Could you be allergic to titanium dental implants?

Could you be allergic to titanium dental implants?

Could you be allergic to titanium dental implants?

For most men and women, dental implants help them to enjoy better oral function after tooth loss, improved facial aesthetics, and greater confidence. And for millions of patients, the process of getting an implant is just another day in their life, without the trouble of complications or side effects. For others, however, this is not the case. Individuals who suffer from allergic reactions to titanium, a metal used in implants, will experience various problems. Here, we’ll discuss what patients need to know about titanium allergies to understand their risk of getting an allergic reaction and other options that they can take.

Are Titanium Allergies Common?

Thankfully, titanium allergies are quite rare, with just 0.6% of cases occurring, as found by a study. This means that roughly 1.8 million people in the country may have an allergy to titanium. Other studies claim that the hypersensitivity or allergic reaction to titanium can be much higher in others and when they occur, mild to severe symptoms may include:

  • – Hives or rash
  • – Implant failure or looseness 
  • – Swelling and sores in the tissues around the mouth
  • – Persistent inflammation of the gums near the implant
  • – Slowed healing of the wound
  • – Inflammation or acne-like swelling of the face
  • – Chronic fatigue syndrome
  • – Joint and muscle aches
  • – Neurological problems

While the risk of titanium for most people is quite low, those who do have it can have a significant impact on their health and wellness. Now, the next question is, how do people know if they are allergic to titanium? 

Titanium Allergy Test

Most allergies are diagnosed using a quick and easy method known as a skin patch test, where a suspected allergen is applied to small areas of the skin (usually the back.) These areas are then covered in waterproof bandages to sit for some time. When the needed time has passed, the treated areas are then evaluated for any sign of irritation which indicates an allergic reaction.  

Unfortunately, skin patch tests are only ideal to use for certain types of allergies and may not be completely accurate for others, such as titanium allergies. Experts use a test called MELISA (Memory Lymphocyte Immunostimulation Assay) to test for titanium allergies. This test uses a sample of the patient’s blood, where their white blood cells are isolated and are then exposed to titanium. In a span of days, the sample is analyzed for allergic reactions. 

MELISA is able to produce a much more accurate result compared to a traditional skin patch allergy test. This is especially true in applications where the titanium comes in contact with soft tissues and bones. Apart from its role in dentistry, MELISA is used in joint replacement surgery to test for metal allergies, while it’s also used in industries where metal allergies need to be determined. Below is a table of some metal allergies that can be detected using MELISA.

Is MELISA Accurate?

MELISA is considered to be much more accurate compared to skin patch tests since this method shows how the metal reacts directly to the blood and tissue inside the body instead of just the skin’s surface. There are, however, a few studies that question the reliability and accuracy of this test. One of these studies from 2016 claimed that 57% of patients who had allergies to titanium also had a reaction to other metals such as nickel. This news comes as a concern because even puro titanium can contain trace amounts of nickel. This means that if a patient has an allergy to nickel, they might also have unwanted reactions to dental implants made from the same metal. 

Unfortunately, nickel allergies are incredibly common — after poison ivy, nickel is the second most common cause of allergic skin rashes. Furthermore, MELISA has yet to be proven 100% accurate by research and medical communities, leaving it wide open for patients to decide if they will trust the process and hope for the best before getting their implants. Because of this, many patients — even those who are known not to have allergies to titanium — look for other solutions to replace missing teeth and opt to avoid the possible side effects connected to titanium allergic reactions.

Alternatives to Titanium Dental Implants

1. Zirconia Dental Implants

Should a patient find themselves allergic to titanium, there’s no need to panic. Thanks to technology, people won’t have to turn to bridges or dentures if they want to proceed with an implant. For those who test positive for titanium allergies, zirconia dental implants provide a great solution. Because zirconia is made primarily of ceramic instead of titanium, patients won’t have to worry about getting any allergic reactions.

People question, however, why zirconia implants aren’t the standard go-to tool for these procedures. This is because unlike titanium implants, zirconia lacks some features such as attachments and a two-part design that help to keep an implant stable. And while zirconia implants clearly have both pros and cons, these can be an excellent choice for anyone who has titanium allergies but still wants the benefit that an implant brings.

2. Bridges for Tooth Replacement

Implants aren’t the only answer to replace a missing tooth, and before they came into the dentistry industry, people solely relied on bridges to close out the gap left from a lost tooth. For many patients, getting a bridge can be a safe and reliable option. Traditional bridges (as seen below) may feature one or more “pontics” or artificial teeth that are supported by the original teeth by the sides of the gap. These teeth are given crowns to securely hold the tooth before the bridge is set, which then allows for any force on the artificial tooth to be assisted by the teeth right next to it. 

However, this means that a significant amount of tooth material will have to be removed from the neighboring teeth to give room for attaching the crowns. Keep in mind though, once the material is removed from the teeth, they will have an increased risk of fractures, recurrent decay, and root canals. On the bright side, bridges tend to have a long and successful record to help restore aesthetics and function after tooth loss, making them a popular choice among patients.

A Maryland bridge has a different attachment and design process which gets rid of the need to remove any surface material from the healthy teeth. As an alternative, the bridge is set in place using an adhesive resin to attach it to one or both of the neighboring teeth, which results in not having to remove teeth most of the time. This procedure eliminates the risk associated with traditional bridges. 

The downside is that the resin used isn’t as strong or durable as the traditional bridge, which may lead to the debonding of the pontic (artificial tooth) or fractures when an excessive force such as biting and chewing is used. So bear in mind that while these bridges are an attractive option, they focus on aesthetic enhancement, rather than a functional replacement for a patient’s lost tooth.

3. Partial Dentures

An option that has stood the test of time when a patient needs to replace one or more teeth is through a partial denture. This is a removable tool that sits on the gums left by the missing teeth or tooth. While partial dentures are usually the less expensive choice, many people don’t choose a device that has a risk of slipping and also don’t want to go through having to remove the dentures at night as they sleep. Moreover, partial dentures have rigid metal frames that provide strength and stability but unfortunately, it can be seen in a few areas and may also be uncomfortable in some patients who suffer from sensitivity or allergies.

There are, however, options that provide all-plastic dentures, but these aren’t as functional as traditional dentures are since they don’t have a sturdy metal frame. But no matter which option the patient chooses, it is estimated that partial dentures can provide 25% usage of a real tooth, bridge, or implant.


While it is rare for people to have an allergic reaction to titanium, they persist to be a real risk to this day. Because of this, it’s best for patients to consider calling a dentist to have a MELISA test performed to check if they have any allergies to titanium to avoid any unexpected side effects. Should a patient be allergic to titanium or if they think they might be, always remember that there are plenty of other options that they can discuss with their dentist to help them achieve the smile they always wanted. Thanks to advancement in our technology, anyone can now enjoy teeth restoration and maintain a healthy smile through many different ways, whether they’re allergic to titanium or not.

Join Dr. Simone Deliperi for our next Webinar on January 30th, 2021 at 4pm New York Eastern Time