Contact Allergy to Dental Materials and Implants

Dental professionals and dental patients are exposed to the same sensitizers, but the outcome is very different. Dental professionals suffer predominantly from irritant contact dermatitis and to a lesser degree from allergic contact dermatitis to acrylates and rubber products. Dental patients rarely have allergic contact stomatitis. In this chapter, the reader will learn about the multiple factors that lead to irritant contact dermatitis and also about the major sensitizers, e.g., methacrylates in dentin bonding agents, dental composite resins (DCR), and prostheses, in addition to rubber chemicals, metals, fragrances, and disinfectants. The various sensitizers that may give lichenoid reactions in patients are also discussed

Chemical Methods for Detection of Allergens and Skin Exposure

Many allergens are widely used in both consumer and occupational products. In many cases, it is difficult to know all the ingredients of a product since most products are not sufficiently labelled. To diagnose and prevent allergic contact dermatitis, the demonstration of allergens in the products from the patient’s environment is important. Chemical analysis of a product can make it possible to demonstrate the presence or absence of known allergens. Simple spot tests or documented analytical methods such as thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC), gas chromatography (GC), atomic absorption spectrophotometry (AAS), and inductively coupled plasma-mass spectrometry (ICP-MS) can be used. Moreover, with chemical methods, the purity of a substance can be checked and new allergens can be isolated and identified. Advanced methods such as mass spectrometry (MS), nuclear magnetic resonance spectroscopy (NMR), and infrared spectrophotometry (IR) are often required to identify isolated allergens