Can SLS-free toothpastes help children with Behçet’s disease and recurrent oral aphthae?

Objective: Sodium Lauryl Sulfate (SLS), a synthetic detergent commonly used in toothpaste, has been implicated in various studies as a cause or trigger of Recurrent Oral Ulcers (ROU). This study aimed to assess the efficacy of SLS-free toothpaste recommendations in pediatric cases with isolated ROU and Behçet Disease (BD). As a secondary aim, we also evaluated whether BD developed during the follow-up of cases with ROU. Method: This is a retrospective cohort study. Patients who received SLS-free oral care recommendations due to ROU or BD and had at least six months of follow-up data were included between February 2023 and August 2023. The clinicians did not recommend specific brands for the SLS-free oral care products. The follow-up parameters included the visual analog scale (VAS, 0-10), the total number of attacks over three months, the average number of ulcers per attack, and the average duration. Results: The follow-up data included 78 patients with ROU and 14 patients diagnosed with BD. The mean follow-up duration was 23 ± 7 months. None of the patients referred for ROU developed BD during the follow-up. The initial VAS scores, number of attacks, number of ulcers per attack, and attack duration were higher in BD patients than in ROU patients. During the follow-up visit after initiating SLS-free toothpaste (at least three months), 38 (48.7%) ROU patients reported lower VAS scores. Six patients with BD reported a decrease in the frequency of attacks. However, there were no statistically significant differences between the baseline and 6-month data regarding the number of ulcers, VAS scores, number of attacks, or attack duration. Conclusion: SLS-free toothpaste could be a good recommendation for ROU cases. Although our limited number of BD cases did not yield statistically significant results, as previously mentioned, some patients reported lower pain scores and fewer attacks.