- Dr Ketaki Kalele
It is rightly said that every coin has two sides. The same is true for the most favored synthetic used over “eras” in our toothpaste, which is sodium lauryl sulfate (SLS) & Paraben!
The “toxic two”
They grey sides of the two chemicals have provoked this nomenclature “toxic two”!
1) SLS is a cleaning agent & surfactant found in toothpastes. The USP of the compound is its :
- efficiency
- low cost
- abundance
- simplicity of use
- ability of “foam” formation which triggers the solubility of plaque & calculus during brushing
As stated by ADA, the foam “cloud” enables the efficient separation of food debris and other accretions stuck to the tooth surfaces, which ultimately are great benefits achieved with single ingredient.
However, recently controversy regarding this “celebrity” ingredient is catching the limelight. The safety concern of SLS is much talked about. According to the National Institute of Health (NIH), SLS is a safe product & the fact of it being a carcinogen is just a rumour. But though not a carcinogen, but SLS is known to aggravate the conditions such as stomatitis & mouth sores/ulcers. 1
2) Paraben, one of the most used preservative in many cosmetics including toothpastes, is banned in many countries including European countries, because of its potential hazards including its role as a potential carcinogen.
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The “Irritating Stuff”
SLS component is known to cause biochemical protein denaturation which results in a visible desquamation of the mucosal membrane. Researchers have reported that frequent local application of toothpastes containing SLS may cause oral lesions due to absorption of the chemical sublingually or from the mucosa. However, a latest (2020) Brazilian research by Esteves et al. has reported cases of oral mucosal desquamation which were diagnosed as Type IV hypersensitivity to SLS from the toothpastes. Their study reported hypersensitivity even with the lowest concentration of 0.25%, which is far below the permissible levels of 0.5-2%. However, all the patients in their case series were also using alcohol-based mouthwashes, which acts as an additive.
Another case series from Brown et al. has also shown evidences of inflammatory changes & erythematous textures of mucosa in patients using SLS containing toothpastes, which resolved on their own after discontinuation of the toothpastes.
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