Nickel Allergies and Dental Health

Photo by Quang Tri NGUYEN on Unsplash.

Our oral health is the gateway to overall health and well being. There’s nothing worse than having a tooth ache! 

Often heavy metals can be contained in the dental care we receive. There is plenty of research highlighting nickel allergies from braces, wires and other orthodontic devices. Some metal dentistry devices or implants can contribute to an individual’s systemic nickel allergy. The amount of nickel from dental devices tends to be significantly less than that ingesting foods higher in nickel.

If you know you’re already hypersensitive to nickel, it might be wise to discuss potential options with your dentist and doctor. Some of the research recommends metal allergy patch testing prior to surgery, so whatever is impacted into the body doesn’t cause an adverse reaction. In September 2019, the FDA’s Center for Devices and Radiological Health published an extensive article noting the Biological Responses to Metal Implants. The brief includes information about how the the immune system responds to metal implants and the specifics of dental implants, orthopedic, neurologic, cardiovascular, and urogenital devices and the local tissue and organ inflammatory responses to metal implants.

Many of us may have had braces or received other dental care that could be contributing to our systemic nickel allergy and we may not realize this fact. Focused on what I eat and the cookware used to make it, I neglected to consider how my stainless steel retainer, cemented on my front teeth for nearly 20 years, could be impacting my nickel allergy. 

At 13 I had very crooked teeth and a massive overbite. Grateful my parents invested in me and my smile, I had braces installed when I was 13 for nearly 2 years. Little did I know that by the age of 24, I’d be diagnosed with a systemic nickel allergy. Fast forward another 10 years I’ve been working towards living low nickel. However it wasn’t until last summer when I had my first root canal that I replaced my stainless steel permanent retainer with a removable nickel free plastic retainer. In hindsight, I probably should have tried using the invisalign to correct my teeth rather than stainless steel braces. However, neither my parents nor I knew back then that I would develop such a severe nickel allergy as an adult. 

To avoid serious dental issues, I love visiting the dentist for preventative dental care. Until recently, I never used to ask my dentist to thoroughly discuss what he planned to use in my mouth and whether or not the product may contain nickel. Personally I am less worried about their tools containing nickel from stainless steel, as I only visit the dentist for 30-45 minutes twice a year. My main interest is avoiding anything being permanently add to my mouth that may contain nickel and how over time it could impact systemic nickel allergy. Luckily I only have a few fillings and I feel fortunate that a plastic resin was used. Amalgam fillings can include some heavy metals, however I cannot speak to whether nickel or stainless steel is a common ingredient that may used in amalgam fillings. 

This past summer, I chose to delay my standard 6 month dental cleaning and extra couple of months because the COVID-19 case count was at an all time high. Before my visit, I had an extensive conversation about what practices and safety protocols my dentist office is taking to prevent exposure for both their patients and staff. Their protocols put me at ease and I finally got my teeth cleaned, last month, where the oral hygienist ravaged my gums for nearly an hour.

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Besides seeking preventative dental care, what else should you consider when caring for your overall oral health when living with a nickel allergy?

Unfortunately many toothpaste products contain additives, sugars, and sodium lauryl sulfate (SLS), a cheap bubbling agent added to many cosmetic products. Using products that contained SLS sensitized and irritated my scalp and gums. I also try my best to avoid unnecessary additives or ingredients high in nickel like soy, oats, nuts or seeds. I can’t eat coconut, but I haven’t had any issues using either toothpaste or shampoos that contain coconut derived ingredients.

I use this Burt’s Bees Extra White with Fluoride Zen Peppermint (affiliate link). Burt’s Bees does offer a similar toothpaste without Fluoride. Both include coconut ingredients, but their toothpaste does not include many of the other terrible fillers found in other toothpastes. 

Consistent when seeking any health care, you have to be your own advocate and inform your providers of your severe nickel allergy. This may involve preparing before your visit to identify a list of questions you want answered. These questions may need to include what companies or manufacturers your dentist partners with to verify whether or not ortho-device or product is nickel free. 

If you’re concerned about what’s in your mouth, it’s best to consult a dental health professional, including a dentist, endodontist or orthodontist. 

What other tips or nickel free dental products do you love to use? Do you regularly keep your dentist updated about your nickel allergy? I’d enjoy hearing about your suggestions or learn more from your experience in the comment section below.

More Research on Nickel Allergies and Dental Care:

Chakravarthi S, Padmanabhan S, Chitharanjan AB. Allergy and orthodontics. J Orthod Sci. 2012;1(4):83-87. doi:10.4103/2278-0203.105871.

IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 13, Issue 7 Ver. I (July. 2014), PP 28-29.

Kolokitha OE, Chatzistavrou E. A severe reaction to ni-containing orthodontic appliances. Angle Orthod. 2009 Jan;79(1):186-92. doi: 10.2319/111507-531.1. PMID: 19123714.

Pazzini, Camila Alessandra, Marques, Leandro Silva, Pereira, Luciano José, Corrêa-Faria, Patrícia, & Paiva, Saul Martins. (2011). Allergic reactions and nickel-free braces: a systematic review. Brazilian Oral Research, 25(1), 85-90. https://doi.org/10.1590/S1806-83242011000100015.

Kulkarni, P., Agrawal, S., Bansal, A., Jain, A., Tiwari, U., & Anand, A. (2016). Assessment of nickel release from various dental appliances used routinely in pediatric dentistry. Indian journal of dentistry, 7(2), 81–85. https://doi.org/10.4103/0975-962X.184649.

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