Adverse reactions in the mouth when using dental amalgam

Abstract

For more than two centuries dental amalgam has been used to treat diseases of hard tooth tissues. In many countries, including Bulgaria, the silver amalgam is still widely used to restore damaged teeth. Along with the toxicity of mercury, various conditions can be observed in the mouth after the use of this metal. Reactions of the oral mucosa after using amalgam present mainly in the form of lichenoid lesions. Oral lichenoid lesions caused by contact with dental amalgam are difficult to distinguish clinically or histologically from other lichenoid lesions or from idiopathic oral lichen planus. They can be caused by contact hypersensitivity. Etiological factors of oral lichen planus include the presence of dental amalgam. Direct contact or accidental implantation of amalgam in the soft tissues can lead to amalgam tattoo. Oral pathogalvanism occurs when various metal alloys are simultaneously present in the liquid medium of the mouth with a local or systemic effect. A variety of reactions and disorders in the tissues in the maxillofacial area have been described, associated with the presence of dental amalgam. The lesions are usually asymptomatic, but rarely patients report pain or tenderness when eating hot or spicy food.