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  • Dentists
  • Dental Hygienists
  • Dental Assisting
Hours: 2 Contact Hours
  • J. Anthony von Fraunhofer, MSc, PhD, FRSC
  • Patricia W. Kihn, DDS
Peer Reviewer(s): Toni M. Roucka, RN, DDS, MA
Item#: L0797
Contents: 1 Course Book (28 pages)
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Allergic Reactions to Metals in the Mouth, 2nd Edition

Price $19.95
Item # L0797
When available, the Online Course format is included with the hard copy, eBook, or audio book formats!

Release Date: July 30, 2013

Review Date: November 11, 2016

Expiration Date: November 10, 2019


A wide variety of materials used for the construction of dental restorations, prostheses, and dental implants have the potential to cause allergic reactions among dental patients. Rates of metal sensitivity are thought to increase with exposure, and an estimated 15% to 20% of people within the western population are considered hypersensitive to at least one metal. Reported effects include intraoral redness, swelling and pain of the oral mucosa and lips, oral/gingival lichenoid reactions, stomatitis, cheilitis, extraoral urticarial or eczematous lesions. Increasing numbers of patients complain about intraoral and extraoral lesions, metallic taste, and skin reactions, which may be related to the dental materials used for restorations.

Hypersensitivity to metals in biomaterials used in dentistry and medicine requires all dental professionals to be aware of metals that patients may be allergic to and to exercise caution when selecting restorative materials. This basic-level course reviews the importance of metals for human health, identifies common harmful metals and their role in disease, and discusses hypersensitivity reactions, with particular regard to metal allergies in medical and dental patients. Corrosion is also discussed relative to its role in the hypersensitivity reactions experienced by dental patients. Chronic exposure to metal corrosion in the oral environment has been associated with swelling, bone resorption, oral lesions, and oral cancer in individuals who are hypersensitive to metals.  For these reasons, it is imperative that dental professionals understand the different types of metals used in biomaterials, factors that increase corrosion susceptibility of dental restorations, and corrosion’s potential to increase patient hypersensitive to metals. Doing so will help dental professionals make more informed decisions about which biomaterials are the safest and most effective.



AGD Subject Code: 017

Western Schools designates this activity for 2 continuing education credits.


Course Objectives

  • Describe the essential role of metals in human health.
  • Identify metals that are harmful to human health.
  • Explain the relationship between hypersensitivity and metals.
  • Describe the process of metallic corrosion.
  • Describe the impact of metallic corrosion in the oral environment.


J. Anthony von Fraunhofer, MSc, PhD, FRSC, is professor emeritus, University of Maryland School of Dentistry, Baltimore, where he also served as director of biomaterials research in the Department of Oral and Maxillofacial Surgery. He has written more than 400 scientific papers and 16 books, and contributed chapters to 15 monographs on dental biomaterials and materials science. Dr. von Fraunhofer is the author of the well-regarded monographs Dental Materials at a Glance and Research Writing in Dentistry, published by Wiley-Blackwell. His special interests are the biomechanical properties of materials used in medicine and dentistry and the degradation, wear, and corrosion of materials in the biosystem.

Patricia W. Kihn, DDS, is a dentist in private practice in Halethorpe, Maryland. In addition to more than 25 years of dental experience, Dr. Kihn has served as a director of regulatory clinical support activities and corporate complaint officer for DENTSPLY and has been an adjunct faculty member in the Department of Restorative Dentistry at the University of Maryland School of Dentistry, Baltimore.


Toni M. Roucka, RN, DDS, MA, is an associate professor of restorative dentistry at Southern Illinois University, School of Dental Medicine, Edwardsville. She maintains an active nursing license and is a Fellow of the American College of Dentists and immediate past president of the American Society for Dental Ethics. Dr. Roucka obtained her DDS degree from the University of Illinois at Chicago College of Dentistry and master’s degree in population health – bioethics from the Medical College of Wisconsin in Milwaukee. Dr. Roucka is a nationally recognized speaker on the subject of ethics in dentistry and has taught restorative dentistry at both Marquette University and the Southern Illinois University School of Dental Medicine. As a volunteer, she has provided dental care to underserved populations in Guatemala, Venezuela, the Dominican Republic, and Tanzania.

  • Courses must be completed on or before the expiration date noted in the course description above.
  • You must score 75% or higher on the final exam and complete the course evaluation to pass this course and receive a certificate of completion.
  • Through our review processes, Western Schools ensures that the course content is presented in a balanced, unbiased manner and is free from commercial influence. It is Western Schools’ policy not to accept commercial support.
  • All persons involved in the planning and development of this course have disclosed no relevant financial relationships or other conflicts of interest related to the course content.
  • There are no prerequisites for this course.