Bright Picture/Visual China
Toothpaste is a type of oral hygiene product. Using toothpaste to brush your teeth effectively is essential for maintaining oral hygiene and improving the health of your teeth and gums. Toothpaste has become a necessity in modern human life. Statistics show that every million people consume about 620 to 800 tons of toothpaste every year. The ingredients of toothpaste are complex and diverse, but they can generally be divided into three categories: flavoring agents, excipients, and functional/therapeutic ingredients. Common flavors include peppermint, spearmint, cinnamon, etc. Common functional ingredients include fluoride , chlorhexidine , zinc compounds/zinc salts and tin compounds, etc. As more functional toothpaste products continue to be launched on the market, the types of flavoring agents and functional ingredients in toothpaste ingredients continue to expand, and their safety has also attracted the attention of regulatory authorities in various countries. Different countries have different regulations on toothpaste market management. In the United States, toothpaste is considered to have therapeutic effects and is managed by the Food and Drug Administration (FDA). The American Dental Association (ADA) plays an important role in toothpaste safety verification. For example, some fluoride toothpastes and desensitizing toothpaste must pass safety verification before being marketed. In my country, in January 2021, the National Medical Products Administration issued the " Toothpaste Registration Information Specification " (Draft for Comments) to further standardize the safety supervision of toothpaste and require toothpaste products to undergo product registration in accordance with the regulations of the national drug regulatory department. Only then can it be put on the market for sale or import.
The most common adverse reaction caused by toothpaste is contact allergy, which is more common in women than men. In the dental clinic, we have found that the number of patients with toothpaste allergies is increasing year by year. Taking the Department of Oral Mucosa of the Peking University Stomatological Hospital where the author works as an example, there will be more than 200 patients with toothpaste allergy in 2021 alone. In the past, the most common allergens reported in toothpaste were flavoring agents, including menthol , spearmint, cinnamon, and other unspecified spices. However, as the types of functional toothpaste products gradually increase and their ingredients continue to expand, cases of allergies to functional ingredients are also increasing. We have received and reported many cases of tin compound allergies in clinical practice. Currently, about 30 allergens have been identified in toothpaste, and these ingredients are present in most toothpaste products.
Contact stomatitis caused by toothpaste allergy often manifests as flaky congestion, erythema, mucosal ulcers, peeling or swelling of the mucous membranes of the lips, cheeks, tongue, gums and other parts. Patients often seek medical attention due to symptoms such as mucosal pain, numbness, and swelling that last for different periods of time. The symptoms last from a few months to a few days, and are often aggravated when eating or brushing teeth. There are cases where a new toothpaste is replaced before the symptoms appear. The symptoms are relieved after stopping using the suspected toothpaste. If the toothpaste is used again, similar symptoms will reappear. In addition, the diagnosis of toothpaste allergy and the determination of allergenic components can be performed by patch testing. Place the solution or ointment containing suspected allergic ingredients into a patch tester and stick it on the patient's back. The doctor will interpret the results after 3 to 5 days. When itching, redness, mild swelling and blistering occur at the site of the specific chemical substance , it can confirm that the test is positive and determine whether you are allergic to a certain ingredient and the degree of allergy. It is an accurate, safe and simple inspection method.
Once symptoms of suspected toothpaste allergy appear, it is recommended to stop using the suspected toothpaste as soon as possible, switch to ordinary fluoride toothpaste or children's toothpaste , and bring the suspected allergy toothpaste to a professional department for treatment under the guidance of a doctor. . Commonly used drugs for treatment include topical glucocorticoids, anti-allergic drugs, etc. The specific treatment plan should follow the doctor's advice. During the treatment period, avoid local irritation such as spicy food or hot and hard food. Generally speaking, it will be relieved and healed in 1 to 2 weeks.
In short, toothpaste allergy is becoming more and more common. Identifying the allergen of toothpaste and trying to avoid using toothpaste products containing this ingredient in the future is the only way to avoid similar symptoms from happening again.
(Authors: Wei Pan and He Wenxiu are deputy chief physicians of the Department of Oral Mucosa, Peking University Stomatological Hospital and doctoral candidates in the Department of Oral Mucosa, Peking University Stomatological Hospital respectively)
