If you’re about to get metal braces, you probably have a lot of questions. Are they safe? Can your body reject them? And ultimately, what are metal braces made of?
Metal braces are made of 3 components: stainless steel brackets, nickel titanium arch wires, and latex ligatures. If you happen to be allergic to any of these materials, it’s important to inform your orthodontist before starting the treatment.
Metal braces materials are biocompatible, which means they don’t cause issues in most patients. So if you’re worried about possible side effects, or weird symptoms, they’re most likely not caused by your braces.
Main Materials Used in Orthodontic Braces
When it comes to orthodontic braces, there are a few key materials that are used by most brands. Each material serves a specific purpose and has its advantages.
Stainless steel is made by combining various metals. For braces, there’s a specific type of stainless steel we use called the 316 grade. People often call it “surgical stainless steel” or “marine-grade stainless steel.”
The 316 grade stainless steel is made up of chromium, nickel, molybdenum, iron, and a bit of carbon. What’s special about this mix is the molybdenum; it helps the steel resist rust. This is especially handy when exposed to salty environments, like the ocean.
There’s another stainless steel version named 316L used in some medical tools. This “L” version has less carbon, which reduces sensitization in patients who need implants and prosthetics. However, for braces, we usually go with the regular 316 because it’s slightly tougher.
One big advantage of using this kind of stainless steel in medicine, including orthodontics, is that it’s generally safe inside the body. Most people are not reactive to it, but there will always be exceptions.
Titanium is an exceptionally strong, lightweight, silver-gray metal. It’s highly resistant to corrosion and is a pure metal, meaning it doesn’t contain nickel.
Pure titanium brackets do exist. They’re known for their biocompatibility and are perfect for patients with metal allergies.
However, titanium braces aren’t as widespread as their stainless steel or ceramic counterparts. One of the main reasons is cost; pure titanium is more expensive. Plus, pure titanium isn’t as strong as stainless steel, and strength is an important factor.
Now let’s talk about titanium alloys; it’s where this metal really shines. Nickel titanium, often referred to as NiTi, is one of the most revolutionary materials in orthodontics. It’s not used for brackets as much as it is for the wires, known as archwires.
NiTi wires are super-elastic. This means they can return to their original shape after being bent. Thanks to their elasticity, NiTi wires are able to follow the crooked trajectory of teeth.
NiTi wires also have shape memory. This property has revolutionized orthodontic treatment. Once bent out of shape, these wires always want to come back to their initial form. As a result, NiTi wires apply continuous gentle force right from the start.
Latex in Ligatures and Elastics
Natural latex is harvested from the sap of rubber trees (Hevea brasiliensis), primarily grown in Southeast Asia. Tapping, similar to the process used in maple syrup collection, is the method used to extract the latex sap. This sap is then processed into rubber, including the one used in orthodontic treatment.
Natural latex exhibits superior elasticity, tensile strength, and resilience. This makes latex a favorite in most orthodontic practices, but it has its drawbacks. A significant concern is latex allergies.
Latex allergic reactions can range from mild irritations to anaphylaxis, which can be severe. So, if you are aware of the possibility of this allergy, it’s best to opt for clear aligners and ask for non-latex rubber bands.
Concerns About Nickel Allergy & Metal Toxicity
Are metal braces toxic?
You may have heard holistic dentists talking about metals leaching into the body and causing chronic, even auto-immune conditions. Because of this, metal braces are considered toxic by these doctors.
This speculation isn’t based on actual science. It’s true that in a highly acidic environment, there’s potential for metal ions to leach from dental appliances. However, saliva is a natural buffer, maintaining a neutral pH in the mouth most of the time.
Studies have shown that while there might be minute levels of metal ion release, they are generally far below the daily intake levels considered to be safe. For example, a study published in the “Angle Orthodontist” in 2001 found that while there was some release of nickel and chromium from orthodontic appliances, these releases were within the safe limits set by the World Health Organization.
Another one of the most common concerns about metal braces is the presence of nickel, which can cause allergic reactions in some individuals. However, a hypersensitivity reaction to nickel, while uncomfortable, is not toxic in the traditional sense. Let’s look at some of the nickel allergy symptoms:
Symptoms of Nickel Allergies Inside the Mouth
Nickel allergy in the mouth, often from orthodontic appliances, can cause various manifestations. Allergic patients might experience redness (oral erythema) in areas the appliance touches. Small sores or ulcers can also develop at these contact points.
Some report a burning sensation, while others note a metallic taste. Less commonly, gums may become swollen (gingival hyperplasia) near the nickel-containing parts. Inflammation of the lips (cheilitis) can also occur.
Though these signs hint at a nickel allergy, other factors can cause similar symptoms. It’s best to get tested and talk to your orthodontist about your symptoms.
Alternatives and Precautions for Patients with Known Nickel Allergies
If you have a known nickel allergy, it is important to choose metal braces that are nickel-free. Luckily, there are several safe options available for you.
Nickel-free metal braces today can be made from materials like titanium, rhodium, or gold-plated stainless steel. These alternatives help straighten teeth without causing harm to sensitive skin and gums.
To ensure the best outcome, make sure to discuss your allergy concerns with your orthodontist prior to getting braces. You can skip fixed traditional braces altogether and opt for clear aligners so you don’t risk any side effects.
Why Metal Orthodontic Braces Don’t Corrode
When you think of metal, you may associate it with rust and corrosion. I’m sure you’ve had the occasional pair of earrings or other jewelry corrode or oxidize.
But don’t worry, your metal braces won’t rust or corrode in your mouth. The secret lies in the materials they’re made of.
Stainless steel braces resist rust because they contain chromium. When exposed to air, the chromium forms a protective layer on the surface. Even if this layer gets scratched, it quickly reforms, keeping the braces rust-free. Nickel, another ingredient, further helps in keeping them shiny and resistant to wear.
Titanium alloys in braces resist corrosion because titanium forms a protective layer when exposed to air. This barrier shields the metal beneath. If damaged, titanium self-repairs quickly, which makes it super biocompatible.
Saliva also plays an important role. The pH levels of saliva range from neutral to slightly alkaline, creating an environment where corrosion is unlikely to occur.
Corrosion resistance is crucial for the health of your mouth and the longevity of your braces. If braces were to corrode, they could cause serious harm to your teeth, mouth, and overall health.
I salute you for taking the time to research what goes into your mouth! Know that metal braces are safe, non-toxic, and rarely cause allergies. And we have proof: millions of people who have worn metal braces over decades with no issues at all.
However, if you suspect allergies to any of the components, it’s best to get tested for nickel and latex. Keep in mind that nickel and latex can still be found in other types of braces, and in retainers too!