Toothpaste-induced contact stomatitis: A retrospective study of 56 cases and scoping review

Toothpaste-induced contact stomatitis (TICS) has mainly been reported as single case reports or short case series. The authors' objective in this study was to report 56 cases of TICS and to perform a scoping literature review.

The records of TICS cases diagnosed from 2022 through 2025 were retrieved from 2 private oral medicine practices, and data regarding demographic characteristics, clinical characteristics, symptoms, toothpaste brand and type used, and management were summarized. The literature was searched via PubMed or MEDLINE, Web of Science, and Embase (Ovid) for TICS cases with available toothpaste brand name and photographic documentation.

Forty-one females and 15 males received a diagnosis of TICS manifesting as white desquamative lesions (35/56), erythema (30/56), and pinpoint hemorrhage (20/56) that mainly affected ventral tongue or floor of the mouth (33/56), lower labial mucosa (23/56), and anterior maxillary gingiva (18/56). Most patients (54/56) were symptomatic, reporting pain or irritation, burning, swelling, and discomfort during tongue movement or toothbrushing. All toothpastes used included flavors, hydrated silica, and sodium saccharin as well as cocamidopropyl betaine or sodium lauryl sulfate. Complete resolution was observed at 1 through 2 weeks after substituting the toothpaste in all cases. The literature review yielded 25 studies including 70 relevant cases.

White desquamative lesions, erythema, or pinpoint hemorrhage on ventral tongue or floor of the mouth, labial mucosa, or anterior gingiva in patients mentioning discomfort during toothbrushing would be suggestive of TICS, which is a clinical diagnosis made on the basis of response to substitution of the suspected agent.

The authors provide a comprehensive overview of clinical manifestations and toothpastes that might be associated with TICS, which may enhance diagnostic awareness among the dental community.