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Cinnamon Contact Stomatitis

Definition

Cinnamon contact stomatitis is a relatively common reaction of the oral mucosa secondary to the chronic use of substances with artificial cinnamon flavoring.

Etiology

The stomatitis is a result of use of cinnamon products such as chewing gum, candy, toothpaste, dental floss, oral solutions etc.

Main Clinical Features

•Redness of the oral mucosa usually associated with desquamation and erosions or ulcerations

•Hyperkeratotic white plaques are common

•Burning and pain are common symptoms

•Buccal mucosa and the lateral borders of the tongue are more frequently affected

•Exfoliative cheilitis and perioral dermatitis may occur

Diagnosis

The diagnosis is based on the history and the clinical features.

Differential Diagnosis

•Amalgam contact stomatitis

•Chronic biting

•Leukoedema

•Lichen planus

•Leukoplakia

•Candidiasis

•Hairy leukoplakia

•Plasma cell stomatitis

•Uremic stomatitis

•Lupus erythematosus

•Epithelial peeling

Treatment

Basic Guidelines

•High level of oral hygiene should be maintained.

•Change or avoid any product which contains cinnamon.

•Avoid antibacterial mouthwashes as these worsen the symptoms.

•If the cinnamon products are reused usually the signs and symptoms soon recur.

Suggested Therapies

•Discontinuation of any cinnamon product improves the condition and the signs and symptoms disappear in approximately 2 weeks time.

•In cases of severe and extended erosions, corticosteroids in the form of topical ointment or low doses of oral prednisone, e.g., 10-15 mg/day for 1 week, help the lesions to heal soon.

•Topical rinses with chamomile four to five times daily improve the symptoms.

References

Allen CM, Blozis GG. Oral mucosal reactions to cinnamon-flavored chewing gum. JADA 1988;116:664–667.

Le Sueur BW, Yiannias JA. Contact stomatitis. Dermatol Clin 2003;21:105–114.

Miller R, Gould A, Berstein M. Cinnamon-induced stomatitis venenata. Oral Surg Oral Med Oral Pathol 1992;73:708–716.

Samio EL, Kanerva L, Contact allergens in toothpastes and a review of their hypersensitivity. Contact Dermatitis 1995;33:100–105.