Clinical efficacy of Psidium guajava―based Herbal gel in the management of recurrent aphthous stomatitis: A randomized clinical trial

Objective: To investigate clinical efficacy of Psidium guajava-based herbal gel in reducing size of recurrent aphthous stomatitis (RAS) of patients eventually relieving pain associated with it. Methodology: Single-blinded, parallel group randomized clinical study which was conducted at School of Dentistry Shaheed Zulfiqar Ali Bhutto Medical University from 15th June 2023 to 16th January 2024. Total 204 participants were randomly assigned to Control and Experimental Groups where Control group was not given any treatment for RAS while Experimental group was advised to apply Herbal gel on ulcer 2-4 times/day for four weeks. Size of ulcer was assessed on first, second, third, fourth, seventh and fifteenth visit days for reduction and eventual healing. One-way ANOVA and POST HOC Tukey test was used to analyze data. Results: Baseline mean size of oral ulcer in both groups was 4.7 (±0.56) units. Experimental group exhibited greater mean ulcer size declination than Control group on every visit. On the second day of treatment, mean ulcer size measurement in Control group was 4.63 ± 0.17-mm and in Experimental group it was 4.29 ± 0.16-mm. On third and fourth days, Control group displayed mean ulcer size reduction of 3.95 ± 0.13-mm and 3.71 ± 0.11-mm as compared to 1.01± 0.07 cm² and 0.17 ± 0.05-mm in Experimental group. On the seventh day, mean oral ulcer size decreased to 2.46 ± 0.09-mm in Control group and disappeared in Experimental group (p = 0.001). Conclusion: Current study found that naturally procured herbal gel reduces size of recurrent aphthous stomatitis quickly confirming that oral ulcer can be treated with herbal gel more effectively that might be helpful in relieving pain associated with it.