Picture: www.dentistrytoday.info
Oh boy. That was what came out of my mouth when a friend brought this issue to my attention. “What do you think of this?” he said. Attached in the text was a screen capture of an Instagram account selling fake fashion braces, boasting how the braces they fixed managed to correct “minor” tooth misalignment in their “patients.” They also claimed that their braces are ‘real’. If only.
“What’s wrong with fake braces?” You may ask. “They’re cute and harmless.” Cute, maybe, but harmless? Think again. There are already two deaths in Thailand linked to fake fashion braces, and both of the victims were just teenagers. The first victim was a 17 year old girl who died from fatal heart failure as a consequence of a thyroid infection originating from the faux braces, while the police also linked the death of a 14 year old girl to the fake fashion braces she bought from a roadside stall.
While the ones who wear legitimate orthodontic braces prescribed by legitimate dental practitioners usually spend their days counting down until the day to take them off arrives, the ones who do not actually need them go on the internet looking for online vendors selling fake braces. It is hard to say why this particular trend became popular but western media speculate that it is because in our Asian society, wearing braces is a symbol of wealth, which is perhaps true as one set of braces can cost you thousands of ringgit.
Braces are a type of fixed orthodontic appliance prescribed by orthodontists to those who need misalignment of teeth or, to a smaller extent, jaws to be corrected so that the teeth and jaws can work in perfect harmony. During consultation, the orthodontist will perform an examination, take a mould of your teeth and x-ray to obtain information and develop a course of treatment. The treatment plan, the type of appliance that will be used or the option of non-treatment will be evaluated and discussed with the patient once all the required information is obtained.
Why are all those steps necessary? Because there are many factors to be considered before starting treatment. Wearing braces is not just about attaching the brackets, the wire and the colourful rubber elastics that you think are cute. Just like any other kind of medical or dental treatment, you may also encounter undesirable side effects while wearing braces. Therefore, the orthodontist also has an unenviable task of deciding whether the benefits of braces outweigh the risks for each of their patient.
The arts and science of orthodontics are so delicate and complicated that general dental practitioners (GDPs) are usually required to attend extra courses on orthodontics which typically last for at least one year, or to complete a master’s degree in orthodontics in order to practise it. Whereas in the curious case of unlicensed fake braces sellers-cum-practitioners, how deep is their knowledge about orthodontics and are they legally qualified to practise it? If things went wrong, could they be held accountable for their actions?
Furthermore, who knows what is in these fake braces? What if there is a harmful substance in them? The fake braces seized by the Thai authorities were found to contain lead. Assuming that these fake braces are worn for at least a few months, lead contained in the metallic components of the braces can leach out into your mouth. And you, unknowingly and inevitably will swallow this poison. Fast forward a few months, you start to experience abdominal cramps, constipation, difficulty sleeping, headaches, and even aggressive behaviour and loss of previously developed skills; signs of lead poisoning.
Many things can go wrong with improperly placed braces. If the wire, bracket or power chain is applied inappropriately, this can result in excessive pressure being forced onto the teeth. As a consequence, bone resorption may occur, which will cause the teeth to become permanently loose, and to the worst extent, become completely mobile and fall out of the sockets. Ask yourself; is it worth losing previously healthy teeth for the sake of ‘fashion’?
Since braces are foreign to the oral environment, they present as an extra structure to accumulate dental plaque. Dental plaque is a biofilm which contains bacteria causing oral diseases such as gum diseases and tooth decay. Therefore, when braces are placed by legitimate dental practitioners, the treatment package also comes with counselling on special oral hygiene care for braces wearers. During each follow up, oral hygiene status is re-evaluated, and early signs of demineralisation (weakening of tooth structure due to acids produced by bacteria in dental plaque) and gum diseases are detected and treated at once.
Otherwise, what is the point of having perfectly aligned teeth if they are not healthy and functional? Your teeth may be straight and even now but they are loose. You cannot even bite your burger with them. And then there are brownish black spots on your teeth that signify tooth decay. Your gum is red, swollen and bleeds on the slightest touch, and your breath stinks because you now have advanced gum disease from neglected proper oral hygiene and gum care while wearing braces. Again, ask yourself; is it worth it?
I also would like you to do one thing before getting braces placed by a ‘fake practitioner’: ask them if they will provide orthodontic retainer after the ‘treatment’ is complete. If they say retainer is not part of the deal, run for the hills, and do not look back. Retainer is one of the most important factors in ensuring and maintaining the success of your treatment. After the braces are removed, the fibres that hold your teeth in position need quite a while to re-organise themselves. Retainer holds your teeth in position until the fibres and your bite stabilise. Failure to wear retainer can cause the teeth to relapse to their ‘original’ position before wearing braces, or sometimes even worse.
Before I end this article, I would like to mention that I have only the best interest of all of you in my heart. This is not about chastising or bringing down anybody’s business; it is about my duty as a dental practitioner and civil servant to do what I can to provide relevant information, so that you are armed with valuable knowledge before deciding to pursue any kind of dental treatment. So please choose wisely.
Dr. Husna Razak (BDS) (KLE VK) is a dental officer working in the Kelantan. Know more about her in The Team page.
References:
- http://www.ndcs.com.sg/ForPatientsAndVisitors/ConditionsAndTreatments/Glossary/Pages/Orthodontics-AfterBracesAlwaysRetainers.aspx
- http://www.nlm.nih.gov/medlineplus/ency/article/002473.htm
- http://www.vice.com/en_uk/read/deadly-fashion-braces-are-big-in-thailand
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]