Rationale for Removal of Dental Amalgam Restoration in a Patient with Systemic Lupus Erythematosus: A Case Based Perspective

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune dysregulation and a high prevalence of oral and perioral manifestations that may complicate dental management. Although dental amalgam remains a safe and durable restorative material for the general population, its mercury content and immunomodulatory properties raise specific considerations in patients with underlying autoimmune disease. This case based manuscript examines the scientific and clinical rationale for removal of dental amalgam restorations in a patient with SLE, with particular emphasis on immune susceptibility, oral mucosal findings, and evidence derived from hypersensitivity and autoimmune literature. Current epidemiologic data do not support a causal relationship between dental amalgam exposure and the development of SLE; however, selected patients may exhibit heightened immune responsiveness or localized oral reactions that warrant individualized clinical intervention. By integrating existing evidence with common oral examination findings, this report provides a balanced, evidence based framework for clinicians considering amalgam removal as an adjunctive strategy in the dental management of patients with SLE.