On the tenth day after extraction, the gingival wounds of children treated with 10% propolis had completely closed. Meanwhile, in the group that received no treatment, the wounds remained open, with an average area of 17.79% of the initial size. This difference was not a coincidence—and the numbers behind it tell an interesting story about a bee-derived substance that has been known since the first century.
This was the main finding of a study published in the Jurnal Kedokteran Gigi (J Ked Gi, Vol. 7, No. 2, April 2016), conducted by Heri Iswanto under the supervision of two researchers from the Department of Pediatric Dentistry, FKG UGM: drg. Sri Kuswandari and drg. Putri Kusuma Wardani Mahendra, M.Kes., Sp.KGA.
Primary Teeth That Refuse to Fall Out on Their Own
Persistent primary teeth are primary teeth that do not fall out even though their permanent successors have already begun to erupt. This condition is commonly found in elementary school-aged children, and its management almost always ends in extraction. The resulting wound requires several days to heal, progressing through three consecutive phases: inflammation, proliferation, and maturation.
The key to healing lies in the proliferation phase. Granulation tissue forms, new blood vessels emerge, and epithelial cells begin to migrate from the edges toward the center of the wound to close it. This process can be accelerated—or, conversely, inhibited—by conditions in a child’s oral cavity. This is where propolis emerges as an interesting candidate for investigation.
Propolis is a resin collected by bees from tree buds and bark and then mixed with bee enzymes to coat the hive. Its main constituents are flavonoids and phenols, including Caffeic Acid Phenethyl Ester (CAPE), which act simultaneously as antibacterial, anti-inflammatory, and antioxidant agents.
Three Parameters, One Conclusion
The study involved 24 post-extraction wounds from persistent primary teeth in children aged 6–10 years. Sixteen wounds received topical application of 10% propolis twice daily—in the afternoon and at night—for three days using sterile cotton buds. The remaining eight were allowed to heal naturally as the control group.
The research team monitored wound development on days one, three, five, seven, and ten using three parameters: wound area, color degradation, and pain symptoms. Digital photographs were taken during each observation session, then traced and measured using Google SketchUp software—a meticulous method for objectively measuring changes in wound area.
The results were striking. On the third day, wounds in the propolis group had shrunk to an average of 34.65% of their initial size. In the control group, the wounds remained at 66.85%. The Mann-Whitney test confirmed a statistically significant difference (p < 0.05) from the third through the tenth day.
“Topical application of 10% propolis can clinically accelerate the healing of post-extraction wounds from persistent primary teeth.” — Heri Iswanto, Sri Kuswandari, and Putri Kusuma Wardani Mahendra, M.Kes., Sp.KGA., in the study’s conclusion
In terms of wound color, the difference was equally striking. On the third day, 25% of wounds in the propolis group had returned to a pink color approaching normal. In the control group, none of the wounds had reached a similar condition. By the seventh day, all wounds in the propolis group (100%) had returned to a normal pink color, while the control group had reached only 12.5%.
No Pain Since the First Day
Perhaps the finding most relevant to parents concerns pain. In the control group, 100% of subjects reported pain on the first and third days after extraction. In the propolis group? Not a single participant reported pain—even from the first day.
This was not merely a coincidence in terms of mechanism. Flavonoids in propolis are known to suppress the lipoxygenase pathway of arachidonic acid metabolism, a pathway responsible for producing pain and inflammatory mediators. Propolis also inhibits PGE2, reduces pro-inflammatory cytokines, and directly affects the activity of inflammatory cells. Its local anesthetic effect has even been described in some pharmacological literature as five times more effective than cocaine.
In terms of safety, propolis is considered safe. Long-term consumption has not shown negative effects on the blood, liver, or kidneys. The safe dose for humans is estimated at approximately 70 mg per day. Propolis gel is also non-toxic in oral application tests in experimental animals.
Nature as a Clinical Partner
The research by drg. Putri Kusuma Wardani Mahendra, M.Kes., Sp.KGA., and her team strengthens the position of propolis as a nature-based therapeutic agent worthy of consideration in pediatric dentistry. This substance, which has been used by humans for two thousand years, apparently has a sufficiently solid scientific foundation to stand alongside conventional medicines.
The 10% concentration used in this study is commercially available and relatively affordable. Its application is simple, noninvasive, and—most importantly for pediatric patients—does not cause pain. In the context of pediatric dental practice, which often has to contend with patient anxiety and discomfort, this is no small matter.
The remaining question is whether these findings are strong enough to encourage a new clinical protocol. The scale of this study was indeed limited, involving 24 subjects with a quasi-experimental design. Replication with larger samples and variations in propolis concentration is still needed. But the direction is already clear—and bees, as usual, seem to know more than we might think.
Authors: Nanda Ayu, drg. Achmad Zam Zam Aghasy, M.Kes.
Photo: Pexels