DIY Dentistry and Mail Order Orthodontics – what you need to know

You may have been reading or hearing about complaints related to DIY Dentistry and Mail Order Orthodontics – this article is a bit of background to it.

But first, here are a few articles and videos on the matter.

Here’s where it recently started:

www.irishtimes.com/news/health/mail-order-dentistry-at-root-of-number-of-complaints-1.3160143

and here is the response from the OSI:

The pitfalls of mail-order dentistry

But it’s not just in Ireland – this is going on around the world:

http://abcnews.go.com/Health/orthodontists-warn-uptick-diy-teeth-straightening/story?id=46029908

http://abc7ny.com/health/doctors-warn-against-do-it-yourself-braces/1794645/

http://komonews.com/news/consumer/doctors-warn-avoid-the-temptation-of-diy-braces

http://fox2now.com/2017/03/06/dangerous-new-trend-on-the-rise-do-it-yourself-ortho/

http://wfla.com/2017/02/27/dyi-braces-dangerous-trend-tampa-bay-area-orthodontist-warns-of-tooth-loss/

http://health.usnews.com/health-care/articles/2017-03-02/diy-teeth-straightening-dont-try-this-at-home

http://www.13newsnow.com/news/diy-braces/412953801

http://www.dailymail.co.uk/health/article-4286186/Orthodontists-reveal-rise-DIY-teeth-straightening.html

http://www.menshealth.com/health/diy-teeth-straightening

In Ireland, dentists are regulated by The Dental Council of Ireland. One of the stipulations of our code of conduct is that we all have to have a complaints procedure. This is usually very simple – at the fundamental level, if you’re unhappy with some aspect of your dental experience, talk to your dentist about it.

If that problem can’t be sorted out by a conversation between you and the dentist, or engaging with the dentist’s formal complaint procedure, then the next simplest avenue for a patient is likely to be the Dental Complaints Resolution Service.

You can find out about them on dentalcomplaints.ie

They provide a service that is free to patients who want to complain about the service they got from a dentist. Since they are free to patients they are much more cost effective to the patient than going to court and the process is usually much faster too.

Earlier this year (July 2017) the Dental Complaints Resolution Service released their annual report for 2016.

We can note a few good things:

  1. The number of complaints for 2016 was down considerably compared to 2015 (from 134 to 102)
  2. The percentage of complaints that were successfully resolved was up considerably (from 44 to 58)

One of the matters that concerned the service was the emergence of complaints relating to home orthodontic treatment where people order orthodontic braces from a website using “home evaluation”, possibly with some “dental selfie” photographs and mouldings that the patient takes of their own teeth using impression materials that they get from the website.

The rise in “home remedy” dentistry has taken off due to social media and video sites like YouTube where people demonstrate how to move teeth using rubber bands and paper clips.

As well as that, there are now companies that will manufacture braces or aligners (like a simplified version of the Invisalign aligers you may have heard of or seen adverts for on TV or at the cinema) to fit an individual person’s teeth using the photos and mouldings that a person takes of themselves and sends into the company.

Now I can see why this appeals to people. Some people are nervous about going to any dentist in the first place, and as well as that, this service is going to be cheaper because it removes the most expensive part of the normal orthodontic process – namely going to any dentist in the first place.

Is mail order orthodontics a bad thing?

There are problems with this – mainly that the orthodontic problem hasn’t been properly diagnosed. There are reasons that teeth aren’t as neatly positioned as a patient would like – my experience is that a patient knows what they don’t like about their teeth, but they rarely know why their teeth are the way they are and they are often even more surprised when they see their own X-rays and I talk them through the X-rays.

I think that would be true for most of my orthodontic colleagues. Even a dentist can’t always tell what’s going on from a photo, they need to examine the patient in person and usually get an X-ray picture before they think of moving teeth.

Why should you have a diagnosis BEFORE you have treatment?

There are three basic reasons:

  1. The orthodontic problem may be related to an underlying problem that is not obvious (eg advanced gum disease or even some cancers or bone disorders)
  2. The orthodontic treatment may be complicated by underlying problems that aren’t obvious (eg unerupted teeth, including extra teeth)
  3. The orthodontic treatment may make another dental problem worse (eg gum disease)

But in addition to that, not all orthodontic treatment goes the way you want or expect. That’s why it’s important to get it reviewed regularly (most people get checked by their orthodontist every 4-8 weeks once they start active treatment) and the orthodontist can change things as needs be before things get worse.

There are other problems with home orthodontic treatment – if there is no dentist involved, or there is a dentist operating over the internet from another country, then the patient doesn’t have the benefit of organisations like the Dental Complaints Resolution Service or even the Dental Council as they only deal with the activity of dentists registered in Ireland.

In the USA:

https://www.mylifemysmile.org/#consumerAlert

In the UK:

http://www.bos.org.uk/News-and-Events/BOS-Statement-Do-it-yourself-braces

and here in Ireland:

http://www.dentalcouncil.ie/files/DC%20Statement%20orthodontic%20devices.pdf

So the American Association of Orthodontists (AAO), the British Orthodontic Society (BOS) and the Dental Council of Ireland all discourage people from attempting orthodontic treatment on themselves.

And so do we.