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Tissue Sloughing and Evidence Based Research

I am looking for the most recent evidence based article which researches the affects as well as uses of non-carious mouth rinses. Recently, my doctor has been advising patients against the use of Listerine, even Listerine Zero as well as Listerine non-alcohol due to affects seen on patients regarding tissue sloughing. Most of the time when I see tissue sloughing, I inquire with the patient current dentifrices, medications, etc. to rule out underlying systemic conditions. And while I do see a lot of patients that present with tissue sloughing that use Crest toothpaste as well as Listerine (not usually in combination) I want to get my facts straight and know exactly what to recommend. The most recent article I could find is 2011, but I do not see anything regarding adverse affects. Any help is greatly appreciated.



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The most recent research I found was from 2007 (sorry!); it states Listerine both with and without alcohol does not contribute to soft tissue lesions or mucosal aberrations (tissue sloughing). Here’s the link, page 17: https://www.adha.org/resources-docs/7822_Incorporating_Antimicrobial_JDH_Rinses.pdf.
 
From what I learned in hygiene school and have further seen in practice, is tissue sloughing is generally caused by sodium lauryl sulfate (SLS) in toothpaste. It’s especially apparent in patients who use Crest Pro-Health toothpaste. For most patients, SLS causes mucosal cells to desquamate individually so the exfoliation isn’t noticed. However, due to the low-water formulation in Crest Pro-Health, because of the use of stannous fluoride and the need to stabilize it, the cells exfoliate in strings, clumps, or sheets. The reason for this isn’t exactly known, but it may due to the fact that the stannous ion carries 2 positive charges, so cells that are negatively charged, stick together (for lack of a better description) which promotes the aggregation of dead and sloughing cells.
 
I hope this helps a bit!

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Thank you so much!

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