Sir, Dr T. A. Parr reported a patient who developed oral ulceration as a consequence of exposure to a fungicide, who was then treated with propolis (BDJ 2006; 200: 64). However, before clinicians consider using propolis, a little background might be worth considering.
Propolis (bee glue, or royal jelly) is a natural substance based on the resin of pines, collected by bees. The term 'propolis' derives from 'pro' (Greek = before), and 'polis' (city) based on the fact that honeybees use propolis to narrow the opening to their hives.
Propolis is a complex entity, containing about 55% resinous compounds and balsam, 30% beeswax, 10% ethereal and aromatic oils, and 5% bee pollen. Contained chemicals include amino acids; flavanoids including flavones, flavonols and flavanones; terpenes; vanillin; tetochrysin; isalpinin pinocembrin chrysin galangin; ferulic acid; caffeic acid; caffeic acid phenethyl ester; cinnamic acid and cinnamyl alcohol.
Propolis has a degree of antimicrobial action against fungi such as C. albicans, and some bacteria1 including a range of oral microorganisms2 and viruses, and may be as effective as aciclovir against herpes simplex virus.3 It also has immunomodulatory activity with augmentation of non-specific antitumour resistance.4
Not surprisingly therefore, many claims, not always substantiated, have been made for the general beneficial effects of propolis. In dentistry, propolis has been used in dentifrices,5 as a storage medium for teeth after evulsion,6 in periodontal therapy7 and in endodontics.8 Propolis ethanolic solutions are the most used propolis products on the market for assisting the treatment of ulcers in the mouth, thrush or skin infections: there is little evidence base.
While I am a great supporter of holistic dentistry and complementary medicine, the fact is that as well as the fact that there is little evidence base for efficacy, phytomedicines such as propolis, though natural, cannot necessarily always be regarded as safe.9 Propolis is, for example, well recognised as causing hypersensitivity and anaphylaxis,10 and as occasionally causing untoward reactions such as allergic cheilitis,11 and oral ulceration.12,13
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Scully, C. Propolis: a background. Br Dent J 200, 359–360 (2006). https://doi.org/10.1038/sj.bdj.4813435
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DOI: https://doi.org/10.1038/sj.bdj.4813435