The Symptoms and Treatment of a Toothpaste Allergy

Most reported reactions to toothpaste involve contact dermatitis of the mouth. Symptoms of contact dermatitis may include sores in the mouth, swollen gums, an irritated tongue, and itching and peeling of the lips and skin around the mouth.

There are two types of contact dermatitis—irritant and allergic. This difference is often difficult to tell apart, and it is not usually an important distinction. Most reactions from toothpaste are allergic contact dermatitis. Toothpaste allergy is rare, most likely because toothpaste is rinsed out of the mouth after the teeth are brushed.

Tending to her pearly whites
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Various ingredients in toothpaste can cause these reactions, the most common of which is cinnamic aldehyde, as well as other flavorings such as balsam of Peru.

Contact dermatitis of the mouth can also be caused by other oral and dental products, including from metals from dental work, mouthwashes, chewing gums, foods from the Toxicodendron family (such as mangoes and cashews), and lipsticks or lip balms.

Metals used in dentistry are known to cause contact dermatitis in the mouth and include mercury, chromium, nickel, gold, cobalt, beryllium, and palladium.


The diagnosis of toothpaste allergy is made with a patch test, which involves the placement of various chemicals on the back for approximately 48 hours (it is not the same as allergy testing). The results of the test are interpreted at 48 hours after placement, and again at 72 or 96 hours after placement.

This typically is done with a paper tape system, such as the TRUE test. The TRUE test is the only FDA-approved test for contact dermatitis in the United States, although some allergists and dermatologists develop more extensive patch test panels with chemicals purchased from Canada or Europe.

A positive test is confirmed when there are blisters, redness, and mild swelling at the site of the particular chemical in question. The site of the positive test usually itches, although the reaction size is typically limited to the site of contact, and therefore is usually smaller than a dime.


The best way to treat toothpaste allergy is to avoid the chemical that is resulting in the allergy. Many people with toothpaste allergy can tolerate natural products, such as those from Tom’s of Maine.

For the treatment of immediate symptoms, a doctor may suggest the use of a low-potency topical steroid (such as over-the-counter hydrocortisone 1% cream) applied to the affected skin on the face for a short period of time.

The long-term use of topical steroids on the face should be avoided as they can cause severe and permanent side effects.

Sores in the mouth, swollen gums, and tongue irritation may need to be treated with systemic corticosteroids (pills or shots) or topical steroid mouthwashes that can be made by a compounding pharmacy.

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