The alarming rise of 'DIY dentistry'
MDlinx May 29, 2024
DIY dentistry and DIY orthodontics are not new concepts. The costs associated with dental and orthodontic care, along with access issues, may entice people to pull their own teeth, fix cavities, or straighten their smiles at home. Some patients in the UK have allegedly even resorted to using super glue to attach homemade teeth to their gums.
Thomas T. DIY dentistry on the rise as 90% of NHS practices not seeing new patients. The Guardian. August 8, 2022.
The self-dentistry trend—compounded by the increase of direct-to-consumer products—may result in serious oral health problems. However, some patients remain unaware of the risks and require education.
What's behind the DIY trend?
“Dentistry has once again been making the front pages of many media outlets recently, thanks to the multitude of patients who have resorted to DIY dentistry—attempting to remove their own teeth because they couldn't access a dentist when they were in pain,” wrote dentist Shaun Sellars, BDS, MA, in the British Dental Journal.
Sellars S. DIY Dentistry. Br Dent J. 2023;235.
Dr. Sellars cited a 2023 report by the UK’s Health and Social Care Committee on NHS dentistry.
NHS dentistry. Ninth Report of Session 2022–23. Health and Social Care Committee. July 11, 2023.
The report found that the service provided was “unacceptable” and that people living with the highest levels of poverty had the greatest difficulty accessing dental care.
Attempted self-procedures
Along with performing extractions with pliers or other tools, self-dentistry can involve teeth bleaching, adding implants, crowns, and veneers, and fixing malocclusions, among other procedures.
According to a review of DIY dentistry published in the International Journal of Chemical and Biochemical Sciences (IJCBS), individuals partaking in DIY dentistry tend to rely on videos posted on YouTube and other video-streaming sites for dental care.
Thirugnanasambandam G, Somashekar G, Rajachandrasekaran Y, et al. Review of do-it-yourself dentistry- time to ring the alarm!. IJCBS. 2023:24(5):1–4.
“The most effective direct-to-consumer dental products eliminate the ‘middleman’—even if a qualified practitioner is inexpensive, straightforward, and convenient, ” the IJCBS authors write. “The majority of these DIY items and the companies that market these products are unregulated, providing little protection to customers.”
Temporary tooth replacement is a popular DIY procedure, and cosmetic crowns can be purchased online, the IJCBS authors noted.
The kit comprises thermal beads the consumer heats to a high temperature and molds into the desired shape of the tooth before inserting to fill the space of the missing tooth. Temporary tooth-filling materials and clip-on veneers are also sold online.
While rare, the authors reported that individuals may even make and install dental implants and dentures.
For DIY scaling, to prevent or treat periodontal disease, OTC medications or teeth cleaning kits, including sprays, scrapers, rotary devices, and whitening pastes, are commonly used along with polishers that run against the teeth. Teeth bleaching products, including pre-fabricated trays, are available online and offline. Individuals may also use homemade products such as baking soda to whiten teeth.
Still, the IJCBS authors caution that high concentrations of bleaching mixes may irritate the gums and cause sensitivity.
Commercially available bleaching products may be ineffective and lack ingredients such as fluoride, which acts as anticariogenic agent. Hence, teeth whitening should be completed under the guidance of a dentist, the authors write.
DIY orthodontic treatments include the use of “make-your-own clear aligners.” Individuals have also reportedly attempted to straighten their teeth using elastic bands and hair ties.
Thirugnanasambandam G, Somashekar G, Rajachandrasekaran Y, et al. Review of do-it-yourself dentistry- time to ring the alarm!. IJCBS. 2023:24(5):1–4.
Serious oral health consequences
“DIY dentistry has its drawbacks despite being popular for its cost-savings, reduced chair time, and convenience,” the IJCBS authors noted. “DIY dental care is not more efficient than dental care received in a dental office.”
Along with inaccurate diagnosis leading to treatments that may worsen the condition, DIY dentistry may result in oral health problems, such as gum damage, along with tooth chips, breaks, or loss.
Together with localized pain, mouth infections can also occur as a result of DIY dentistry. These infections may spread throughout the body, creating potential health consequences.
Additionally, damage or complications caused by DIY dentistry may require extensive and costly treatment to resolve the issue.
Perception of risk
Still, the perception of risk associated with DIY treatments is minimal for some individuals. A study published in the Journal of Clinical and Experimental Dentistry evaluated the general public’s preference for and knowledge of DIY orthodontics and their awareness of the associated risks.
Acosta-Lenis C, Bollu P, Chaudhry K, et al. Public perceptions and understanding of risks associated with do-it-yourself orthodontics: a survey study. J Clin Exp Dent. 2022;14(9):e712–e718.
An online questionnaire was administered to 526 individuals, none of whom had professional dentistry and orthodontics experience. Among those who considered DIY orthodontics, financial reasons stood as the most commonly selected incentive.
These individuals generally had a lower level of education, low income, and lack of knowledge about the differences between a GP and an orthodontist. Women were more likely to use DIY orthodontics than men.
Of the respondents, 122 had considered DIY orthodontics, but 26 of those individuals “did not consider the clinical exam and diagnostic records important and would be comfortable without in-person supervision,” the authors wrote. Moreover, 83 of the 122 indicated that while they would be comfortable without in-person supervision, they still considered this treatment modality "doctor-directed.”
The study found that a quarter of potential users of DIY orthodontics “do not consider risks involved,” with many considering their own dentist responsible for detecting problems during treatment. Some believe DIY orthodontics is risk-free. “Moreover, one third of respondents will consider DIY orthodontics in the future,” the authors reported.
What this means for you
DIY dentistry is popular but associated with serious oral health problems. Your patients are at risk if they remain unaware of these consequences and may require education on the topic. As physicians, you can question your patients about their use of DIY dentistry, as it may be implicated in symptoms such as localized pain or local and widespread infections.
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