Mint condition? A survey of allergenic ingredients in UK toothpastes

Toothpastes may induce cheilitis, intraoral lichenoid changes and immediate hypersensitivity reactions. There is little published information documenting the range of allergens in toothpastes. In 2024, a survey was conducted of 291 toothpastes sold by 5 of the UK's largest cosmetics suppliers. Labelling quality and ingredients were recorded. Of the 291 toothpastes, 2 (0.7%) had no ingredients list. Of the remaining 289 (99.3%), the mean number of ingredients was 16.6; 286 (99.0%) contained fragrance, often labelled nonspecifically as 'aroma'. Limonene was in 159/289 (55.0%) and menthol-related compounds were in 105/289 (36.3%). The most frequent preservatives were sodium benzoate or benzoic acid (36/289, 12.5%; 11/289, 3.8%). Polyaminopropyl biguanide, banned in cosmetics in 2015, was declared in 3/289 (1.0%). Sodium lauryl sulfate was present in 159/289 (55.0%). Stannous (tin) fluoride, associated with allergic cheilitis, was present in 21/289 (7.3%). Dermatologists should consider exposure to toothpaste allergens when managing patients with cheilitis, oral mucosal symptoms or immediate systemic symptoms associated with toothbrushing.