Palladium in dental alloys--the dermatologists' responsibility to warn?

Palladium is increasingly used in industry, but also in fine jewelry and in dentistry. Thus, palladium-silver alloys comprise a substantial part of the noble metal ceramic alloy sales in Western countries. The increased use of this metal seems, however, to be paralleled by a rise in the number of reports of palladium allergy. Recently a European study reported a sensitization rate of 2.8%. In Austria, where palladium has started to displace amalgam in dental fillings because of concerns about mercury toxicity, and gold due to price factors, we have found a sensitization rate of 8.3% in unselected eczema patients. Despite the current lack of clear clinical relevance of this finding, these numbers should motivate us to question this substance as "the alloy of the future".