Hyaluronic Acid

What it is

Hyaluronic acid (HA) is a linear polysaccharide of the glycosaminoglycan class, built from repeating disaccharide units of D-glucuronic acid and N-acetyl-D-glucosamine. The molecular weight of natural HA ranges from 0.5 to 8 MDa. Cosmetic formulations predominantly use sodium hyaluronate — the sodium salt of HA, which is more water-soluble.

HA is a key component of the extracellular matrix of connective tissues: in the oral cavity it is found in the gingival sulcus, periodontal ligament and ground substance of the mucosa. The concentration of HA in healthy gums is 1.5–2 times higher than in inflamed tissue — this provided the rationale for therapeutic use of exogenous HA in periodontitis.

How it works

The primary mechanism is hydration and water reservoir formation. The HA molecule can retain water molecules in a quantity 1000 times its own mass. When applied to gingival mucosa, HA creates a viscoelastic hydrogel layer that reduces tissue dryness, improves epithelial turgor and mechanically protects damaged areas.

The second mechanism is regeneration acceleration. HA regulates fibroblast proliferation by activating CD44 and RHAMM receptors. Low-molecular-weight HA fragments (oligo-HA) act as pro-inflammatory signals, stimulating immune cell migration into the zone of injury; high-molecular-weight HA, conversely, exerts an anti-inflammatory effect, suppressing synthesis of pro-inflammatory cytokines (IL-1β, TNF-α).

In periodontology, HA inhibits adhesion and biofilm formation by Porphyromonas gingivalis and Fusobacterium nucleatum — key periodontopathogens — by competing for binding sites on the epithelial surface.

Efficacy

Pistorius et al. (2005) showed that subgingival irrigation with an HA solution as an adjunct to scaling and root planing (SRP) significantly reduced periodontal pocket depth and gingival bleeding compared with SRP alone. Casale et al. (2016), reviewing 14 clinical studies, recorded accelerated healing of surgical wounds in the oral cavity with HA applications.

For toothpastes, the optimal concentration is 0.2–0.5%: at lower concentrations the effect is negligible; at high concentrations the viscosity of the formulation becomes critical. High-molecular-weight HA (>1 MDa) with an anti-inflammatory profile shows the best results.

Safety

Sodium hyaluronate is one of the safest ingredients in cosmetics. Non-toxic, non-allergenic for the overwhelming majority of users (rare reactions are linked to impurities or enzymatic hydrolysates). Biodegradable by hyaluronidase enzymes. Widely used in medicine (injectable fillers, ophthalmic viscoelastics, intra-articular injections).

One note: HA in the oral cavity is enzymatically cleaved by hyaluronidases from pathogenic bacteria. This does not reduce efficacy but determines application frequency — at least twice daily.

Role in the QDRO formula

In the v.daily line, hyaluronic acid is the key ingredient for the "sensitive gums" and "gum care" segment. Synergy with allantoin delivers a dual regenerative potential: HA provides hydration and an anti-inflammatory barrier; allantoin accelerates epithelial cell division.

In the v.pro line, HA supports the health of periodontal tissues as an indirect context for the remineralisation programme: inflamed gums reduce ion bioavailability at the tooth neck and dentine, making gum health a prerequisite for remineralisation efficacy.