Stomatitis or systemically-induced contact dermatitis from metal wire in orthodontic materials

5 patients with dermatitis or stomatitis related to the use of orthodontic appliances are described. All the patients were patch tested with the European standard series. One had a ++ reaction to potassium dichromate, one a ++ reaction to nickel, and the remaining 3 no positive patch tests. 3 of the patients had recurrent vesicular hand eczema, which flared after oral challenge with 1 of the metals used in their orthodontic appliances. 2 of these 3 patients had negative patch tests. The dermatitis of 4 of the 5 patients cleared completely upon the removal of their metal orthodontic appliances or their replacement with appliances made of acrylics.