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Allergies in Dentistry

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Types of dental materials associated with allergic or other adverse reactions
1. “Base metal” alloys containing Nickel used to make crowns and bridges. An example would be a “non-precious” metal alloy used to make a Porcelain Fused to Metal (PFM) crown or bridge.
2. Gold alloys used for crowns and bridges that may contain base metals.
3. Dental amalgam: Very rare allergic reactions to the metals in amalgams – the allergic individual may have a family history of metal allergies.
4. Acrylics or denture reline materials: A very small percentage of patients may have allergic or irritant reactions to the chemicals in these materials.

Medications used in Dentistry associated with allergic or other adverse reactions
1. Antibiotics such as Penicillin, Sulfa drugs, Tetracycline: Allergy to Penicillin is the most common drug allergy. Allergic reactions can range from a rash, to hives, and can even result in a life-threatening anaphylactic response that can cause difficulty breathing, requiring emergency action and treatment. Erythromycin is usually prescribed for patients allergic to Penicillin, and allergy to Erythromycin is rare.
2. Local and Topical Anesthetics: Some individuals are allergic to benzocaine. If you have a benzocaine allergy, your dentist will make sure to not use topical anesthetics containing benzocaine and avoid using any local anesthetics related to benzocaine.
3. Epinephrine (“adrenalin”) in local anesthetics: Many patients believe they may have had an allergic reaction to the epinephrine, when what has actually occurred is an adverse reaction to the amount of epinephrine the patient received in the local anesthetic. Local anesthetic injections can sometimes inadvertently deliver some epinephrine into the bloodstream and this can cause the patient’s heart to beat faster, or feel like the heart is “racing” – this causes significant concern and anxiety in most patients. Some individuals are more sensitive to epinephrine, and local anesthetics do contain different concentrations of epinephrine. Certain dental procedures require more local anesthetic and this increases the overall amount of epinephrine the patient receives. It is important to discuss this situation with your dentist, because the dentist can use anesthetics with less or with no epinephrine if necessary.
4. Prescription whitening/bleaching agents – misuse and overuse of these products can cause adverse, rash-like irritant reactions to gum and oral tissues and can also damage the teeth by demineralizing the enamel.

OTC Consumer Dental Products associated with allergic or other adverse reactions 1. Toothpastes and mouth rinses containing Sodium Laurel Sulfate (SLS): In a very small percentage (less than 2%) of patients, SLS can irritate the soft tissue lining of the mouth and in some cases can cause localized areas of surface epithelium (skin) of the oral tissue to slough, similar to how skin can peel off after sunburn. For example, some patients report a “slimy feeling” in their mouth when waking up in the morning, and this may indicate a reaction to SLS. Many dentists, periodontists and oral pathology/oral medicine specialists are familiar with this condition and can help patients identify SLS as the causative agent. Treatment consists of discontinuing use of any toothpastes or mouthrinses containing SLS and monitoring the patient for resolution of the problem.
2. Tartar control toothpastes: In some individuals, the tartar control ingredient has been reported to cause sensitivity reactions that irritate oral tissues.
3. Toothpastes, mouth rinses and floss containing natural oil flavoring agents such as cinnamon: These can produce a rash-like reaction (mucositis) on the oral tissues that may feel like it is burning the tissue.
4. Topical pain relieving gels (topical anesthetics) that contain benzocaine
5. Whitening/bleaching agents – Overuse of these products can cause adverse, rash-like irritant reactions to gum and oral tissues and can also damage the teeth by demineralizing the enamel.

Last updated: Aug-29-06

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