The Nickel Crown

An Essay on How a Routine Pediatric Dental Procedure Can Poison a Child

When Tiffany was three years old, her pedodontist placed amalgam fillings and stainless steel crowns in her mouth. Immediately after the procedure, this previously healthy toddler became ill. Her white blood cell count surged — her body mounting a systemic response to the toxic metals now cemented into her molars. She developed recurring fevers, chronic low energy, and diminished capacity to maintain normal function. For a full year she did not gain a single pound. Her doctors suspected leukemia and placed her under the care of an oncologist.¹

The leukemia was never confirmed because there was no leukemia. When Tiffany was finally seen by holistic dentist Mark Breiner and tested for biological reactivity to dental materials, she was found to be reactive to both mercury and nickel — the two metals sitting in her mouth. The metals were removed. She recovered. The “leukemia” was a normal physical reaction to being poisoned by metals that a small child’s system could not handle.¹

Breiner, who treated Tiffany, called it “a tragedy that should never have begun.”¹ Her case is documented in a published dental textbook. It is not an allegation. It is a clinical account with a clear sequence: healthy child, dental procedure, immediate systemic illness, failed diagnosis by specialists, correct diagnosis through materials testing, complete recovery upon removal. And it raises a question that pediatric medicine has never systematically asked: when a child develops unexplained systemic illness shortly after dental work, could the dental materials be the cause?

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What “Stainless Steel” Actually Means

The term “stainless steel crown” obscures what the device contains. Stainless steel is a nickel-based alloy. So-called “chrome crowns” — the standard restoration placed on decayed baby teeth across pediatric dentistry — are nickel-containing stainless steel crowns.² These are not stainless steel in the way a kitchen sink is stainless steel. They are medical devices implanted in the oral mucosa of developing children, in constant contact with saliva, acids, and — frequently — other metals.

Nickel is not a benign material incidentally present in these crowns. It is a known carcinogen, a known allergen, and a systemic toxin. It is used to induce cancer in laboratory animals.³ ⁴ Nickel is highly toxic to the nervous system and has been linked to arthritis and to several types of cancer, including lung and breast cancer.³ Huggins observed that most adverse reactions to nickel in dental applications are similar to those of mercury toxicity: neurological disturbances, emotional upsets, and blood disorders — including leukemia.²

The EPA’s maximum allowable contaminant level for nickel in drinking water is 0.1 parts per million. To put that number in context: the EPA’s limit for arsenic is 0.01 ppm and for cyanide is 0.2 ppm. By the EPA’s own regulatory framework, nickel is considered one-tenth as toxic as arsenic but twice as toxic as cyanide.⁵ Nickel is immediately fatal at concentrations of 30 ppm or greater.⁵

If nickel is this toxic, why is it placed in children’s mouths? The answer is identical to the reasoning behind mercury in amalgams. The American Dental Association considers nickel to have lost its toxic properties when combined with other metals in an alloy. What this position ignores is the fact that acids and electrical currents in the mouth continuously corrode the alloy, releasing nickel ions into the saliva — a corrosion process that continues for as long as the metal remains in the mouth.⁵

At least 10 to 20 percent of women are allergic to nickel. About 6 percent of men are. If your ears get irritated by earring posts, you fall into this category.⁶ Nickel allergy is the most common metal allergy in the general population.⁷ None of this is obscure or contested information. It is available in standard references. And none of it is routinely considered before a pedodontist cements a nickel-containing crown onto a toddler’s molar.

The Market Logic

Nickel dominates pediatric dental materials not because of its safety profile but because of its cost and convenience. Huggins documented that nickel had captured approximately 80 percent of the crown market overall, and over 90 percent in some regions. Many of his patients thought they had received gold crowns. They had not.² The gap between what patients believe is in their mouths and what is actually there is vast. The terminology itself is misleading: “chrome crowns” are nickel crowns. “Stainless steel” is a nickel alloy. The word “nickel” rarely appears in any communication between the dentist and the parent.

Pedodontists favour stainless steel crowns on baby teeth because they can be placed rapidly — they are preformed shells that require minimal chairside adjustment.¹ The economics reinforce the practice. Insurance reimburses stainless steel crowns at a higher rate than it does amalgam fillings.¹ A pedodontist placing stainless steel crowns moves faster and earns more per procedure than one placing alternative restorations. The financial incentive points in one direction. The safety data, such as it exists, points in another. Huggins noted that the cost difference between a nickel crown and a gold crown was roughly thirty to forty dollars.² The saving is real. Whether it is worth it — for the epileptic, the patient with MS, or, in this context, the three-year-old now under the care of an oncologist — is a question the reimbursement structure does not ask.

The approval process for dental restorative materials focuses on aesthetics, strength, durability, and ease of use. Of 44 test parameters used by a prominent US dental school to evaluate materials, only two relate to biological safety — one for cell destruction and one for irritation in a hamster cheek pouch. Neither examines the systemic effects of chemical or corrosive byproducts that leave the material and enter the body.⁸ Jess Clifford, who developed the original dental materials reactivity test and maintains a database of over 9,900 dental products tested against more than 41,000 patients, identified a clear pattern: products containing nickel, beryllium, cadmium, and mercury perform poorly across the board. Even when combined with other components, there is no reliable mechanism to isolate these metals from causing problems.⁸

A Battery in a Child’s Mouth

Nickel crowns do not sit inertly in the mouth. Nickel generates electrical current — specifically, negative electrical current, which Huggins identified as more damaging than positive current because it accelerates the conversion of mercury into methyl mercury.² When a child has both amalgam fillings and stainless steel crowns — as Tiffany did, as Evan did — the dissimilar metals create a galvanic cell. The mouth becomes a low-voltage battery. Saliva serves as the electrolyte. Electrons flow from one metal to the other, and this flow drives the release of metallic ions from both materials simultaneously.⁵

This means the child is not dealing with one toxic exposure but two, each amplifying the other. The nickel releases nickel ions. The amalgam releases mercury. The electrical current between them accelerates both processes beyond what either material would produce alone. The resulting mixture — mercury, nickel, copper, tin, and other metal compounds — is continuously released into the saliva and swallowed. Huggins called it a “corrosion soup.”² The child does not experience a one-time exposure to a fixed amount of nickel. The exposure is constant, 24 hours a day, for as long as the metals remain in the mouth. Every sip of hot liquid increases mercury vapour release from the amalgams. Every bite of acidic food accelerates corrosion.

The clinical implications extend beyond individual toxicity. Huggins documented that mercury disrupts white blood cell metabolism and stimulates allergic reactions.² He noted that a white blood cell count surging from 5,000 to 50,000 is the kind of change that leads a doctor to suspect leukemia — and that mercury can produce exactly this kind of surge.² Mercury can cause two DNA chains to combine within lymphocytes, doubling the number of chromosomes present. By definition, Huggins notes, this is malignancy.² The distinction between “mercury-induced blood abnormality” and “leukemia” may be invisible to standard haematological testing. The treatment, however, is entirely different. One requires chemotherapy. The other requires removing the metals from a child’s mouth.

Allergists have reported that when a slightly allergic patient receives braces — also nickel-based — they expect the allergies to worsen. The electrical current generated by orthodontic braces is generally several times higher than that created by amalgam fillings alone. Some of the worst reactions Huggins observed occurred in patients who had combinations of nickel, gold, and amalgam — for instance, when amalgam and gold restorations were present under orthodontic bands.²

Not an Isolated Incident

Evan, the young son of one of Breiner’s patients, got so sick every few weeks that he could not walk. He was hospitalised repeatedly. The doctors at Yale Medical Center confirmed that something was systemically wrong but could not identify the cause. They ran the tests their training told them to run. They consulted the specialists their protocols told them to consult. The dental work Evan had recently received did not appear in the diagnostic picture because no protocol placed it there.¹

Breiner asked the boy’s mother whether any dental work had recently been done. A pedodontist had placed amalgams and stainless steel crowns in Evan’s mouth. Breiner removed the metals. Evan recovered immediately. In the many years since, he has never had a recurrence of the original problem.¹

The pattern across these cases is consistent: a healthy child receives routine dental work involving nickel and mercury; the child develops systemic illness — recurring fevers, failure to thrive, blood abnormalities, cascading health deterioration; the medical workup fails to identify a cause; the connection to dental materials is made only when someone outside the standard referral chain thinks to ask the question; removal of the metals resolves the illness. The pattern is not subtle. It is invisible only to a system that has decided not to look for it.

Breiner notes that there are no statistics available to evaluate the extent of this problem. There is no way of knowing how many children have suffered unnecessary illness brought on by dental procedures, because the question is not built into any standard diagnostic protocol.¹ A child arrives at the paediatrician with a fever, a spiking white cell count, and no obvious infection. The doctor orders blood work, imaging, referrals. At no point does the intake form ask: “Has your child had dental work in the past six months?” The question does not exist in the system.

Consider what this means in practice. Stainless steel crowns are the default restoration for decayed baby teeth. Millions of children receive them. The known nickel allergy rate in the general population is between 5 and 20 percent depending on sex and prior exposure.⁶ ⁷ Even at the low end, this means that a significant fraction of children receiving these crowns are reactive to the primary metal in them — and no one tests for this before placement. The children who develop dramatic systemic reactions, like Tiffany and Evan, are the visible cases. They get sick enough to be hospitalised, to see oncologists, to prompt someone to eventually ask the right question. The children who develop subtler reactions — chronic low-grade illness, recurring infections, failure to thrive, behavioural changes — are a population that has never been measured because no one has designed a study to look for them.

Children Are Not Small Adults

Children’s developing detoxification and elimination systems have fewer defences against toxic assault than adult systems.³ This is not a subtle distinction. A three-year-old’s liver, kidneys, and lymphatic system are still maturing. The blood-brain barrier is less developed. Body weight is lower, so the dose-per-kilogram of any toxin is proportionally higher. A nickel crown that an adult’s system might tolerate — or at least compensate for — can overwhelm a toddler’s capacity to detoxify. Everything that applies to dental material toxicity in adults applies with greater force to children — and the evidence base for safety in children specifically does not exist.

As Nagel documents: there is no evidence of the safety of standard dental materials for use in children. The fact that a dentist uses certain materials regularly does not mean they have been proven safe.³ Breiner puts it more directly: children’s physical systems are more vital and reactive than those of adults, so toxic intrusions can cause severe problems. It is important to be extremely wary about dental work suggested for young children. Too many dentists recommend invasive dental procedures that can have devastating consequences.¹

The vulnerability runs in both directions. Children are more susceptible to the initial toxic insult, and they are less able to signal what is happening to them. A three-year-old cannot articulate that she feels different since her dental appointment. She presents with fevers and lethargy. Her paediatrician sees a sick child and begins the standard diagnostic workup. The temporal relationship between dental work and illness — which would be the first thing an adult might report — is lost unless the parent makes the connection independently.

Nickel is a carcinogen that disrupts normal biological function when released from dental materials.⁴ Porcelain crowns — often presented as a more aesthetic alternative — are frequently backed onto a nickel thimble and reinforced with nickel-containing stainless steel.³ ⁴ The child’s options, as typically presented by a pedodontist, range from one nickel-containing material to another.

The Controlled Experiment

Breiner’s own son Adam provides what amounts to a natural controlled experiment — the kind of evidence that removes ambiguity about the relationship between nickel exposure and systemic collapse in a child.

Adam had a history of chronic ear infections as an infant, successfully managed with homeopathic treatment. He swam daily without developing further infections. At age twelve, he needed orthodontic work. Two nickel bands were placed on his upper first molars. Within days, he developed an ear infection. Breiner removed the bands. Adam recovered quickly with homeopathic treatment.⁶

A few months later, doubting his own conclusion, Breiner had the orthodontist replace the bands. Adam developed another ear infection by the next day and came down with pneumonia. The bands were removed again. This time Adam did not respond quickly to treatment.⁶

Breiner sent a sample of Adam’s blood to the head of immunology at the University of Colorado, a researcher studying nickel. The finding was unequivocal: Adam was extremely sensitive to nickel, and the metal had overwhelmed his body’s capacity to function normally. The researcher’s framework described this as the nickel having “shut down his immune system” — in terrain terms, the toxic burden had exceeded the child’s ability to detoxify and maintain equilibrium. It took two weeks for Adam to recover from the ear infection and pneumonia that followed the second exposure.⁶

The structure of this case is worth dwelling on. Exposure, illness, removal, recovery. Re-exposure, illness, removal, slow recovery with laboratory confirmation from a university research department. This is the sequence that establishes causation in clinical medicine: temporal association (symptoms began within days of exposure), rechallenge producing the same result (the second placement reproduced the illness), biological plausibility confirmed by independent laboratory testing (the University of Colorado confirmed extreme nickel sensitivity and systemic overwhelm), and resolution upon removal of the exposure (recovery followed both removals, though more slowly after the second).

Each of these criteria is met independently. Together, they constitute the kind of evidence that, in any other medical context, would be considered dispositive. A drug that produced this sequence would be withdrawn. A food additive that produced this sequence would be banned. A dental material that produces this sequence continues to be the standard of care in pediatric dentistry.

The Absent Question

Dental materials compatibility testing exists. It has existed for decades. Clifford’s laboratory can screen a patient’s blood serum against over 90 components of dental materials and cross-reference the results against thousands of brand-name products.⁸ The test identifies which materials provoke biological reactivity in that specific patient and which are tolerated. It is available. It is not expensive relative to the cost of dental treatment, let alone relative to the cost of a year of oncological investigation for a three-year-old. And it is almost never performed on children before dental work begins.

The test works. Breiner documents a case in which he inadvertently used a material flagged as unsuitable on a chemically sensitive patient’s compatibility test. She called that night with a reaction. He checked her record, discovered his error, replaced the material immediately, and the reaction resolved.⁸ The experience removed any remaining doubt he had about the value of pre-testing. For children, who are more reactive and less able to compensate for toxic insults, the case for pre-testing is stronger, not weaker. Breiner’s position is straightforward: if you are ill, never proceed with any dental work until you have had a compatibility test.⁸

Munro-Hall and Munro-Hall make a broader observation about dental metals and sensitivity: constant exposure can cause allergy or sensitivity to build up over time. A patient who initially tests negative for a metal may develop sensitivity after years of continuous exposure. Their conclusion is that if there are any symptoms causing concern, non-metal restorations are preferable.⁹ As the inventor of the MELISA metal sensitivity test, Professor Vera Stejskal, put it: “Only robots should have metal spare parts.”⁹

The acceptance and approval process for dental restorative materials has very little to do with long-term sustained biological safety.⁸ It has everything to do with mechanical performance, cost, and ease of use. The materials are tested for whether they hold up in the mouth. They are not systematically tested for what they do to the body.

The Structural Blind Spot

The individual dentists, paediatricians, and oncologists in these stories are not villains. Breiner notes that most dentists he knows are ethical, caring individuals who simply do not know the potential negative health effects of some of the materials and procedures common in dentistry.¹ The pedodontist who placed nickel crowns in Tiffany’s mouth was following standard practice. The oncologist who investigated her for leukemia was responding appropriately to her blood work. The doctors at Yale who could not explain Evan’s deteriorating health ran the tests available to them. Each specialist did their job. The problem is that no specialty owns the question that connects them.

No standard paediatric intake protocol asks about recent dental work. No standard dental protocol screens children for metal sensitivity before placing restorations. No standard oncological workup for a child with unexplained white blood cell elevation includes dental materials in the differential diagnosis. The question — could the metals in this child’s mouth be causing the illness? — does not appear on any form, in any specialty, at any stage of the diagnostic process.

This is not a gap that someone overlooked. It is a gap that the structure of medical and dental specialisation guarantees. The dentist places the material and considers the job done when the crown seats properly. The paediatrician evaluates the sick child but has no training in dental materials toxicology. The oncologist investigates the blood abnormality within the framework of haematological disease. Each specialist’s field of vision ends exactly where the next one’s begins, and the connection between dental materials and systemic illness falls into the space between them.

Tiffany spent a year under an oncologist. Evan was hospitalised repeatedly at Yale. Adam developed pneumonia. In each case, the cause was identified only because someone outside the standard diagnostic framework thought to ask a question the system is not designed to ask. Breiner happened to ask about dental work. The University of Colorado immunologist happened to be researching nickel. These were accidents of proximity, not features of the system.

Breiner’s observation remains unanswered: we have no way of knowing how many children have suffered unnecessary illness brought on by dental procedures.¹ We do not know because we do not ask. We do not ask because the question has never been incorporated into clinical practice. The materials keep being placed. The children keep getting sick. And the connection keeps being made, when it is made at all, by accident — by a mother who notices the timing, by a holistic dentist who asks about metals, by an immunologist who happens to be studying nickel that year. The system that placed the metals in the child’s mouth has no mechanism to discover what the metals do once they are there.

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References

¹ Breiner, M.A. Whole-Body Dentistry: A Complete Guide to Understanding the Impact of Dentistry on Total Health. Quantum Health Press, 2011.

² Huggins, H.A. It’s All in Your Head: The Link Between Mercury Amalgams and Illness. Avery Publishing, 1993.

³ Nagel, R. Cure Tooth Decay: Heal and Prevent Cavities with Nutrition. Golden Child Publishing, 2010.

⁴ Artemis, N. Holistic Dental Care: The Complete Guide to Healthy Teeth and Gums. North Atlantic Books, 2013.

⁵ Fife, B. Oil Pulling Therapy: Detoxifying and Healing the Body Through Oral Cleansing. Piccadilly Books, 2008.

⁶ Breiner, M.A. Whole-Body Dentistry, Chapters 25 (Orthodontics) and 26 (Your Children).

⁷ Yoho, R. Judas Dentistry: How Dentists Scorn Science, Break the Hippocratic Oath, and Wreck Their Patients’ Minds and Bodies. 2023.

⁸ Breiner, M.A. Whole-Body Dentistry, Chapter 27 (Dental Materials), citing Clifford Consulting & Research data from 41,000+ patients.

⁹ Munro-Hall, G. and Munro-Hall, L. Toxic Dentistry Exposed: The Link Between Dentistry and Modern Chronic Diseases. 2nd edition, 2009.