Effect of sodium lauryl sulfate on recurrent aphthous stomatitis: A systematic review

J Oral Pathol Med. 2019 May;48(5):358-364. doi: 10.1111/jop.12845. Epub 2019 Mar 27.


The present systematic review sought to evaluate the effects of Sodium Lauryl Sulfate (SLS)-free compared to SLS-containing dentifrices on (Recurrent) aphthous stomatitis (RAS) in patients with this condition. Cochrane, Medline (PubMed) and Embase databases, and some trial registries were searched through December 2017. There was no language, nor publication year restrictions. We included double-blinded randomized controlled trials that compared the effects of dentifrices with and without SLS on RAS in humans. Data extraction was compliant with PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. PROSPERO 2018:CRD42018086001. Four trials were included in this review (all crossover studies; n = 124 participants) and two contributed to the main meta-analysis based on the random-effect model. SLS-free dentifrice, when compared to SLS-containing statistically significantly, reduced the number of ulcers, duration of ulcer, number of episodes, and ulcer pain. Sensitivity analysis of the four studies as parallel-group trials shows a consistent direction of effect in favor of SLS-free dentifrice usage. In conclusion, the qualitative and quantitative synthesis of the eligible trials for this review showed that use of SLS-free consistently reduced all four parameters of ulcers measured. The available evidence suggests that patients with RAS may benefit from using SLS-free dentifrices for their daily oral care. However, future well-designed trials are still required to strengthen the current body of evidence.

Keywords: canker sore; dentifrice; detergents; sodium dodecyl sulfate; sutton disease 2; toothpastes.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Dentifrices / adverse effects*
  • Dentifrices / therapeutic use
  • Humans
  • Randomized Controlled Trials as Topic
  • Recurrence
  • Sodium Dodecyl Sulfate / adverse effects*
  • Sodium Dodecyl Sulfate / therapeutic use
  • Stomatitis, Aphthous / chemically induced*
  • Stomatitis, Aphthous / drug therapy*


  • Dentifrices
  • Sodium Dodecyl Sulfate