Diet

Advise patients with contact stomatitis to avoid spicy foods. Instruct contact stomatitis patients to avoid soft drinks, candies, and chewing gums in case of allergy to flavoring agents. Recommend that contact stomatitis patients avoid the causative food in cases of contact urticaria.

Prevention

Advise contact stomatitis patients to avoid known causative agents (see Diet).

Long-Term Monitoring

Replacement of dental restorations and prostheses may be very expensive and stressful for patients and should not be recommended when their causative role in contact stomatitis is doubtful.^[60] Removal of fillings or restorations does not always produce a complete resolution of symptoms, even in patients with positive patch test results to mercury or other dental compounds. Replacement is advisable when the mucosal lesions are adjacent to dental restorations, especially in cases of localized lichenoid reactions.^[61] Titanium may be a satisfactory alternative for patients who are allergic to palladium and other transition metals.

Sensitization to nickel is common in the general population. Establish relevance before removal of dental metal. Avoid prostheses containing transition metals in patients with history of nickel dermatitis.

Sensitization to palladium chloride is associated with nickel allergy due to cross-sensitization.

Establish relevance before removal of dental restorations in patients with sensitization to mercury derivatives.

Gold allergy is often not relevant, and dental gold removal may not prove curative.

Sensitization to acrylates is usually relevant. Patch testing with acrylates may cause active sensitization. Active sensitization to metals or acrylates as a consequence of dental procedures is rare.

Medication

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Media Gallery

Irritant contact stomatitis of the tongue.
Close-up view of irritant contact stomatitis of the tongue.
Acute allergic stomatitis involving the oral mucosa and the lip due to benzocaine.
Allergic contact dermatitis involving the lips and the perioral area due to propolis.
Allergic contact reaction due to nickel in a dental brace.
Allergic contact stomatitis on the gingiva in a patient with a positive patch test result to nickel, palladium, and mercury.
Leukoplakialike lesion in a patient who is allergic to mercury.
Lichen planus–like lesion adjacent to a dental restoration.
Contact urticaria of the lip due to food allergy.
Contact urticaria of the tongue in a patient with latex allergy.
Close-up view of contact urticaria of the tongue in a patient with latex allergy.
Positive patch test result to mercury.
Positive prick test result to latex.

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Author

Antonella Tosti, MD Professor of Dermatology, Department of Dermatology and Cutaneous Surgery, University of Miami, Leonard M Miller School of Medicine

Antonella Tosti, MD is a member of the following medical societies: American Academy of Dermatology, International Society of Dermatology, European Academy of Dermatology and Venereology, Women's Dermatologic Society, Canadian Dermatology Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: PharmaDerm<br/>Received income in an amount equal to or greater than $250 from: Valeant; Pharmaderm.

Coauthor(s)

Massimiliano Pazzaglia, MD, PhD Fellow, Department of Dermatology, University of Bologna, Italy

Disclosure: Nothing to disclose.

Bianca Maria Piraccini, MD, PhD Director of Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum--University of Bologna, Italy

Bianca Maria Piraccini, MD, PhD is a member of the following medical societies: American Academy of Dermatology, Council for Nail Disorders, European Academy of Dermatology and Venereology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Dermatology of Southwest Ohio

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Craig A Elmets, MD Professor and Chair, Department of Dermatology, Director, Chemoprevention Program Director, Comprehensive Cancer Center, UAB Skin Diseases Research Center, University of Alabama at Birmingham School of Medicine

Craig A Elmets, MD is a member of the following medical societies: American Academy of Dermatology, American Association of Immunologists, American College of Physicians, American Federation for Medical Research, Society for Investigative Dermatology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: University of Alabama at Birmingham; University of Alabama Health Services Foundation<br/>Serve(d) as a speaker or a member of a speakers bureau for: Ferndale Laboratories<br/>Received research grant from: NIH, Veterans Administration, California Grape Assn<br/>Received consulting fee from Astellas for review panel membership; Received salary from Massachusetts Medical Society for employment; Received salary from UpToDate for employment. for: Astellas.

Contact Stomatitis Treatment & Management

Diet

Prevention

Long-Term Monitoring

References

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