Fluoride Toothpaste: A Cause of Perioral Dermatitis

In 1976, a letter to the editor reported two cases where patients with perioral dermatitis (PD) saw improvement after ceasing the use of fluoride toothpaste. A 63-year-old woman's PD resolved within two weeks and a 20-year-old woman's PD cleared within one week after switching to non-fluoride toothpaste. The authors proposed that fluoride toothpaste might worsen PD by acting as a pro-inflammatory agent in those with existing mild perioral inflammation. They were conducting a double-blind, cross-over study to explore this hypothesis but recommended withholding final judgments until the study's completion. The letter also noted that fluoride toothpaste became widespread in the U.S. around 1956-1957, which might explain the later recognition of PD in Europe where fluoride toothpaste was introduced subsequently.