CS Praza do Ferrol, Praza Ferrol 11, 27001 Lugo, Spain,
Med Oral Patol Oral Cir Bucal. 2019 Jul 1;24(4):e452-e460. doi: 10.4317/medoral.22939.
The aim of this systematic review was to summarise the clinical information available about oral mucosal peeling (OMP) and to explore its aetiopathogenic association with dentifrices and mouthwashes.
PICOS outline. Population, subjects diagnosed clinically and/or pathologically. Intervention, exposition to oral hygiene products. Comparisons, patients using products at different concentrations. Outcomes, clinicopathological outcomes (primary) and oral epithelial desquamation (secondary) after use. Study design, any. Exclusion criteria, reports on secondary or unpublished data, in vitro studies. Data were independently extracted by two reviewers.
Fifteen reports were selected from 410 identified. Descriptive studies mainly showed low bias risk, experimental studies mostly an "unclear risk". Dentifrices or mouthwashes were linked to OMP, with an unknown origin in 5 subjects. Sodium lauryl-sulphate (SLS) was behind this disorder in 21 subjects, tartar-control dentifrices in 2, and flavouring agents in 1 case. Desquamation extension was linked to SLS concentration. Most cases were painless, leaving normal mucosa after desquamation. Tartar-control dentifrices caused ulcerations more frequently.
OMP management should consider differential diagnosis with oral desquamative lesions, particularly desquamative gingivitis, with a guided clinical interview together with pathological confirmation while discouraging the use of the product responsible for OMP.
本系统评价的目的是总结口腔黏膜剥脱症（OMP）的临床资料，并探讨其与牙膏和漱口水的病因发病学关联。
PICOS 概述。人群，临床和/或病理诊断的受试者。干预，暴露于口腔卫生产品。比较，使用不同浓度产品的患者。结局，使用产品后的临床病理结局（主要）和口腔上皮脱落（次要）。研究设计，任何。排除标准，二次或未发表数据报告，体外研究。数据由两名评审员独立提取。
从 410 篇中筛选出 15 篇报告。描述性研究主要显示低偏倚风险，实验研究主要显示“不确定风险”。牙膏或漱口水与 OMP 有关，5 名患者病因不明。21 名患者的口腔黏膜剥脱症与十二烷基硫酸钠（SLS）有关，2 名患者与牙石控制牙膏有关，1 名患者与调味剂有关。剥脱程度与 SLS 浓度有关。大多数病例无痛，脱落后黏膜正常。牙石控制牙膏更常引起溃疡。
OMP 的管理应考虑与口腔脱屑性病变的鉴别诊断，特别是脱屑性龈炎，通过有针对性的临床访谈和病理确认，同时应劝阻使用引起 OMP 的产品。
