Randomized Control Study of the Effects of Turmeric Mouthwash on Oral Health Status, Treatment-Induced Mucositis, and Associated Oral Dysfunctions Among Patients With Head and Neck Cancer

Abstract

BackgroundOral mucositis is the most severe and debilitating adverse effect of cancer treatment, resulting in inadequate nutritional intake, treatment disruptions, and dose alteration, leading to increased hospital costs and decreased tumor control.ObjectiveThe aim of this study was to determine the effectiveness of turmeric mouthwash on oral health status and onset and severity of treatment-induced oral mucositis and associated oral dysfunctions among head and neck cancer patients.MethodsA randomized controlled design was adopted (CTRI/2018/06/014367). Turmeric mouthwash was administered to the experimental group (n = 46) and benzydamine mouthwash was given to the control group (n = 46). Oral health status and mucositis were graded using the Oral Health Assessment Tool and the World Health Organization oral toxicity criteria, respectively. Oral dysfunctions were measured by a patient-reported oral mucositis symptom scale and xerostomia short-form inventory. All outcome variables were measured weekly during the entire course of radiation therapy.ResultsBoth groups were comparable with regard to their demographic and outcome variables (P > .05). The incidence of intolerable mucositis in the control group was 100% compared with 17.8% in the experimental group. Repeated-measures analysis of variance demonstrated significant differences in the onset and severity of oral mucositis (P = .001), oral health status (P = .001), and oral dysfunctions (P = .001) between the experimental and control groups.ConclusionTurmeric mouthwash was effective in reducing the severity of oral mucositis and associated oral dysfunctions as compared with benzydamine mouthwash.ImplicationsUse of turmeric, a nontoxic and cost-effective intervention, can be an alternative to the traditional management of oral mucositis.

Efficacy of turmeric in the treatment of oral mucositis in patients with head and neck cancer after radiotherapy or chemoradiotherapy: a systematic review and meta-analysis

“…However, at the 3-week follow-up visit, the results changed. After removing the articles of Delavarian et al, 2019, Arun et al, 2020Thomas 2023, no significant difference was observed. Similarly, at the 4-week follow-up visit, the result changed when the article by Shah et al was removed.…”

“…Various treatment types of turmeric have been designed to improve oral mucositis, and they include mouthwash, gel, and other oral treatments (Charantimath, 2016;Shah et al, 2020;Kia et al, 2021;Soni et al, 2022;Thomas et al, 2023). However, the previous metaanalyses did not consider the differences between various treatment types (Dharman et al, 2021;Zhang et al, 2021).…”

“…Of the total articles identified, 8 were excluded for various reasons: 1) not an RCT (n = 1); 2) no detailed clinical outcomes (n = 2); 3) combination treatments (n = 2); 4) not all patients with HNC (n = 3) (Supplementary Table S2). Finally, eight articles met our criteria for inclusion and were added to our meta-analysis (Rao et al, 2014;Patil et al, 2015;Charantimath, 2016;Delavarian et al, 2019;Arun et al, 2020;Shah et al, 2020;Kia et al, 2021;Soni et al, 2022;Thomas et al, 2023).…”

“…Curcumin is known for its anti-inflammatory and antioxidant properties (Gupta et al, 2012). Turmeric has been utilized to prevent and alleviate oral mucositis caused by chemotherapy and radiotherapy (Patil et al, 2015;Kia et al, 2021;Soni et al, 2022;Thomas et al, 2023). Otherwise, other therapies have been adopted to treat oral mucositis, such as chlorhexidine gluconate (Cardona et al, 2017) and zinc sulfate (Tian et al, 2018).…”