Assessment of the effect of gluten free toothpaste on the ulcerative events in children with celiacdisease: before and after pilot study

Abstract

Aim:This study aims to assess the effect of an experimental gluten-free toothpaste on the ulcerative events in children with celiac disease. Thus, providing the celiac children with gluten, sodium lauryl sulphate (SLS), fluoride, and parabenfree toothpaste without inducing inflammatory or immune reaction. Such toothpaste is not available in the Egyptian market. A gluten-free toothpaste was formulated and produced for this study. Methodology: Twenty children diagnosed with celiac disease, aged from 6 to 15 years and on a strict gluten-free diet were recruited from the gastroenterology clinic at New Children University Hospital (Abo El Rish Hospital). Each participant was provided with a tooth brush and an experimental toothpaste. The parents were asked to use the glutenfree toothpaste 3 times daily for their children and report every time if there is any inflammation or any reaction associated with using the toothpaste. All children were recalled weekly for follow-up during the first month and at 3 & 6 months after using the toothpaste for assessment. Results: During different follow-up intervals (starting from one week until 6 months), all the cases were free from any ulcers and/or inflammation with a 100% success rate during toothpaste use. Conclusion: The toothpaste did not cause any undesirable side effects during use. Assessment of the effect of gluten free toothpaste on the ulcerative events in children with celiacdisease: before and after pilot study Mansoura Journal of Dentistry 2021;8(30):10-15. 11 Eman Adel Abdelhameed ingredients. The only real difference you will find is the thickening agent. In traditional toothpastes, these are generally corn or other grain-based starches that can cause problems for those who have celiac disease. The new alternatives utilize cellulose gum-based thickening agents. Cellulose gum is the common vernacular for carboxymethylcellulose (CMC), which is derived from the cell walls of woody plants, generally trees or cotton (Pelak, 2015). The most frequently used detergent at present in most toothpastes is sodium lauryl sulfate. Sodium lauryl sulphate may be irritant to the skin and mucosa. It may also damage the mucosal mucin layer by denaturing its glycoproteins. The epithelium will then be more exposed for irritants resulting in aphthous ulceration in some patients. It has also been claimed that there is a connection between the use of toothpaste or mouthwash containing SLS and an increased frequency of recurrent aphthous ulcers (RAU) in some patients. A product without SLS may thus be recommended for patients with RAU (Iqbal et al., 2011). RAU is a symptom of celiac disease (Pray, 2011). As a result, celiac patients have to avoid toothpastes containing SLS (Rakel, 2017).