ORTHODONTIC TREATMENT: DON’T DO IT YOURSELF

crooked teeth

Amos Dudley is a capable young man who gained fame by straightening his own teeth. He was a college student majoring in digital design when he decided to be his own orthodontist. Dudley challenged himself to “ …save money, make yourself happier, and stick it to the dental appliance industry, all in one shot.”

DIY CLAIM TO FAME

The media loved his story. The meme is that a college student saved thousands of dollars and straightened his own teeth for $60. His story has stimulated a wave of Do It Yourself  “orthodontists” all over the country. There are hundreds of Youtube video “tutorials” on this subject. The American Association of Orthodontists (AAO) found that 13% of its members have patients who had previously tried to straighten their own teeth. The orthodontists had to treat self-inflicted damage in 39% of these patients. Sadly, many had damage that couldn’t be repaired.

TRY STRAIGHTENING YOUR OWN TEETH?

In truth, straightening your own teeth is a terrible idea. A much wiser approach is DDIY: Don’t Do It Yourself.  Let’s put the Amos Dudley story in perspective, then discuss the reasons why orthodonture should be done by orthodontists.

First of all, the true cost of Amos Dudley’s project was more than the $60 cost of materials for his homemade aligners. He made them using a laser scanner and 3D printer. He had access to these devices as a student at the New Jersey Institute of Technology. Tuition there is $16,000 for in-state students, $30,000 for students from out-of-state. The NextEngine laser scanner he used sells for about $3,000, and the StrataSys 3D printer for about $20,000.

Amos Dudley invested a great deal of time and study in his project. He did a great deal of research in orthodontics and learned to take impressions of his teeth. He’s a very, very intelligent and resourceful guy. Moreover, his teeth were only slightly misaligned, to begin with.

Did Amos Dudley succeed?  He did! That is, his media exposure got him the offer of his dream job at a Boston engineering company. Formlabs designs and manufactures… 3D printers.

DUDLEY’S ADVICE

What does Dudley say about DIY orthodontics? He advises against it, writing “..if you want to lose your lunch…” search Google for photos of DIY braces gone wrong. Dudley’s right. He took a big risk, brought costly resources into play, and he’s a gifted engineer. He was lucky, and he knows it. And he’s right when he advises against trying it yourself. The vast majority of attempts at DIY orthodonture are much more primitive and much less successful than Amos Dudley’s.

NOT SO SIMPLE

Laymen think moving teeth is very simple. Push on a tooth, and it moves in the direction it’s pushed. Well, there’s a lot more to it.  “Human physiology, occlusion, biomechanics, craniofacial growth and development, tooth size, shape, and morphology, as well as the patient’s overall lifelong dental health, must be taken into consideration.” So writes Jeffery Iverson, DDS, MS, an Assistant Professor at the University of Utah School of Dentistry.  In fact, moving teeth properly involves precision dissolving and rebuilding of bone. There’s nothing simple about it.

Still, the possibility of saving money is a temptation some people find hard to resist. Hence, taking only the dollar outlays into account, DIY orthodontics looks like a bargain. It’s more often quite the opposite.

DON’T DO IT YOURSELF

The most popular DIY approach to DIY orthodonture is wrapping a rubber band around two adjacent teeth. Tension on the rubber band is meant to move the teeth closer together. In some cases, this does happen. However,  the risk of serious dental complications is very real. These include tooth loss, gum damage, root damage, and tooth fracture. When infection flares up, it can spread through the blood to the rest of the body. This can become life-threatening.

DIY teeth straighteners also utilize string, fishing line, and paper clips, with similar results and complications. Some people try biting on pencils. Others rub salt into their gums and then press on their teeth with their fingers.

MAIL ORDER ALIGNERS

Amos Dudley made it clear that he would never consider making aligners for anyone but himself.  However, a growing number of companies have entered the market for mail-order orthodontics.

At the low end, the process is somewhat similar to what Dudley worked out. The company sends an impression kit to the customer. The customer makes impressions of his or her teeth at home. Some vendors also require photos. When the company receives these impressions, they make aligners and return them to the customer. Some companies take a more sophisticated approach and refer customers to local facilities for a 3D scan.

WHAT COULD POSSIBLY GO WRONG?

This process can go wrong in any number of ways.

To begin with, a customer’s overall dental status isn’t evaluated by an in-office examination by a qualified, licensed professional. No x-rays are taken and reviewed. Hence, a variety of complications can easily be overlooked.

Also, making good dental impressions requires some skill. In fact, some states restrict the types of impressions trained dental assistants can take. The accuracy of dental impressions is strongly affected by technique and materials. It is very difficult for an untrained layman to evaluate the accuracy of impressions he or she makes. Thus, the aligners made based on self-made impressions are likely to be a poor fit. That’s a setup for failure, in the best case. In the worst case, well, it can make things worse than they were to begin with.

In addition, the mail-order model doesn’t include the monitoring that an orthodontist provides for patients. Moving teeth is almost never a straight-line process. Teeth can move faster than anticipated, or more slowly. Hence, appliances need to be adjusted. For example, Invisalign trays are changed every two weeks. Furthermore, oral health issues may come up during treatment. An orthodontist can identify and manage these. A mail-order company can’t do that.

DOLLARS AND SENSE

It should be clear that straightening your own teeth with homemade appliances is out of the question. No one should consider it, period. This is not debatable. It’s crystal clear. It may look inexpensive, almost free. It isn’t. You get what you pay for. With rubber bands and the like, you’re paying for a near-zero chance of success, and a significant risk of disaster. It could end up costing much more than regular orthodontic treatment would have. How can that ever make any sense?

Mail order aligners appear to fall above rubber bands and below in-office orthodontic treatment in terms of cost. However, there are serious issues in trying to move teeth without the direct supervision of an orthodontist. Complications can arise which require an orthodontist to correct – if they’re correctable at all.

DON’T DO IT YOURSELF (DDIY)

The idea straightening your own teeth is an unwise one. See an orthodontist. If this seems like self-serving advice, know that there is no shortage of patients. Actually, the demand for orthodontic treatment has never been stronger. The process of dissolving and remodeling your bone should be managed by a licensed professional. That’s what straightening teeth involves. Don’t do it to yourself. It isn’t worth the risks to your health and wallet.