Management of Nickel Sensitive Patients in Orthodontics

An allergic response to nickel in the oral mucosa from nickel containing orthodontic appliances is more infrequent than from nickel contact on the epidermis,it can occur, particularly in females. If nickel-related intraoral clinical signs and symptoms appear, the orthodontist should be prepared to undertake or continue treatment without the use of Ni-Ti wires and even without stainless steel. The frequency of orthodontic treatment and the common use of nickel containingorthodontic materials raises the interesting question of whether orthodontic treatment may act to increase or decrease the burden of nickel hypersensitivity in the population. There is evidence that oral exposure to nickel may induce immunologic tolerance to nickel and thereby reduce the incidence of nickel allergies. Nevertheless when clinical signs or symptoms presumed to be due to nickel hypersensitivity are distressing to patients there are many choices of materials available to the orthodontist as alternatives.