Allergies What Is a Toothpaste Allergy? By Daniel More, MD Updated on April 10, 2022 Medically reviewed by Daniel More, MD Print Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatments Frequently Asked Questions Toothpaste allergies are not common, but they can happen. An allergy to toothpaste is a form of contact dermatitis, causing sores, itching, and peeling inside the mouth and around the lips. Flavorings in toothpaste, such as mint, are the most likely to be responsible for an allergic reaction, though other ingredients may contribute as well. This article will discuss the symptoms and causes of toothpaste allergies, and how to find the right toothpaste for you. PeopleImages/Getty Images Toothpaste Allergy Symptoms Symptoms of an allergy to toothpaste include: Swollen gums Sores in the mouth Burning or itching sensation around the mouth Tongue irritation Itching and peeling of the lips and skin around the mouth Severely cracked, dry lips are a common symptom of toothpaste allergy. This is known as cheilitis. Causes of Toothpaste Allergic Reactions There are two types of contact dermatitis—irritant and allergic. This difference is often difficult to determine, and it is not usually an important distinction. Most reactions from toothpaste are allergic contact dermatitis. Both natural and synthetic (manmade) chemicals used to add peppermint, spearmint, and cinnamon flavoring are responsible for the majority of allergic reactions to toothpaste. Since most toothpastes contain these flavorings, it can be challenging to find one that does not cause a reaction in people who are allergic. Other ingredients in toothpastes that may cause contact dermatitis include: Cocamidopropyl betaine (CAPB), a lathering or foaming agent Propylene glycol, a preservative Essential oils, such as tea tree oil (which helps control bacteria in the mouth) Parabens, a preservative Some toothpastes also use gluten as a thickener. This can cause symptoms in people who must avoid gluten. Very rarely, the fluoride in toothpaste may cause an allergic reaction. There have only been two published case reports of this type of allergy, and one of them noted that a flavoring agent could also be responsible. So fluoride allergy is extremely unusual. Toothpaste Brands That Are Gluten-Free Allergens in Other Oral Care Products Contact dermatitis of the mouth can also be caused by other oral and dental care products, including mouthwashes, chewing gums, and lipsticks or lip balms. Metals used in dentistry that can cause contact dermatitis in the mouth include mercury, chromium, nickel, gold, cobalt, beryllium, and palladium. Diagnosis The diagnosis of toothpaste allergy is made with a patch test. With this, small amounts of allergens are placed on the skin of your back and covered with an adhesive sheet. The sheet stays on for approximately 48 hours. The results of the test are interpreted at 48 hours after placement, and again at 72 or 96 hours after placement. The TRUE test is the only FDA-approved patch test for contact dermatitis in the United States, although some allergists and dermatologists use more extensive patch test panels with chemicals purchased from Canada or Europe. A positive test is confirmed when there is itching, redness, mild swelling, and blistering at the site of the particular chemical. What Is Contact Dermatitis? Treatments for Toothpaste Allergy The best way to treat toothpaste allergy is to avoid the chemical that is resulting in the allergy. Many people with an allergy to artificially flavored toothpastes can tolerate naturally flavored versions. Others may need to use toothpastes in non-traditional flavors, such as mango or berry. 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. Summary An allergy to toothpaste causes contact dermatitis. Symptoms include sore gums, a burning tongue, cracked lips and redness around the mouth. Most toothpaste allergies are caused by ingredients used to add flavoring. For people who are allergic to certain toothpastes, the only way to avoid symptoms is by finding a toothpaste that doesn't contain the offending ingredients. A Word From Verywell If you think you are allergic to your toothpaste, consider trying one in a different flavor or a natural version. If your symptoms persist, talk to a dentist or dermatologist, who can guide you on next steps, whether that means being tested for allergens in toothpaste or finding an alternative product to keep your teeth clean. Frequently Asked Questions What type of toothpaste is less likely to cause allergy symptoms? Read labels to avoid specific allergens. You can try over-the-counter natural toothpaste, but even some of those include flavorings, which can cause a reaction. If you're extremely sensitive, try to find a toothpaste with no flavoring. Learn More What You Should Know About Skin Allergies Is a swollen tongue a sign of an allergic reaction? Often, a swollen tongue is a sign of an allergic reaction. It may also be caused by a non-allergic reaction to a medication. Injuring your tongue (biting, burning, etc.) can cause the tongue to swell as well. Learn More Common Causes of a Swollen Tongue Can toothpaste with essential oils be good for teeth? Yes. Research shows that some essential oils have higher antibacterial properties than traditional fluoride toothpaste and are safe and effective. But some people have allergic reactions to essential oils, such as tea tree oil. Learn More An Overview of Herbal Supplements 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Pathogens. 2019;8(1):20. doi:10.3390%2Fpathogens8010020 By Daniel More, MD Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and formerly practiced at Central Coast Allergy and Asthma in Salinas, California. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit