Metal patch testing in patients with oral symptoms

The number of patients with metal allergies has increased recently, and patch testing is useful for investigating such patients. However, the efficacy of restoration removal in patients with oral metal allergies is disputed. This study aimed to investigate the relationships between oral symptoms and metal allergies. We conducted a retrospective analysis of 60 patients with oral symptoms. The most common oral symptom was an abnormal oral sensation. Thirty-eight percent of the patients exhibited positive allergic reactions to one or more metal. Nickel was the metal allergen that produced positive reactions most frequently. Of the seven patients whose restorations were removed, complete and partial remission were achieved in one and two patients, respectively. Interestingly, metal alloy removal was effective in 33% (n = 1) of the positive patch test group and 50% (n = 2) of the non-positive patch test group. Our results demonstrated the difficulty of predicting the efficacy of restoration removal at ameliorating oral metal allergies based on patch testing alone.