Am I allergic to the metal in my crowns?

I just read that you can have allergy reactions due to metal crowns (I seem to have allergies to many earrings, regardless of gold or silver). I did not think about this prior to my current crown work. My dentist just implanted two temporary plastic crowns (next appt. is in 2 weeks). Since I could not afford porcelain crowns, my insurance will only pay for metal (teeth 29 & 30). The dentist is going to fuse porcelain over #29 (which I have already paid for). Now upon reading about this metal allergy problem, I do not know what to do.

This is the first time at this particular dentist through my insurance. I have my qualms concerning him (different reasons) & would like a second opinion concerning my questions. I would appreciate your advisement in this matter. Thank you!
- Teresa from New York

Teresa,
You’re asking a good question, and you’re asking it in time to make sure you don’t have a problem with these crowns. And, unfortunately, this is what you get when your insurance company creates these preferred provider lists. They pick the cheapest dentists who use the cheapest materials, and you can get problems like this.

It is the responsibility of your dentist to ask enough questions to prevent any sensitivity reaction to any metals that are in any crowns placed in your mouth. His medical history form should ask specifically if you have any issues with metal sensitivity. But, judging from your worries, you don’t believe that you were asked this question.

When people have metal sensitivities or metal allergies, the offending metal is almost always nickel, chromium, or beryllium. And yes, these metals are used in cheaper metal alloys for dental crowns including porcelain fused to metal crowns. They are also used in some gold and silver alloys in jewelry because they’re relatively light and strong and won’t tarnish.

Here’s what I would do at this point. I would call and ask to speak with the dentist, and would inform him directly that you have metal allergies, and so the alloy used in your crowns needs to be either precious metal or semi-precious metal – no base metals. If they don’t let you speak directly with the dentist, be sure to let them know that this is a serious issue and write down the name of the person you end up speaking with, so that you can follow up. And since it doesn’t sound like you trust this dentist, I would go one step further and would tell him or his staff person that you want a written copy from him with a list of the composition of the metal alloy used in your crown before the crown is permanently cemented in your mouth, or else you will not consent to having it cemented. The dental laboratory will send to the dentist a little certificate with a list showing the composition of any metals used in the crowns, and you would be asking for a copy of this. Look it over and make sure there is no nickel, chromium, or beryllium in the alloy before you let them do anything in your mouth, on the day you come in to get these crowns cemented. Don’t even let them take the temporary crowns off until you can see this certificate – that way you are completely free so you can walk out if they don’t produce it. If they have nothing to hide, they should readily provide this information.

Other links:
The metals that we use in the gold alloys of gold fillings do not contain any of these base metals: nickel, chromium, or beryllium.

Follow-up – See Teresa’s follow-up e-mail and our answer.

This blog sponsored by Boca Raton TMJ dentist Dr. David Kagan.

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