Can (SLS) Sodium Lauryl Sulfate cause Mouth Ulcers?

SLS Sodium Lauryl Sulfate Contribution to Mouth Ulcers

While my initial interest was in hair thinning and the relationship with SLS (Sodium lauryl sulfate) in shampoo, as I investigated discussions on using SLS in products I came across other scientific papers. I found an old study which was investigating the effect of SLS in patients who had re-occurring mouth ulcers. I’ll put the link in at the end.

While the study paper gets overly technical on the use of an effective denaturant Sodium lauryl sulfate (SLS) in its role as an asynthetic detergent commonly used in toothpaste, I can reduce it to the basics here.

It was noticed that a proportion of dental patients reported re-occurring mouth ulcers [recurrent aphthous ulcers (RAU)]. These developments of painful, recurring solitary or multiple necrotizing ulcerations are problematic and have a difficult solution.

They took 10 volunteer patients aged between 13-35, 8 men and 2 women who suffered from this multiple minor RAU and screened as otherwise healthy individuals. The participants were instructed not to change diet, lifestyle, or smoking habits (three smokers) during the trial.

In order to record the number of ulcers seen during the study period all involved were given pictures of RAU and written information on recognising the signs of ulcers to allow them to record the number of ulcers in a diary. These were examined at least every 2nd week along with a visual inspection of their oral mucosa by the clinical examiner.

Before the start of the study the patients recorded in this diary the number of ulcers occurring in a 3-month period during which the participants used their regular toothpaste, which contained SLS.

The mean incidence of RAU in each patient in this 3 month period before the study period was 17.8 ulcers.

A washout period of 1 week before the study trial saw the patients brushing with a surfactant-free paste.

Two different pastes were used during this study, both included the same basis formula with 0.1% fluoride and differed only in detergent content. One contained 1.2% SLS, and the other was SLS free and served as a control.

The patients were randomly allocated to one of the test toothpastes for the first 3 experimental months, succeeded by the l-week washout period during which the participants brushed with the surfactant free paste. Then the patients changed to the other toothpaste for another 3-month period. Both pastes, coded to ensure a double-blind design, were used by all participants.

Results.
In short, brushing with an SLS-free dentifrice reduced the number of aphthous ulcers significantly,compared with ulcer frequency both in the pre-study and in the SLS experimental period, from 14.3 after using the SLS-containing dentifrice – to 5.1 ulcers after brushing with the SLS-free dentifrice! Put another way, the mean reduction was 70% compared with the prestudy period and 60% during the experimental study period.

Subject  Pre-study  Toothpaste   Toothpaste

no.                                     1*                       2†

1                    23                5                          16

2                   19                 2                         14

3                   13                 4                         12

4                   24               10                        11

5                  29                 12                       28

6                  25                  3                        17

7                  15                  4                         12

8                 18                   9                         16

9                  7                      1                       10

10                  5                     1                          7

Mean            17.8               5.1                    14.3

SEM               2.5                 1.2                       1.8
* Without sodium lauryl sulfate.
† With sodium lauryl sulfate.

The suggestion is therefore that all 10 patients benefited from using the detergent-free, denaturating effect of SLS containing toothpaste, but further comprehensive studies are necessary before any final conclusion can be drawn concerning the role of SLS in toothpaste.

Reference:

Bente Brokstad Herlofson and Pal Barkvoll
Department of Oral Surgery and Oral Medicine.
Dental Faculty,
University of Oslo,
1109 Blindern. N-0317,
Oslo,
Norway
Herlofson BB. Barkvoll P. Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study.
Acta Odontol Scand 1994: 52: 257-259. Oslo. ISSN 0001-6357.

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