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The clinical manifestations of contact allergic dermatitis to dental materials are not uniform. This study was performed to detect the frequent allergens in the dental series associated with contact dermatitis and to define the causal relationship between the different allergens and the relevant clinical presentations. Between the years 2000 and 2004, 134 patients, aged 20-80 years, were patch tested. 121 patients were included in the study. The most frequent oral manifestations were cheilitis and perioral dermatitis (25.6%), burning mouth (15.7%), lichenoid reaction (14.0%), and orofacial granulomatosis (10.7%). 18 (14.9%) patients were dental personnel, all of whom suffered from hand dermatitis. The common allergens detected included goldsodiumthiosulphate (14.0%), nickel sulfate (13.2%), mercury (9.9%), palladium chloride (7.4%), cobalt chloride (5.0%), and 2-hydroxyethyl methacrylate (5.8%). Positive reactions to metals were frequent in all the different clinical variants, and no specific association between a specific clinical presentation and a particular allergen was found. Allergy to mercury was not a significant factor contributing to the pathogenesis of oral lichenoid reactions. However, a strong association with contact allergy to mercury in dental fillings was found in 2 patients with orofacial granulomatosis.

This study presents a 10-year survey of 2285 patients tested to common preservatives in northern Israel. The demographic and clinical data were analysed using a revised MOAHLFA index. Patch testing was based on the International Contact Dermatitis Research Group (ICDRG) guidelines. 411 (18%) patients were found to have positive reactions to 1 or more preservatives. The most frequent allergens tested positively were thimerosal, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), and formaldehyde. The reactions to MCI/MI remained stable around 1.7% throughout the years 1995-1998, with a significant increase to 3.7%-4% (P = 0.029) during 1999-2004. The reactions to formaldehyde remained low around 0.3% until 1999; however, a considerable increase throughout the years 2000-2004 was noted, with rates of 1.5%-1.9% (P = 0.028). The sensitivity rates for parabens, quaternium-15, imidazolidinylurea, and diazolidinylurea were low and unchanged, mostly under 0.5%. As for methyldibromoglutaronitrile (MDBGN), sensitivity rates around 2% were detected for the years 1996 and throughout 2000-2004. Overall, this extensive survey showed a concerning increase in the sensitivity rates for MCI/MI, formaldehyde, and MDBGN.