Allergic reaction to dental braces

Author: V. Dimov, M.D., Allergist/Immunologist and Assistant Professor at University of Chicago
Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at NSU

A 15-year-old girl is at the allergy clinic for evaluation of suspected allergic reaction to dental braces. Braces were placed by an orthodontist 2 months ago, and within a week, she started to feel oral itching and gagging. No history of nickel or latex allergy.

Physical Examination showed mild gingival erythema and dry lips.

What could be the cause of symptoms?

Delayed hypersensitivity to dental braces materials (nickel, cobalt, etc) is rare but described in the literature. Typically, patients have oral or perioral lesions.

What would you recommend?

Regarding the suspected delayed hypersensitivity to dental braces materials (nickel, cobalt, etc), the following is recommended:

- TRUE patch test
- ask the orthodontist to provide the materials of the braces to be added to the patch test

References

Cutaneous and oral eruption from oral exposure to nickel in dental braces. Schultz JC1, Connelly E, Glesne L, Warshaw EM. Dermatitis. 2004 Sep;15(3):154-7.
http://www.ncbi.nlm.nih.gov/pubmed/15724351

Full text from Medscape: http://www.medscape.com/viewarticle/496365_3

Nickel allergy and orthodontics, a review and report of two cases. British Dental Journal 204, 297 - 300 (2008).
http://www.nature.com/bdj/journal/v204/n6/full/bdj.2008.198.html

TRUE patch test info for nickel.
https://www.truetest.com/PatientPDF/Patient_Nickel.pdf

Published: 02-12-2014
Updated: 05-28-2014