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TiO2 comes in many different forms. However, only a few of these forms are considered food-grade (acceptable to be added to food). Many studies that raised concern about the safety of TiO2, including the concern for genotoxicity, used forms of TiO2 that are not considered acceptable for use in food and have different properties than food-grade TiO2. Other studies did use food-grade TiO2, but took steps to break the material down into smaller particles than what would normally be found in food.

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Separately, concerns have been raised about titanium dioxide impacting one's genetic code. This can be traced to a 2009 study which found that titanium dioxide nanoparticles caused DNA damage and genetic instability in mice. A 2022 study published in Food and Chemical Toxicology also raised concerns about the DNA-damaging effects of titanium dioxide as a food additive. The study noted that results evidenced a DNA-damaging effect, and added that there may also be impacts to chromosomal integrity, an indicator of cancer risk.

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