When someone gets a dental implant, it is commonly made out of titanium. And titanium is also used in other procedures, as some hip replacements use titanium alloys. While many people with these implants seem to do fine, some people have asked whether titanium can be a trigger for Graves’ Disease, Hashimoto’s Thyroiditis, or another autoimmune condition.
Before I answer this, you might wonder why titanium is commonly used in the first place. One reason why it is commonly used is due to its high resistance to corrosion (1), which obviously is very important. Another reason is because most people seem to have a low sensitivity to titanium when compared to other metals. In fact, one study showed that all casting alloys seem to have a potential for eliciting adverse reactions in individual hypersensitive patients, although it listed titanium as being a possible exception (2). However, as I’m about to discuss, some people do in fact react to titanium, and of course this can be a big problem for someone who has a dental implant, or titanium as part of a hip or knee replacement.
Why Is Titanium Problematic In Some People?
Although most people don’t have a problem with titanium implants, a small percentage of people are sensitive. A clinical study involving 1,500 people who received dental implants showed that nine of these patients demonstrated a titanium allergy (3). The good news is that only 0.6% of these patients experienced problems with the dental implants. On the other hand, if titanium can lead to certain chronic health conditions, then even a small percentage o f negative reactions might be too high. Another study involved fifty-six patients who developed clinical symptoms after receiving titanium-based implants, and 21 of these tested positive for a titanium allergy, with another 16 showing ambiguous results (4). Sometimes someone will experience symptoms caused by these implants but they won’t make the connection, and many times their doctors also won’t be able to figure this out..
For example, a few years ago it was revealed that the actor Dick Van Dyke had experienced severe headaches which affected his sleep and caused chronic fatigue. Over a seven year period he saw numerous healthcare professionals, received a CAT scan, MRI, and a spinal tap, along with other tests, but everything came back negative. It wasn’t until his dental implants were removed that he finally received relief from his symptoms.
Once again, most people do fine with titanium implants. But these patient experiences I mentioned show that in some cases, titanium can lead to severe symptoms. In some cases the symptoms can be debilitating. And many times people live with these symptoms for years before it is figured out that the problem is due to titanium.
Can Titanium Trigger Autoimmunity?
There is no concrete evidence that having titanium implants can trigger an autoimmune response. However, this doesn’t mean that it’s not possible, as other metals such as mercury and nickel have been associated with thyroid autoimmunity (5) (6). As a result, if someone with Graves’ Disease or Hashimoto’s Thyroiditis was diagnosed with their condition after getting an implant which consisted of titanium, then this is a factor that should be considered. Of course it can be difficult to make such a connection, as someone can be in the “silent” autoimmune stage for years, which means they might have elevated antibodies for many years, yet no positive tests or symptoms. As a result, even if someone with an autoimmune thyroid condition began presenting with symptoms shortly after getting a titanium implant, this doesn’t necessarily mean the implant was responsible for the development of their condition. With that being said, if you have a titanium implant and then developed an autoimmune thyroid condition, then it might be worth doing some testing to see if you have a sensitivity to titanium.
What Other Options Are There?
Before someone gets a dental implant, or a hip or knee replacement which involves titanium, it probably would be a good idea to get a metal allergy assessment along with some allergy testing. Skin testing is an option, as the sensitivity of patch tests has been shown to be about 75% for a type IV metal allergy, although so far no study related to dental implant allergies has used this method (7). A lymphocyte transformation test is another option, although false-positive results are possible (7). There is also a Memory lymphocyte immuno-stimulation assay (MELISA) test (8), which can determine if someone has an allergy to a metal such as titanium. In my opinion it should be routine to get such testing before getting a metal implant.
Another option is to use something else other than titanium. Zirconia is a ceramic and is an option to consider. It has been used to replace hip joints, and can also be an option to consider with dental implants. However, even though one is less likely to be sensitive to zirconia, a sensitivity is still possible. But if I were getting a dental implant I probably would choose a zirconia implant over a titanium implant.
In summary, although many people do fine with titanium implants, there are some people who have a titanium allergy. And in some cases titanium can cause severe symptoms. Although there is no research which shows that titanium can trigger an autoimmune thyroid condition such as Graves’ Disease or Hashimoto’s Thyroiditis, if someone received a titanium implant and then developed an autoimmune thyroid condition, it might be a good idea to do some testing to see if they have a sensitivity to titanium. For those who are sensitive, zirconia can be an alternative option to consider.