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

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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.

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References

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

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  3. 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):219–226

    Article  PubMed  Google Scholar 

  4. 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):224–228

    Article  PubMed  Google Scholar 

  5. 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):116–121

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

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

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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

    Google Scholar 

  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):227–237

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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):155–159

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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):86–122

    Article  PubMed  Google Scholar 

  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):128–138

    Article  PubMed  Google Scholar 

  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):518–539

    Article  Google Scholar 

  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):507–512

    Article  Google Scholar 

  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):195–221

    Article  PubMed  Google Scholar 

  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):377–385

    Article  PubMed  Google Scholar 

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

    PubMed  PubMed Central  Google Scholar 

  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):5–20

    Article  PubMed  Google Scholar 

  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):177–182

    Article  PubMed  Google Scholar 

  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):339–343

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  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):216–222

    Article  PubMed  Google Scholar 

  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):138–143

    Article  PubMed  Google Scholar 

  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):301–305

    Article  PubMed  Google Scholar 

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Acknowledgements

We gratefully wish to thank laboratory technician Louise Rosgaard Duus for her assistance with the laboratory work, project nurse Anne Marie Topp for helping with the coordination of the participants and assistant professor Kasper Rosing for assistance with the statistical analyses.

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Authors and Affiliations

  1. Section for Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, Department of Odontology, Faculty of Medical and Health Sciences, University of Copenhagen, 20 Noerre Allé, 2200, Copenhagen N, DK, Denmark

    K. R. Larsen, J. Reibel & A. M. L. Pedersen

  2. National Allergy Research Centre, Department of Dermatology and Allergology, Gentofte University Hospital, 28 Kildegaardsvej, 2900, Hellerup, DK, Denmark

    J. D. Johansen & C. Zachariae

Authors
  1. K. R. Larsen
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  2. J. D. Johansen
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  3. J. Reibel
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  4. C. Zachariae
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  5. A. M. L. Pedersen
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Corresponding author

Correspondence to K. R. Larsen.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Funding

We gratefully thank the Faculty of Medical and Health Sciences, University of Copenhagen, the Danish Dental Association and Toyota Fonden, Denmark, for the financial support.

Ethical approval

The study was approved by the Regional Ethics Committee, Copenhagen, Denmark (Protocol No. H-3-2013-033) and performed in accordance with the Helsinki declaration.

Informed consent

The study participants were both informed by letter and gave oral and written consent.

Electronic supplementary material

Appendix 1

Test-series and test components provided by Chemotechnique, Vellinge, Sweden if other is not indicated. Italics indicates overlapping of test series (DOCX 23 kb)

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Larsen, K., Johansen, J., Reibel, J. et al. Symptomatic oral lesions may be associated with contact allergy to substances in oral hygiene products. Clin Oral Invest 21, 2543–2551 (2017). https://doi.org/10.1007/s00784-017-2053-y

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  • DOI: https://doi.org/10.1007/s00784-017-2053-y

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