I have recently been diagnosed with a titanium allergy. I have two crowns on my left side, upper and lower. I have various odd symptoms that have been addressed with my dentist. They have been checked out and I’ve been told everything “looks” fine. The dull ache surrounding my upper remains. I’m wondering if I have a titanium post and if this is possibly contributing to this dull ache and possibly other unexplained ailments throughout my body. Where do I go from here?
– Jennifer from Kentucky
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Titanium allergy used to be considered very rare, but with the increasing use of dental and orthopedic implants, which almost always use titanium, there are increasing reports of titanium allergy. The MELISA Medica Foundation, which conducts the MELISA test for metal sensitivities, estimates that as many as 4% of the population could be allergic to titanium. However, this test has been criticized as generating false positives, and my guess would be that titanium allergy is less prevalent than that.
Titanium is a very biocompatible metal, apparently due to its high corrosion resistance. Given this corrosion resistance, I would not think that the presence of titanium in a post inside of a tooth would affect tissues outside of the tooth, but I guess that would be possible. If you want to investigate that, I would just go to the dentist that put the post in your tooth and ask if it is titanium. Your dentist should have a record of the type of post that was inserted. I will add that there should only be a post in your tooth if the tooth has had a root canal treatment.
Metal posts are often used in root canal teeth to help retain the buildup that is placed in the tooth and the buildup in turn helps retain the crown on the tooth. For many years, stainless steel posts were the standard. Stainless steel contains nickel, and it is estimated that 10 to 20% of people are allergic to nickel. It was assumed that this wasn’t an issue, because the post was sealed inside the tooth and not in contact with living tissue. Then, about 30 years ago, it was discovered that corrosion products from the stainless steel could leach through the teeth and many dentists, including me, switched to using titanium posts.
Could your dull ache be from a metal sensitivity? I would say that it could. I would wonder if there is any metal in the crowns you have—that is something worth checking also. There could also be a problem with the occlusion of the crowns. In any of these scenarios, everything would “look fine,” but that doesn’t mean that everything actually is fine.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
In this woman’s case, if the post is causing her problems, are these posts easy to replace? If not, what options are available? – Annmarie
Response by Dr. Hall
I didn’t address that possible problem, but the posts are very difficult to remove from the tooth and trying to remove a post could potentially damage the tooth irreparably.
Are there metal-free dentists around that could help this individual? Or is “metal-free” a marketing gimmick?
Response by Dr. Hall:
More and more dentists lately are becoming “metal-free,” or, if they use metal in restorations, they use less and less.