[General health damage by restorations of composite]

It seems warranted to state that the fourth generation bonding systems have diminished the probability of bacterial damage to the dental pulp. Dentin and in particular the bonding system may protect the pulp partly at least against toxic side-effects of the numerous components leaching from the composite and against the temperature rise caused by the setting reaction. Generalized toxic side-effects caused by the substances released by the restoration and its bonding system are not impossible and are suspected because of in vitro research, but they are assessed to be unlikely in vivo. Generalized and local allergic reactions may appear. The prevalence of allergy to composite may be higher than due to dental silver amalgam, lichenoid lesions excepted. Yet, allergic reactions are not often reported, supposedly because it is either not observed or possibly due to a lack in awareness of such symptoms.