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Dental Amalgam May Cause Oral Lichen Planus

Dental Amalgam May Cause Oral Lichen Planus

Friday, December 24th 2004

Dental amalgam may cause oral lichen planus (OLP) lesions, according to the results of a study published in the December issue of the Archives of Dermatology. Removal of the amalgam can resolve the lesions if the patch test yields positive results.

"The concept of contact allergy to dental restorative materials aggravating or inducing OLP is well recognized but somewhat controversial," write Ronald Laeijendecker, MD, from Albert Schweitzer Hospital in Dordrecht, the Netherlands. "However, several authors have reported resolution of signs and symptoms in OLP after replacement of amalgam, particularly if there was a positive patch test result to mercury, which is the most important allergen in amalgam."

The objective of this study was to determine contact allergies in patients with OLP and to evaluate the effect of partial or complete replacement of amalgam fillings following a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam.

Group A consisted of 20 patients with oral lesions confined to areas in close contact with amalgam fillings. Group B consisted of 20 patients with lesions extending 1 cm beyond the area of contact with amalgam fillings. In group C, which also consisted of 20 patients, the oral lesions had no topographic relationship with amalgam fillings. Group D consisted of 20 control subjects with signs of allergic contact dermatitis.

Patients with a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam were advised to have replacement of amalgam fillings that were in close contact with the oral lesions. This occurred in 13 patients of group A and in eight patients of group B, all with significant improvement after three months. Of two patients in group C who had amalgam replacement, one patient improved. None of the patients with concomitant cutaneous lichen planus or in group D had positive patch test reactions to mercury compounds.

"Contact allergy to mercury compounds is important in the pathogenesis of oral lichen planus, especially if there is close contact with amalgam fillings and if no concomitant cutaneous lichen planus is present," the authors write. "In cases of positive patch test reactions to mercury compounds, partial or complete replacement of amalgam fillings will lead to a significant improvement in nearly all patients."

In an accompanying editorial, Roy S. Rogers III, MD, and Alison J. Bruce, MD, from the Mayo Clinic in Rochester, Minnesota, praise this careful study and agree that patch testing can be of benefit in patients with lesions of OLP in close apposition to dental metal restorations.

"Removal and replacement of dental metal restorations is a costly and time-consuming procedure," the editorialists write. "Removal should be considered based on objective evidence of symptomatic lichenoid tissue changes in apposition to or close to a dental metal restoration. The strong probability of long-term clearing, with a small probability of relapse of the lichenoid tissue changes, can be assessed by performing patch testing to dental metals."

The editorialists report no financial disclosures.

Arch Dermatol. 2004;140:1434-1438, 1524-1525

Footnote from Ideal Health:

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Certified Organic Chlorella
Diatomaceous Earth
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Homay Chi water Ionizer/alkaliser
Hydrated Bentonite
Mineral & Toxic Element test

Related health information can be found here:

Beet Root – liver and kidney cleanser, iron deficiency anemia
Benefits of fasting and detoxifying
Dandelion – Liver/Kidney tonic, blood cleanser
Looking for a natural energy booster with the added cleansing power of Cholorophyll?

Related articles can be found here:

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Selenium

If you need help or advice, you are welcome to email our naturopathic team with your health question.

Disclaimer: The health information presented here has been written for the New Zealand health consumer. It is of a general nature and is only intended to provide a summary of the subjects covered. The information is not intended to be comprehensive or to provide medical advice to you. While all care has been taken to ensure the accuracy of the information, no responsibility or liability is accepted, and no person should act in reliance on any statement contained in the information provided. All health ailments should be treated by a qualified health professional.

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