Evaluating the Efficacy of Tulsi and Aloe Vera in the Management of Oral Submucous Fibrosis and their Correlation with Salivary Levels of Iron and Lactate Dehydrogenase: A Prospective Study

Introduction: Oral Submucous Fibrosis (OSMF) is a chronic, potentially malignant condition marked by fibrous bands in the oral cavity. It causes burning sensation with spicy foods, blanching of the oral mucosa, and progressive stiffness, leading to restricted mouth opening. Natural remedies like Tulsi (Ocimum sanctum Linn), and aloe vera are known for their antioxidant, anti-inflammatory, and healing properties. However, clinical evidence evaluating their efficacy in OSMF management remains limited. Aim: This study Aimed to evaluate the effectiveness of natural antioxidants, “Tulsi” and “aloe vera”, in managing OSMF and their association with changes in salivary levels of iron and Lactate Dehydrogenase (LDH). Materials and Methods: The present prospective study was conducted from January 2020 to September 2021 at Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences, Andhra Pradesh, India. Sixty patients were divided into two groups: Group A received topical Tulsi paste, while Group B received aloe vera gel. Both groups included 28 males (93.3%) and 2 females (6.7%) with mean ages of 40.0 and 42.7 years, respectively. Salivary iron and LDH levels were measured before and after treatment. Clinical parameters such as mouth opening, burning sensation, and tongue protrusion were assessed biweekly over six weeks. Data was analysed using IBM Statistical Package for Social Sciences (SPSS) Version 20 software with descriptive statistics, Chi-square tests, t-tests, and Analysis of Variance (ANOVA). Statistical significance was set at p≤0.05. Results: Significant improvements in clinical parameters were observed in both groups (p<0.001). The Tulsi group showed more pronounced enhancements in mouth opening (p<0.001) and tongue protrusion compared to the aloe vera group. Salivary iron levels increased significantly in both groups (p<0.001), with no significant intergroup difference (p=0.39). However, the Tulsi group exhibited greater reductions in salivary LDH levels (p=0.001) compared to the aloe vera group (p=0.009). Conclusion: Topical application of Tulsi paste and aloe vera gel effectively reduced burning sensation while improving mouth opening and tongue protrusion. Tulsi demonstrated superior results compared to aloe vera in clinical outcomes and salivary LDH reduction, highlighting its potential for OSMF management.