Nickel sensitivity in pediatric dental patients.

A nickel sensitivity patch test was applied to 700 child dental patients, aged 5-12 years,from the Dental Clinic at the University of Western Ontario and nearby pediatric dental offices. Approximately one-half the children were known to have nickel-containing dental appliances. From a case history obtained from the paten ts, the history of the wearing of pierced earrings and other jewelry was ascertained. The overall positive patch test rate was 8.1% with the females having a rate of 9.5% and males 6.8%. Positive patch tests were more frequent for girls wearing earrings than those without earrings. Positive patch tests were more frequent for boys and girls with nickel-containing intraoral devices than those without the nickel devices. However, none of the differences were statistically significant. A study of exposure time revealed a trend toward more response over time, but this was not statistically significant. Old formulation nickel-chromium crowns were associated with a significantly higher patch test rate in children 8-12 years old. This suggests that in the development of intraoral appliances consideration should be given to the nickel content. It has been reported that the problem of nickel contamination and associated skin contact is potentially serious, but no effort has been made to define its magnitude (Sunderman et al. 1975). Fisher (1973) has stated that nickel is one of the most common causes of allergic contact dermatitis, especially in women. Attention has been drawn to the problem of allergy and dermatitis from exposures to nickel owing to the presence of nickel in alloys used in orthopedic prostheses, cardiac pacemaker electrodes, cardiac valve replacements, sutures, and intravenous cannulae, as well as exposures due to jewelry (Sunderman 1977). Nickel-associated problems also have been of some concern in dentistry. Park and Shearer (1983) demonstrated in vitro that nickel is released from simulated orthodontic appliances. Bergman et al. (1980) reported that nickel from nonprecious dental casting alloys accumulated in mouse tissues. Blanco-Dalmou et al. (1984), using a 5% nickel sulphate gel, found that 20.7% of men and 31.9% of women developed an allergic response to nickel. With 2.5% nickel sulphate in white petrolatum, Prystowsky et al. (1979) found that 9% of adult women and 0.9% of adult men revealed a positive response. The purpose of the present study was to determine the level of nickel sensitivity in a child population by using a skin reaction test. The study also compared the skin test reaction of those children with nickel-containing intraoral appliances with those who did not possess those devices.