A Challenge to Diagnose Amalgam Associated Lichenoid Reaction in Elderly Patient

Abstract

<p class="AbstractContent"><strong>Introduction:</strong> Several studies reported the association between erosive oral lichenoid reaction (OLR) and amalgam which often arises without symptoms and rarely becomes chief complaint of patient in contrast with its local inflammatory reaction. Amalgam filling was popular in elderly patients. A decline in the protective functions of the oral mucosa could expose elder people to a variety of chemicals and put them in the higher risk to suffer from OLR.</p><p class="AbstractContent"><strong>Case Report</strong>: A 70-year-old female patient has chief complaints of taste loss and dry mouth. In the next scheduled visit, operator found a non-scrapable reticular with a reddish inflamed area on buccal mucosa adjacent to amalgam fillings which was painful when being stretched. The Amalgam filling associated OLR diagnosis was established. The lesion was reduced significantly after replacing amalgam filling followed by topical application of steroid. Many factors may contribute as the challenging factors for undetected OLR lesion during the first visit such as elderly altering mental status and pain perception.</p><strong>Conclusion:</strong> Although the Amalgam filling associated OLR was a relatively common lesion in the elderly, factors that contribute as challenging factors to diagnose OLR must be comprehended by the dentist, in order to have a precise diagnosis.