In up to 77% of failed root canals, Enterococcus faecalis—a gram-positive bacteria naturally found in intestines—has been a culprit. Although calcium hydroxide (CaOH), the most widely used intracanal medication, has a sufficient antibacterial range, it has minimal effect of E. faecalis. Aloe vera is a popular ingredient in oral products such as mouthwash and toothpaste: due to its anti- 1) bacterial, 2) inflammatory, 3) viral, and 4) fungal qualities. 

By performing a literature search of “aloe vera,” “E. faecalis,” “CaOH,” and “endodontics” either alone or in combinations, the authors of a Cureus article sought answers to, “Is aloe vera more effective than CaOH as an intracanal medication against E. faecalis?” They found nonsignificant differences between aloe vera and CaOH in efficacy as antimicrobials, with aloe vera “neither higher nor equivalent to that of conventional medications.” It was pointed out that virtually no intracanal medication can totally get rid of bacteria. Aloe vera, however, is both biocompatible and exhibited no toxicity to the tissues surrounding the apex of a tooth root. More studies are called for.