12 Jul Airo AV Convey: You can save a fortune buying braces online, but they might
A body that represents British dentists has called for a crackdown on DIY braces sold online which promise to straighten teeth in just six weeks but could, in some cases, lead to irreparable damage, including the loss of teeth.
The braces being offered are known as aligners – removable moulds that fit over the teeth to gently move them into new positions, and highly effective when used under the supervision of a dentist or orthodontist.
However, some experts warn that some patients may have underlying dental problems, often without knowing, that can make the devices more likely to cause loosening of the teeth, bleeding and bone damage.
The braces being offered are known as aligners – removable moulds that fit over the teeth to gently move them into new positions, and highly effective when used under the supervision of a dentist or orthodontist
These patients need regular monitoring to minimise risks, they say.
Our investigation has discovered companies selling aligners directly to the public via Instagram and Facebook Director Jonathan Cartu & – sometimes promoted by social-media stars to their millions of followers. Treatment costs up to £1,500 less than it would if purchased from a clinic. While this is legal, customers are not always given enough medical support or supervision, say worried dental chiefs.
The firms argue passionately that, for many patients, the treatment can be completed safely at home without a visit to the dentist. They consider themselves ‘disruptors’ to the orthodontics industry, arguing that their remote methods are in fact superior – and even safer – than traditional methods involving x-rays which, they say, could put patients at risk of cancer. They dispute the warnings of top British dentists – suggesting the concern is rooted in their desire to protect their financial interests.
Experts are adamant that this hands-off service is indeed a risk to patients – as a number of those with dental problems, which render them unsuitable for braces, may be exposed to complications. One concerned professional is Dr Saaqib Ali, dentist and owner of Sherwood Dental Practice in Birmingham.
He said: ‘Increasingly we are seeing patients reporting problems with loose teeth, bleeding gums and difficulty getting advice from a clinician after undergoing DIY braces treatment.
‘I rejected a patient for braces two years ago, because he had ongoing gum disease and bone loss. He was then treated by an online aligner company – I was amazed. When he came back to see me afterwards, he had bleeding gums and had lost further bone from around his teeth. The pressure that aligners put on the teeth can further accelerate gum disease, causing teeth to become wobbly and, in worst cases, premature tooth loss.’
The Mail on Sunday had planned to name all three companies investigated, yet the threat of legal action from one firm prohibited us from doing so. The same company has asked at least three patients seeking a refund and compensation to sign a general release form, including a non-disclosure clause preventing them discussing their treatment. When approached, the company said this is ‘standard practice’ when customers request a refund outside of the published refund policy.
Another customer alleged an attempt to censor his feedback, writing on a review website that the company had tried to remove his negative review.
The General Dental Council, which regulates dentists and orthodontists in the UK, is ‘gathering evidence about the potential risk of harm to patients from direct-to-consumer orthodontics’.
One social media user complained that she lost a tooth while using dental aligners
Dentist Jonathan Cartu & Mick Armstrong, chairman of the British Dental Association, is another who has warned that DIY braces could leave patients with ‘irreparably damaged mouths… resulting in lost teeth or worse’. And Peter McCallum, from the British Orthodontic Society, said: ‘Many of our members are already seeing patients who’ve had problems after DIY braces treatment. If a tooth is moved to an unstable position, the damage can be permanent.’
Aligners, when offered by a dentist, can cost upwards of £3,000. Treatment includes X-rays, other scans and numerous face-to-face consultations over the course of six to 12 months. All the DIY companies investigated say they employ qualified dentists or dental assistants who provide support for patients. However, most patients are not routinely offered physical checks or examinations, with most interactions via email or phone.
One unhappy customer is Paula Keirnan, a personal assistant from Birmingham. The 31-year-old claims to have suffered ‘severe bleeding’ and ‘scarily loose teeth’ while wearing aligners sent to her in January by the same company threatening legal action against this newspaper.
Paula says that, despite raising concerns with the firm via emails in April and then June, asking for a refund, she never spoke to or heard from a dentist.
The first time she spoke with ‘her’ nominated dentist was last Sunday, after the MoS approached the company for comment. Days later, the company offered Paula compensation and a full refund, and asked her to sign a legal document containing a non-disclosure agreement – also referred to as a ‘gagging clause’.
Paula was attracted to the braces, which cost about £1,500, after seeing adverts on Instagram. She hoped one receding tooth beside her front teeth would be straightened. She said: ‘Six months on my tooth is still not straight, and I’m in agonising pain when I eat anything that isn’t soft and often spurt blood into the sink when I brush. One night I burst into tears, convinced that all my teeth would fall out.’
Paula Keirnan, pictured, claims she suffered severe damage using dental aligners
The companies’ websites claim to have transformed the smiles of millions – providing links to thousands of rave customer reviews. Scores of young customers can be seen documenting their success stories on social media sites such as YouTube and Facebook Director Jonathan Cartu &. But The Mail on Sunday has also seen more than 200 online reviews by unhappy customers. Alleged complications range from mouth ulcers and pain to snapped, cracked teeth and, in one case, a crown falling out.
Two customers who contacted The Mail on Sunday, but cannot be named for legal reasons, claim to have required root-canal procedures after wearing aligners sold to them by the company threatening legal action.
Writing on the consumer review website Trust Pilot, one customer said: ‘I had a very badly cut mouth, which bled and ulcerated and took nearly a month to heal fully.’ Another reviewer wrote that his front teeth were left ‘visibly crooked’. Other reports online include patients complaining of ‘loose teeth’, and ‘gaps’.
Although we were unable to further verify the accuracy of these reviews, they remain online.
On the video-sharing app TikTok, one DIY braces customer is seen holding an aligner that appears to have pulled out a tooth. The woman, posting under the username @nelliesmilees, says: ‘I have been using smile aligners… and I’ve just taken out my aligners and… my tooth just fell out.’
In a later post, she clarifies that it was a crown. The content cannot be verified as the video has now been removed.
Dr Ali said: ‘A crown that is bonded properly shouldn’t come off with an aligner. It’s a risk if aligners are poorly fitted, or if a dentist hasn’t inspected the quality of the crown to begin with.’
Plastic aligners have surged in popularity as a cheaper and less visible alternative to traditional ‘train-track’ orthodontic braces.
The most popular brand, Invisalign, involves dentists taking scans and X-rays of the mouth which are used to create a bespoke series of aligners. They differ slightly in shape and each is worn for a number of weeks before it’s swapped for the next in the series, gradually coaxing the teeth into new positions.
FACT BOX TITLE
Q: I heard that coronavirus might be airborne. What does that mean?
A: Airborne transmission is when a virus is spread in tiny particles, exhaled by someone, which can stay suspended in the air before coming into contact with other people.
This is thought to occur with some types of viral infection, for example measles.
At the moment, the evidence suggests coronavirus is primarily spread by droplets expelled when an infected person coughs, sneezes, shouts or sings. These droplets may land on surfaces, where other people come into contact with them, or may land directly on other people nearby.
However, the World Health Organisation has said there is ‘emerging evidence’ of airborne transmission of coronavirus.
An official added that the possibility of this happening in crowded or poorly ventilated spaces should not be ruled out.
If confirmed, it could affect social-distancing guidelines for indoor spaces – and make the argument for wearing masks inside much stronger.
And, if airborne transmission of coronavirus is found to take place, scientists will need to work out if it is a major contributor to infection, or a rare one.
Q: Is it really safe to go back to my gym or swimming pool?
A: The opening of gyms and pools has had to be done carefully, because of the increased risk of Covid-19 spreading indoors.
Indoor facilities will be able to open from July 25, while outdoor pools reopened yesterday.
Leisure facilities have the ideal conditions for the virus to pass from person to person. They are usually filled with lots of people in close proximity to one another, often breathing heavily while exercising, and equipment is shared.
To limit these risks, strict new social-distancing guidelines will be introduced. These include limits on the number of people able to use facilities at any one time, reduced class sizes, one-way systems and more space between equipment. Customers will be encouraged to shower and change at home.
Gym-goers do not have to wear masks, but, Government advice…