An occasionally irregular blog about orthodontics

Careful with that phone …does mobile phone use influence metal ion release from braces?

Careful with that phone …does mobile phone use influence metal ion release from braces?

Does mobile phone use influence metal ion release from braces?

As regular readers of the blog will know most of the papers that I review are trials or systematic reviews. However, every now and then a paper comes along that is not a  trial  but makes me think. This is one from a team based in Iran and the USA who evaluated whether mobile phone use influences metal ion release from orthodontic appliances.

Effect of mobile phone use on metal iron release from fixed orthodontic appliances.

Saghiri et al

2015 Volume 147, Issue 6, Pages 719–724

In the literature review they point out that mobile phone use has expanded over the last 10 years and there are some  concerns that this may have a detrimental effect on our  health.  While there is an increasing amount of research into these potential problems,  the results of this research are not clear.

The main concern is that mobile phones emit radio frequency electromagnetic radiation (RFER) and this may have negative effects on our organs and cells. The authors of this paper propose that as the mobile phone is held in close proximity to the mouth during conversation, there is a risk of exposure of the mouth and any orthodontic appliances to the radiation. As orthodontic appliances contain nickel, there is then a potential for mobile phone use to influence nickel release from orthodontic appliances, leading to potential harm.

What did they do?

They took 50 healthy patients with an average age of 25 years who had fixed appliances.  Eligible patients needed to have worn orthodontic appliances for at least two months and no more than four months.  (I was not sure of the reason for this criteria). They also excluded patients who had any metallic restorations and missing teeth.  The participants were asked not to eat seafood, canned food or drink hot tea and coffee or to smoke for three days before their appointments.

At the first appointment the participants were asked not to use their mobile phones for one week. Saliva samples were taken from them at the end of this week.  They were then given the chronometer and asked to record the amount of time that they spent on their phone during the second week of the study. At the end of the second week the investigators collected saliva samples again. Finally, they measured the amount of nickel in the saliva samples. They carried out appropriate statistical testing.

What did they find?

I thought it was really interesting that  there was a significant increase in salivary nickel when the patients used their mobile phones. They also showed that this effect was greater for women because they spent twice as long on the phone than men !

In the discussion they outlined that  previous research has revealed that the use of mobile phones results in an increased rate of saliva secretion. The increased salivary flow then results in increased corrosion of orthodontic appliances. As a result, the use of mobile phones was associated with increased nickel loss from the appliances.

What did I think?

I feel that this interesting exploratory study  may provide clinically relevant findings.  This was a longitudinal observationsal study with each person acting as their own control and the methodology was sound. I do wonder whether they could have found a better way to record the amount of time that the phonese were used. I know that my phone records this.

My most important concern was that it I was not clear whether the difference they detected, while being statistically significant, was clinically significant.  It was unfortunate that they did not address this in the discussion. I am, therefore, not sure whether the use of mobile phones can cause harm.

As with all studies we should consider the “so what” question and I cannot help feeling that they did not really answer this question because they did not address the issue of clinical significance.  Therefore,  in the absence of any information on whether the amount of nickel released can cause harm, this study will not make me change my practice. What do you think?

ResearchBlogging.orgSaghiri, M., Orangi, J., Asatourian, A., Mehriar, P., & Sheibani, N. (2015). Effect of mobile phone use on metal ion release from fixed orthodontic appliances American Journal of Orthodontics and Dentofacial Orthopedics, 147 (6), 719-724 DOI: 10.1016/j.ajodo.2015.01.023

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There Are 6 Comments

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  1. Thanks for highlighting this. I have to admit my first thought was ‘what a load of nonsense’, but I’m happy that a well designed study can prove my thoughts wrong. I do wonder where they found patients who fited the criteria and were willing to avoid the food and drink described, and not use their phone for a week!!

    However I agree, we don’t know if this has potential clinical implications or not. I wonder if the ions are coming more from the brackets or the archwires?

    • Kevin O'Brien says:

      Hi Megan, thanks for the comment. I agree that they did very well to find the participants who would not use their mobile phones for a week! I really would like to know the clinical implications of the increased ion release. I wonder if the authors are reading this blog and wish to make a comment?

  2. Chris Lowe says:

    This was interesting. My one thought is that, if Nickel is being released, how do we stand with those patients with a nickel allergy. This isn’t usually a problem with most orthodontic cases but might there be an increased risk?

    • Kevin O'Brien says:

      Hi Chris, you’ve made a good point and I am not sure the answer. Is there anyone out there and let us have this information?

  3. Michelle says:

    Hi did authors mention Nickel free braces?

  4. Jim Williams says:

    They mentioned an increase of saliva flow with phone use. Could this be associated with longer periods spent talking and is there any information regarding increased saliva flow being associated with increased ion release. In other words, is the act of talking itself related to ion release

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