Galvanic pain

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Galvanic pain (also called galvanic shock),[1] is an unusual type of dental pain caused by an electrochemical circuit formed when adjacent or opposing dental restorations made of dissimilar metal alloys (e.g. amalgam and gold)[1] come into contact in the presence of saliva.[2] When the metals contact, saliva can act as an electrolyte, creating a galvanic cell and causing galvanic corrosion of the metals to gradually take place,[1] and a sudden, small amount of electric current is generated, flowing through oral tissues and stimulating the nerves in the dental pulp.[1][2]

Diagnosis[edit]

There may also be a metallic taste in the mouth due to release of metal ions.[1] Placing a layer of rubber (e.g. a dental dam) between the dissimilar metals and observing if the pain is gone is diagnostic for galvanic pain.[3]

Prevention and management[edit]

The placement of dissimilar alloys in teeth where they will be in continuous (e.g. adjacent) or intermittent (e.g. opposing) contact is not advised by some,[2] while others advise to use a cavity lining underneath the metallic filling in situations where there will be contact with a dissimilar metal.[1] Long term galvanic pain is unlikely because polarization will likely occur,[1] or corrosion products will coat the external surface of alloy and act as an insulating layer against further galvanism.[3] Others therefore argue that because galvanic pain is generally short-living and self-limiting, concern about galvanic pain should not factor into the clinical decision of what restorative material to use.[3] The treatment depends upon the level of pain. If there is minimal pain, then the dentist typically just waits to see if the situation will resolve itself.[3]

Treatment of galvanic pain which is severe or does not resolve by itself may include placing a layer of varnish, resin, or non-metallic restorative material over the offending metal to break the contact between the dissimilar metals.[1][3]

References[edit]

  1. ^ a b c d e f g h Soratur, S.H. (2002). Essentials of dental materials (1st ed.). New Delhi: Jaypee Bros. Medical Publishers. pp. 50,100,101. ISBN 9788171799893. 
  2. ^ a b c Davis, edited by J.R. (2003). Handbook of materials for medical devices. Materials Park, OH: ASM International. p. 224. ISBN 9781615032594. 
  3. ^ a b c d e Williamson, R (Jan–Feb 1996). "Clinical management of galvanic current between gold and amalgam.". General dentistry 44 (1): 70–3. PMID 8940574.