AVOCADO LEAVES EXTRACT AS

POTENTIAL TOPICAL ANTIBACTERIAL

SOLUTION FOR MOUTH ULCERS

BY:
RANDY GERALD C. CORONEL
PHIL ANGEL Q. DEL MUNDO
Chapter 1: Introduction

Nowadays, many diseases are continuing to spread whole wide world.

Many of us are being affected with or without even knowing of their
cause/s. When it hits it to our body like diseases, conditions or even lesions,
we notice right away that there is something different in ourselves but most
of the times, we just ignore it. We always think that it is just a minor wound
that will heal after few days. But we didn’t even know if that simple
wound is malignant or not, contagious or not, and simply signs of having
medical conditions. We are being benighted about everything like in our
environment, hygiene, mental, emotional, social, physical health especially
in our oral health issues.
“According to WHO (World Health Organization), “Oral Health is a key
indicator of overall health, well-being and quality of life.” It is stated that
we can define the person’s lifestyle through his or her Mouth whether he is
having a good lifestyle or bad. Whether the person is having a good oral
hygiene or not.”(www.who.int)
Many experts says, “Mouth is a Mirror of your Health.”
“According to Denis F. Kinane, BDS, PhD, at University of Pennsylvania in
Philadelphia, he stated that “Any disease related to the mouth has an
impact elsewhere in the body.”
Researchers are studying the association between oral health,
inflammation, and disease. Inflammation, which is the body’s response to
infection, seems to play a key role in many health conditions, including
heart disease, diabetes, and gum disease.”(www.webmd.com)
“According to the Department of Health (DOH), Oral Disease continues to
be a serious public health problem in the Philippines. The prevalence of
dental caries on permanent teeth has generally remained high throughout
the years. It is due to having lack of education about oral health, bad oral
hygiene, lack of nutrition due to poverty, and lack of proper dental care.
In the National Monitoring and Evaluation Dental Survey conducted by DOH in
2011, statistics further showed 77% or more than 7 out of 10 Filipinos have never
been to a dentist.” That’s why millions of Filipinos are suffering or having an oral
health issues just like toothache, dental caries, gum and periodontal diseases and
one of the most complaint and painful inside our oral cavity is the Mouth Ulcer. (
www.manilatimes.net)
Mouth ulceris the loss or erosion of part of delicate tissue that lines the
inside of the mouth (Mucous Membrane).It develops on the linings of the
cheeks and lips, tongue or even the base of the tongue. There are multiple
causes. The most common cause is Injury or trauma, such as accidentally
biting the inside of your cheeks, ill-fitting dentures, fractured teeth,
undergoing orthodontic treatment due to brackets and or fillings. Other
causes include aphthous ulceration, vitamin deficiency, stress, certain
medications, and skin rashes in the mouth, viral, bacterial, and fungal
infections, systemic medical diseases, xerostomia, genetics and rarely
malignancy. For the minor form of mouth ulcer usually healed for about 10
days
Mouth Ulcers are usually white, red, yellow, or grey in color and are
inflamed around the edge. The individual ulcer begins as round or oval
shaped area of erythema which develops in a pin point central area of
white ulceration. There are 1 or more painful sores on part of the skin
lining the mouth. It has swollen skin around the sores. There are problems
with chewing or tooth brushing because of the tenderness. We lost our
appetite due to irritation of the sores by salty, spicy, or sour foods and
sometimes it causes nutritional deficiency especially to the children who
are suffering from this and most of them are living in the 3 rd world country
just like Philippines.
It is really tough for most Filipinos to provide basic necessities. But it is
tougher to provide for the oral health care due to poverty, lack of education
and ignorance.
Therefore, this research aims to inform and orient the people about the
importance of oral health awareness and having a good oral hygiene. Also,
this study helps to provide something affordable yet effective medicine for
mouth ulcer just like topical antibacterial solution made from avocado
leaves which is one of the crops in the Philippines. It has a lot of benefits
into our body that also can be used for those people with mouth ulcers that
can lead to practicality of everyone.
Background of the Study:

At the end of nineteenth century, several plant species were introduced

into the Philippines. These came from different parts of the world and
included fruits, vegetables and medicinal plants. Some proved to be
valuable and easily adapted to the Philippine conditions while others were
less promising and did not gain a wide acceptance among the populace.
One of the introductions which proved to be suitable to the Philippines soil
and climatic conditions was the Avocado.
It is known as “Aguacate” in Spanish and “Alligator Pear”, “Palta Pear”,
“Midshipman’s Butter” in English while in Filipino, it is “Abokado.” It was
introduced into the Philippines in 1890 by the Spaniards through seeds
coming from Mexico. However, it was only introduced successfully into the
Philippines by the Americans in 1902 - 1907.
In 1913, the Agriculture, together with the College of Agriculture of
University of the Philippines Los Banos, started the countrywide spreading
of avocado trees. Now, Avocados are found growing all over the country,
most of which are cultivated in backyards.
Since then, Avocado has been used for the treatment of Scabies, Dander,
and Ergotism by Mexican Folk and Saint Antonius, respectively in ethno
medicine. It was also used by women in the form of an ointment and also
treating skin eruptions.
The predominant carotenoid in Avocado is Lutein, a-carotene, b – carotene,
zeaxanthin, neoxanthin, and violaxanthin are the other carotenoids present
in small quantities in it. Tocopherols have also been identified in its acetone
extract. It has been reported that these lipophilic carotenoids may have
potential anti carinogenic effects. A compound, persin, isolated from
Avocado Leaves has been used to carry out the induction of apoptosis in
human breast cancer cells
Avocado Leaves has an Analgesic effects. It has been reported that
administration of 1600 mg / kg an aqueous leaf extract of avocado was able
to reduce the writhing assay and hot plate test respectively. The results
along with the inhibition of formalin induced pain indicated the analgesic
effect of the extract on mice.
It has anti - inflammatory activity of the extract was observed upon its use
in mice with Carrageenan induced edema, as it resulted in reduction of
swelling. Moreover, no toxicity symptoms in mice were found even after
administration of 10g/kg of extract.
Aqueous leaf extract of avocado consisting of alkaloids, flavonoids,
saponins, and tannins produced significant dose dependent anti – ulcer
activity when administered orally to sick rats (rats pre - treated with
ulcerogenic drugs – indomethacin ethanol.
It has an Anti-fungal Property. This compound was found to exhibit anti-
fungal property against the fungal pathogen
(Colletotrichumglocosporoids) by inhibiting spore germination. Seed
extracts of avocado have also shown to be toxic towards other fungal
pathogens like Candida. Another study has shown that a topical cream
consisting of mixture of Avocado oil inhibited the growth of the canine skin
pathogens and could be used as an alternative for the commonly used
antibiotic and anti fungal agents.
Moreover, it has wound healing properties of the Avocado fruit extract has
been confirmed. The topical or oral administration of the fruit extract in
wounded rats resulted in the complete epithelialization of the wound.
Other parameters like rate of wound contraction and hydroxyproline
content of of tissues along healing with histological observation
One of the forms or kinds of Mouth Ulcer is the Recurrent Aphthous
Stomatitis (Aphthae or Canker Sores). Canker Sore is the informal term
used mainly in North America which refers to mouth ulcer. The term
“Aphtha” came from the Greek word meaning “Mouth Ulcer”.
There are 3 classifications of Recurrent Aphthous Ulcer: The Minor
Aphthous Ulcer or Mikuliccz ulcers, Major Aphthous Ulcers or Suttons
Ulcer, and Herpetiform Ulcers.
The most common type of Mouth ulcer is the Minor Aphthous Ulcer. It is
less than 1cm (2-4mm) and do not leave scars. The sores usually heal
within 2 weeks. It occurs mainly in person 10 – 40 years old and often cause
minimal symptoms. They have an ulcer floor that is initially yellow but
assumes gray hue as healing and epithelization proceeds. They are
surrounded by erythematous halo and some odema. They are found
mainly on lips, cheeks, floor of the mouth, sulci or ventrum of the tongue.
The other types of Recurrent Aphthous Ulcers are Major Aphthous Ulcer
and Herpetiform Ulcers.
Major Aphthous Ulcers or Suttons Ulcers are larger and longer duration
than MRAS (Minor Recurrent Aphthous Ulcer). They are more painful,
round or ovoid. They reached 1 cm in diameter or even larger. They occur
on the dorsum of the tongue and healed for about 10 – 40 days or longer
and it leaves with scarring.
And the last type of RAS (Recurrent Aphthous Stomatitis) is the
Herpatiform Ulcers which is very seldom to happen. These are found in
slightly older age group. It is commonly found in females. They heal in 10
days or longer and painful. They recur so frequently that ulceration may be
virtually continuous.
Mouth Ulcers often cause pain and discomfort and may alter the person’s
choice of food. They may form individually or multiple ulcers may appear
at once. And once it was formed, the ulcer may be maintained by
inflammation and or secondary infection. Rarely, a mouth ulcer that does
not heal may be a signed of oral cancer.
There are millions of Filipinos have never seen a dentist. They didn’t even
care about their oral health. And just simple mouth ulcer which they only
endure and sometimes it can cause much further injury or infection.
Statement of the Problem

This study aims to determine the efficacy of Avocado Leaves Extract as

Potential Topical Antibacterial Solution for Mouth Ulcer. Specific questions
that the researcher aims to answer the following:
1. What type of antibacterial agents present in avocado leaves?
A. What are the Active Components of Avocado Leaves (P. Americana)
that contributes its Antibacterial Properties?
 B. Does Avocado Leaves Extract antibacterial property effective?
C. What are the components that inhibit and stop the growth of
microorganism on wounds or ulcers?
 
2. Is it safe to in oral cavity?
A. Is it safe for human consumption without any side effects?

3. Does Avocado Leaves Extract effective as Potential Topical

Antibacterial Solution for Mouth Ulcer?
4. Does Avocado Leaves Extract as Potential Topical Antibacterial
Solution for Mouth Ulcer convenient and affordable for everyone?
 
5. What are the benefits we can get from Avocado Leaves Extract?
Hypothesis:

1. Avocado Leaves Extract is effective as Potential Topical Antibacterial

Solution for Mouth Ulcer.
2. Avocado Leaves Extract as Potential Topical Antibacterial Solution for
Mouth Ulcer is
safe to use in oral cavity of human.
3. The active components of Avocado Leaves contribute any anti-bacterial
properties.
4. There are benefits we can get from Avocado Leaves Extract.
5. Avocado Leaves Extract as Potential Topical Antibacterial Solution for
Mouth Ulcer is convenient and affordable for everyone.
6. There are components that inhibit and stop the growth of microorganism
on wounds or ulcers.
Significance of the Study

The result of this research will be beneficial and contribute to the following:
 Socioeconomic Significance:
• In this study, this will inspire everyone to be practical in treating wounds
like Mouth Ulcer. This product tends to be cheaper, convenient wherein
everyone can afford.
Clinic Significance:
• This will help to the Clinician, Dentist especially Orthodontist to help
their patients (Orthodontic Patients) to relieve and manage the pain. This
will contribute to help their patients to treat the Mouth Ulcer in an
Alternative Way.
Patients:
• This will help them to heal, and relieve the pain. This will help also to
free from infection. This will help for them to eat well and bring back
their appetite.
Parents:
• This will help for them especially for their children who have Mouth
Ulcer in treating the wounds. This will not contribute traumatic
experience in healing Mouth Ulcer.
Students:
• This will help for them especially Dentistry Students to be informed on
what are the factors, causes and effects of Mouth Ulcer and how to
manage the pain and the healing process. 
Readers:
• This will be useful for them to give further knowledge about Mouth Ulcer
and Avocado Leaves.
Future Researchers:
• This will help for them to develop research writings, analysis,
interpretation, skills needed to make a good study.
CHAPTER 2
REVIEW OF RELATED LITERATURE

This chapter presents the related literature and studies after the thorough
and in-depth search done by the researchers. This will also present the
synthesis of the art, theoretical and conceptual framework to fully
understand the research to be done and lastly the definition of terms for
better comprehension of the study.
Related Literature:
Foreign Research Articles

The effect of Avocado leaf extract (Persea Americana Mill) on the

fibroblast cells of post-extraction dental sockets in Wistar Rats
Background: Tooth extraction, a common practice among the dental
profession, causes trauma to the blood vessels during the wound healing
process. The acceleration of wound healing, within which fibroblasts play
an important role, is influenced by nutrition. Avocado leaves contain a
variety of chemicals, including flavonoid compounds, tannins, katekat,
kuinon, saponin and steroids/triterpenoid.
Avocado leaves also contain glycosides, cyanogenic, alkaloids and phenols
which function as anti-inflammatory, antibacterial and antioxidant agents.
This avocado leaf content could be used as an alternative medicine to
accelerate the wound healing process in post-tooth extraction sockets.
Purpose: To determine the role of avocado leaves (Persea americana Mill)
in accelerating fibroblast cells proliferation in tooth socket post-extraction.
Methods: The sample was divided into four groups, a control group and
three treatment groups. The treatment groups used avocado leaf extract
and 3% CMC Na solution which was inserted into the tooth sockets of
Wistar rats. Both the control and treatment groups had their mandibula
decapitated with all the required specimens being prepared on the 3rd and
7th days of the experiment. Mandibular decapitation and tooth extraction
socket were prepared by HPA (Histology Pathology Anatomy) with
Hematoxylin Eosin (HE) staining.
The fibroblast proliferation was analyzed by means of a light microscope at
400x magnification. The obtained data was analyzed using a t-Test. Result:
The t-Test obtained a significance value 0.001 (p <0.05) between the control
and treatment groups. The number of fibroblast cells increased in the
group treated on the third day and decreased in the group treated on the
seventh day.
Conclusion: Avocado leaf extract (Persea americana Mill.) accelerates
proliferation of fibroblast cells in Wistar rats post-tooth extraction. (Majalah
Kedokteran Gigi, 2018)
 Using Avocado Leaves to Prevent Streptococcus Viridans’ Inhibition in
Growing Caries in Mouth
Background: Bacteria play an essential role in the process of dental caries.
Caries prevention efforts are made in many ways using an antiseptic or
herbal mouthwash including avocado leaves that have the effect of
antifungal, antimicrobial, analgesic, and anti-inflammatory. Purpose: This
study aims to determine the effectiveness of avocado leaf extract
concentration of 60% and 80% for blocking the inhibition of the
Streptococcus viridans, the bacteria that has a crucial factor in the
formation of dental caries.
Method: The research was a quasi-experimental research using two
samples in each treatment group. The sample consisted of 3 treatment
groups of young avocado leaf extract concentration of 60%, 80%. Methods
of data analysis used descriptive quantitative research. Result: The results
showed that the leaf extract of avocado with a concentration of 60% does
not affect inhibiting the growth of bacteria Streptococcus viridans with an
average of inhibition of 26.43mm.
However, the avocado leaves extract with a concentration of 80% affect the
growth of Streptococcus viridans bacteria with an average inhibition of 27.6
mm. Conclusion: The conclusion of this study proves that avocado leaf
extract has potent antibacterial activity against the growth of Streptococcus
viridans. (Prasko, Politeknik Kesehatan, Kemenkes Semarang, Jl. Tirto
Agung Pedalangan, Banyumanik, Indonesia, 2017)
The researchers gathered data necessary regarding this studies. To be able
to come up further studies on the use of avocado leaves extract
antimicrobial property. To determine the effectiveness of avocado leaves in
wound healing and if it can also be used as a potential antibacterial
solution for mouth ulcers for fast healing.
End of Presentation