title: Copper allergy from dental copper amalgam?
abstract: A 65-year-old female was investigated due to a gradually increasing greenish colour change of her plastic dental splint, which she used to prevent teeth grinding when sleeping. Furthermore, she had noted a greenish/bluish colour change on the back of her black gloves, which she used to wipe her tears away while walking outdoors. The investigation revealed that the patient had a contact allergy to copper, which is very rare. She had, however, had no occupational exposure to copper. The contact allergy may be caused by long-term exposure of the oral mucosa to copper from copper-rich amalgam fillings, which were frequently used in childhood dentistry up to the 1960s in Sweden. The deposition of a copper-containing coating on the dental splint may be caused by a raised copper intake from drinking water, increasing the copper excretion in saliva, in combination with release of copper due to electrochemical corrosion of dental amalgam. The greenish colour change of the surface of the splint is probably caused by deposition of a mixture of copper compounds, e.g. copper carbonates. Analysis by the X-ray diffraction technique indicates that the dominant component is copper oxide (Cu2O and CuO). The corresponding greenish/bluish discoloration observed on the back of the patient's gloves may be caused by increased copper excretion in tears.
authors.affiliation: Department of Occupational and Environmental Medicine, Lund University Hospital, Sweden. lars.gerhardsson@ymed.lu.se
authors.forename: Lars
authors.initials: L
authors.lastname: Gerhardsson
authors.forename: Bert
authors.initials: B
authors.lastname: Björkner
authors.forename: Magnus
authors.initials: M
authors.lastname: Karlsteen
authors.forename: Andrejs
authors.initials: A
authors.lastname: Schütz
mesh_terms: D003300:Copper / Q000009:adverse effects* / Q000276:immunology*; D003723:Dental Amalgam / Q000009:adverse effects*; D003877:Dermatitis, Contact / Q000209:etiology* / Q000276:immunology; D004563:Electrochemistry; D005260:Female; D006801:Humans; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry; D014961:X-Ray Diffraction
chemical_list: D003300:Copper; D003723:Dental Amalgam