[Amalgam problems: recommendations on patient assessment and counseling].

Assessment of patients with alleged or supposed amalgam-associated problems is difficult. Various methods, classified as medical, dental and "traditional" are discussed. Medical methods comprise epicutaneous sensitivity testing and determination of the mercury concentration of various body fluids such as saliva, urine and blood. Patients with amalgam restorations regularly exhibit increased readings. However, such measurements are not very appropriate since there are no generally applicable threshold values. Dental examination focuses primarily on oral lichenoid lesions of the mucosa in the vicinity of alloy restorations. Aggravation of a patient's general health status and/or exacerbation of pre-existing symptoms following the insertion or removal of an alloy filling may be indicative for amalgam incompatibility. Recommendations for everyday practice are given.