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Buying braces online might not give you the smile you're after...

British dentists have 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. They are removable moulds that fit over the teeth to gently move them into new positions and are highly effective when used under the supervision of a dentist.

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. These patients need regular monitoring to minimise risks.

Online companies are selling aligners directly to the public via Instagram and Facebook – 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 dental clinic. While this is legal, customers are not always given enough medical support or supervision.

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 such as loose teeth and bleeding gums. If a tooth is moved to an unstable position, the damage can be permanent.

Aligners, when offered by a dentist may be more costly but include  X-rays, other scans and numerous face-to-face consultations over the course of six to 12 months. However, at the DIY companies, most patients are not routinely offered physical checks or examinations, with most interactions being via email or phone.

The most popular brand that we use at Dental Logic, Invisalign, involves the dentist 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 is swapped for the next in the series, gradually coaxing the teeth into new positions.

X-rays are essential. You need to check how much bone, or root, is under the gum, as too little can cause teeth to become loose when they move. Many people, even in their 30s and 40s, have lost a significant amount of bone due to gum disease, and   don’t realise it. It is impossible to detect this with 3D scans.

Dentists need to physically examine the patient regularly to check if the aligners are too tight, which can cause ulcers and painful cuts. It’s also common for patients to need filing down of tooth enamel, to prevent overcrowding. They also need to check for evidence of gum disease, which three-quarters of us have but don’t know it.

Investing in braces is not like a purchasing a new outfit. You need to be dentally fit to commence work, have the right preparation such as scans, consultations and x-rays and have regular consultations throughout the process. When done properly by the dentist, the effect can be increased confidence and life changing .

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