|
 
 |
| STUDENT FORUM |
|
| Year : 2016 | Volume
: 7
| Issue : 4 | Page : 157-159 |
|
The Role and Implications of “Do It Yourself” Tooth Movement
Sydney A Schneider
School of Dental Medicine, University of Connecticut, Farmington, Connecticut, USA
| Date of Web Publication | 21-Dec-2016 |
Correspondence Address:
Sydney A Schneider
School of Dental Medicine, University of Connecticut, Farmington - CT 06030, Connecticut
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2155-8213.195977
“Do It Yourself” (DIY) tooth movement has gained widespread attention recently in the United States. Options ranging from kits that consumers can purchase online to straighten their teeth without stepping a foot out of their homes to online instructional videos are readily available. These options offer the consumer convenience as well as a way to save a significant amount of money while promising to provide the desired end product of a beautiful smile. Unfortunately, most of the general population is unaware of the implications of such methods of orthodontic tooth movement. It is the responsibility of dental professionals to put their educational background to use and uphold the ethical principles of clinical practice by educating the public regarding the consequences of using these methods to straighten their teeth. DIY orthodontics is undoubtedly a threat and an opportunity for the orthodontic community, and its potential to impact the field should not be underestimated.
Keywords: Aligners, braces, orthodontics, orthodontic appliances, public health
How to cite this article:
Schneider SA. The Role and Implications of “Do It Yourself” Tooth Movement. Dent Hypotheses 2016;7:157-9 |
| Introduction | |  |
In the United States, the phrase “Do It Yourself” (DIY) refers to the completion of specific tasks by a person, a Do it Yourselfer, without any expertise, education, or training in how to complete the task. Often these amateurs are self-taught having watched a few instructional videos available online or having taken a very brief workshop. In the United States, Do it Yourselfers might attempt to plant a garden, paint a house, or tile a floor. Where specialized knowledge or equipment is needed − such as repair of an automobile − the Do it Yourselfer defers to someone with expertise, a professional.
Correcting malocclusion is a multistep process. It involves both treatment planning and execution of the treatment plan. Both tasks require specialized education and training that includes a minimum of 4 years of dental school followed by 2 to 3 years of orthodontic residency. Tooth movement is not something for DIY amateurs. Despite this warning, there are people who try.
Do it yourself orthodontics
In 2016, that someone was an engineering student at the New Jersey Institute of Technology. Confronted with an estimate for orthodontic treatment that was beyond his budget and being unhappy with the esthetics of his smile, he consulted the internet and decided he could correct his malocclusion himself. A CNN Money article described how he diagnosed his problem, calculated the distance he needed to move his teeth in order to align them, and divided that distance by the “maximum recommended distance a tooth should travel” to design each step in the treatment.[1] Although this particular individual claims that he does not intend to make a business out of his “success,” it is highly likely that another entrepreneur will take this idea and run with it.
Imagine what parents with three children all needing orthodontic treatment might think after reading this news article. Not only could they do this at home, but a great deal of money would be saved. This type of orthodontic treatment appears to be very convenient and easy, but the reality is, it is not at all like tiling your bathroom floor.
While this is an example of an extreme DIY treatment, it is not on the market. Another “more affordable” and “appointment-free” DIY method for orthodontic treatment is an online kit that consumers can purchase online. This product includes instructions and necessary materials to take dental impressions in one’s own home. These impressions are mailed to the company, and in the return mail, the customer receives a set of customized “aligner” trays to be worn each day to gradually move the teeth into the desired position. These companies claim to give patients the “guidance” they need along the way to straighten their teeth from home.[2] With only an impression sent to the company, it is difficult to comprehend how these dental labs can make thorough evaluations and diagnoses of the orthodontic needs of their cyber patient.
Why would consumers consider do it yourself orthodontics?
The most probable reason why the consumer would consider DIY orthodontic treatment would be cost. In the United States, orthodontic treatment is expensive, and for a family with three children all needing treatment, this cost could be excessive or unaffordable. Another reason might be, and this is my own subjective observation, what parents observe in the orthodontist’s office. A comment I have often heard voiced by parents is that “the orthodontist doesn’t do much” at appointments. They see assistants with each patient adjusting and performing most of the daily tasks. What they do not appreciate is that the orthodontist is responsible for the complete diagnosis, treatment plan, and oversight of the bonding, de-bonding, and every checkup. While the assistant is frequently making the adjustments of the wires and brackets, they only do so as instructed by the orthodontist. It is the busy staff that many parents observe and comment upon, not knowing that the orthodontist is the team leader making the decisions of what is done at each visit. In addition, parents often do not understand why treatment lasts so many months. It might be helpful if the orthodontist discussed and disclosed to parents what is involved in treating the patient in an understandable language for both the parent and patient. By consciously clarifying their role in the patient’s orthodontic treatment, such misconceptions could be minimized.
What can the American Association of Orthodontists do about do it yourself orthodontics?
Although it might not fully alleviate the problem, if each orthodontist spent a few more minutes of conversation when initiating treatment, the public’s understanding of the complexity of orthodontic treatment might increase. This effort is important to eliminate the misconception that tooth movement can be accomplished by just about anyone with a DIY kit from the internet. In addition to the previously mentioned clear aligner trays that have been used for DIY tooth movement, some other internet offerings include instructional videos that show consumers how to move teeth using paperclip braces, rubber bands around teeth, and dental floss wrapping teeth.
The American Association of Orthodontists (AAO) has cautioned the public regarding the new DIY orthodontics via media relations efforts, including publication of articles in the national media. The AAO has delivered the message that “those who attempt self-care may be putting their oral health at risk, and urged anyone interested in teeth straightening procedures to see an orthodontic specialist.” The most recent AAO press release “reminds consumers that any time a dental procedure is undertaken by an untrained, unsupervised individual, there is a substantial risk for irreparable damage.”[3] This is certainly a good first step, but is it enough? Given the magnitude of the issue, further steps should be taken to generate regulations for the parts of the DIY industry where possible.
In addition, the orthodontist community should also make an effort to encourage general practice dentists to raise further awareness of the issue, especially since many dental patients see a general dentist on a regular basis. If general dentists and pediatric dentists could join in the campaign, it may lead to success in raising greater awareness among the patient population from the very beginning about these tempting alternatives. In addition, a pamphlet, for example, could be prepared in an understandable language for the general population that could be distributed to dental clinics and practices that are willing to support the effort to educate the public about DIY orthodontics. Simply having these pamphlets in an orthodontist’s office will not likely have an impact, as patients who would step foot into an orthodontic practice probably already intend to pursue professional treatment. The genesis of the problem and the most susceptible consumers are those who have not yet pursued professional orthodontic treatment. Thus, if these individuals can be thought of as the target population, efforts to intervene with DIY orthodontics may be more effective.
Is do it yourself orthodontics a threat or an opportunity?
The potential for acceptance of DIY orthodontics by the public should not be taken lightly. The orthodontic and dental community should recognize the threat this new technology poses to public health and take control of it, manage it, and license it. However, if the orthodontic community does not recognize the issue and take serious action, DIY orthodontics has the potential to negatively impact the specialty. DIY orthodontics becomes a threat when it is sought out by the public rather than professional treatment because of its convenience and financial benefits for the consumer. Not only is it competition for the orthodontist but it also has serious implications for public health. In addition, poor treatment outcomes from DIY orthodontics often end up requiring a professional orthodontist to fix the erroneous case. These are key ways in which DIY orthodontics is a threat to the field.
The DIY orthodontic movement also presents an opportunity. The publicity surrounding this technology has increased awareness about having a beautiful smile. It has also created awareness among the adult population for orthodontic treatment. For orthodontists, DIY orthodontics kits are a form of advertising for orthodontic treatment and it has generated a flow of patients into orthodontic practices.
DIY orthodontics could become a readily available option for the general public. All dental professionals, especially orthodontists, should recognize this as a possible threat to public health and take action to protect the public by generating regulations. With that in mind, it would be wise for organized dentistry and the orthodontic community to take control of this innovation by setting standards for its practice. The American Dental Association did exactly this when the idea of dental therapists was introduced. As with the failure to stop the dental therapist movement, attempts to stop the DIY orthodontic innovation are unlikely to be successful. This means taking steps to protect the public from harm and creating necessary regulations to ensure that the public’s health is the first priority.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | King H. College Student 3D Prints His Own Braces. CNN Money. Cable News Network; 2016.  |
| 2. | Saint Louis C. Straighter Teeth By Mail. Well. The New York Times; 2015. |
| 3. | AAO Cautions the Public as New DIY Orthodontics Approach Gains Attention. American Association of Orthodontists. AAO; 2016. |
| This article has been cited by | | 1 |
Direct-to-consumer orthodontics |
|
| Sawsan Tabbaa, Teresa Nguyen, Youssef Toubouti, Humam Saltaji | | The Journal of the American Dental Association. 2022; | | [Pubmed] | [DOI] | | | 2 |
Adult patient preference for an orthodontic care provider in Canada |
|
| Matthew Brown, William Wiltshire, Fabio Henrique de Sa Leitao Pinheiro, Dieter J. Schönwetter | | American Journal of Orthodontics and Dentofacial Orthopedics. 2022; | | [Pubmed] | [DOI] | | | 3 |
Direct-to-consumer orthodontics: surveying the user experience |
|
| Anna Wexler,Ashwini Nagappan,Andrew Beswerchij,Rebekah Choi | | The Journal of the American Dental Association. 2020; 151(8): 625 | | [Pubmed] | [DOI] | | | 4 |
Comparison of patient factors influencing the selection of an orthodontist, general dentist, or direct-to-consumer aligners |
|
| Jeffrey C. Olson,Bhavna Shroff,Caroline Carrico,Joseph Boyle,Steven J. Lindauer | | American Journal of Orthodontics and Dentofacial Orthopedics. 2020; 157(4): 526 | | [Pubmed] | [DOI] | |
|
 |
|
|
|
Search Pubmed for
