The World Health Organization has defined oral leukoplakia (OL) as "a white patch or plaque of the oral mucosa that cannot be characterized clinically or pathologically as any other disease". A 21-year-old male with OL presented with a bilateral burning sensation in the buccal mucosa. The patient had amalgam restorations, and an epicutaneous patch test indicated a positive response to amalgam. The amalgam restorations were therefore removed and the cavities were refilled with a composite resin restorative material. During 5 years of follow-up, there was no recurrence of the oral lesions. This case illustrates that amalgam fillings may cause OL lesions.