxicity caused by doxorubicin.[24] Similarly, DADS
also has protective effects against ethanol‑induced hepatic
damage. Garlic has neurological effects on the brain. Like
protection from a loss of intellectual capacity, memory, and
depression, and acts as a potential preventive and therapeutic
agent in the treatment of Alzheimer’s disease.[25,26] Factors
associated with aging, such as spatial memory deficits, are
also being improved by garlic extracts. Data from some
studies show that large amounts of garlic products should be
avoided during the period of neural growth because DADS
may have adverse effects on hippocampal neurogenesis and
neurocognitive functions.[10,27]
Influence on carcinogens or risk factors
The antioxidant activity is due to its major, unique organosulfur
compounds, which are water‑soluble.[26,27] AGE has the potential
to enhance radioprotection and ultraviolet suppression by
increasing glutathione peroxidase and other ROS‑scavenging
enzymes, thereby reducing the risk of radiation‑and
chemically‑induced cancer.[27,28] It also helps in preventing
the range of ROS‑induced DNA, lipid, and protein damage
 Kataria, et al.: Aged garlic extract as a wonder herb in medicine
implicated in disease and aging processes.[29] AGE has a
potential effect on regulating HIV replication by inhibiting
tumor necrosis factor‑and hydrogen peroxide‑induced
activation of NF‑kB in human T‑cells.[30]
Effect on Oral Health
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Suppression of pathogenic oral microflora and effect on
plaque microorganisms
Garlic extract has a beneficial effect against many dental and
periodontal pathogens, and it also inhibits arginine–gingipain,
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a cysteine protease that acts as a major virulence factor of
Porphyromonas gingivalis (the oral pathogen most associated
with chronic periodontal disease).
Bachrach et al.[31] conducted a study to evaluate the antibiotic
action of pure allicin against common oral pathogens, against a
biofilm of Streptococcus mutans, and as an agent to inactivate
proteases associated with the virulence of P. gingivalis.
Allicin inhibited the growth of all bacteria tested, including
the Gram‑positive caries‑associated bacteria S. mutans,
Streptococcus sobrinus, and Actinomyces oris, which were
slightly less sensitive to allicin than the Gram‑negative
periodontitis‑associated bacteria Fusobacterium nucleatum
and Aggregatibacter actinomycetemcomitans. Therefore, the
results suggested that the gingipain proteases contribute to the
relative resistance of P. gingivalis to allicin.
Bakri and Douglas[32] also suggested in their study the evident
inhibitory effect of garlic against Candida albicans and also
it was very active against a range of oral Gram‑negative
species while being less active against oral Gram‑positive
species. Altogether, the assumed periodontal pathogens
tested (A. actinomycetemcomitans, F. nucleatum, P. gingivalis,
and Prevotella intermedia) had lower minimum inhibitory
concentrations and maximum bacterial concentrations than
the other organisms tested.
The antimicrobial effect of garlic extract has been proven
to be effective against Gram‑positive bacteria and some
Gram‑negative pathogens. Pratiwi et al.[33] conducted a study in
Jakarta to show the viability of biofilms produced by S. mutans
serotypes c and f. Garlic (A. sativum) is known to inhibit the
proliferation of various types of pathogenic bacteria. There was
a statistically significant decrease (P ≤ 0.001) in the viability
of biofilms produced by S. mutans serotypes c and f when
exposed to garlic extract concentrations of 50% and 100%.
El‑Samarrai and Rashad’s[34] in vitro study indicated that garlic
extracts (water and ethanol) and chlorhexidine were effective
in retarding the acid production by Mutans Streptococci.[35]
Another study by Chavan et al.[36] showed that the garlic
extract was found to be effective against S. mutans when tested
in vitro and in vivo.
Effect on gingival and periodontal health
Periodontal diseases are initiated by pathogens such as
P. gingivalis by producing inflammatory reactions in gingival
Journal of Indian Association of Public Health Dentistry ¦ Volume 21 ¦ Issue 4 ¦ October-December 2023
tissues. The chronic inflammation caused by such pathogens
leads to retraction of the gingiva, resorption of the alveolar
bone, and tooth loss. Bachrach et al.[31] stated in their study
that the beneficial effects on oral health by relieving gingival
inflammation and gingival bleeding. Shetty et al.[37] also
exhibited protease activity of the periodontal pathogens,
which shows garlic extracts as a potential therapeutic agent for
periodontitis. Bramanti and Ngatidjan[35] conducted an in vitro
study on Wistar rats and experimented with garlic extract’s
effects on gingival wound healing.
Antimycotic activity
Cavallito et al.[38] in 1944 discovered the compound allicin. It
has an antibiotic and antifungal compound (phytoncide), and
its unstable oil fraction is the most potent active anti‑Candida
component.[39] In many in vivo studies, aqueous garlic extract
has been shown to be effective even at a dilution of 1:100
against the common tinea corporis, capitis, and cruris fungal
skin infections.[40]
Disegha and Akani’s[41] in vitro study showed the antimycotic
activity of garlic extract on Aspergillus nidulans, Penicillium
niger, C. albicans, and Scupularis species against a conventional
antifungal agent (fluconazole 10 mg). Results obtained by
measuring zones of inhibition of fungal growth after 24 h of
incubation showed high but varied levels of antifungal efficacy.
Bakhshi et al.[42] conducted a randomized clinical trial on
40 patients with denture stomatitis to compare the efficacy of
nystatin mouthwash against aqueous garlic extract. During the
course of the study, nystatin accelerated erythema recovery.
Many in vitro studies are carried out to show the effect of garlic
extracts on C. albicans. A study by Groppo et al.[43] showed
the antimicrobial activity of garlic extract as an alternative
to chlorhexidine. Khodavandi et al.[44] showed the antifungal
effect of allicin alone and in combination with azoles against
Candida strains.
Effect on oral submucous fibrosis
Jiang et al.[45] conducted a randomized clinical trial in a
Chinese patient cohort to show the efficacy and safety of allicin
in the treatment of stage II oral submucous fibrosis (OSF).
The comparison was against triamcinolone acetonide;
both injections were given intralessionally once a week for
16 weeks. At 40 weeks, the results of this study showed
an increase in mouth opening, improvement in the burning
sensation, and a higher Oral Health Impact Profile‑14 score
in the allicin group than in the TA group. Allicin intralesional
injections improved mouth opening, burning sensation, and
oral health‑related quality of life in these stage II OSF patients.
Allicin can be used as an adjunctive treatment for OSF patients.
Effect on dental hard tissues
Garlic extract has been shown to be not only effective for soft
tissue but also bacteriostatic due to the enzymatic activity
of alliinase. It has also been reported that garlic extract
has inhibitory potential against isolated multidrug‑resistant
S. mutans strains from human caries teeth.
291
 Kataria, et al.: Aged garlic extract as a wonder herb in medicine
Mohammad et al.’s[46] study revealed no significant difference
between the radiographic findings of vital pulpotomy in
primary molars with the two medicaments was found. Mahfouz
and Wahba[47] revealed that there was moderate‑to‑severe
inflammation in the formacresol‑treated group and the presence
of severe pulpal fibrosis. Odontoblast remained vital in most
cases treated with both tri‑antibiotic paste and A. sativum. In
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both studies, it was concluded that A. sativum oil has a good
healing potential, which makes the residual pulp tissues healthy
and functioning.
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Limitations
Being a potential herb with many therapeutic properties,
garlic extracts must be used with proper care to avoid some
adverse effects. The antiplatelet effect of AGE is shown to be
a potential risk factor for postsurgical bleeding. As a result, it
should be avoided in warfarin‑treated patients and postsurgery
patients.[23] A case of chemical burn in the oral mucosa was
reported after applying topical raw crushed garlic to the right
maxillary and mandibular attached gingiva.[48] Malodor and
mucosal irritation have been reported by patients who used
mouthwashes containing garlic extract.
The long‑term use of garlic from the ancient period until
now gives enough evidence for it. From the abovementioned
studies, we know that AGE has biological effects that
inhibit the atherogenic process in the cardiovascular system,
have anti‑coagulation effects on the hemopoietic system,
have antioxidant and anti‑inflammatory effects through
complementary ways to inhibit carcinogenesis, and have
antimicrobial and antifungal effects on the oral pathogens
contributing to oral diseases. Various authors have proven it
as a therapeutic agent with little to no adverse effects on the
system in their clinical trials. The health benefits of AGE due
to all its properties suggest it as a powerful curative source for
several oral diseases. As a result, the review article emphasized
all of the significant effects of AGE on oral health.
Conclusion
The current review of the properties of AGE shows that it
has broad‑spectrum beneficial effects on systemic health
as well as oral health.[3,5] As a herbal agent with numerous
pharmacological effects, it piques the public’s interest as an
alternative to other antibiotics.[5] It can be used intraorally as a
topical agent, as a mouthwash or as dentifrices, and as capsules.
The well‑demonstrated benefits of AGE with little or no adverse
effects on oral diseases may also be used as a means to improve
general health because of the close relationship between
periodontitis and some systemic diseases such as diabetes,
hypertension, atherosclerosis, and others.[6,7] Unlike antibiotics,
AGE does not show resistance to any pathogen in its long‑term
use, which makes it an even better potential choice of agent.[9]
To conclude from the abovementioned data, AGE may be useful
for many oral diseases, and it should be used in further in vivo
trials to prove its efficacy in the general population.
292 Journal of Indian Association of Public Health Dentistry ¦ Volume 21 ¦ Issue 4 ¦ October-December 2023
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. Lee JS, Somerman MJ. The importance of oral health in comprehensive
health care. JAMA 2018;320:339‑40.
2. Haumschild MS, Haumschild RJ. The importance of oral health in
long‑term care. J Am Med Dir Assoc 2009;10:667‑71.
3. Dörfer C, Benz C, Aida J, Campard G. The relationship of oral
health with general health and NCDs: A brief review. Int Dent J
2017;67 Suppl 2:14‑8.
4. Munro CL, Grap MJ. Oral health and care in the intensive care unit:
State of the science. Am J Crit Care 2004;13:25‑33.
5. Mosihuzzaman M. Herbal medicine in healthcare – An overview. Nat
Prod Commun 2012;7:807‑12.
6. Papu S, Jaivir S, Sweta S, Singh BR. Medicinal values of garlic (Allium
sativum L.) in human life: An overview. Greener J Agric Sci
2014;4:265‑80.
7. Block E. The chemistry of garlic and onions. Sci Am 1985;252:114‑9.
8. Kodera Y, Ushijima M, Amano H, Suzuki JI, Matsutomo T. Chemical
and biological properties of S‑1‑propenyl‑l‑cysteine in aged garlic
extract. Molecules 2017;22:570.
9. Kasuga S, Uda N, Kyo E, Ushijima M, Morihara N, Itakura Y.
Pharmacologic activities of aged garlic extract in comparison with other
garlic preparations. J Nutr 2001;131:1080S‑4S.
10. Kurita M, Matsutomo T, Kodera Y. 3‑allyltrisulfanyl‑alanine formation
during the preparation of aged garlic extract. J Agric Food Chem
2020;68:14577‑83.
11. Lachmann G, Lorenz D, Radeck W, Steiper M. The pharmacokinetics
of the S35 labeled labeled garlic constituents alliin, allicin and
vinyldithiine. Arzneimittelforschung 1994;44:734‑43.
12. Pushpendran CK, Devasagayam TP, Chintalwar GJ, Banerji A, Eapen J.
The metabolic fate of [35S]‑diallyl disulphide in mice. Experientia
1980;36:1000‑1.
13. Wang W, Tang J, Peng A. The isolation, identification, and bioactivities
of selenoproteine in selsenium‑rich garlic. Chinese Biochemical Journal
1989;5:229‑34.
14. Guo Z, Muller D, Pentz R, Kress G, Siegers CP. Bioavailability
of sulphur‑containing ingredients of garlic in the rat. Planta Med
1990;56:692‑3.
15. Matsutomo T, Ichikawa M, Kodera Y. Pharmoacokinetics of water
soluble organosulfur compounds from garlic. J Clin Biochem Nutr
2008;45 Suppl 1:100‑4.
16. Nagae S, Ushijima M, Hatono S, Imai J, Kasuga S, Matsuura H, et al.
Pharmacokinetics of the garlic compound S‑allylcysteine. Planta Med
1994;60:214‑7.
17. Amano H, Kazamori D, Itoh K, Kodera Y. Metabolism, excretion, and
pharmacokinetics of S‑allyl‑L‑cysteine in rats and dogs. Drug Metab
Dispos 2015;43:749‑55.
18. Ried K, Travica N, Sali A. The effect of aged garlic extract on
blood pressure and other cardiovascular risk factors in uncontrolled
hypertensives: The age at heart trial. Integr Blood Press Control
2016;9:9‑21.
19. Ried K. Garlic lowers blood pressure in hypertensive individuals,
regulates serum cholesterol, and stimulates immunity: An updated
meta‑analysis and review. J Nutr 2016;146:389S‑96S.
20. Bhattacharya S, Sil PC. Promising natural cardioprotective agents in
drug‑and toxin‑induced pathophysiology. In: Cardioprotective Natural
Products: Promises and Hopes. World Scientific, Singapore; 2018. p.
47‑120.
21. Xiong XJ, Wang PQ, Li SJ, Li XK, Zhang YQ, Wang J. Garlic for
hypertension: A systematic review and meta‑analysis of randomized
controlled trials. Phytomedicine 2015;22:352‑61.
22. Macan H, Uykimpang R, Alconcel M, Takasu J, Razon R, Amagase H,
et al. Aged garlic extract may be safe for patients on warfarin therapy.
 Kataria, et al.: Aged garlic extract as a wonder herb in medicine
J Nutr 2006;136:793S‑5S.
23. Malhotra U, Hasday M, Romanos GE, Javed F. Assessment of routine
diet (garlic consumption) as a pre‑ and postoperative protocol in oral
and maxillofacial surgical interventions: An evidence‑based literature
review. Nutr Health 2020;26:135‑9.
24. Borek C. Antioxidant health effects of aged garlic extract. J Nutr
2001;131:1010S‑5S.
25. Tsuneyoshi T. BACH1 mediates the antioxidant properties of aged
Downloaded from http://journals.lww.com/aphd by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
garlic extract. Exp Ther Med 2020;19:1500‑3.
26. Matés JM. Effects of antioxidant enzymes in the molecular control of
reactive oxygen species toxicology. Toxicology 2000;153:83‑104.
27. Schaffer EM, Liu JZ, Milner JA. Garlic powder and allyl sulfur compounds
enhance the ability of dietary selenite to inhibit 7,12-dimethylbenz[a]
anthracene‑induced mammary DNA adducts. Nutr Cancer 1997;27:162‑8.
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 05/06/2024
28. Rahman K, Lowe GM. Garlic and cardiovascular disease: A critical
review. J Nutr 2006;136:736S‑40S.
29. Hiramatsu K, Tsuneyoshi T, Ogawa T, Morihara N. Aged garlic extract
enhances heme oxygenase‑1 and glutamate‑cysteine ligase modifier
subunit expression via the nuclear factor erythroid 2‑related factor
2‑antioxidant response element signaling pathway in human endothelial
cells. Nutr Res 2016;36:143‑9.
30. Li Z, Le W, Cui Z. A novel therapeutic anticancer property of raw garlic
extract via injection but not ingestion. Cell Death Discov 2018;4:108.
31. Bachrach G, Jamil A, Naor R, Tal G, Ludmer Z, Steinberg D. Garlic
allicin as a potential agent for controlling oral pathogens. J Med Food
2011;14:1338‑43.
32. Bakri IM, Douglas CW. Inhibitory effect of garlic extract on oral
bacteria. Arch Oral Biol 2005;50:645‑51.
33. Pratiwi PD, Budiardjo SB, Fauziah E, Rizal MF, Suharsini M, Sutadi H,
et al. Garlic extract effectivity against the viability of biofilms produced
by Streptococcus mutans serotypes C and F in pediatric patients with
early childhood caries. J Int Dent Med Res 2019;12:894‑9.
34. El‑Samarrai SK, Rashad JM. Garlic extracts and acidogenicity of
Mutans streptococcus. J dent 2013;3:314-7.
35. Bramanti I, Ngatidjan SP. The acceleration of garlic (Allium sativum
L) ethanolic extract on gingival wound healing process in Wistar rats.
J Med Sci 2013;45:51‑60.
36. Chavan SD, Shetty NL, Kanuri M. Comparative evaluation of
garlic extract mouthwash and chlorhexidine mouthwash on salivary
Streptococcus mutans count – an in vitro study. Oral Health Prev Dent
Journal of Indian Association of Public Health Dentistry ¦ Volume 21 ¦ Issue 4 ¦ October-December 2023
2010;8:369‑74.
37. Shetty S, Thomas B, Shetty V, Bhandary R, Shetty RM. An in‑vitro
evaluation of the efficacy of garlic extract as an antimicrobial
agent on periodontal pathogens: A microbiological study. Ayu
2013;34:445‑51.
38. Cavallito CJ, Buck JS, Suter CM. Allicin, the antibacterial principle of
Allium sativum. II. Determination of the chemical structure. J Am Chem
Soc 1944;66:1952‑4.
39. Lemar KM, Passa O, Aon MA, Cortassa S, Müller CT, Plummer S,
et al. Allyl alcohol and garlic (Allium sativum) extract produce oxidative
stress in Candida albicans. Microbiology (Reading) 2005;151:3257‑65.
40. Venugopal PV, Venugopal TV. Antidermatophytic activity of
garlic (Allium sativum) in vitro. Int J Dermatol 1995;34:278‑9.
41. Disegha GC, Akani NP. Antimycotic effect of Allium sativum on
selected fungi. Curr Stud Comp Educ Sci Technol 2015;2:228‑44.
42. Bakhshi M, Taheri JB, Shabestari SB, Tanik A, Pahlevan R. Comparison
of therapeutic effect of aqueous extract of garlic and Nystatin mouthwash
in denture stomatitis. Gerodontology 2012;29:e680‑4.
43. Groppo FC, Ramacciato JC, Motta RH, Ferraresi PM, Sartoratto A.
Antimicrobial activity of garlic against oral streptococci. Int J Dent Hyg
2007;5:109‑15.
44. Khodavandi A, Alizadeh F, Aala F, Sekawi Z, Chong PP. In vitro
investigation of antifungal activity of allicin alone and in combination
with azoles against Candida species. Mycopathologia 2010;169:287‑95.
45. Jiang X, Zhang Y, Li F, Zhu Y, Chen Y, Yang S, et al. Allicin as a
possible adjunctive therapeutic drug for stage II oral submucous fibrosis:
A preliminary clinical trial in a Chinese cohort. Int J Oral Maxillofac
Surg 2015;44:1540‑6.
46. Mohammad SG, Raheel SA, Baroudi K. Clinical and radiographic
evaluation of Allium sativum oil as a new medicament for vital pulp
treatment of primary teeth. J Int Oral Health 2014;6:32‑6.
47. Mahfouz SM, Wahba OM. Comparative evaluation of pulpal response
to tri‑antibiotic paste and Allium Sativum with formacresol as
pulpotomy medication in primary teeth: An in vivo study. Egypt Dent J
2019;65:3131‑42.
48. Patil B, Ruchika AN. Allium sativum: Oral mucosal burn. Int J Oral
Health Dent 2018;4:247-8.
293