Chamomile: An anti-inflammatory for oral health

German chamomile (Matricaria chamomilla) and Roman chamomile (Anthemis nobilis) – although the review searched for “chamomile” in general.

To conduct a systematic review and meta-analyses to explore the use of chamomile as an anti-inflammatory agent, particularly as an anti-inflammatory for oral health.

This study was conducted as a systematic review. Whilst the authors broadly searched for inflammation, the main area of focus was oral health.

For the search strategy the population was human adults, the intervention was any chamomile preparation, and the outcomes of interest were inflammation, pain severity, gingival bleeding and anti-microbial effects.

It is noted that the details of the search terms were not included in the methodology, so it is not clear how extensive these were and whether the authors searched using botanical names or common plant names, or whether the terms included active compounds, such as chamazulene.

The search was performed using only one electronic bibliographic database – PubMed. Two authors were involved in study screening and data extraction. They did not look at the risk of bias for included studies.

Chamomile was administered in a range of oral products. Chamomile oral gel, chamomile mouthwash or gargle, chamomile powder for cleaning teeth, topical gel and chamomile extract.

Topical gels and creams ranged from 1.3 to 3% chamomile (w/v), and mouthwashes ranged from 20% to 160% (w/v).

Eleven randomised controlled trials were included in the analysis. Nine of these looked at oral inflammation, one nasal inflammation and one skin inflammation.

The first meta-analysis pooled data from seven studies and looked at overall inflammation. There was no statistically significant improvement in inflammation from using chamomile compared to controls, with a pooled mean of −1.57 (95% CI: −4.05 to 0.91). These studies included oral, nasal and skin inflammation and a wide range of chamomile products, and the heterogeneity, which measures variability between studies, was high.

A second meta-analysis included four studies and explored pain severity; there was a significant improvement following the use of chamomile compared to controls with a pooled mean of −0.61 (95% CI: −0.76 to −0.46).  For these studies, the heterogeneity was low at 0%, with three trials on oral care and one on skin inflammation.

For gingival bleeding, although there was a trend toward improvement, the pooled effects showed no statistically significant reduction in bleeding following chamomile treatment compared to controls. For anti-microbial effects, there was a trend toward improvement which also was not statistically significant.

The next meta-analysis pooled data from the studies that just examined the oral cavity. There was no statistical improvement in mucosal inflammation as shown by pooling data from three studies, and these tests looked for ulcers, swelling and redness. However, a final meta-analysis on gingival inflammation pooled data from three studies and showed a statistically significant improvement in the Gingival Index (gum inflammation), with a pooled mean difference of -0.70 (95% CI: -1.25 to -0.15), and the heterogeneity was low.

The systematic review retrieved and analysed 11 studies that examined the effectiveness of chamomile in treating inflammatory skin and mucosal conditions, with chamomile made available in topical gels, creams, oral mouthwashes and powders.

Overall, chamomile was not effective as an anti-inflammatory treatment but it did relieve pain severity in studies that included skin and nasal inflammation, and oral care.

In focusing on oral care, there were no improvements in visible mucosal inflammation as indicated by ulceration and swelling in the mouth, but chamomile did specifically improve gingivitis inflammatory scores, but not gingival bleeding. 

Overall, the results for chamomile were mixed probably due to the array of different products and varying concentrations used, and the varying medical conditions looked at in the review.

Chamomile is well known for its anti-inflammatory properties and is used to treat skin irritations and gut disorders. Its effects are attributed to volatile oil compounds like chamazulene and alpha-bisabolol, and flavonoids including apigenin. Future research could benefit from the standardisation of products, such as apigenin-7-glucoside, as per European and U.S. pharmacopoeia recommendations. This would allow for a more accurate comparison of the effects of different products.

Accounting for the botanical species and parts of the plant used, as well as the method of preparation would futher benefit future work. One study that explored the effects of chamomile extracts from five different parts of the plant on human T cells found varying immunomodulatory activity dependent on the plant part and method of extraction (they used aqueous extracts of whole plant and root, ethanolic extract of flowers and root, and an ethanolic mother tincture). Aqueous root extract inhibited T cell migration, whereas both aqueous root and aqueous whole plant extracts reduced T cell activation. Whole plant extract and ethanolic flower extract significantly reduced interleukin-2 intracellular levels (2). This reaffirms the importance of recording the preparation and plant parts used.

Chamomile was effective in improving pain severity in a range of inflammatory conditions, and reduced gingivitis scores suggesting that its analgesic and anti-inflammatory properties could be of particular benefit as an anti-inflammatory for oral health. Overall, the analyses included a diverse set of studies including skin, nasal and oral inflammation, and there was no significant improvement in inflammation overall across all studies analysed.

It must be noted that this study lacks any record of the complete search strategy and the risk of bias was not discussed, precluding reliable interpretation of the results. Further research is needed to better understand chamomile’s anti-inflammatory potential, in particular its application in dentistry.

1. Valmy J, Greenfield S, Shindo S, Kawai T, Cervantes J, Hong BY. Anti-inflammatory effect of chamomile from randomized clinical trials: a systematic review and meta-analyses. Pharm Biol. 2025 Dec;63(1):490-502. doi: 10.1080/13880209.2025.2530995. Epub 2025 Jul 15. PMID: 40665590; PMCID: PMC12269088.
2. Lairikyengbam D, Wetterauer B, Schmiech M, Jahraus B, Kirchgessner H, Wetterauer P, Berschneider K, Beier V, Niesler B, Balta E, Samstag Y. Comparative analysis of whole plant, flower and root extracts of Chamomilla recutita L. and characteristic pure compounds reveals differential anti-inflammatory effects on human T cells. Front Immunol. 2024 Apr 24;15:1388962. doi: 10.3389/fimmu.2024.1388962. PMID: 38720895; PMCID: PMC11077421.