The nickel problem.

Abstract

Clinical use of the new base-metal alloys in restorative dentistry involves a risk for both dentist and patient. It is the responsibility of the dentist to determine if a patient is allergic to nickel prior to treatment with a restoration containing a nickel alloy. A patch test is recommended for nickel sensitivity in every patient when such a restoration is planned. In addition, the dentist should include in the work authorization order to the dental laboratory the type of alloy he wants for a particular patient. The dentist should be prepared to check for the presence of nickel in a casting suspected of containing it using the dimethylglyoxime test. The evaluation record for nickel sensitivity should include the patient's name, age, history of allergies, medication, name of drug, dosage, and reaction. The record should be kept in the patient's chart.