Use test with l‐carvone in toothpaste on sensitized individuals

Abstract

Background: The mint flavour carvone (l-carvone) is considered a weak contact allergen. However, contact allergy to carvone is more prevalent in patients with oral lichen planus or oral lichenoid lesions (OLP/OLL).Objective: Our aim was to investigate how carvone affects sensitized individuals through a use test with toothpaste containing carvone. Non-flavoured toothpaste served as control.Methods: Subjects were patch tested prior to the use test-14 subjects allergic to carvone (11 with OLP/OLL), 20 subjects with OLP/OLL and 3 healthy controls. The month-long use test comprised of using toothpaste twice daily. Subjects were examined fortnightly. Clinical signs were assessed with a mucosal scoring system. The subjects' oral health-related quality of life was measured with the oral health impact profile (OHIP-49).Results: Local reactions to the carvone toothpaste presented as aggravated OLL (7/10) and peri-oral eczema (2/10) in allergic subjects. They also had significantly higher mucosal and OHIP scores compared with those receiving non-flavoured toothpaste. Conclusion:In sensitized individuals, oral exposure to carvone gives aggravated oral lesions and/or peri-oral eczema. The lesions mimic OLP and allergic individuals are therefore at risk of not being assessed with regard to flavour contact allergy.

Contact sensitisation in oral lichen planus: An Australian perspective

“…It is unclear whether the concentrations of carvone in toothpastes are sufficient to elicit allergic contact stomatitis in patients with oral mucosal disease 27 . However, a recent study suggests that exposure to carvone in toothpaste caused oral lesions mimicking OLP and peri‐oral eczema 28 . In our study, carvone was felt to be the main causal sensitiser in spearmint, given that almost all of the patients who tested positive to spearmint also had a positive reaction to carvone.…”

Current and Potential Applications of Monoterpenes and Their Derivatives in Oral Health Care

“…Some reports indicated that eugenol allergy symptoms can resemble burning mouth syndrome [190,191]. Additionally, while uncommon, some toothpaste ingredients [192], including menthol [193] and carvone [194][195][196][197], can cause dermatological issues including contact dermatitis. In line with this, a retrospective study analyzed carvone patch tests results.…”