Who would have thought that a kitchen ingredient costing only a few thousand rupiahs could have medical potential strong enough to rival a patented drug? Dr. drg. Indra Bramanti, M.Sc., Sp.KGA(K), from the Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, found an answer in the gingival epithelium of Wistar rats.
In a study published in the Journal of Medical Sciences (Volume 45, No. 2, June 2013), Bramanti and colleagues from the Department of Pharmacology and Therapy, Faculty of Medicine, UGM, Ngatidjan and Setyo Purwono, demonstrated that an ethanolic garlic extract gel (Allium sativum L.) could accelerate gingival wound healing, particularly by increasing the epithelial thickness of injured tissue.
A Small Wound, a Big Question
The study arose from a seemingly simple problem that addresses a genuine community need: commercially available medications for healing oral wounds are relatively expensive and may sometimes cause serious side effects. Garlic, which has been used traditionally for more than 5,000 years—including by the ancient Greeks to relieve toothache—was therefore a logical candidate for further investigation.
The researchers created 2.5-mm-diameter excisional wounds using a punch biopsy on the mandibular labial gingiva, precisely between the right and left incisors of the rats. Thirty 10-week-old male Wistar rats were divided into five treatment groups: a negative control (Na CMC gel), a positive control (Benzydamine® gel), and three groups receiving ethanolic garlic extract gel at concentrations of 20%, 40%, and 80%. The gels were applied three times daily for seven days, and wound tissue was collected on days 5 and 7 for histological examination.
Before conducting the animal experiment, the researchers also verified the active compounds in the extract using thin-layer chromatography (TLC). The results clearly identified allicin and alliin, two major active compounds in garlic, in both the extract and the gel preparation.
Thicker Epithelium, More Tangible Hope
The most notable finding emerged on day 5: epithelial thickness in the wound tissue of all groups receiving garlic extract gel was significantly greater than that of the negative control group (p<0.05). The effect was even comparable to that of Benzydamine®, a commercially available medication.
“Topical administration of ethanolic garlic extract accelerates gingival wound healing in rats by increasing epithelial thickness.” — Bramanti et al., Journal of Medical Sciences, 2013
However, the findings came with an important qualification. The number of newly formed blood vessels and fibroblasts in the treatment groups did not differ significantly from those in the negative control group (p>0.05). This suggests that garlic's mechanism of action in gingival wound healing may be more focused on re-epithelialization rather than angiogenesis or fibroblast proliferation.
The researchers suspected that this effect was mediated by garlic's anti-inflammatory compounds, including allicin, flavonoids, and triacremonone. These compounds suppress the inflammatory phase, allowing the proliferative phase, including re-epithelialization, to proceed more rapidly.
Between the Kitchen and the Clinic
The garlic extract used in this study was obtained from a traditional market in Tawangmangu, Central Java. It was then processed through maceration with 70% ethanol and concentrated using a rotary evaporator at the UGM Integrated Research and Testing Laboratory. The gel formulation was prepared at the Department of Pharmaceutical Technology, Faculty of Pharmacy, UGM, making the study genuinely interdisciplinary.
The findings open an important discussion for dental practice: could plant-based herbal medicines derived from locally available resources become valid alternatives, particularly for communities with limited access to modern medicines? Bramanti et al.'s study does not answer this question clinically in humans, but it provides a sufficiently strong scientific foundation for further investigation.
Faster-healing gingival wounds using a material that grows in one's own garden. Simple, perhaps—but the implications extend far beyond that.
Authors: Nanda Ayu, drg. Achmad Zam Zam Aghasy, M.Kes.
Photo: Pexels