Herbal Extracts in Orofacial Pain: Systematic Review, Direct and Indirect Meta-analysis

Abstract

There is limited knowledge regarding the efficacy of the use of herbal extracts in orofacial pain. A systematic review and a meta-analysis of randomized controlled trials, to assess the analgesic effect of herbal extracts on pain intensity in various painful orofacial conditions was conducted. Sixty-two studies were included. The intervention treatment consisted in the use of herbal extracts compared with placebo and/or standard treatment. The primary outcome was pain intensity assessed before and after the intervention, using any pain scale from 0 to 10. Pain scores were compared with baseline scores in each treatment. When compared with standard therapy, the pooled results of the patients who received herbal extracts reported lower pain intensity; in periodontal pain (mean difference [MD] = -0.92, 95% confidence interval [-6.69, 4.85]), oral surgery pain (MD = 18.80 [8.80, 28.79]), oral neuropathic pain (MD = 20.34 [6.16, 34.52]), endodontic pain (MD = -8.04 [-11.72, -4.37]), oral mucosal pain (MD = 8.74 [2.76, 14.73]), and temporomandibular pain (MD = 30.94 [6.04, 55.83]). The findings indicate a pain-attenuating effect of herbal extracts such as Cannabis, Turmeric, Capsaicin, Licorice, Ginger, Chamomile, Clove, Hypericum perforatum, Arnica montana, Aloe vera and Calendula use in oral surgery pain, oral neuropathic pain, oral mucosal pain, and temporomandibular pain. The findings of this study indicate that herbal extracts may provide a valuable alternative to traditional pain medication. Additionally, it may also be a promising source for developing new active ingredients for pharmaceuticals.