Intraoral Contact Lichenoid Reaction to Dental Amalgam

Oral lichenoid reactions are histologically and clinically very similar to oral lichen planus, but differ, as in these cases the underlying cause is particularly identifiable. Various etiological factors for such lesion are dental restorative materials, drugs, food additives, oral hygiene products etc. Most common cause in oral cavity is contact sensitization to dental amalgam restorations which may result in clinical lesion as well as symptoms of burning sensation. Patch tests may identify such lesions but are not routinely recommended and hence diagnosis depends mainly on clinico-pathologic correlation. Histopathology has certain limitations due to overlap of findings with oral lichen planus. But with the advent of immuno-histochemical markers this pitfall can also be rectified. Treatment in case of dental material associated lesion involves simply removal/ replacement of the culprit material. We report a case of oral lichenoid reaction due to dental amalgam restoration which was successfully diagnosed and treated.