YSK that SLS, an ingredient added to most commercial toothpastes, causes canker sores

xapr@lemmy.sdf.org to You Should Know@lemmy.world – 313 points –
Do Certain Toothpastes Cause Canker Sores?
askthedentist.com

I learned about this many years ago and the difference after I started using only SLS-free toothpaste was night and day. I used to get canker sores any time I would bite the inside of my cheek, hit my gums with the hard parts of my toothbrush, etc., and this completely stopped a while after I switched to SLS-free.

SLS is Sodium Lauryl Sulfate, by the way, and it's a detergent. From what I understand, the only reason why it's added to toothpaste is to make more foam when you brush. But the SLS-free toothpaste I use makes plenty of foam, so I have no idea why they add it. It's one of those things about the modern world that makes absolutely no sense. The ads and packaging should say in big letters: "now with even more canker sores!"

Unfortunately, the vast majority of toothpastes on the market (at least in the US) have SLS. I can only seem to find SLS-free toothpaste in natural food/supplement stores. It's extra difficult to find toothpastes that are SLS-free but that keep fluoride too. The difficulty (and price? I haven't compared) is completely worth it to me though.

TL;DR: The SLS (Sodium Lauryl Sulfate) in most toothpastes is unnecessary and causes canker sores (painful sores in your mouth and gums). If you have this problem, you will likely benefit from SLS-free toothpaste (some still include fluoride) that you can usually find at natural food stores.

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You should also know that SLS is banned in the EU, so this post made no sense to me until I went to Google for answers...

I swear, sometimes it's hard to fathom the little ways you got it rough over there.

A Google listicle about "7 banned substances in the EU" or some shit, straight up lied to me.

SLS (Sodium laurilsulfate) is not banned, not even particularly regulated, in medicinal products, in the EU.

"The vast majority of SLS use is in oral products (tablets and capsules) where it rarely displays any adverse reactions."

It only is "not permitted", as a food additive in the EU, and there is a 2017 study which argues for its regulation in skin products, because of irritation.

I was careless on the internet, and the world is more complicated than it seemed at first glance. Story as old as time.

Wut
italy here, and I'm holding a toothpaste with SLS rn (Elmex Sensitive Professional)

-- Edit
Same goes for Sensodyne Herbal Fresh
Funny cuz none of these make much foam, and also I almost never get canker sores

Yep, can confirm that toothpastes in the EU contain SLS

Just checked my toothpaste, and it contains SLS. Maybe the EU has tighter limits than the FDA when it comes to using SLS in a toothpaste.

There’s one thing everyone should know about toxicology: you can use just about anything safely as long as the concentration is low enough. It’s very rare to find a compound where even a single molecule can be considered harmful. There are lots of compounds where the safe limits is ridiculously low, so using them safely is about the same as avoiding them all together. However, there are also lots of compounds where we routinely dance the line of harm and benefit. For example, many medications fall into this category. Technically, vitamins are in that category too, but most people never come close to eating too much of a specific vitamin.

We should make a list of all the bizzare unhealthy twisted sick things that are part of normal daily life for Americans but banned/illegal in every other country.

I think the article is misleading. The studies don't seem to show that SLS causes canker sores, but if you do suffer from them, it will exacerbate them or delay their healing. The article says "studies", while only citing one study, that actually recruited patients who already suffered from the sores. A double blinded cross-over trial concluded that "The number of ulcers and episodes did not differ significantly between SLS-A, SLS-B, and SLS-free. Only duration of ulcers and mean pain score was significantly decreased during the period using SLS-free. Although SLS-free did not reduce the number of ulcers and episodes, it affected the ulcer-healing process and reduces pain in daily lives in patients with [canker sores]." Although I don't have access to the full version, so I can't view the details. By the way, SLS-A was an SLS-free toothpaste spiked with 1.5% SLS, and SLS-B was a commercially available toothpaste with 1.5% SLS in it already.

You can tell that the article is trying to sensationalise something by such phrases as:

  • "But there’s no reason to accept a hazardous chemical in your toothpaste." You know what else is in your toothpaste? Sodium fluoride. Which is lethal at high enough dose. It's all about the concentration.

  • "It’s strong stuff — the cleaning solution I use on our garage floor is 50% SLS." Well, yes, if you use it at concentrations ridiculously above the ones found in a toothpaste, of course it's going to be "strong stuff". You know what else is strong stuff? 100% acetic acid. Yet somehow, at 10% we happily consume it as vinegar. By the way, vinegar - great cleaning agent!

Don't get me wrong, if you're sensitive to SLS, by all means avoid it. But I'm not a fan of articles that make blanket statements about a chemical that is mostly harmful in the concentration that it's used in hygiene products. It's another one of those "aspartame gives you cancer" (which it doesn't by the way).

Well, technically it's the excessive drying out of the mucous membrane that causes tissue damage which results in a canker sore/aphthous ulcers. But saying SLS isn't the cause is like saying

guns don't kill people, massive physical trauma and excessive blood loss from being shot kills people

SLS can still cause drying of the mucous membranes in the mouths of people who don't regularly suffer canker sores. That drying can lead to tissue damage, and that can then become a sore. It just happens less frequently than for people like me, who are sensitive. But it's due to the chemical action of the SLS.

I get the point of your gun analogy, but I don't think it's an apt one. It's not like only people sensitive to gunshot wounds die from gunshot wounds. If you shoot a person with a gun the damage is pretty certain. If cankers were as certain to be caused by SLS then everyone using SLS-containing toothpaste would have cankers. We don't. The bottom line is that the article linked to by OP is making misleading claims.

But I despite me not agreeing that the gunshot wound analogy is apt here, I get what you mean, so maybe the title of the lemmy post would be better phrased as something like "YSK that SLS [...] can be the cause of cankers in sensitive people". Which is also kinda the point I was trying to make in the last paragraph of my original reply.

Edit: formatting

Edit: I'm coming back to this after a while and after a very long weekend, so I missed the second half of your post. Just ignore the explainy bits where it sounds like I think you don't agree with me, sorry! I want to leave those in though, in case they help anyone else who happens across the post.

I'm speaking on the mechanics is the problem: it's more akin to an otherwise nonfatal shot causing someone to bleed out because they have haemophilia. Sometimes, people without haemophilia will die of a gunshot that should not have been fatal, due to infection or similar.

Aphthous ulcers are caused by damage to the mucous membranes in the mouth which then gets infected. While the article could be more clear that people without the sensitivity are at much lower risk, the mechanics of it would suggest it can affect anyone. As someone with the sensitivity and having tested it by occasionally using SLS toothpaste (not always voluntarily), I can tell you that if I use toothpaste containing SLS, it's a guarantee I will develop mouth ulcers within a day. I get them sometimes even without because there are a heap of causes, but sticking to non-SLS toothpaste is the surest way to avoid them.

Without the sensitivity, it might just be "the straw that breaks the donkey's back". Maybe you're dehydrated already, and stressed or malnourished, and because the SLS dried out the mucous membranes in your mouth just enough so some damage turns into an ulcer. That damage can be caused by biting your lip, a fragment of potato chip stabbing your gum, etc etc.

The fact is that it's plenty possible to make effective toothpaste without SLS, so there doesn't seem to be a good reason to keep using it in toothpastes when it's demonstrably a problem. Soaps are a different question; I haven't found SLS-free soap to alleviate any skin or hair problems for me, nor seen any research on the subject, so it may well be fine. "Not for internal use" kind of warning label.

Side note: at one point I had thirteen or fourteen ulcers at least half a centimetre in diameter each. They got so big they started to merge. I couldn't eat or drink anything, the pain made me nauseous, and that lasted three days. Five was a pretty common number for me, but since cutting out SLS I only occasionally get one or two. It sucks so bad when it's bad, I just hope these posts help someone who's suffering figure it out for themselves.

Most stores (in US) have Sensodyne. I switched to them when I learned that my old toothpastes were causing cankers. I'll never go back

Bert's Bee's makes an SLS free charcoal toothpaste that I've been using over a year. Great stuff, mint flavored, and you can see how much toothpaste you aren't using (since it's black) and adjust your usage accordingly.

Even using a pea sized drop seems like too much sometimes.

Sensodyne has SLS too. Its largely a scam toothpaste to be honest. It just has a numbing agent in it and costs twice as much. Maybe youve just gotten lucky but that shit was useless for me and still gave me sores.

Sensodyne is a brand, not a specific toothpaste, and some of their products do have SLS, but sensodyne pronamel, at least here in Canada, does not have SLS.

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Americans have such weird issues. It's almost like unfettered capitalism is a problem or something.

but at least californians are abundantly notified of every product that causes cancer.

Literally every product. People feel so much safer after that :)

I found this out on my own as an adult after years of being unable to build a toothbrushing habit from childhood.

-Brush teeth

-canker sores

-hurts to much to brush for a week

-forget about brushing altogether

-month or two later remember that i should be brushing my teeth regularly

-repeat

Now that i know the problem i can buy toothpaste that doesn't actively harm me, but that doesn't fix the 20 years of not brushing or make it easier to build that habit as an adult :/

I use an SLS toothpaste and have never had canker sores but I agree it seems silly to add it when even a small dab of toothpaste creates an unnecessary amount of foam with proper brushing.

and have never had canker sores

They come from a virus most people have living dormant inside them. Various factors may increase the breakout rate, but the virus is the true source. Sounds like you're one of the lucky few uninfected.

You're thinking of cold sores, I think OP just means mouth ulcers. I'm not sure what the word canker means, could be an American term.

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Sensodyne Pronamel is SLS free and has fluoride.

Kroger also sells a generic version that can be cheaper. In the US anyways.

Also, be careful with Sensodyn because not all of their toothpaste is SLS free. Always read the labels!

I used to get terrible stomach aches after brushing and it was enough that I completely stopped brushing for a long stupid time. Even when I made myself do it I ended up with this tons of skin falling off inside my mouth every morning if I brushed before bed. It was absolutely nasty. When the dentist used those plastic trays with the fluoride foam it would leave me curled up on the couch for the rest of the day in pain.

One day my wife suggested that maybe I have a problem with SLS and I switched to sensodyne pronamel which was the cheapest SLS free toothpaste I we could find and all of these problems went away. I'm now a regular brusher and feel stupid for not figuring it out years ago because my teeth have suffered from my ignorance.

In the interest of being thorough I switched back to my old toothpaste for a day and the symptoms immediately returned after just one night-time brushing. Sure I could go through many more changes to try to pin down exactly whether it is SLS or something else that's different between the two toothpastes I was using, and I recognize that, but SLS was enough of a reason for me to switch and I'm happy now.

I hate these sores with a passion. You can fix them instantly with Oralmedic from the internet (possibly currently undergoing supply chain issues but that is temporary). It is agonizing— you are cauterizing the sore— but provides immediate and permanent relief. You can also get a laser for it, which does not hurt but is way higher effort and costs a ton more. I am passionate about my sore hatred so I have done this.

If you don’t want to do either, Canker Shield is available on Amazon and reduces sore lifespan to around 24-48hr. Also painful to use but nothing is as bad as Oralmedic or debacterol. Combine that with supplements (not one size fits all, lysine seems to have high success rate though) and you can deal with these while away from home.

Anyway this tip actually reminded me to check my travel toothpastes which naturally do have SLS. So thank you. I had noticed an uptick to a sore every couple months since Covid “ended” but that cause slipped my mind

That lazer sounds really cool. What one did you get?

I had one custom made to avoid the cost of medical grade/dental lasers. You can make your own pretty easily with a diode and some other parts but I wanted a good shape for reaching the affected areas and my metalwork skills are nonexistent. I had it specced at 810nm, 600mW.

Be sure not to do this without knowledge of high powered lasers! At that wavelength and wattage it’s pretty weak for lasers, but still >100x the wattage of a typical laser pointer. It won’t burn through things like other similar lasers, but it will blind you with no warning and no room for error if you’re not careful and using the right glasses. Lasers are not actually very fun at all since you have to be very cautious.

Ahh so it is a DIY lazer. I was thinking it was a commercial product you would buy.

There are commercial medical/dental lasers but they’re decently more expensive. Still worth it but as a laser hobbyist I’m comfortable with the things. You can find them by searching for an 808nm dental laser.

Oh, they’re kind of big, which is the other downside. Make sure to still use the appropriate glasses

There’s also a device that uses red light instead, I think called luminance red. Not as effective but way cheaper than everything but a DIY with your own diode, and still reduces sore length for most people

Also make sure you choose a toothpaste that has stannous fluoride and not sodium fluoride. It's much more effective

Also stains your teeth.

Interesting. The back of a tube of sensodyne in my medicine cabinet right now says that stannous fluoride may stain teeth. Hard to understand why a 2013 article would contradict a 2023 toothpaste warning.

My sensodyne toothpaste also says that but then right below there it says "this product is specially formulated to help prevent staining" so 🤷

SLS is in SO many products. Switching to a shampoo free from sulphates cured my dandruff and halted my hair loss.

Surprise, not rubbing surfactant into your scalp makes it healthier haha

I used to suffer canker sores fairly regularly. I switched to Non-sls toothpaste, took Supplements with folic acid and B12, and now I only get them when I bite my cheek or something

Lysine helps too for prevention and healing

Extra super mega plus a million on this advice! I suffer these ulcers too and they're horrible. I have three right now, in fact.

I bear good news though: King Soopers/Ralph's/Kroger has SLS-free toothpaste for cheap now! Check the ingredients in your region of course but this is the one I get: https://www.kroger.com/p/kroger-enamel-protection-mint-breeze-gentle-whitening-for-sensitive-teeth-toothpaste/0004126037699

To quickly check any grocery store brand though, you can also look for "Compare to Sensodyne ProNamel". That's a brand name one with no SLS. These should all pretty easily available in US grocery stores, from what I've found.

Does Sensodyne have any ingredients that cause this?

All of their toothpastes have fluoride but most don't have SLS, only the ones that foam more do.

Their websites lists these as not containing any SLS:

  • Sensodyne Extra Whitening

  • Sensodyne Full Protection

  • Sensodyne Fresh Mint

  • Sensodyne Tartar Control

  • Sensodyne Fresh Impact

  • Sensodyne True White Mint

  • Sensodyne True White Extra Fresh

And these ones do contain SLS:

  • Sensodyne Deep Clean
  • Sensodyne Rapid Relief
  • Sensodyne Sensitivity & Gum
  • Sensodyne Complete Protection
  • Sensodyne Repair and Protect

I am roughly 40 and don't believe I have ever had a canker sore. I don't even know what that is.

I do have good luck buying SLS free toothpaste that has fluoride, I believe it is happy brand. Widely available and I live in a pretty remote area. Not always with fluoride, you have to look at the package. Low foam 🙂

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After looking for years for a solution to treat those and trying so much shit that often ended up making the sores even worse I found good product. Dexamethasone solution. Rinse a couple times and its good. Also doesnt hurt.

toothpaste brands that you find in asia have an even higher quantity of SLS and it's completely fucked

I suffered for years before finding out about SLS causing canker sore outbreaks. Switched to an SLS free toothpaste, and haven't had a canker sore in years. Little advice for people still suffering from them though, rinsing your mouth out with peroxide, instantly stops the pain. Also no burning sensation like you get with a fresh cut. It also seems to shorten their duration too. Just be careful not to swallow any.

Huh. A while ago the toothpaste I was using (plus many subsequent toothpastes I attempted to use) started causing the skin on the inside of my mouth to start peeling. Wonder if that's the same cause.

For informational purposes, the only standard brand I've found that doesn't do that to me is Arm and Hammer.

I've always thought I was mildly allergic to some brands of toothpaste, wonder if this was related.

My symptoms were sores in the corners of my mouth/gums - took a couple weeks before they'd show up and the only way to get them to go away was heavy rinsing with water after brushing (which is not recommended because of fluoride mineralization)

Switched to Tom's toothpaste (with fluoride) a few years ago and have had 0 issues since

Glad to hear. I used to use Tom's but unfortunately I couldn't find the SLS-free flavors locally anymore. I just checked their website and it seems they got rid of most of their SLS-free flavors.

Also, unfortunately, the brand I had been using, Jason, seems to be dropping most of their toothpastes. It took me a while to find a new, clean brand to use, but I think I finally found it: Burt's Bees. It seems to be one of the cleanest toothpastes I've ever seen, according to https://www.ewg.org/skindeep/ and it's available at my local Target stores!

This is true! In the US, I use Biotene. It's unfortunately somewhat expensive, (I think I pay around $6/tube), but I happily fork it over for no fucking canker sores.

I'd be curious how others feel but personally painfully brushing the sore causes it to heal the quickest in my experience.

Not joking

I notice they heal faster when brushing twice a day but absolutely do not brush the actual sore. I use listerine which absolutely burns like a cigarette being pushed directly into it. But after a minute or so it gets overloaded with pain I guess and stops hurting for a few hours.

I'm telling you though brushing the sore works. Do it a single time, try it trust me no joke.

I agree. Makes me want to cry but it works. The other thing I do trust hurts less is put powdered alum on it. Burns a little bit but definitely speeds up the healing process.

I have found mouthwash to be the best solution. If you feel one coming on or bite you mouth and think you might get it, mouthwash ASAP.

you should also know that people in the past would just brush with a fresh twig and maybe some salt, and their teeth were absolutely fine within the limits of not having any sort of dental care beyond "pull a bad tooth out with pliers".

and nowadays we have fancy electric toothbrushes that are way more effective than a twig, so really i see little reason to use toothpaste beyond society as a whole having been convinced that if your mouth doesn't taste like mint it's DISGUSTING.

They also had way less sugar in their diet then

Yeah no joke. Those mouth bacteria fuckers love sugar. Keep a standard western diet and brush with a salty twig and you'll be needing dentures within the decade.

Through some rough experimentation, a rigid diet of Kirkland Signature Greek Yogurt mixed with honey 3x a day will prevent a canker sore from forming after biting your lip. The non-SLS toothpaste helps too.