There are many uses of titanium dioxide that we don't know about because they were made exempt from being on the package in 1977, said Faber, who added that nothing much has changed since – other than the FDA approving some other uses of the color additive, such as expanding the use of mica-based pearlescent pigments (prepared from titanium dioxide) as color additives in distilled spirits over recent years.

Titanium dioxide (E 171) is authorised as a food additive in the EU according to Annex II of Regulation (EC) No 1333/2008.  

In June 2022, Health Canada weighed in on the debate, releasing a report on the safety of titanium dioxide. Their expert panel reviewed toxicity studies, including ones involving genetic damage. The expert panel found that previous studies used different forms and properties of titanium dioxide and deliberately broke the material into smaller particles than what you would normally see in food.