Cocamidopropyl betaine: another possible oral healthcare chemical associated with plasma cell lesions of the oral cavity.

OBJECTIVE

To examine the apparent increase in plasma cell lesions of the oral cavity over the course of the past two decades and to propose a possible explanation and therapeutic approach for a subset of these cases.

STUDY

DESIGN

Data from cases evaluated at the University of Iowa Surgical Oral Pathology Laboratory (UI-SOP) between July 2003 and May 2024 were retrospectively reviewed to analyze demographics, clinical presentations, and trends in the incidence of these lesions. Additionally, a subset of clinical cases seen at the Oral Pathology Clinic from 2023 to 2024 was examined to explore a potential association with the use of cocamidopropyl betaine (CAPB)-containing toothpaste.

RESULTS

A total of 61 cases were retrieved from UI-SOP archive and analyzed. An increase in the histopathologic diagnoses of oral plasma cell lesions was observed. The clinical case series would seem to indicate CAPB as a possible additional chemical associated with plasma cell gingivitis.

CONCLUSIONS

Eliminating the CAPB-containing toothpaste appeared to be a predictable reason for resolution of the gingival/mucosal phenotype in multiple patients. Further collection of cases in a controlled prospective manner may be helpful in confirming the association.