Contact allergies to dental materials in patients

Abstract

Background Concerns regarding contact allergies and intolerance reactions to dental materials are widespread among patients. Development of novel dental materials and less frequent amalgam use may alter sensitization profiles in patients with possible contact allergy. Objective This study was aimed at analysing current sensitization patterns to dental materials in patients with suspected contact allergy. Methods This retrospective, multicentre analysis from the Information Network of Departments of Dermatology (IVDK) selected patients among 169,834 patients tested in 2005–2019, and registered with (i) an affected area of ‘mouth’ (and ‘lips’/’perioral’), (ii) with the dental material in question belonging to three groups: dental filling materials, oral implants, or dentures or equivalents, and (iii) were patch-tested in parallel with the German baseline series, (dental) metal series, and dental technician series. Results A total of 2,730 of 169,834 tested patients met the inclusion criteria. The patients were predominantly women (81.2%) and 40 years or older (92.8%). The sensitization rates with confirmed allergic contact stomatitis in female patients (n=444) were highest for metals (nickel 28.6%, palladium 21.4%, amalgam 10.9%), (meth)acrylates (HEMA 4.8%), and the substances propolis (6.8%) and ‘balsam of Peru’ (11.4%). The most relevant acrylates were HEMA, HPMA, MMA, EGDMA, and PETA. Few male patients were diagnosed with allergic contact stomatitis (n=68), and their sensitization rates were highest for propolis (14.9%) and amalgam (13.6%), but not (meth)acrylates. Conclusion Allergic contact stomatitis to dental materials is rare. Patch testing should focus on metals such as nickel, palladium, amalgam, and gold, but also (meth)acrylates and the natural substances propolis and ‘balsam of Peru’.