CATEGORY 64 AUSTRALASIAN DENTIST CLINICAL Curcumin, a bioactive compound found in turmeric, a flowering plant belonging to the ginger family (Zingiberaceae) and scientifically known as Curcuma longa, has gained attention for its potential therapeutic benefits in the management of gingivitis and periodontitis over the past decade. Gingivitis is characterised by inflammation of the gingiva, while periodontitis involves more severe inflammation affecting the supporting structures of the teeth. Left untreated patients may present with swollen or puffy gingiva, bright red or dark purple gingiva, tender and bleeding, bad breath, gingival recession, tooth mobility or loss, infection and pain. Current trend indicates a decline in edentulism and greater retention of natural dentition across the globe. This is a positive shift that reflects better community access to dental education and dental services. However, the prevalence of gingivitis, periodontitis, and related tooth loss remains a significant public health concern especially given the association between periodontitis and systemic conditions. As the global population continues to age, coupled with greater retention of natural dentition, there is a corresponding rise in the prevalence of periodontal disease across all socioeconomic community groups. Current non-surgical treatments include lifestyle changes, scaling, root planning and use of adjunctive treatments including topical or oral antibiotics. In the post-covid era, patients are reluctant to consider pharmaceutical adjunctive therapies including topical or oral antibiotics for periodontal disease. As such, patients may elect to consider effective alternative botanical therapeutic options such as curcumin for the management of their periodontal disease. Over the past 10 years, several studies have explored the use of curcumin as an adjunctive treatment for gingivitis and periodontitis with promising results. Clinical trials have demonstrated that local application of curcumin as an adjunct to scaling and root planning can reduce periodontal inflammation associated with gingivitis and periodontitis and improve clinical parameters such as probing depth and plaque index. Moreover, studies have demonstrated the efficacy of PerioGold® Gel: Is it the new “gold” in adjunctive treatment of periodontal disease? By Mr Brett Chalklin and A/Prof Ramesh Balasubramaniam OAM subgingival application of curcumin gel in improving periodontal parameters in chronic periodontitis. These findings were further supported by other studies that reported on the significant anti-plaque and anti-inflammatory effects of curcumin when used as an adjunct to scaling and root planning. In a systematic review and meta-analysis by Zhang et al., 2021, curcumin when compared to chlorhexidine was found to be effective in reducing periodontal inflammation as assessed by various clinical parameters. The anti-inflammatory and antimicrobial properties of curcumin have been well-documented in the medical literature. Curcumin inhibits the production of inflammatory cytokines in macrophages stimulated by lipopolysaccharides, which are associated with periodontitis. It is postulated that curcumin’s ability to reduce periodontal inflammation and alveolar bone loss is through the inhibition of specific signalling pathways. Antibacterial activity against periodontal pathogens like Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia was noted for 2% curcumin oral nanogel. Given curcumin’s poor absorbability in general, innovations related to nanoparticle applications in medicine are now being utilised to increase its absorbability. The research supports the use of this nanotechnology as being a critical aspect to its clinical effectiveness. Studies employing these nanotechnological approaches have demonstrated effective therapeutic outcomes, highlighting the potential of nanoparticle-mediated delivery systems in optimising the clinical application of curcumin. However, further clinical studies are warranted to establish standardised protocols for the effective use of curcumin in periodontal care. PerioGold® Gel is an oral health product that was pioneered in Perth, Australia and formulated with a blend of potent natural ingredients, supported by scientific research. The natural ingredients include microencapsulated curcumin, aloe vera and elderberry that work together in synergy to help improve oral health. Two recent laboratory studies conducted at The University of Western Australia have found this gel to exhibit effective antiinflammatory and antioxidant properties on a range of cell lines. As such, PerioGold® Gel – containing 0.1% microencapsulated curcumin complex, may be used as an adjunctive aid for gingivitis and periodontitis as part of a patient’s daily oral hygiene routine. It is recommended that a pea size amount of PerioGold® Gel is to be applied 2-3 x day to the gingival tissues after flossing and brushing. PerioGold® Gel is designed to rapidly absorb and disperse very quickly. There is no need to rinse or spit out after application and it is safe to swallow. It is recommended that patients don’t eat or drink for about 15 minutes after application to allow for optimal absorption. u PerioGold® Gel is available for dentists to recommend to their patients. For more information about PerioGold® Gel, visit periogold.com. Declaration of Conflicts of Interest: Mr Brett Chalklin and A/Prof Ramesh Balasubramaniam OAM were involved in the formulation of PerioGold Oral Gel (www.periogold.com) and receives royalties from the sales of this product.
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