Dr. Katie To explains why titanium works in hip replacements but not oral implants. The mouth is bacteria-rich, constantly exposed, and sits inches from the brain, unlike the closed, sterile environment of joints. She argues clinicians should test individual patient biocompatibility instead of assuming all materials are safe.
The body of the patient dictates what works for them, not our profession, not what the research papers say. And so in our practice, we strictly implement biocompatibility testing. And the funny thing is, it's available and it's easy to do. It's just that we skip that step because we think the body can tolerate it. How bad can it be? And I have surgeons actually call me and argue, my patient has titanium hips, why not titanium implants in the mouth? Yeah. And I remind him, I say, Doc, the hips doesn't have an open microbiome like the mouth. You have bacteria because we put saliva under microscope on every single patient on a phase contrast and spirochete, amoebas. The hips doesn't have that environment. Open, hostile, and exposed to so many things. And it's not 3 inches from the brain either. And then it goes silent. Because again, we're using the brain and say, oh my God, if I can put titanium in the knee and the hips, why not in the mouth? But the mouth is a very different environment. Then the hip socket is not open every day.
