Top

Clinical Oral Investigations

Published in:

01-11-2017 | Original Article

Symptomatic oral lesions may be associated with contact allergy to substances in oral hygiene products

Authors: K. R. Larsen, J. D. Johansen, J. Reibel, C. Zachariae, A. M. L. Pedersen

Published in: Clinical Oral Investigations | Issue 8/2017

Abstract

Objective

Dental materials and oral hygiene products may be responsible for oral contact allergic reactions. We aimed to determine the occurrence of allergies in patients with symptomatic oral lichen planus (OLP), oral lichenoid lesions (OLLs) and stomatitis and investigate if patch testing could identify contact allergies to dental materials and oral hygiene products in these patients.

Methods

Forty-nine patients (7 men, 42 women) aged 31 to 77 years (61 ± 10.3 years) with symptomatic OLP, OLL or stomatitis and 29 healthy age- and gender-matched control subjects were included. They underwent an interview, clinical examination, oral mucosal biopsy and epicutan testing to the European baseline series, a toothpaste and dental material series.

Results

Nineteen patients had OLP, 19 OLL and 11stomatitis. Oral burning/itching was the most common symptom (83.7%), and 65.3% patients had more than one symptom. Patients visited their dentist more often than the healthy subjects and had statistically higher DMF-T and DMF-S scores. Nineteen patients (38.8%) and 10 healthy control subjects (34.5%) had allergic contact reactions primarily to fragrance ingredients. No differences could be found between OLP, OLL, stomatitis and healthy controls with regard to allergic contact reactions. However, contact allergy to aroma substances differed significantly between the patients and the healthy control subjects (p = 0.02). This type of contact allergy was most common in patients with OLP and OLL (p = 0.01). Avoidance cleared symptoms in all cases.

Conclusion/clinical relevance

Allergic reactions to aroma substances in oral hygiene products are common in patients with symptomatic OLP, OLL and stomatitis.

Available only for authorised users

Sainio EL, Kanerva L (1995) Contact allergens in toothpastes and a review of their hypersensitivity. Contact Dermatitis 33(2):100–105CrossRefPubMed

Munksgaard EC, Hansen EK, Engen T, Holm U (1996) Self-reported occupational dermatological reactions among Danish dentists. Eur J Sci 104:396–402

Goon AT, Isaksson M, Zimerson E, Goh CL, Bruze M (2006) Contact allergy to (meth)acrylates in the dental series in southern Sweden: simultaneous positive patch test reaction patterns and possible screening allergens. Contact Dermatitis 55(4):219–226CrossRefPubMed

Gunatheesan S, Tam MM, Tate B, Tversky J, Nixon R (2012) Retrospective study of oral lichen planus and allergy to spearmint oil. Australas J Dermatol 53(3):224–228CrossRefPubMed

Isaac-Renton M, Li MK, Parsons LM (2015) Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis 26(3):116–121CrossRefPubMed

Vivas AP, Migliari DA (2015) Cinnamon-induced oral mucosal contact reaction. Open Dent J 31(9):257–259CrossRef

O'Gorman SM, Torgerson RR (2015) Contact allergy in cheilitis. Int J Dermatol. doi:10.1111/ijd.13044 PubMed

Hensten-Pettersen A (1998) Skin and mucosal reactions associated with dental materials. Eur J Oral Sci 106(2 Pt 2):707–712PubMed

Torgerson RR, Davis MD, Bruce AJ, Farmer SA, Rogers RS 3rd (2007) Contact allergy in oral disease. J Am Acad Dermatol 57:315–321CrossRefPubMed

10.

Raap U, Stiesch M, Kapp A (2012) Clinical symptoms and diagnostic workup of allergic reactions on the oral mucosa. Hautarzt 63(9):687–692CrossRefPubMed

11.

Larsen KR, Johansen JD, Arenholdt-Bindslev D, Reibel J, Pedersen AM (2013) Dental materials can cause oral allergic reactions. Ugeskr Laeger 175(25):1785–1789

12.

Ahlgren C, Axéll T, Möller H, Isaksson M, Liedholm R, Bruze M (2014) Contact allergies to potential allergens in patients with oral lichen lesions. Clin Oral Investig 18(1):227–237CrossRefPubMed

13.

Jacobsen N, Hensten-Pettersen A (1989) Occupational health problems and adverse patient reactions in orthodontics. A. Eur J Orthod 11(3):254–264CrossRefPubMed

14.

Hensten-Pettersen A, Jacobsen N (1991) Perceived side effects of biomaterials in prosthetic dentistry. J Prosthet Dent 65(1):138–144CrossRefPubMed

15.

Jacobsen N, Aasenden R, Hensten-Pettersen A (1991) Occupational health complaints and adverse patient reactions as perceived by personnel in public dentistry. Community Dent Oral Epidemiol 19(3):155–159CrossRefPubMed

16.

Jacobsen N, Hensten-Pettersen A (1989) Occupational health problems and adverse patient reactions in periodontics. J Clin Periodontol 16(7):428–433CrossRefPubMed

17.

Scully C, Beyli M, Ferreiro MC, Ficarra G, Gill Y, Griffiths M, Holmstrup P, Mutlu S, Porter S, Wray D (1998) Update on oral lichen planus: etiopathogenesis and management. Crit Rev Oral Biol Med 9(1):86–122CrossRefPubMed

18.

Pedersen AM, Reibel J, Nordgarden H, Bergem HO, Jensen JL, Nauntofte B (1999) Primary Sjögren's syndrome: salivary gland function and clinical oral findings. Oral Dis 5(2):128–138CrossRefPubMed

19.

Löe H (1967) The gingival index, the plaque index and the retention system. J Periodontol:610–616

20.

Kramer IRH, Lucas RB, Pindborg JJ, Sobin LH (1978) Definition of leukoplakia and related lesions: an aid to studies on oral cancer. Oral Surg Oral Med O Path 46(4):518–539CrossRef

21.

van der Meij EH, van der Waal I (2003) Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. Oral Pathol Med 32(9):507–512CrossRef

22.

Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, Cannavó A, Giménez-Arnau A, Gonçalo M, Goossens A, John SM, Lidén C, Lindberg M, Mahler V, Matura M, Rustemeyer T, Serup J, Spiewak R, Thyssen JP, Vigan M, White IR, Wilkinson M, Uter W (2015) European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis 73(4):195–221CrossRefPubMed

23.

Bindslev-Jensen C (2011) Skintests for immediate hypersensitivity. In Johansen JD (ed.) Contact dermatitis 5th ed., Springer Berlin Heidelberg, pp 511–7

24.

Dillon JS (2005) Dehydroepiandrosterone, dehydroepiandrosterone sulfate and related steroids: their role in inflammatory, allergic and immunological disorders. Curr Drug Targets Inflamm Allergy 4(3):377–385CrossRefPubMed

25.

Suri V, Suri V (2014) Menopause and oral health. J Midlife Health 5(3):115–120PubMedPubMedCentral

26.

Avlund K, Osler M, Mortensen EL, Christensen U, Bruunsgaard H, Holm-Pedersen P, Fiehn NE, Hansen AM, Bachkati SH, Meincke RH, Jepsen E, Molbo D, Lund R (2014) Copenhagen Aging and Midlife Biobank (CAMB): an introduction. J Aging Health 26(1):5–20CrossRefPubMed

27.

Thyssen JP, Linneberg A, Menné T, JohansenJD (2007) The epidemiology of contact allergy in the general population—prevalence and main findings. Contact Dermatitis 57(5):287–299

28.

Yiannias JA, El-Azhary RA, Hand JH, Pakzad SY, Rogers RS 3rd (2000) Relevant contact sensitivities in patients with the diagnosis of oral lichen planus. J Am Acad Dermatol 42(2 Pt 1):177–182CrossRefPubMed

29.

Raap U, Stiesch M, Reh H, Kapp A, Werfel T (2009) Investigation of contact allergy to dental metals in 206 patients. Contact Dermatitis 60(6):339–343CrossRefPubMed

30.

Laine J, Kalimo K, Happonen RP (1997) Contact allergy to dental restorative materials in patients with oral lichenoid lesions. Contact Dermatitis 36(3):141–146CrossRefPubMed

31.

Hosoki M, Bando E, Asaoka K, Takeuchi H, Nishigawa K (2009) Assessment of allergic hypersensitivity to dental materials. Biomed Mater Eng 19(1):53–61PubMed

32.

Lavy Y, Slodownik D, Trattner A, Ingber A (2009) Toothpaste allergy as a cause of cheilitis in Israeli patients. Dermatitis 20(2):95–98PubMed

33.

Francalanci S, Sertoli A, Giorgini S, Pigatto P, Santucci B, Valsecchi R (2000) Multicentre study of allergic contact cheilitis from toothpastes. Contact Dermatitis 43(4):216–222CrossRefPubMed

34.

Ahlgren C, Bruze M, Möller H, Gruvberger B, Axéll T, Liedholm R, Nilner K (2012) Contact allergy to gold in patients with oral lichen lesions. Acta Derm Venereol 92(2):138–143CrossRefPubMed

35.

Ahnlide I, Ahlgren C, Björkner B, Bruze M, Lundh T, Möller H, Nilner K, Schütz A (2002) Gold concentration in blood in relation to the number of gold restorations and contact allergy to gold. Acta Odontol Scand 60(5):301–305CrossRefPubMed

Title: Symptomatic oral lesions may be associated with contact allergy to substances in oral hygiene products
Authors: K. R. Larsen
J. D. Johansen
J. Reibel
C. Zachariae
A. M. L. Pedersen
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 8/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-017-2053-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Symptomatic oral lesions may be associated with contact allergy to substances in oral hygiene products

Abstract

Objective

Methods

Results

Conclusion/clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion/clinical relevance

Please log in to get access to this content

Other articles of this Issue 8/2017

Exploration of bacterial species associated with the salivary microbiome of individuals with a low susceptibility to dental caries

Does dental trauma in the primary dentition increases the likelihood of trauma in the permanent dentition? A longitudinal study

Hypermethylation of IFN-γ in oral cancer tissues

In situ effect of enamel salivary exposure time and type of intraoral appliance before an erosive challenge

Liquid-based versus conventional cytology of oral brush biopsies: a split-sample pilot study

Early bone formation around immediately loaded implants with nanostructured calcium-incorporated and machined surface: a randomized, controlled histologic and histomorphometric study in the human posterior maxilla