© 2020 Endeavor Business Media, LLC. Discussion The most common allergen occurring in the authors’ search was flavoring, which was present in 95 percent of the toothpaste contained in the Walgreens database. 7. This article is intended to promote understanding of and knowledge about general oral health topics. Upon seeing him at his four-week follow-up visit, his rash had almost completely resolved (Figure 2). I love that it doesn't have fillers and chemicals that are not the best for your gums and overall health. One sign of a toothpaste allergy is a severe form of chapped lips, known as cheilitis.  The generally recommended patch-test concentration is 10%. Contact us to sponsor a DermNet newsletter. Several patch-test studies in different test populations with propylene glycol in concentrations between 2 and 30% revealed a frequency of positive reactions in a range of 0.1 to 3.8% of the patients tested. Eight of 80 toothpastes contained this allergen. According to a recent multicenter study of allergic contact cheilitis from toothpaste, the majority of cases responsible for toothpaste allergies were flavoring, and particularly important were those relating to derivatives extracted from the main varieties of mint, such as spearmint, peppermint, menthol, and carvone—widely used in toothpastes to produce a sensation of freshness.. Methods The authors used a recently published database of all toothpastes that are commercially available at Walgreens pharmacies (operated by Walgreen Co., Deerfield, Illinois). The database was created by a dermatologist with specific expertise in ACD. Fisher AA. He underwent patch testing and was found to have a 1+ reaction to fragrance mix 1 and cinnamic alcohol. Cinnamal, also called cinnamaldehyde, is a yellow oily liquid that gives cinnamon its spice. I am really enjoying this toothpaste. 2004;15:5–6. This ingredient is related to flavoring and all of the toothpastes that contained essential oils in the database also contained flavoring. Sainio EL, Kanerva L. Contact allergens in toothpastes and a review of their hypersensitivity . Walgrave SE, Warshaw EM, Glesne LA. Zug KA, Rietschel RL, Warshaw EM, et al.  Methods of essential oil extraction include distillation, maceration, solvent and carbon dioxide extraction, expression, and enfleurage. Dental sensitivity can make life difficult for patients—and it can make treating them difficult for you. 2009;23(1):17–22. 17. » Clinical aspects and patch tests. According to studies, The Natural Dentist proved to kill germs and reduce gingivitis and gingival bleeding. Dental hygiene products are only one part of the equation, but they can help keep clinicians safe and patients healthy, happy, and loyal to the practice. Dermatology Online Journal 15 (12): 14. Propolis is composed of beeswax, resin and vegetable balsam, essential and aromatic oils, pollen, and other substances.  ACD has most commonly been reported when paraben-containing products are used on damaged skin. Allergy to cinnamate. The consistency, use, packaging, shipping, etc were all great and I'll be using more Smile Natural Products, however, this particular blend is for someone who enjoys heat a bit more than me. If diagnosed with cinnamate allergy, avoid exposure to cinnamate containing products. Allergy to teat tree oil: retrospective review of 41 cases with positive patch tests over 4.5 years. This has been reported due to cinnamic aldehyde present in a mouthwash used by the patient. This flavor was designed especially for sensitive teeth. In one case, prick testing with a mint leaf was positive, but a negative reaction was seen with the patient's mint-flavoured toothpaste. After a two-week period, the gingival lesions subsided and your diagnosis was confirmed. Contact Dermatitis. Parabens are commonly used preservatives in many over-the-counter products. Differential diagnosis: Mucosal diseases such as lupus, lichen planus, mucous membrane pemphigoid, pemphigus vulgaris, and candidiasis should be considerations. Tailoring appointments: Special needs patients. Presentation: Amy Anderson is your patient today. Laryngeal edema and anaphylactic shock after topical propolis use for acute pharyngitis. Kris Potts, RDH, outlines the background behind activated charcoal toothpastes, and why some consumers are indicating a preference for them. It leaves my teeth and mouth feeling refreshed. This RDH has many ways that she helps pregnant patients. Coupled with cinnamon’s ability to decrease inflammation, this blend of flavors alleviates pain associated with sensitive teeth while leaving your breath especially fresh. Formula: 2-ethoxyethyl p-methoxy cinnamate – C14H18O4, Appearance: slightly yellow viscous liquid, Sensitiser: cinnamates and its derivatives, See smartphone apps to check your skin. It's also a good idea to see your dentist or doctor. A study of more than 2,000 patch-tested individuals found that tea tree oil, the most common essential oil allergen, elicited a positive reaction in 1.8 percent of these patients.  Parabens are popular preservatives because they are inexpensive, colorless, odorless, and nontoxic. Try out our toothpaste for sensitive teeth! Many of the same allergens are found in mouthwashes as toothpaste, added for the ‘fresh clean taste’ flavouring. TheraBreath is based on pharmaceutical-grade CIO2 active ingredients that have already been used successfully by thousands of people in 59 countries. The patient was switched to Tom’s of Maine Natural Orange and Mango Toothpaste and LISTERINE Antiseptic Mouthwash, Natural Citrus. Contact cheilitis to oral hygiene products. Toothpastes can contain a number of potential allergens. Flavoring is added to toothpaste not only to make toothpaste more enjoyable to use, but also to freshen breath. Symptoms may appear immediately or several days later (delayed contact and photocontact dermatitis). Discontinuing the product or ingredient is usually all that is needed for resolution. 25. Australas J Dermatol 2006; 47: 300-301. Scheman A, Jacob S, Zirwas M, et al. All rights reserved.  Because most toothpaste is flavored with either a variation of mint or cinnamon, it can be challenging to find toothpaste free of these flavors for those who have an allergy. Dermatitis noted that in the past, cinnamon derivatives were a common cause of allergic reactions to toothpaste. His lips were fissured, intensely dry, and slightly swollen. Some authors recommend confirming the product patch test results using a start-restart test or repeated open application test (ROAT). You can try switching to a new variety or brand and see if your symptoms resolve. 2008;59(3):426–431. 1975;1(2):70–76. 2004;22;432–433. Dermatitis. This is in contrast to products such as chewing gum that contact the tongue and buccal mucosa. Australas J Dermatol 2005; 46: 15-17. I wish there was a expiration date on the container or a "packaged on" date. Extraoral characteristics: The perioral areas may be affected as well with redness of the lips and peeling of the tissue. Although allergy to fragrance or flavorings is common, in the majority of cases we have seen, patients with cheilitis and fragrance allergy have not improved following avoidance of flavorings.  It is a surfactant used as a lathering agent or foaming agent, which is why it is often added to toothpaste. As you examine the intraoral areas, you find the following (see Figure 1): Clinical impressions: The tissue exhibits a diffuse red color without ulceration. Therefore it is important to add an extended toothpaste series and the patient's own products. Its great mint taste leaves your mouth clean and fresh. 16. Ed Rietschel RL, Fowler JF. Woodstock Natural Products Inc. introduces The Natural Dentist Antimicrobial Rinse. While you might hear about food allergies, pollen allergies or drug allergies often, you might not hear about a toothpaste allergy all that much. Flavoring agents in general are widely consumed by most individuals through not only dental products, but also mints, gums, salsa products, cola drinks, canned products, and even some cosmetics such as lipsticks and lip balms.  There are many essential oils, but only the most prevalent ones known to cause contact dermatitis, such as ylang ylang, tea tree oil, compositae mix, propolis, and colophony, are included in most patch-testing trays. Contact Dermatitis 1995; 33: 100-105. Octocrylene (2-ethylhexyl-2-ciano-3, 3-diphenyl acrylate), a relatively new cinnamate that has both UVB and some UVA absorbing properties is photostable and thought to be non- allergenic and non-irritating.  Tea tree oil was utilized specifically in one of the toothpastes in our database. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Compendium. Burdock GA. Review of the biological properties and toxicity of bee propolis. Fantastic! Chlorhexidine—the good, the bad, and the ugly. Nielsen A. If it does turn out that you are allergic to an ingredient in your toothpaste, the good news is that there are plenty of toothpastes out there that you can switch to.  Parabens are found worldwide in creams, pastes, beauty products, glues, fats, and oils.  The main categories of substances used in the formulation of toothpaste are abrasives, detergents, binding agents, humectants, preservatives, coloring agents, antiseptics, fluoride salts, and flavorings. She is a 34-year-old female who has been seen in your practice for about five years. Activated charcoal: An all-natural tooth whitener? They are commonly used as preservatives in personal care products. I purchased this for my teething toddler. Dermatitis 2009; 20: 95-98. While it's not that common, it can occur, which is why it's important to know what to look for. Diagnosis: Contact stomatitis caused by a reaction to a type of toothpaste containing cinnamic aldehyde. Bentonite Clay, Organic Cold-Pressed Coconut Oil, Organic Cacao, Xylitol, Clove Bud Essential Oil, Cinnamon Bark Essential Oil. 10. Best toothpaste ever. Many of the relevant allergens can also be irritants, which may lead to false-positive results. My mouth definitely feels clean as well. [Sponsored content]. It also has some antimicrobial effects and its use has increased because of its nontoxic, low irritancy features. Clinical factors the authors have noted in their experience that increase the likelihood of finding a relevant contact allergen to explain cheilitis include asymmetrical presentation, with one side being persistently more involved than the other and an obscured vermillion border, indicating that the eruption is spreading beyond the lip and onto the skin. Most reported cases of stomatitis from cinnamon are from toothpaste and gum. DermNet NZ does not provide an online consultation service.
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