The idea of taking matters into your own hands to try to close a gap between two teeth or otherwise encourage tooth growth to change direction is nothing new. But the trend of do-it-yourself orthodontics has exploded in recent months, fueled by numerous YouTube how-to videos from teens (and pre-teens), easy availability of gap bands and other DIY kits from online merchants and even the ability to create your own ortho aligners by way of a 3D printer.
But while some of the videos, boasting thousands and hundreds of thousands of views, show happy and excited teens eager to share this great, cost-saving “discovery” with the world, orthodontists say it’s not only unwise — it’s downright dangerous.
Among the possible consequences are bone loss, infection and sometimes even teeth falling out. The financial cost can be far greater than going the conventional, safe and supervised route of having a reputable orthodontist fit you with braces and monitor its effects on the way to giving you a more-perfect smile.
The Origin of Do-It-Yourself Braces
The fake braces trend had taken hold and was causing concern in Asia—notably Malaysia, Indonesia and Thailand—even before news media in the U.S. began giving it widespread coverage in the summer of 2015.
In many Asian countries, including the Philippines, wearing braces—financially out of reach to many—is considered a status symbol and is seen as a sign of wealth and style, not to mention a way for impressionable teens to join the “in crowd.” Filipino media reported fake braces increasingly being sold in open-air markets and by other vendors hawking them as being as easy to attach as clip-on earrings. But health concerns—they were cited as causing mouth sores and decaying teeth, as well as posing a risk from lead in many wires—caused the Philippines Food and Drug Administration to issue a health warning regarding the use of DIY braces.
Fake braces were banned by authorities in Thailand after a rash of medical problems, including the deaths of two young people, were tied to the devices, dating back to 2006. The crackdown, with hefty fines and prison sentences for those selling or importing the devices, only pushed the market underground.
The fad has continued among Asian teen circles, and spread to other areas around the globe. Now it has come to the U.S., where braces used to be shunned at all costs by adolescents who feared being ostracized by their peers.
Parents and dental professionals alike are concerned and want to get America’s teens to understand the dangers of unapproved orthodontic treatment and devices.
High Risk Of Damage
Many teens here in the U.S. are not so much looking to be cool with wires strung across their teeth as they truly want a way to close an embarrassing or unsightly gap or force some crooked teeth to grow in the right direction. For them, the answer seems to be as simple as using small rubber bands, also called gap bands and widely used by orthodontists. Many others have posted videos on YouTube showing how to use elasticized hair ties. Or instructions on tightening and securing floss to accomplish the task.
Infection Or Root Damage
But is it really so simple, when you consider the risks? Orthodontists say, emphatically, “No!” The rubber bands or ties easily can work themselves up to the base of the tooth and even become lost under the gum line. That can cause, at the least, a severe infection, or worse, bone or root damage and/or permanent loss of a tooth. And that in turn can end up costing far more than the orthodontic treatment ever would have.
Self-applied rubber bands also lack the calibration that a dentist will ensure. New Zealand Association of Orthodontists President Alan Isaac pointed out that you cannot control where the band works, and that its placement determines the degree of tipping, or direction change, of the tooth. Further, if the rubber band works its way underneath the gum, it could seriously damage the ligament, or fibers, holding the tooth in.
Worse than a simple infection, that kind of damage can lead to tooth loss.
The Internet is teeming with numerous graphic photos showing the disfigurement that can occur.
A New York Times story related the consequences to one man who, as a child, had tried to fix the gap between his front teeth by using rubber bands. One band worked its way under his gums and became stuck, causing the teeth to protrude. Eventually the root damage became so severe he lost the teeth and now wears veneers. His experience, he told the Times, was “pretty traumatic.”
The fact of the matter is that the average person cannot see underneath the gums and has no way of knowing what is happening below the surface. For instance, there may be more bone around one tooth’s root than another. That could mean movement that is out of sync.
Professionally installed braces are what controls the movement of the teeth – in all directions – and stabilizes them. An orthodontist who is checking the patient at regular intervals is able to observe and measure the movement that is unique to each patient. Then the orthodontist will make the proper adjustments of the braces to ensure that patient’s teeth ultimately reach their planned, optimal alignment.
American Association of Orthodontists Consumer Alert
Dental professionals and orthodontists across the U.S. increasingly have been warning teens and their parents of the risks of do-it-yourself orthodonture. And yet the trend has continued at a fever pitch, prompting the American Association of Orthodontists to issue a Consumer Alert and a public service announcement via YouTube.
The AAO alert says, in part: “Moving teeth is a medical procedure and needs personal supervision by an orthodontist. Please be wary of any suggestions to move teeth with rubber bands, dental floss, or other objects ordered on the Internet. Moving teeth without a thorough examination of the overall health of the teeth and gums could result in the permanent loss of teeth, which may result in expensive and lifelong dental problems.”
DIY Braces Kits
Teens and adults who are looking to address bigger issues than a gap between two teeth are discovering what they believe are viable alternatives to costly, traditional orthodontic treatment.
SmileCareClub and CrystalBraces are two companies that have emerged to challenge the 10 or so companies cleared by the FDA to manufacture aligners, which the agency considers to be prescription devices. Along with orthodontist treatment, the FDA-cleared aligners, from companies like Invisalign and ClearCorrect, typically cost $4,000 to $6,000.
The mail-order aligners can be purchased for about half the cost. But orthodontists and other medical professionals warn that the savings are not worth it, especially since the mail-order devices are being prescribed to patients sight-unseen.
The mail-order manufacturers may be skirting the law, since they do have orthodontists from throughout the country signed up as advisers reviewing photographs taken by patients at home.
Orthodontists warn that aligners may not be appropriate for everyone, no matter what an online prescriber may tell you.
“You can waste your time and money trying to do something that’s physically impossible,” Chattanooga, Tenn., orthodontist Dr. DeWayne McCamish told the New York Times, adding that he would not rely on someone’s “selfie” in lieu of an in-person examination to determine the patient’s needs and course of treatment.
Among the unforeseen consequences of opting to do-it-yourself could be a negative impact on your health insurance.
While CrystalBraces, for one, advertises that insurance “might” help pay for the company’s mail-order braces, that is a risk consumers may not want to take.
In New Zealand, a spokesperson for Southern Cross says flatly, “We don’t reimburse for cheap DIY (do-it-yourself) treatments bought over the Internet under our health insurance policies. Health insurance is designed to pay for medically necessary treatment undertaken by medical professionals/experts in their respective fields.”
As with any medical procedure, it is best for you to consult your insurance carrier to understand what is covered and what is not.
And there are other consequences as well, from the pain of an infected gum to the pain your pocketbook will feel after you make an emergency visit to your dental professional, who may—or may not—be able to remedy the damage from trying to be your own orthodontist.
A Tampa orthodontist told WTSP-TV of one patient whose teeth were so badly impacted by her DIY attempt years before that she faced having the teeth pulled.
“The risks outweigh the benefits,” the orthodontist said. “The odds are you will do some damage to your mouth long-term.”
Proper Medical Methods – Why Choose An Orthodontist
The choice to use a professional orthodontist is a smart one.
Orthodontists are trained professionals who have completed a four-year post-graduate program to become dentists, then continue with a two- to three-year specialty course of study to learn about the intricacies of the jaw as well as movement of the mouth and teeth. They perform in-depth examinations of their patients so they know what type of orthodontic treatment to recommend—if any.
Orthodontists have sophisticated technology and equipment to guide them in their recommendations for their patients. There are several options for treatment and type of orthodontic device, depending on the patient’s physiology, age and extent of tooth, jaw or gum issues. An orthodontist who has seen the patient in person and evaluated his or her condition is in the best position to recommend what type device will work most effectively and what course of treatment should be followed.
Types of Devices Available
There are several options for orthodontists to recommend for their patients, including metal braces, clear braces, Invisalign and Damon system braces.
Metal braces are what traditionally has been prescribed for patients. These are usually made of steel or gold archwires. Nowadays you can get these in bright colors, and can switch out the colors at each visit, depending on your mood or maybe the season. You can cheer for your school team one month and get colors to coordinate with every holiday!
Clear braces are made from a ceramic composite so they can blend more easily with the tooth color and therefore be less visible. But they also are more brittle and prone to breakage when pressure is needed. They also are more expensive than the traditional metal braces.
Lingual braces are attached to the lingual, or tongue side of the mouth so they are virtually undetectable. They are custom made for your teeth so they can be small, flat and more comfortable for the wearer. Not all orthodontists offer this often, because of the complexity involved.
Invisalign is a brand of invisible braces that uses 3D technology to design a series of clear trays that gradually move the teeth to their desired position. They are removable so you can eat or drink what you want and continue flossing and brushing as usual. But they rely on your self-discipline to use as directed. This may not be an option in the case of severe overcrowding.
The Damon system uses a state-of-the-art sliding-door mechanism to hold the archwire in place. This sliding door mechanism makes a tunnel to hold the archwire while allowing it to slide freely.
Proper Care Is Worth The Cost
It is true that orthodontic treatment isn’t cheap—it can run anywhere from a few to several thousand dollars. That is why many teens or young adults resort to do-it-yourself methods. But many orthodontists offer free in-office consultations. Then, they work up a planned course of treatment and expected schedule for office visits, discuss the options with you and let you choose what course to follow. Their business office staff will help you determine what portion of the cost may be covered by your insurance carrier and can assist you in choosing a suitable payment plan.
The bottom line for teens and their parents who are either looking to avoid the high cost of professionally installed and monitored braces or are looking for an easy fix: Don’t try this at home.
Teeth are a living part of the body, made of bone and containing nerves and tissue. They are connected to our jaws, held in place by our gums and connective tissue, in an intricate and delicate kind of “puzzle.”
Orthodontists are specially trained professionals who are best qualified and equipped to take all the necessary X-rays and measurements, then calculate—at set intervals of time—how much to move the teeth so the delicate balance is not negatively impacted. And to see to it that at the end of this process, you have the smile that provides the fantastic look you deserve.
Attempting to do a doctor’s job on your own is both foolish and dangerous. And you could end up spending much more money and time than you had anticipated. Or worse, you may not be able to repair the damage at all.
So leave this important job to a professional: your licensed, certified orthodontist.
The best place for you to start in searching for unbiased, accurate information is:
The American Association of Orthodontists—This website is full of answers to the questions you may have about orthodontists, why they are your best choice, what to expect and other topics.
When searching for an orthodontist in your area and on your insurance plan, be sure to check for certifications and licenses. Orthodontists undergo rigorous training followed by two or more years of specialized post-graduate education in orthodontics at an accredited orthodontic residency program. Only then can one be called an orthodontist, and only orthodontists can be accepted for membership in the American Association of Orthodontists. Orthodontists may become certified by the American Board of Orthodontics after voluntarily dedicating hundreds of more hours to prepare to demonstrate their knowledge, judgment and expertise in providing the highest level of patient care.