Cocamidopropyl betaine: another possible oral healthcare chemical associated with plasma cell lesions of the oral cavity.

Introduction

Plasma cell gingivitis has been recognized and described for many decades and has generally been associated with sensitivity reactions to various oral healthcare products or food flavoring agents. Plasma cell gingivitis is recognized as clinical lesions that are flat to slightly raised, erythematous, and diffuse but confined to the attached gingival surfaces. Whereas plasma cell mucositis has been a term utilized when lesions extend beyond the attached gingival surfaces. 3 abstracts on plasma cell lesions of the oral cavity were presented at last year's meeting and anecdotal discussions amongst oral pathologists revealed a general sense that these lesions have been increasing in incidence.

Materials and methods

We will present a small case series where cases were associated with CAPB containing toothpastes. The rise of cocamidopropyl betaine containing dentifrices began approximately in 2008 as a result of trying to eliminate sodium lauryl sulfate from oral healthcare products. However, it is not well-known that CAPB was recognized as 2004 allergen of the year by dermatologists.

Results

Simply changing the CAPB containing toothpaste resulted in resolution of the gingival/mucosal phenotype in multiple patients. However, we also eliminated other substances which have been associated with plasma cell gingivitis such as cinnamon or herbal ingredients making a definitive association impossible.

Conclusion

This abstract discusses another possible oral healthcare chemical that clinicians should be aware of in the diagnosis and potential management of oral plasma cell lesions. We also wish to seek out more evidence of whether the association is real or possibly due to the synergistic effect of multiple oral healthcare product chemicals.