Use of Turmeric and Curcumin in the Management of Oral Sub Mucous Fibrosis (OSMF)

Apoorv Jain^*, Sayali Balsaraf, Priyanka Paul and Sharayu Nimonkar Belkhode

^*Correspondence: Apoorv Jain, Sharad Pawar dental college and hospital, Datta Meghe Institute of medical science (deemed to be university) Sawangi meghe, India, Email:

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Introduction

Oral Sub Mucous Fibrosis (OSMF), a premalignant oral disease that often affects the buccal mucosa, was initially defined by Schwartz (1952). This disorder causes limited mouth opening, burning feelings, tongue protrusion, and reduced cheek flexibility. Food consumption is limited, oral cleanliness is an issue, and speaking is difficult due to the narrow mouth opening. The disease's an etiology includes areca nut chewing, chilli intake, genetic and immunologic causes, and nutritional deficiencies [1]. It is frequent in South Asian countries and has a malignant transformation incidence of 5–15 per cent. ( Effectiveness of Various Treatment Modalities in the Management of Oral Submucous Fibrosis-A Clinical Study Shrinivas, Aradhana Rathod, Deepa B.V3 Assistant professor, Department of Dentistry, Koppal Institute of Medical Sciences, Koppal, Karnataka, India; [2] Assistant professor, Department of Prosthodontics, Al-Badar Rural Dental College and Hospital, Kalaburgi, Karnataka, India; [3] Senior Lecturer, Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore, Karnataka, India. OSMF has become much more common as the consumption of areca nut with tobacco has become more popular. Nutritional supplements, antioxidants, immunomodulatory, biogenic stimulators, enzymes, fibrinolytic drugs, and vasodilators are among the medical interventional treatments that have been documented in the literature in systemic, topical, and intralesional forms [4]. Advanced lesions are surgically treated. The primary objective of treatment should be to retain oral function while also halting the growth of cancer. Given the disease's widespread prevalence in socioeconomically disadvantaged groups, a cost-effective treatment strategy is required [5]. Various plants are utilized in medicine because of their anti-oxidant properties, the most prevalent of which are polyphenols. Curcumin is a polyphenol chemical produced from the Curcuma longa plant, which most commonly is found in South Asia and appears yellow in colour. It has antiinflammatory, antioxidant, and anti-cancer capabilities, among other therapeutic and medical characteristics [6]. Many researchers have utilized curcumin as a noninvasive supplement to standard treatment to treat OSMF. As a result, this study was conducted to determine the bio-efficacy of turmeric in the treatment of OSMF. Oral Sub Mucous Fibrosis (OSMF) is the most frequent oral malignancy, accounting for up to 80% to 90% of all oral malignant neoplasms. Although the prevalence of oral cancer is on the rise [7].Oral cancer is believed to be the 6th to 9th most prevalent anatomical site for cancer globally, depending mostly on the country and even particular regions. Patient’s gender and region (in certain countries). Despite the low frequency, it is possible. Constitute the most prevalent site for cancer in many areas, particularly in Asia’s southeast part. The following are the major etiological and predisposing variables for OSCC: UV rays, smoking and drinking habits, and ultraviolet radiation. However, various additional variables have been linked, including Human Papilloma Virus (HPV) and Candida infections, dietary inadequacies, and genetic susceptibility [8]. OSCC is a condition that can develop in premalignant lesions in the mouth, such as OSMF. According to studies, dysplasia can be seen in roughly 25% of biopsied OSMF patients. As a result, it's critical to treat and control OSMF as soon as possible. New treatment ideas for oral squamous cell carcinomas (SCC) have emerged in recent years, including preoperative simultaneous neoadjuvant Radio-Chemo Therapy (RCT) and one-stage surgery with tumour removal and rebuilding [9]. When it comes to long-term survival, there's a lot of evidence that a combination treatment based on neoadjuvant radiochemotherapy is better than an adjuvant treatment that includes surgery and postoperative radiation. Clinical outcomes are directly related to the stage of the illness and the extent of lymph node spread at the time of presentation. Furthermore, several parameters, such as tumour depth, vascularity, and perineural involvement, are important [10].

Peri Neural Invasion (PNI) and tumour budding are also well-known prognostic indicators. On the other hand, the influence of other characteristics on survival, such as anatomic location, age, tumour grade, and other biological markers, is still unknown, due to the wide variation in findings in the literature, which is mostly comprised of restricted case series. The relevance of measuring treatment results in patients with oral sub mucous fibrosis associated with OSCC is to measure the quality of life [11]. The influence of oral sub mucous fibrosis associated with OSCC and its therapy on the quality of life and performance status of people with oral sub mucous fibrosis was investigated in this study.

The Latin term terra “merita”, often known as “turmeryte”, is the source of the name turmeric. Curcumin, a substance found in turmeric, is its most potent constituent. It is a safe, non-toxic, and potent plant that, thanks to its powerful therapeutic effects on many different bodily systems, can serve as a natural substitute for many predictable medicines. Turmeric has long been used in households on the belief that it can neutralize hazardous substances [12]. The time has arrived when turmeric is used in medical facilities rather than only in homes. It has been revealed via numerous studies that turmeric possesses antioxidant and antiallergic qualities. As a result, clinicians should utilize turmeric to treat precancerous lesions such as oral sub mucous fibrosis. Human studies have virtually always yielded promising cures for oral sub mucous fibrosis. However, further extensive trials must still be carried out before turmeric use in oral sub mucous fibrosis may be applied clinically [13].

Turmeric has a great potential as a medicinal treatment for treating Oral Sub Mucous Fibrosis (OSMF). Our study's main goal is to compile evidence on the usage of turmeric/curcumin in the treatment of OSMF. The study's secondary purpose is to review the limitations of prior studies in order to identify evidence gaps for future research, make an evidence-based recommendation for the use of turmeric/curcumin in OSMF patients, and propose future research directions. After treatment with turmeric formulations, all of the trials included in this review demonstrated an improvement in mouth opening. This conclusion might also be drawn from a meta-analysis of three RCTs. There has been a similar improvement in tongue protrusion, burning feeling, and cheek flexibility. The scarcity and low methodological quality of research collected for this topic demonstrate the lack of credible evidence regarding turmeric's usefulness in the treatment of OSMF [14].

We believe that RCTs with a bigger sample size and longer follow-ups are required, with a focus on the recurrence of signs and symptoms.

A range of therapeutic strategies are used to address this problem. Given the severity of the disease load in highincidence countries, a cost-effective, safe, and efficient solution is necessary. Turmeric's anti-inflammatory and anti-oxidant properties have shown promise in the treatment of OSMF. The study's objectives were to determine the efficacy of turmeric in controlling OSMF based on existing research [15].

The goal of this study was to examine if herbal medicines (1 g Tulsi and 1 g turmeric mixed in a glycerine base) were useful in treating Oral Sub Mucous Fibrosis (OSMF). The participants in the study ranged in age from 17 to 56 and did not have any systemic issues. Three to four times a day, the patients were given drugs to ingest. Blood samples were obtained before and after treatment to look for any systemic changes produced by the medicines. The burning sensation and mouth opening were measured before and after treatment. For the next three months, patients were seen once a month [16]. On the Visual Analogue Scale (VAS), the difference in mouth opening and variations in the burning sensation was statistically analyzed. Both the burning sensation and the openness of the mouth improved statistically. The use of Tulsi and turmeric together is both safe and beneficial. Tulsi is a fragrant plant in the basil family Lamiaceae (tribe ocimeae) that is native to the eastern hemisphere tropics and is said to have originated in north-central India. Tulsi is referred to as "The Incomparable One," "Mother Medicine of Nature," and "The Queen of Herbs" in Ayurveda, and is regarded as an "elixir of life" with unrivalled medical and spiritual properties. The anti-inflammatory activity of Tulsi is related to its eugenol and linoleic acid content, as well as inhibition of both the cyclooxygenase and lipoxygenase pathways of arachidonic acid metabolism, which has been shown in both acute and chronic inflammatory models in animals [17].

Curcumin's high anti-oxidant and free-radical quenching characteristics play a key role in the compound's inhibitory effects on carcinogenesis' early phases. Antioxidants have been linked to the pathophysiology of OSMF, hence this preparation may aid in the healing of this condition.

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