I had dental implant surgery about three months ago. I’m still in the healing stage and have not gotten the crown on top yet. Now, the area is pretty well healed up, but it has been driving me crazy this whole time. It’s like a deep itch that doesn’t ever seem to stop. My gums are red and irritated in the area too. I initially thought it was an infection and went back to the doctor. He says it’s not and that I just need to work on my hygiene, which TBH, was a bit offensive. I’ve always been good about keeping my teeth clean and I have never experienced anything at all like this.
I do have some metal allergies, so I asked about doing zirconia, but my dentist swore this wouldn’t be a problem because apparently, “nobody’s allergic to titanium.” It really feels like a problem though. Since my dentist seems set on blaming me, is there something I can do check or deal with this, aside from taking the dental implant out?
There’s definitely something going on, but it’s tough to say if it’s an allergic reaction.
Studies have shown that only 0.6% of the population has a true titanium allergy, but they’re actually to blame for a large number of implants that fail for “unknown causes.” The small number is promising because it really is a great metal that few people react to. That’s why it’s chosen for use throughout the body too. However, because it rarely poses an issue—many dentists will never have a single patient with a titanium allergy—it’s easy for people to forget that some people do have a genuine problem with it.
The non-scientific preliminary way of testing is to take an antihistamine. If your symptoms subside while you’re on it, you’re probably dealing with an allergy. That’s not definitive and you shouldn’t base a big decision on it, but it may point you in the right direction. Your best bet is to visit an allergist and be tested for reactions to titanium and other metals. With test results in hand, you can then approach your dentist to find out if any of the metals you react to were in your dental implant. It could be that you’re sensitive to something else and that you didn’t receive pure titanium; alloys are common.
When people need metal-free dentistry, zirconia dental implants are probably the best bet. They’re quite similar to titanium in terms of how well they work with the body and longevity. The issue is primarily that they have less “flex” to them, and so any kind of force that would make them “bend” could break them. It doesn’t happen often, but much more than it would with titanium. Compounding the issue, most are done as a single piece, so you’ve got the part that goes below your gumline and the part above in one piece. That also makes them more prone to micro cracks, and thus breakage. When they break, the whole thing has to go. It’s catastrophic. There are newer technologies emerging, including ones that mimic the titanium design, but dentists are slow to adopt. It’s not too surprising that your dentist won’t work with them. However, if you can’t have titanium, you need a viable missing tooth replacement. Ask him what he recommends. If he can’t provide metal-free options or options that don’t include the metals you’re responding to, you may have to ask around to find someone who uses zirconia and feels confident in his results.
Regardless of whether it’s a titanium allergy or something else, the level of inflammation you’re experiencing is a problem. Something’s not right and these symptoms could mean it’s failing or contribute to its failure. They’ve got to be controlled. If your dentist isn’t willing to examine causes, it’s a good idea to get a second opinion. It’s ok to visit another general dentist, but if you don’t get answers there, check with a specialist such as a periodontist or prosthodontist.
This blog is sponsored by Dr. Steve Sirin, an Elgin dental implant provider.