HomeDental Metal Allergy
What is dental metal allergy?
It is a metal allergy that is suspected to involve metallic elements contained in dental materials.
Symptoms may occur at sites away from the mouth.
The main clinical symptoms of dental metal allergy are ¡°mucositis or lichen planus(Fig.1) of the mouth at the site of contact with metal¡± or ¡°eczematous reaction or palmoplantar pustulosis£¨Fig.2£© at remote sites away from the mouth¡±.
Fig.1 lichen planus(provided by Department of Oral Biology & Engineering Graduate School of Biomedical and Health Sciences Â鶹AV)
Fig.2 palmoplantar pustulosis(provided by Department of Oral Biology & Engineering Graduate School of Biomedical and Health Sciences Â鶹AV)
Examination and Diagnosis of Dental Metal Allergy
- Questionnaire
The patient will be asked if he/she has a history of allergic symptoms and if he/she has ever had a rash from metal products. - Patch test(Fig.3)
A patch test is a method of diagnosing allergic symptoms by directly applying a metal reagent suspected of causing allergic reactions on the skin. Since patch tests are often difficult to perform in general dental office, they are generally performed at medical institutions such as dermatological clinics that conduct such tests.
Fig.3 patch test(provided by Department of Oral Biology & Engineering Graduate School of Biomedical and Health Sciences Â鶹AV)
- Metal Identification Test
This test is performed to determine if there are any materials in the mouth that contain metallic elements that have tested positive in the patch test. Since the components of dental metals commonly used for both insured and uninsured treatment are generally known, general examination of the mouth and x-rays can be used to determine the presence of such materials.
If the type of metal used is unknown, a sample of the metal surface in the mouth can be lightly scraped to determine its composition, but this is often difficult for general dentists and medical institutions to handle and is performed at outpatient clinics specializing in dental metal allergies.
Treatment of Dental Metal Allergy
The basic treatment is to remove metal-containing crowns and replace them with materials (resin, ceramic, etc.) that do not contain allergy-positive metals.
Since allergy-positive metals can be found not only in dental metals, but also in other materials that we come in contact with in our daily lives and in foods, symptoms often do not improve immediately after removal, and we monitor the patient's symptoms with temporary teeth for a certain period of time.
It should also be noted that symptoms may be transiently aggravated by contact with shavings when metal coverings are removed.
