Aloe Vera: An Ancient Plant for Modern Dentistry

Bill Wolfe D.D.S., N.M.D.

History

In 1980 my dental laboratory technician suggested that Aloe Vera gel might have some uses in dentistry. I was not even sure what Aloe Vera was, so I decided to do some personal research. Through my readings, I discovered that the Aloe Vera plant had many medicinal uses dating back to pre-Christian times, and was even referred to in the Bible, as well as in many technical and professional journals over the past few decades.

I learned that the Aloe Vera plant is remarkable because it is one of the most durable plants known to mankind. The plant has a miraculous ability to self-seal and self-heal, and contains all the nutrients within its leaf in order to survive. When the leaf is damaged, the plant seals the wound and regenerates in accelerated time. Also, it thrives in an arid environment and can withstand extreme heat and physical abuse. Ancient Hebrew tribes used to uproot their aloe plants when they migrated, replant them upon arriving at their destination, and the plants would flourish again. With such a prestigious history, I wondered why I had not heard about Aloe Vera before. There are basically two reasons why the use of Aloe Vera for medicinal purposes was not widespread.

Although the plant is one of the most durable plants in the world, it is a succulent, and cannot survive extreme cold, damp, freezing climates. Therefore, knowledge of Aloe Vera did not spread into Northern Europe or Great Britain, where there are profound freezing winters. In these areas of the world, familiarity with the plant and its uses is still limited.

The second reason tor its limited usage was due to the inadequacy of Aloe Vera gel as a commercially viable product, because of it's "perishability." When a leaf is harvested, it is dissected to gain access to its gel. Exposure to air causes Aloe Vera to oxidize, and its potency is only maintained for about 48 hours at room temperature. Beyond this time, the plant can become contaminated, which often led to disappointing results on the part of people who were unaware of the shelf-life problem of the gel.

A resurgence of interest in the healing capabilities of the Aloe Vera plant developed in the 1950's. Through the work of Drs. Collins, Wright, and Crewe with radiation burns, the Aloe Vera plant assumed a degree of medical credibility. In 1959 the FDA concluded from studies conducted by the Atomic Energy Commission at the radiation burn center at Los Alamos Laboratories in New Mexico that aloe gel did have a healing effect on skin tissue. Further studies demonstrated the effectiveness of the plant's gel, but perishability was still a problem.

I was particularly interested in studies from Russia in 1976 reporting success in treating periodontal (gum and bone) disease with Aloe Vera, and the 1979 studies performed at the University of Chicago Burn Center. Then I ran across the name of Dr. Eugene Zimmerman. Dr. Zimmerman had been my oral pathology professor at Baylor College of Dentistry, and unknown to me, was conducting research on Aloe Vera and its properties at the same time I was attending dental school there in 1969.

I telephoned Dr. Zimmerman and asked him about his past Aloe Vera research. He expressed his positive feelings about the healing potential of the plant's gel for dentistry, especially since a "stabilization" process had been developed to preserve the Aloe Vera gel. The gel was now a viable commercial entity, with the ability to maintain its potency for years. However, Dr. Zimmerman felt that more research was required in order to substantiate its dental uses. I was now really curious.

After using the gel on various conditions with my dental patients, I phoned Dr. Zimmerman once again to tell him of our experiences, and asked him if he would be willing to perform any further dental research with the gel. His positive answer gave me the motivation and commitment to fund a grant to Baylor College of Dentistry to further investigate Aloe Vera and its oral health benefits. The following presentation is a synopsis of the results of research performed at Baylor (to A.O.A.C. standards) under the guidance or Dr. Zimmerman.

Bactericidal studies
Various percentages of Aloe Vera gels were tested in culture media consisting of the following organisms: Staphylococcus aureus, Streptococcus viridans, Candida albicans, Corynebacterium xerosis, and the five strains of Streptococcus mutans most commonly found in dental plaque. The gel was bactericidal against the above bacteria and fungicidal against Candida albicans (the cause of moniliasis or 'denture sore mouth.') An important finding by Zimmerman was that the dramatic effects of the aloe gel were not apparent until there was at least a 70% concentration of the gel. To achieve a 70% or greater concentration, an Aloe Vera gel must be stabilized with anti-oxidants in order to minimize the otherwise necessary preservatives which lessen the percentages of Aloe Vera in the product.

Virucidal studies
The Aloe Vera gel formula was found to be virucidal against Herpes simplex and Herpes zoster viruses.

Anti-inflammatory studies
Prednisolone and Indomethacin (common anti-inflammatory drugs) were utilized in a comparative study with the Aloe Vera gel to observe the effects on tissue culture cells. The gel was found to be just as effective as Prednisolone and Indomethacin, without having the long term toxicity of either drug.

Cell cytotoxicity studies
Human embryonic kidney cells (HEK cells) were utilized to determine the effectiveness of aloe gel on cellular longevity. The cellular death rate was found to be reduced by 2/3 when cultured with the aloe gel. Note: It is important to acknowledge research by Dr. Wendell Winters, Associate Professor of Microbiology at the University of Texas Health Science Center, San Antonio, Texas. Dr. Winters found that although Aloe Vera promoted the growth and healing of healthy human cells, the gel did not have the unwanted effect of stimulating the growth of cancer cells.

Dr. Zimmerman's studies proved the Aloe Vera gel formula to be nontoxic, bactericidal, virucidal, and fungicidal against a broad range of micro-organisms, and a stimulator of cellular life-extension. This research and the clinical effects which I had witnessed in my office resulted in a commitment on my part to discover the uses of the aloe gel in all aspects of dental health. Now that I had laboratory and clinical evidence of the effectiveness and biocompatibility of my Aloe Vera formula, I felt that the next step for oral health should be to develop an Aloe Vera-based toothpaste.

Because a tooth paste or a tooth gel must include abrasives (of which examples are listed below), a surface active agent (foaming agent), a sweetener to counter the taste of the various ingredients (including the pungent taste of aloe gel), and a breath freshener, I was concerned about how much the healthful properties of the gel might be compromised by being combined in such a formula.

Relative Abrasiveness of Various Compounds on Tooth Enamel

Abrasive	Surface loss of Enamel
Flour of pumice	.300 (highest index of abrasiveness)
Alumina	.300
Tin Oxide	.083
Calcium Carbonate	.012
Magnesium Trisilicate	.009
Calcium Pyrophosphate	.005
* Hydrated Silica	.002
Sodium Metaphosphate	.001
Tribasic Calcium Phosphate	.001 (lowest index of abrasiveness)

The bactericidal effects on dental plaque are a primary concern in evaluation and measuring the effectiveness of a toothpaste. Such bactericidal potency can be measured in the laboratory by means of a 'sensitivity disc' method of analysis. This method utilizes agar plates ("Petri" dishes) upon which are grown bacterial cultures of the various micro-organisms to be tested. The next project tested the Aloe Dent toothpaste formula against the various bacterial components of dental plaque (LM-7, BHT, AHT, 6715, and GS-5 strains of Streptococcus mutans bacteria.) After two hours of incubation, sterile paper discs were placed on the inoculated dishes. On each disc 0.3 grams of sample toothpaste was used in each experiment.

Each dish was examined after 24 and 48 hours to detect zones of clearing for inhibition (kill) of the Streptococcus mutans bacteria. The measurement from the edge of the disc to the end of the clear zone surrounding the disc indicates the depth of 'kill' of the bacteria, i.e., the larger the number of millimeters, the more potent the bactericidal effects. The chart below demonstrates the results after 48 hours of bactericidal analysis, comparing the Aloe Vera toothpaste formula to two popular brands of flourided toothpaste.

Streptococcus Mutans Bacteria Strain Numbers	Aloe Vera toothpaste	Brand 1	Brand 2
	After 48H	After 48H	After 48H
LM-7	16mm	9mm	11mm
GS-5	15mm	12mm	13mm
6715	10mm	11mm	9mm
BHT	20mm	10mm	14mm
AHT	16mm	16mm	10mm

This chart demonstrates the bactericidal effectiveness of Aloe Vera toothpaste against the 5 strains of Streptococcus mutans bacteria in dental plaque. The fact that the Aloe Vera toothpaste™ range was greater than that of either Brand 1 or Brand 2 is very noteworthy, as the bactericidal results from the Brand 1 or Brand 2 testing are due to fluoride. Aloe Vera toothpaste was able to achieve equal or better results without the addition of fluoride, which is controversial due to its wide range of potentially harmful systemic effects.

Conclusion
The previous research is only a partial indication of the potential benefits which Aloe Vera can provide for dentistry. I encourage health professionals to investigate, experiment, and conclude for themselves as to the effectiveness, new uses, and exciting future which Aloe Vera has in dentistry.

References
1) Kent CM. Aloe Vera. Arlington VA. 1979:14.
2) Goats BC. The Silent Healer: A Modern Study of Aloe Vera. Garland, TX, 1979.
3) Sims RM, Zimmerman ER. Report on effect of aloe vera on growth of certain micro-organisms. Baylor College of Dentistry, Dallas Microbial Assay Services. Ava Inc Archives. 1969; Vol 1:230-233.
4) El Zawahr M, Hegazy RM, Helal M. Uses of aloe in treating leg ulcers and dermatosis. Dermatology (1973 Jan-Feb):72.
5) Crewe J. The external use of aloe. Minn J of Med. (1937 Oct) 20 (538-539.)
6) Collins E. Alvagel as a therapeutic agent in treatment of Roentgen and radiation burns. Radiological Review and Chicago Medical Recorder. (1935 June) 57:137-138.
7) Wright CS. Aloe vera in the treatment of roentgen ulcers and telangiectasis. JAMA. 1936 (106):1363-1364.
8) Lushbaugh CC, Hale DB. Experimental acute radiodermatitis following beta irradiation. Cancer.
1953:698.
9) Brasher JW, Collings CK, Zimmerman ER. The effects of prednisolone, indomethacin and aloe vera gel on tissue culture cells. Oral Surgery, Oral Medicine, and Oral Pathology. 1969.27 (1): 122-128.
10) Bovik EG. Aloe vera: Panacea or old wives tale? Texas Dental J. 1966:15.
11) Rowe TD, Parks LM, Lovell BK. Further observations on the use of aloe vera leaf in the treatment of third degree x-ray reaction. JAMA. 1941:270.