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25 February 2021

Correlation between dental materials and contact allergies

Lara Figini

The number of allergies has been growing continuously. According to the WHO, the number of allergy sufferers rose from 3% to 30% between 1960 and 1995. For Langen et al. (2013) the most common allergic diseases are hay fever (14.8%), bronchial asthma (8.6%) and contact dermatitis (8.1%). The introduction of new materials in dentistry has increased the likelihood of an intolerance or allergic reaction following dental treatments. In dental treatment, the type IV reaction, the cellular-mediated delayed reaction or late reaction in relation to dental materials, is particularly relevant. The standard method for detecting contact allergies is the patch test, with standardized test substances, nevertheless, due to false-negative or false-positive documented reactions, a clear diagnosis is difficult. It should also be specified that information on the components of dental materials, as well as on their potential release in an intraoral setting are missing or incomplete.

Materials and Methods
In an observational study, published on SWISS DENTAL JOURNAL  July 2019, the authors quantify the frequencies and symptoms of allergies to dental materials. The authors collected data in the Department of Dental Prosthetics and Materials in Leipzig. Clinical patient data have been systematically collected since 2012.

The objective mucosal findings and the patients’ complaints are documented in detail in a specifically designed data sheet. This study included 86 subjects (83.7% women and 16.3% men) with oral symptoms of a contact allergy with an average age of 63 (24–86).

The most common allergies were to metals, of which nickel and cobalt were the most common allergens. Furthermore, many allergies were indicated to ingredients of cosmetics and composites. Allergies to components in methacrylate-containing denture resins came in at rank 5. 52.4% of the patients showed mucosal changes. Contact stomatitis (54.5%) and an oral lichenoid lesion (20.5%) were most frequently diagnosed. 86% of the patients reported subjective complaints. Pain and burning sensations in the mouth were mostly reported.

From the data of this study, which must be confirmed in other similar studies, it can be concluded that contact allergies to dental materials are not infrequent and the most widespread form is contact stomatitis (54.5%).

Clinical implications
Dental materials are among the most common artificial materials that are incorporated into the human body. It is the dentist’s responsibility to choose which materials and combinations of materials to use. The manufacturing process and the intraoral processing should be conscientiously and carefully coordinated. Appropriate dental allergy history, clinical examination of the oral cavity for changes in the oral mucosa, analysis of specific dentures, and screening for psychogenic disorders are necessary to clarify the origin of these symptoms.

For additional information: Contact allergies to dental materials

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