Galvanic phenomena occurring in the mouth strips in the treatment of dental patients. Their influence on the functional state of organs and tissues of the oral cavity. Causes of galvanic syndrome: why there is a "current" in the mouth

From Galvani's first experience, it is known that dissimilar metals are a source of the so-called galvanic current, which can irritate living tissues. This should be taken into account by a dentist when prosthetics and filling teeth with dissimilar metals (gold, stainless steel, amalgams), which act as electrodes; while saliva is an electrolyte. The release of metal ions into saliva creates a condition for the occurrence of microcurrents of various sizes in the oral cavity. The strength of the resulting current depends on the pH of the saliva, the state of the metal surface, the quality of the metal prostheses and their distance from each other.

In some cases, a potential difference also arises between metals of the same name, for example, between amalgam alloys of different compositions or between crowns made of identical metals if there is a metal filling under them. Microcurrents arising in the mouth can cause a phenomenon that is called galvanism in dentistry. Galvanic currents arising in the mouth, in the presence of different metals, cause increased irritability of taste reception and some perversion of taste sensations.

The most common symptoms of galvanism: constant burning of the oral mucosa of various localization (80%); - metallic and sour taste, which usually appears 3-5 months after prosthetics (70%); salivation disorder (58%); headache(47%); insomnia (19%); pain in the abdomen (8%); vomiting (3%)% feeling of sparks in the eyes (1%). As a rule, several symptoms appear at once, often patients cannot identify them specifically, but experience only a feeling of discomfort. Chronic inflammation of the oral mucosa may develop: it becomes hyperemic, the papillae of the tongue swell, erosions and ulcers occur.

As a result of electrochemical processes in the oral cavity, a large amount of trace elements and metal ions will enter saliva from metals (especially from solder). As a result of their toxic effect on the receptor apparatus of the oral mucosa, local inflammation processes develop. The taste sensitivity to sweet, sour and salty is reduced and perverted. This can lead to a violation of the mechanical and chemical processing of food in the oral cavity and speech production. In addition, when such saliva enters the digestive tract and the action of trace elements of saliva on the mucous membrane of the stomach and intestines, exacerbations of chronic gastrointestinal diseases can occur.

The strength of the current that occurs between dissimilar metals correlates with the degree of subjective complaints. At a current of 80 μA, the phenomena of galvanism are strongly pronounced, at 25-80 μA there are weak sensations, and at 5 μA there are practically no complaints. After the replacement of dissimilar metals by homogeneous, the phenomena of galvanism disappear.

In dentistry, electric current is also used for therapeutic purposes. The use of continuous low voltage direct current (30-80 V) and small power (up to 50 mA) for medicinal purposes is called galvanization. Under the action of direct current in the oral mucosa, vasodilation occurs, blood flow is accelerated, and the permeability of the vascular wall increases, which is accompanied by hyperemia and fever. Such reactions contribute to the activation of local metabolism, regeneration of the epithelium and connective tissue. Irritation of receptors in the affected area leads to a change in their excitability. At the same time, afferent impulsation in the central nervous system causes reflex reactions of local, segmental and generalized type, which leads to a change in the functions of internal organs (blood pressure, heart rate, etc.).

By using electric current you can enter medicinal substances in the tooth tissue (drug electrophoresis). Finally, direct electric current is used to prevent pain during various dental interventions. The analgesic effect of direct current is associated with the development of electric tone phenomena in tissues, causing a change in their excitability during the passage of current. At the same time, excitability increases under the cathode (kathelektroton), under the anode it decreases (anelectroton). With prolonged current transmission, excitability also decreases under the cathode (Verigo's cathodic depression phenomenon).

Question #4

Electromyography is a method for studying the motor apparatus, based on the registration of skeletal muscle biopotentials.

EMG founded on registration of action potentials of muscle fibers functioning as part of motor (motor, or neuromotor) units.

motor unit(ME) consists of motor neuron and group of muscle fibers innervated by this motor neuron. AT chewing Muscles have about 100 muscle fibers per motor neuron. temporal- up to 200.

The action potential of a single ME when registered with a needle electrode usually has the form of a 2-3 phase oscillation with an amplitude of 100-3000 μV and a duration of 2-10 ms.

EMG reflects the degree of motor innervation, indirectly indicates the intensity of contraction of an individual muscle.

Vibrations are recorded with a special device - electromyograph.

Galvanosis is a pathology of the oral cavity, due to the presence of various metals in the patient. They cause a difference in electrical potentials. The patient may experience symptoms such as a burning tongue, a change in taste perception, and a decrease in saliva production. Worsening is not ruled out general condition – general weakness, increased physical and mental fatigue, mental lability (irritability) and an unmotivated feeling of anxiety.

Causes of galvanosis

Galvanization is dental disease due to intolerance to structures made of various metal alloys. Against their background, galvanic currents appear, electrical conductivity increases, and, as a result, symptoms of irritation of the oral mucosa. Some patients are diagnosed general malaise, the cause of which can be quite difficult to diagnose.

According to statistics, from 15 to 35% of patients who have previously undergone treatment and prosthetics are subject to galvanization.

Normally, electrochemical processes are recorded in the oral cavity, but they tend to significantly increase their intensity in the presence of amalgam fillings, metal inlays, as well as non-removable metal prostheses, and orthodontic structures. Galvanosis can also be provoked. The symptoms are especially pronounced in the presence of corrosion on the elements of individual prostheses.

The strength of the current and the difference in electrical potentials increases in proportion to the content of metal oxides in saliva. Some experts consider the presence of a difference not as an independent pathology, but as one of the suggestive factors, against which the risk of oral pathologies increases. The term "galvanism" is used only for obvious irritations of the oral cavity and signs of general malaise.

Predisposing factors include:

  • mechanical damage artificial metal structures;
  • soft tissue injuries of the oral cavity;
  • violation of the rules for the operation of prostheses;
  • initial defects of bridges, inlays, etc.;
  • decrease in the pH of saliva under the influence of prostheses, leading to inflammation of the gums, periodontium and digestive tract.

Classification

In accordance with modern classification It is customary to distinguish between two main forms of pathology - typical and atypical.

On the background typical galvanism patients constantly complain of burning and dryness in oral cavity and . The potential difference is 3 or more units. On examination, reddening of the mucous membranes and signs of leukoplakia (the appearance of plaques or milky white plaque) are revealed. With this form, such general symptoms as moderate intensity, general weakness, decreased performance and constant irritability are almost always present.

For atypical variety the difference in electrical conductivity of the salivary fluid and the potential difference in the currents formed in the patient's mouth are characteristic by about three times compared to normal values. With this form, patients from time to time complain of dry mouth, periodic fatigue and a burning sensation of the tongue. The difference between the atypical form is that only one of the above symptoms is manifested.

Clinical signs

The symptomatology of the pathology most often manifests itself 1-2 months after the installation of a metal structure. In some cases, this period can be much less - 1-3 weeks.

Symptoms of galvanism:

  • sour (metallic) taste;
  • change in taste perception;
  • feeling of dryness in the mouth;
  • burning tongue.

The sour taste tends to intensify during the intake of sour and spicy foods nutrition. The change in taste is that sweet can seem bitter.

Against the background of long-lasting galvanosis, the patient's sleep is disturbed, and sharp drops moods. This symptomatology is a sign of a general decrease in the body's immunity, and failures of neuro-reflex connections in the body.

Diagnostics

To establish and verify the diagnosis, a dentist performs a general examination, collects a detailed history, and also measures potentiometric indicators using special equipment - microammeters, potentiometers and millivoltmeters. Additional research methods - facial area, immunogram, saliva analysis and skin allergy tests.

The normal indicators of the potential difference are from 60 to 140-180 mV, and the strength of the galvanic current is not higher than 5-6 μA. The excess of these indicators with a high degree of probability indicates galvanization.

note

For verification and differential diagnosis the patient may need to be examined by an oncologist, an allergist, and a neuropathologist.

Treatment of galvanosis of the oral cavity

Therapy of this pathology involves the elimination of the influence of the factors that caused the disorder. Mandatory removal metal tabs and prostheses, treatment of local inflammatory diseases of the oral cavity and general somatic diseases, as well as measures are being taken to strengthen general immunity.

If adequate measures are not taken in a timely manner, galvanosis causes inflammation of the mucous membranes, allergies due to the appearance of corrosion products in saliva, and also precancerous diseases(particularly leukoplakia).

The disease greatly increases the likelihood of developing malignant neoplasms oral cavity.

If symptoms of galvanosis are detected during the examination, it is first necessary to rid the patient of predisposing factors, i.e., remove metal structures from dissimilar alloys and with signs of oxidation. If this measure is ineffective, all prostheses with metal components should be removed and replaced with prostheses made of identical alloys.

After the replacement of structures, conservative (if necessary, and surgical) treatment of diseases of the oral mucosa is necessarily carried out, especially if we are talking about precancerous pathologies. At the same time, measures are being taken to strengthen common defensive forces organism. If neurological or vegetative-vascular disorders are diagnosed, the patient is prescribed a referral to a specialized specialist.

Galvanosis is a disease characterized by the occurrence of electric currents due to the presence of metal prostheses in the oral cavity.

Reason: the presence of prostheses in the oral cavity from different metal alloys.

Clinical picture

Discomfort in the mouth ( metallic taste, burning tongue, taste perversion, salivation disorders - often dry mouth), headaches, general well-being, irritability, carcinophobia. Unpleasant sensations in the oral cavity usually appear 1-2 months after prosthetics. The manifestations of galvanosis also include rhinitis, skin rashes.

When examining the oral cavity, hyperemia of the lateral surfaces and the tip of the tongue, swelling of the tongue, paresthesia, glossalgia are revealed. The presence of crowns, fillings from different metals is noted: gold and chrome-cobalt alloys, and other combinations. Oxide films are found in the area of ​​adhesions. Less commonly, on examination, changes can be detected: gray-white spots, ulcerative defects.

Diagnostics

  • Measurement of the potential value of metal elements of the oral cavity, current strength between metal prostheses. Normal electrochemical potential (ECP) in the oral cavity - 120-140 μV. If the ECP is above 140 μV, it is necessary to remove metal elements from the oral cavity if there are corresponding complaints.
  • Determination of pH, composition of saliva.
  • Allergy tests.

Differential Diagnosis:

  • Allergy to dentures.
  • Oral injuries.

Treatment of galvanosis

  • Removal of a metal prosthesis.
  • Selection of another material for prosthetics.

Treatment is prescribed only after confirmation of the diagnosis by a specialist doctor.

Essential drugs

There are contraindications. Specialist consultation is required.

  • (antifungal agent). Dosage regimen: inside, at a dose of 150 mg 1 time / day. The duration of the course of treatment is 7-14 days.
  • Terfenadine (antiallergic, antihistamine). Dosage regimen: inside, adults and children over 12 years old at a dose of 60 mg 2 times or 120 mg 1 time / day.
  • (immunomodulating agent). Dosage regimen: inside, adults and adolescents over 12 years of age, 1 table. 3-4 times / day. The duration of a continuous course of treatment is not more than 8 weeks.
  • (general tonic). Dosage regimen: inside, 20-40 drops 2 times / day. before meals. The course of treatment is 25-30 days.

Many patients who have partially changed crowns note that over time, unpleasant feeling- tingling, weak discharges of electricity, metallic taste. What are the reasons for this phenomenon? The question is answered by the portal expert, dentist the highest category, MD, doctor psychological sciences, professor Berlov Anton Vladimirovich.

This question existed from my point of view from that period of time when electrically conductive elements (products made of metals and their alloys) began to be used for treatment in dentistry. Style and lifestyle modern man most often dictates the need to have a beautiful natural smile, which, unfortunately, can only be returned with the help of an orthopedist.
Modern dentistry is armed with various metals and alloys, both noble (gold, platinum, silver) and base (stainless steel, cobalt-chrome alloy), etc.
When choosing fixed structures, most often, as practice shows, many patients, trying to reduce material costs, ask the doctor to cover the teeth included in the smile line with crowns that have exceptional aesthetics, which is naturally justified, and chewing teeth which are less noticeable when smiling and talking, the material is cheaper.

“As a result, an electric charge arises on a conductor immersed in an electrolyte (saliva), and an electrochemical potential difference arises between dissimilar conductors, i.e. a galvanic cell is formed.Accordingly, in the presence of various metal inclusions in the oral cavity, pathological effects on the human body are possible, such as: chemical-toxic, electrogalvanic and allergic. Such symptoms, based on practice, are observed in patients using non-precious metal bridges (mainly brazed structures, where solder of another type is used). chemical composition) and patients who use a combination of low-quality metals with noble ones.

Previously, this was called "denture metal alloy intolerance". Now, this is a typical form of galvanization.
Galvanosis is a disease that includes a complex clinical symptoms observed in the patient: metallic taste in the mouth, burning tongue, feeling of bitterness, feeling of electric current, change in salivation, deterioration in general condition, irritability, bad dream. As a rule, all these symptoms appear a few months after the introduction of metal structures into the oral cavity. As a result of a decrease in the protective factors of the body, patients often experience inflammatory complications in the maxillary soft tissues(gingivitis, papillitis, herpes, etc.). And also leukoplakia and other precancerous diseases of the mucous membrane are not excluded.
If all of the above symptoms occur, you should contact your orthopedic doctor to remove the "causal" metal inclusions.

Local immunocorrective therapy, general immunocorrective therapy, drug treatment local inflammatory manifestations and other types of complications.
To avoid all this, a competent selection of the designs of future bridges will help, a competent specialist who will take into account all possible long-term effects prosthetics and of course, which refers to the patient not to make attempts to save on their own health. Since the problems that arise in the future will require even greater material costs.

- a disease that occurs when there are metal prostheses in the oral cavity that change electrochemical processes and lead to the development of such symptoms as a metallic taste in the mouth, taste perversion, burning of the tongue, decreased salivation, a violation of the general condition of the body (headaches, irritability, weakness, fatigue, anxiety). Diagnosis includes the study of clinical symptoms and dental examination data, the measurement of potentiometric indicators. Treatment of galvanosis is complex: removal of the causative factor (prosthesis, inlays), immunocorrection, treatment of local inflammatory and general somatic diseases.

General information

Galvanosis is a pathological process that occurs in the oral cavity due to intolerance to dentures made of various metals. At the same time, excessive galvanic currents appear, the electrical conductivity of saliva increases, and clinical signs of irritation of the oral mucosa appear, and then general symptoms of the body's troubles.

According to statistics, intolerance to metal inclusions (crowns, bridges, inlays, implants) occurs in 15-35% of patients who visit a dentist. As a result, the importance of right choice materials for prosthetics and implantation, as well as timely elimination of defects and replacement of old dentures.

Causes of galvanosis

In the oral cavity and normal conditions certain electrochemical processes occur, but their intensity increases significantly in the presence of various metal inclusions - amalgam fillings and metal inlays, bridges and individual crowns, orthodontic appliances and implants. The picture deteriorates with simultaneous presence in the mouth of alloys of various metals, as well as as a result of damage and signs of corrosion of previously installed dentures.

The appearance of metal oxides in the oral fluid leads to an increase in galvanic currents (current strength and electrical potential difference). Galvanism occurs - a state in which healthy person the excess of potentiometric indicators above the norm is revealed in comparison with people who do not have any metal inclusions in their mouths. At the same time, the person does not present any health complaints, and during a dental examination, no signs of pathology of the oral cavity are detected.

We can say that galvanism is not a disease, but a predisposing factor that increases the risk of developing diseases. But in the presence of galvanism and the appearance of symptoms of irritation of the oral mucosa and common symptoms malaise, the diagnosis of galvanosis is established.

Predisposing risk factors for the development of the disease are the initial defects of metal inclusions installed in the oral cavity, mechanical damage to prostheses during their operation and changes in the pH of saliva to the acid side in periodontitis, stomatitis, diseases gastrointestinal tract.

Classification

Distinguish between atypical and typical shape galvanose. Atypical form galvanosis is characterized by an excess of potentiometric indicators (potential difference, galvanic current strength, electrical conductivity of saliva) in the oral cavity by three or more times compared to physiological norm and the presence of single clinical signs diseases - periodic complaints of "burning tongue", dry mouth, fatigue (usually only one of the listed symptoms bothers).

A typical form of galvanosis manifests itself along with an increase in potentiometric indicators by more than 3 times by constant clinical manifestations diseases - both local (metallic taste in the mouth, burning, dryness, identification during a dental examination of signs of mucosal hyperemia, stomatitis, gingivitis, leukoplakia, etc.) and general (weakness, irritability, headache, decreased performance).

Symptoms of galvanosis

The first signs of the disease appear, as a rule, 1-2 months after the installation of a metal denture, implant or orthodontic appliance (in some cases, this period is reduced to 1-3 weeks). In this case, there is an unpleasant sensation of a taste of metal in the mouth (“sour taste”, “acid in the mouth”, as the patients themselves say), which is aggravated by the use of spicy and sour food. The taste is often distorted ("sweet seems bitter"), there is a burning sensation of the tongue, dry mouth.

With the preservation of galvanism in the mouth for a long time, it begins to break down general well-being galvanic patient. Periodic headaches appear, the quality and duration of sleep are disturbed, general weakness worries, fast fatiguability, decreased performance, increased irritability, anxiety, mood swings. Such non-specific symptoms indicate violations of the neuro-reflex connections between organs and systems, a decrease in the body's resistance to the effects of adverse factors.

If the metal inclusions that caused the appearance of galvanism are not removed in a timely manner, they begin to develop in the oral cavity. inflammatory changes in the form of gingivitis, papillitis, stomatitis, and also allergic reactions associated with the release of metal corrosion products into saliva. Galvanosis, which persists for several years, often leads to the appearance of leukoplakia and other precancerous diseases of the oral mucosa, which significantly increases the risk of developing malignant neoplasms in this area.

Diagnosis of galvanosis

The diagnosis is established on the basis of complaints, dental examination data of patients with metal seals, crowns, bridges and other inclusions and measurement results of potentiometric indicators (if appropriate equipment is available).

Normally, the potential difference in the oral cavity in a healthy person does not exceed 60 mV, the strength of the galvanic current is not more than 5-6 μA, the conductivity of saliva is less than 5-6 μS. Measurements are made using special equipment– potentiometers, microammeters, millivoltmeters.

For differential diagnosis with others pathological processes oral cavity and general somatic diseases, if necessary, consultations of a gastroenterologist, allergist, oncologist, psychotherapist are prescribed, additional laboratory and instrumental research– saliva analysis, biochemical analysis blood, immunogram, skin-allergic tests, computed tomography facial skull and etc.

Treatment of galvanosis

When identifying signs of galvanosis, it is first necessary to eliminate causal factor which led to the development of the disease. To do this, a thorough examination is carried out with the identification of all metal inclusions in the oral cavity and the removal of problematic products (dissimilar metals, signs of corrosion). If the elimination of individual problematic crowns does not lead to an improvement in the patient's condition, it is necessary to remove all existing metal inclusions, after which full-fledged prosthetics are performed from homogeneous materials, not causing the appearance signs of galvanism.

The next step is the sanitation of the oral cavity, medical and surgical treatment identified inflammatory and precancerous diseases. Promotion in progress nonspecific resistance body (local and general immunocorrection is carried out). Treatment of identified vegetative-vascular, neurotic disorders is carried out with the involvement of specialists of the appropriate profile (therapist, neurologist, psychotherapist).

Prevention of galvanosis includes a thorough sanitation of the oral cavity with regular visits to the dentist (2 times a year), installation metal crowns, prostheses made of homogeneous metals, the use modern technologies production of dental products (one-piece cast constructions, full coverage of metal crowns with ceramics, rejection of soldered prostheses, etc.).

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