engleski

US3 Allergy in dental practice

Allergy reactions of the oral mucosa comprise an array of clinical manifestations, some of them difficult to differentiate from toxic reactions. Type-I reactions are most frequently seen related to application of polymers in the oral cavity, such as orthodontic bonding and fissure sealant materials. There may also be systemic manifestations such as urticaria. Type-IV reactions may be seen related to most dental materials used, from amalgam and gold to polymers. These reactions appear as chronic reddening and/or ulceration of the oral mucosa. Lichenoid reactions have histopathological characteristics compatible with type-IV allergy reactions and are the most prevalent material-adverse reactions seen in the oral cavity. Recent advances have been made in characterizing the more prevalent allergens on oral mucosa, such as methacrylates, natural rubber latex (NRL) proteins, rubber glove chemicals and disinfectants. This improved understanding has clearly enhanced the success, particularly for type I NRL allergies. Skin patch tests, applying a series of dental materials in non-toxic concentrations on the skin, have been used to identify sensitization. However, the value of those tests can be questioned. Although obvious advances have been made in characterizing dental allergens and understanding potential exposure, improved diagnostic and management techniques are still needed. Corticosteroid therapy is all too often the only treatment. Drug allergy including local anaesthetics, and systemic antibiotics and NSAIDs, may also present in the dental environment, causing life-threatening emergencies specially in 'at risk patients'. The GDP has to know the principles of prevention, diagnosis and management of these situations.

allergy; dental practice

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