Role of herbal and natural products in the management of potentially malignant oral disorders

Potentially malignant oral disorders are visibly abnormal areas of the oral mucosa, which are white keratotic, raised roughened areas, which have the probability of malignant transformation. These may be a source of significant anxiety for the patient and the clinician. Though not all premalignant lesions transform into oral carcinomas, certain high-risk lesions have been identified such as leukoplakia, lichen planus, and oral submucous fibrosis. Their management remains controversially polarized between surgical excision to prevent malignant change and conservative medical or surveillance techniques. Drugs obtained from plant extracts, like lycopene, have been recently used in the treatment of leukoplakia and oral submucous fibrosis (OSMF). Beta-carotene and the retinoids are the most commonly used antioxidant supplements for chemoprevention. Beta-carotene is a carotenoid found primarily in dark green, orange, or yellow vegetables. Turmeric and its active ingredient "curcumin" are being studied upon as chemopreventive agents in the management of OSMF. Tulsi and turmeric offers a safe and efficacious combination of natural products for symptomatic treatment of both burning sensation and mouth opening in patients of OSMF. Ayurvedic preparations like Erandabhrishta Haritak and Pippalyadi Choorna have been used in OSMF. This chapter focuses on various modalities currently available and discusses the efficacy and safety of such herbal products and natural extracts in the management of potentially malignant oral disorders.