ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Use of SLS-Free Dentifrices is Beneficial for Patients with Recurrent Aphthous Stomatitis
Clinical Question In a patient with recurrent aphthous stomatitis, how does the use of sodium lauryl sulfate-free dentifrices compare to the use of SLS-containing dentifrices in terms of incidence of ulcers and pain over a 2-month period?
Clinical Bottom Line The use of SLS-free dentifrices proves to be beneficial in patients with recurrent aphthous stomatitis in terms of a reduction in both quality of pain and number of ulcers over a 2-month period.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22435470Shim/201290 Patients with recurrent aphthous stomatitis.Randomized Controlled Trial
Key results90 subjects were divided into 3 groups. Group I used an SLS-free dentifrice and SLS-A (SLS-free + 1.5% SLS). Group 2 used SLS-A and SLS-B (commercially available 1.5% SLS-containing dentifrice). Group 3 used SLS-B and SLS-free dentifrices. The groups used one dentifrice for 8 weeks, followed by a 2 week washout period, then used the other dentifrice for 8 weeks. There was no significant difference in the number of aphthous ulcers between the use of SLS-free, SLS-A, and SLS-B. However, the duration of ulcers and mean pain score was significantly lower with the use of the SLS-free dentifrice.
#2) 8811135Herlofson/199630 Patients with recurrent oral ulcerations.Randomized Controlled Trial
Key resultsThree different dentifrices, a SLS-containing dentifrice, a cocoamidopropyl betaine (CAPB)-containing dentifrice, and a detergent-free dentifrice were used on 30 subjects with recurrent oral ulcerations. A significantly higher frequency of aphthous ulcers was recorded in the patients that used the SLS-containing dentifrice as compared to the other two.
#3) 96568647Chahine/1997Patients with recurrent aphthous ulcers.Randomized Controlled Trial
Key resultsThere was a statistically significant reduction in recurrent aphthous ulcers when using an SLS-free dentifrice for 2 months as compared to using an SLS-containing dentifrice for a 2-month period.
Evidence Search "Stomatitis, Aphthous"[Mesh] AND "Sodium Dodecyl Sulfate"[Mesh]
Comments on
The Evidence
Validity: The best evidence found (Shim, 2012) was a double-blinded RCT, and this evidence supported the use of SLS-free dentifrices to reduce pain and duration of recurrent aphthous stomatitis (RAS). However, this study showed no significant reduction in the incidence of RAS over the 8-week period. The next study (Herlofson, 1999) was also a double-blinded RCT, and it showed a reduced incidence of RAS with the use of a SLS-free dentifrice but did not evaluate pain levels. The third study (Chanhine, 1997) was not double-blinded; it also showed a reduced incidence and also did not record the quality of pain. Perspective: The only study that recorded with quality of pain, showed reduced pain. I would believe the other studies would have showed this is they would have recorded it.
Applicability Recurrent aphthous stomatitis is a commonly occurring oral disease. The results obtained from this study allow us to recommend the use of SLS-free dentifrices for patients with RAS, in addition to other therapies.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry)
Keywords Recurrent aphthous stomatitis, sodium lauryl sulfate, SLS, aphthous ulcers, oral ulcerations
ID# 2700
Date of submission: 03/21/2014spacer
E-mail stapletonm@livemail.uthscsa.edu
Author Michael Stapleton
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Robert Kaminski, DDS, MS
Faculty mentor/Co-author e-mail KaminskiR@uthscsa.edu
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