Česká Stomatologie a Praktické Zubní Lékařství (Jun 2007)
Most Frequent Contact Allergens of Oral Cavity and Lips
Abstract
Oral cavity is frequently or permanently exposed to a wide spectrum of compounds, some of which possess irritation or sensitization potential. Persons who are subjected to stomatological treatment and use oral hygiene are exposed to growing number of new, technologically more complex biomaterials, which may lead, due to hypersensitivity, to discomfort in oral cavity. The paper provides a survey of the main groups of contact allergens of oral cavity including lips with emphasis to dental metals and synthetic resins. The cause of contact stomatitis or cheilitis may also be frequent topically acting therapeutic and disinfection preparations including phytotherapy, foods, spices and ingredients and drinks together with additives. Standard epicutaneous (patch) tests represent the main method of examination for the demonstration of contact hypersensitivity, legally binding from the forensic standpoint. Their principle lays in the exposure of a small skin area to a suspect allergen for 48h in occlusion conditions. The recommended finding tests are the "European standard" sets with 25 most often European allergens (nickel, chromium, cobalt, perfumes, epoxides, Peruvian balsam, formaldehyde etc.) and the series "Dental Screening" with 25 most frequently orally used dental materials (acrylates, additives of polymerization, mercury, palladium, tin, copper etc.) supplemented by amalgam, iridium, indium, platinum, menthol and sorbic acid. A detailed anamnesis, interdisciplinary collaboration with dentists and correctly performed epicutaneous tests are prerequisites for discovery of the source of contact sensitization in oral cavity and a causal treatment.