Dental Implants Metal Allergy

Dental implants are considered the gold standard for dental restorations. With dental implants, skilled oral surgeons can replicate the natural arrangement of roots and teeth, creating dental restorations that look and function just like healthy, strong natural teeth. The dental implant post replaces the root of a natural tooth, stimulating the bone that encompasses it and securely supporting a dental crown, which is a ceramic artificial tooth that is crafted to match the color and glow of the surrounding natural teeth. Dental implant posts are usually made of titanium, a material that has a long history of proven effectiveness for medical implants. If you have a metal allergy, you might assume that this means you’re ineligible for dental implant treatment, but this is probably not the case. It’s helpful to understand the ins and outs of allergies and implants before you decide if implants could still work for you.

Foreign substances enter the body all the time, in the foods we eat, the plants and animals we touch, and the air we breathe, for example. When certain specific substances enter the body and a person is allergic to them, they cause the immune system to overreact. Sometimes, these immune responses show up as a simple rash that goes away when the allergen is removed, and sometimes, they can cause life-threatening responses, and different allergens affect different people in different ways. It’s possible to be allergic to pretty much anything, and many people are allergic to metals. Most of the time, metal allergies are triggered by nickel, which can be present in inexpensive jewelry and cause contact allergy responses like redness, itching, and infection on the skin. Cobalt and chromium are also allergenic for some people, but again, these are usually exposed only to the skin. When a person with a metal allergy has metal surgically placed in their body, the allergic reaction occurs there, and the body rejects the implant.

Historically, dentists have used metal in routine dental procedures, like fillings to repair cavities. The metal used for these treatments is a metal amalgam that is made specifically for dental use. This amalgam is a combination of precious metals, like silver and gold, mixed with copper, tin, and, historically, small amounts of mercury. The formula for dental amalgam has a practical purpose, with each metal contributing characteristics that make it beneficial for clinical uses. Dental amalgam has been used safely for centuries, but there have been some infrequent cases of rashes or inflammation caused by dental amalgam. If this concerns you, know that the metal used for dental implants is very different from the dental amalgam used for less invasive dental procedures.

The beneficial properties of titanium were first discovered in the 1950s, and titanium was first used for medical and dental implants shortly thereafter. Titanium is consistently lauded for its effectiveness in medical and dental applications because it is osseophilic, which means that it is attractive to bone tissue. Bone tissue is stimulated by the presence of titanium in the bone, which encourages bone cells to develop and adhere to the metal. As a titanium implant site heals, the bone and implant fuse together, in a process called osseointegration, creating a durable bond between the two and making the implant a permanent part of the body. When people are allergic to metals like nickel, they may assume they’re also allergic to titanium, but this is often not the case. Titanium is an inert metal that rarely triggers reactions; in some studies, as few as .6% of implant recipients had an adverse reaction to the metal. Be sure to work with a reputable, skilled oral surgeon who uses high-quality components that are certified pure titanium, and ask about testing to determine whether you’re allergic to titanium if you’re concerned. Some dentists use skin patch tests for allergies, but blood tests are more accurate. The MELISA test isolates white blood cells, where allergic reactions occur, and exposes them to titanium to measure their immune response; this is the recommended test for allergies as rare as titanium allergies. Allergic reactions to contact with titanium dental implants, when it does occur, includes hives and lesions in the mouth, patches of dry gum tissue, swelling, and inflammation surrounding the implant. Of course, if these symptoms occur, the only solution is to remove the implant.

If your dentist determines that you’re not a good candidate for titanium implants, or if you simply don’t want to have metal permanently placed in your body, dental implants could still be an option. Thanks to advances in dental technology, zirconia implants can work well for people who want dental implants but don’t want metal in their body. Zirconia is highly inert and has a very low risk of allergic reaction, and it has demonstrated effective osseointegration at rates comparable to titanium. It’s strong, stable, and resistant to bacteria, and zirconia itself is white, like teeth, which helps zirconia implants remain completely camouflaged in the gums. Not all implant designs or arrangements can be accommodated with zirconia, but in many cases, zirconia implants are appropriate and effective. Zirconia implants were developed relatively recently, in 1987, and are now widely used. Because they’re relatively new, however, there aren’t as many options for different implant components, so they may not be appropriate for more complex dental restorations that require several different shapes or types of implants. Their shorter history also means there’s less data available about their long-term success, though studies indicate that they show great promise for people who want dental implants without titanium.

If you and your dentist determine that you’re ineligible for titanium implants and also zirconia implants, either because of allergy or for other reasons, you may want to consider a dental bridge. Dental bridges are long-term dental restorations that use dental crowns on adjacent sides to support an artificial tooth or row of a few teeth; they’re used to restore gaps where teeth are missing. Dental implants and dental bridges can last a long time when cared for properly, and both are cared for like natural teeth, by brushing the teeth twice daily and flossing daily and seeing the dentist regularly. Your dentist can also clean your dental restoration with professional tools, making sure to avoid damaging the visible ceramic material and cleaning around the dental restoration where your toothbrush can’t reach. This will help your dental restoration stay strong, attractive, and safely in your mouth for a long time to come.