Prevalence of gold sensitivity in asymptomatic individuals with gold dental restorations

Background: The clinical relevance of positive patch test reactions to gold sodium thiosulfate in asymptomatic individuals with gold dental restorations is often unclear. Knowledge of the prevalence of gold sensitivity in individuals with and without gold dental restorations is required to better understand the relevance of these reactions. Objective: To determine the prevalence of positive patch test reactions to gold in asymptomatic individuals with gold dental restorations (gold patients) compared with similar individuals without gold dental appliances (nongold patients). Methods: One hundred thirty-six healthy, asymptomatic patients were patch tested to gold sodium thiosulfate, nickel sulfate and palladium chloride. Readings occurred after 2 days and 7 days. Results: Of the patients tested, 24 of 71 (33.8%) gold patients had a positive reaction to gold versus 7 of 65 (10.8%) of the nongold patients, P < .001. Of those with a positive gold reaction, 12 of 31 (38.7%) also had a positive nickel reaction. Nickel alone was positive in 18 of 71 (25.4%) of gold patients versus 11 of 65 (16.9%) of nongold patients. 19 of 29 (65.5%) of those with a positive nickel reaction also reacted to palladium and 19 of 22 (86.4%) of those with a palladium reaction also reacted to nickel. The rate of allergy to gold computed over a 3-year period for patients patch tested in the Oregon Health Sciences University (OHSU) Contact Dermatitis Clinic was 13.5% (46/342). Conclusions: The prevalence of gold sensitivity in individuals with gold dental restorations is approximately 33.8%. This is significantly greater than the 10.8% prevalence seen in individuals without gold dental appliances, as well as greater than the 3-year rate from the OHSU Contact Dermatitis Clinic. This data should help shed light on issues of clinical relevance.