[Epitheliolysis of the mouth mucosa (mucosal peeling) as a side effect of toothpaste]

OBJECTIVE OF INVESTIGATION: An unusual type of mucosal peeling appearing in 6 women and 1 man after use of a new toothpaste (Odol med 3 Samtweiss) is described.

The seven patients, aged 31 to 72 (average 53 years), were suffering from general sloughing of the oral mucosa. In all parts of the oral cavity including the gingiva propria a white leukoedema-like layer was found that peeled off spontaneously or could be lifted off easily using a forceps in flakes up to 1 cm2. There was no bleeding, but in two cases there were painful erosions. Specimens were examined histologically and cultured, especially for Candida species.

Histology of the removed membranes showed an epithelium composed of 2-15 layers without dysplasia or vesicles. Normal oral flora was found. All patients had begun using a new toothpaste 2-4 weeks before. When its use was discontinued, the lesions disappeared. Possible causes for the lesions (sodium lauryl sulphate, Sodium polyphosphates) are discussed.