Orthodontic appliances for patients with a nickel allergy

An allergy to nickel is one of the most common causes of allergic contact dermatitis— an itchy rash that appears when a normally harmless substance touches the soft tissue. Nickel is one of the metals most commonly found in materials that are used to make orthodontic appliance components, with the element being present in stainless steel, nickel–titanium and other alloys.

A significant increase in the level of nickel in saliva and serum has been found in patients following the insertion of fixed orthodontic appliances. Nickel is also the metal that is most likely to cause contact dermatitis in patients with orthodontic appliances. The first part of the article will look at the causes, signs, symptoms and epidemiology of a nickel allergy, and ways in which the reaction is diagnosed will be explained. The article will go on to focus on the nickel content of orthodontic appliance components and examine the alternative products that are either nickel-free or have a very low nickel content that are suitable for patients with the allergy.