The Effect of Honey as a Treatment for Oral Ulcerative Lesions: A Systematic Review

Abstract

Background and objectives: A healthy oral environment features a rapid turnover rate of epithelium cells capable of regeneration and repair, with the oral epithelium contributing as a physical barrier and immune defense. However, the oral cavity can be subjected to unique damage, such as ulcerations. Honey is reported as a therapeutic agent for wound healing, due to its antioxidant, antibacterial and anti-inflammatory properties. Methods: A systematic review was performed following the PRISMA 2015 Guidelines, to assess the efficacy and safety of the therapeutic use of honey in the oral cavity. Four electronic databases were searched (PubMed, Cochrane Library, Scopus, and Web of Science) for randomized controlled trials examining the effect of honey on oral cavity conditions. Results: In total, 2,832 records were identified, and after applying exclusion criteria, 13 studies were included. Honey was applied topically throughout, for chemotherapy or radiotherapy-induced oral mucositis (n = 11), dental wounds (n = 1), and recurrent aphthous stomatitis (n = 1), all of which are ulcerations with different pathologies. In the majority of studies (12/13), honey reduced the severity and/or duration of the condition compared with control groups (all p<0.05). However, a group treated with Manuka honey (n = 1) experienced adverse effects and considerable participant attrition. Conclusions: Honey is an effective treatment for a range of oral ulcerative conditions. Future research should focus on compositional analysis of honeys to determine those with optimal beneficial properties, and whether Manuka honey is safe to use in the oral cavity.

The bioactive, antioxidant, antibacterial, and physicochemical properties of a range of commercially available Australian honeys

“…Based on the observed antioxidant characteristics of the honeys, there is potential for further investigation into antioxidant-related health benefits of commercial Australian honey, including determining if these samples are efficient at reducing plasma antioxidant content in vivo . Additionally, given the observed association between the antioxidant characteristic FRAP and antibacterial activity, the synergistic anti-inflammatory potential should be investigated ( Hunter et al, 2020 ).…”

“…Honey is used as a food source and for medicinal purposes across a variety of different cultures ( Hunter et al, 2020 ; Mandal and Mandal, 2011 ), and is produced as a combination of nectars and bees salivary secretions (Codex Alimentarius, 2001 ). Honey is a supersaturated sugar solution consisting predominantly of fructose (~38%) and glucose (~31%) ( Pascual-Maté et al, 2018 ), and a variety of over 200 other substances ( da Silva et al, 2016 ).…”

Toxicities Caused by Head and Neck Cancer Treatments and Their Influence on the Development of Malnutrition: Review of the Literature

“…Honey [34] Reduction in severity and duration of severe symptoms, weight maintenance and weight gain.…”

“…While there is limited evidence favoring any one oral health product [ 32 ], there is encouraging evidence for the use of sterile solutions, including saline, for oral hygiene maintenance [ 33 ]. Further interventions also include the use of honey, which has been successful in reducing the severity and duration of OM symptoms [ 34 ].…”

Sensory and Compositional Properties Affecting the Likeability of Commercially Available Australian Honeys

“…The antibacterial effects of honey are ascribed to its physicochemical properties (including pH and viscosity), which have the ability to prevent the growth of bacterial species [7], and the production of hydrogen peroxide as a by-product of the breakdown of glucose caused by glucose oxidase [8]. The combined effects of the antioxidant and antibacterial properties can further lead to their synergistic anti-inflammatory effects [9,10].…”