Allergies are real in orthodontics. The first step is a comprehensive medical and dental history.

The most common allergies are:

1. Latex (Gloves, Braces Elastomerics)
2. Nickel (Metal braces and Wires)

I find most real allergies are usually only in adults. Whenever a patient declares that they have a latex allergy, the first question I ask is, “tell me what happens”. True allergies can manifest just as mild itching all the way to anaphylaxis. If a patient mentions anaphylaxis or swelling of the mouth or tongue or throat, I’ll often request a medical clearance from the patient’s allergist or PCP in order to proceed with treatment with braces.

Although it’s possible to reduce latex or nickel exposure with self-ligating, ceramic braces or aligners vs traditional metal braces with elastomeric ties, it often can add to the patient expense. These products are often more expensive. Treatment is often slower with non-latex elastics vs latex elastics.

I’ve never seen an allergy to clear aligners, but reportedly in the literature it does happen albeit, very rare.