Dear Dr. Hall,
My husband is in the process of receiving dental implants, “all on 4’s,” in the front, on top. He has had the temporary teeth placed in his mouth and we are waiting for the permanent teeth to be implanted. Here’s the problem: I suffer from chemical sensitivity and I am reacting to one of the substances in his mouth. Whenever I get close to him (especially at night), his mouth smells like rubber. I have to pull the covers over my face, the smell is so strong.
The posts are made from titanium, the teeth that he has in now are acrylic, and the permanent teeth will be porcelain. The posts are screwed very tight in his jaw, and my husband isn’t thrilled at the prospect of having them removed. I understand how he feels, but I will have to be living with this chemical exposure on a long term basis, which is not good for my health . . . or his!
The oral surgeon said that the titanium posts were the only ones that work for his particular situation. Of course, oral surgeons follow the “standard of care,” and don’t make it their business to be concerned about environmental health and educating themselves on alternative options.
What are your thoughts on replacing the posts with a less toxic material?
– Joan Marie
(See Dr. Hall’s answer below.)
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Dear Joan Marie,
I think there are several options to what you are smelling in your husband’s mouth, and it is very unlikely for that to be the titanium implant posts. The titanium posts are embedded in the bone and I can’t imagine that they are giving off any smell at all. Even with titanium exposed to the air, it’s very inert so I don’t believe it gives off any smell. You could test that by asking the dentist to let you smell one of the implant fixtures.
It’s possible you’re smelling the acrylic in the temporary teeth. Acrylic does give off a very slight smell. It is also possible that there is food debris collecting somewhere in his mouth, maybe under the temporary implant denture, and that’s what you’re smelling. If that’s the case, I’d check with the dentist to find a way to improve the oral hygiene of the case. Possibly a Waterpik would help clean out under the denture better. Rinsing with hydrogen peroxide can also help clean out old food debris, but you have to be careful not to use the peroxide for more than a couple of weeks or it will stimulate the growth of an oral yeast infection.
About replacing the titanium posts, that would be several involved surgical procedures. It’s not just that they are screwed into the bone. After they are placed, there is a process called osseointegration that occurs where the bone fuses to the titanium. So the posts would have to be surgically removed with some of the attached bone. That would mean that bone grafting would have to be placed to grow some of the bone back, which would take a few months. Then new holes would have to be made in the bone for zirconia posts, which is the alternative to titanium. And then it can’t be absolutely guaranteed that there will not be any sensitivity reaction to the zirconia. Titanium is a very bio-compatible material with very rare instances of sensitivity. The same is true of zirconia. Neither one has an undisputed record of no sensitivity. See my blog posts about titanium allergy and zirconia allergy.
Another point that occurs to me is that, while you are complaining about the smell, you haven’t said that you have had an actual sensitivity reaction. I don’t know if you could clarify that.
All things considered, I think it would be a risky proposition to try replacing the titanium posts when that is probably not the source of the smell and even if it were there is no guarantee that the zirconia would be any better.
– Dr. Hall
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