The dangers of direct-to-consumer orthodontics

DIY orthodontcicsWith the huge rise in DIY orthodontics, or direct-to-consumer solutions available to the UK public, Dr Ramtin Taheri gives us some advice on what to tell your patients.

You have most likely encountered advertisements promising to deliver braces to patients to straighten their smile without ever needing to see an orthodontist.

This probably sounds too good to be true for your patient. So it is important for you to educate them and make sure they have the facts.

Explain that any orthodontic treatment should begin with a thorough consultation. This allows for a professional to properly examine teeth and inspect for any traits that the orthodontic appliance will need to cater for.

If a patient has periodontal disease, this could worsen and should be treated before any braces commence. As patients never see a dental professional throughout their treatment with these DIY braces, there is no way of monitoring any potential issues that may present at any time.

Additionally, the only way that DIY braces can create space to solve crowded teeth is to push them forwards. Often this can lead to pushing the teeth out too far. This results in gums receding and more commonly, open bites (front teeth do not crossover or meet).

Only tooth movement in one direction can correct crowding (ie buccal movement/tipping). So without IPR or attachments, it is not possible to complete difficult movements.

Therefore, these DIY braces always have to default to the simplest movement, not the best smile. Emphasise that an orthodontist can create space in ways to overcome these issues.


The danger of DIY braces is that they take a very minimal approach to healthy alignment.

Instead, they place an emphasis on visual results that don’t always offer long-term guarantees. A careful look at some of the patients that they use for demos on their websites shows incomplete space closure, especially midline diastemas. There is almost always a little space left.

We know this is in fact potentially more damaging to a patient’s long-term dental health because of chronic food impaction. These patients are also forever worrying if they have visible food caught in their teeth. They have just traded one problem for another.

I view these DIY braces as a dangerous ‘quick fix’ approach that can harm the patient and may need dental intervention.

While clear aligners may just be an appliance, they nonetheless require an orthodontist to oversee them.

They must make sure they are successful at every stage and don’t cause damage. Taking away the dentist is a scary thought.


The British Orthodontic Society (BOS) and Oral Health Foundation announced their plans for a national campaign to warn patients about the risks of direct to consumer orthodontics at BOC 2019 in Glasgow.

The BOS says it is: ‘Extremely concerned about this trend’. It recommends that: ‘Patients attend to see an experienced/trained clinician in person who will be able to carry out a full clinical and orthodontic assessment and discuss their particular orthodontic and dental requirements and ensure all appropriate and available options are considered.’

Put simply, the message you must convey is: DIY braces just can’t do this.

However, dental professionals can and will always ensure teeth are straight. They also ensure they end up in a healthy long-term position.

This article first appeared in Orthodontic Practice magazine. You can read the latest issue here.

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