“Still relying on age-old methods to solve your teeth gap issues when you have an easy peasy solution available?” This is the question that cricketer Virat Kohli and actor wife Anuskha Sharma ask as they feature in an advertisement that talks about buying teeth aligners off the shop shelf and literally fixing your smile. Promoting orthodontic treatment in a direct-to-consumer business model, Anushka says these are “easy to book, easy to use and easy on the pocket,” while Kohli suggests downloading an app to order the aligner, making it as simple as ordering food online.
The advertisement is attracting a lot of flak across social media platforms with orthodontists and other experts across the country condemning the frivolous manner in which the dental specialty has been reduced to. While the celebrities are being pulled up for the “thoughtless endorsement” of the product and being trolled with negative comments like, “There is more to orthodontics than just waving a wand,” the medical fraternity is extremely saddened by the overall cavalier approach of D2C companies to diagnosis and treatment.
But this advertisement is not an exception. There is a spurt of companies that promise to deliver aligners to the patient’s home, bypassing the orthodontist. This poses a grave threat to the dental health of these patients. The Indian Orthodontic Society had also raised serious concerns about companies that offer dental scans at home and direct purchase of teeth aligners and conducted a nationwide awareness earlier this year about how these appliances were being positioned as a replacement for high quality personalised orthodontics. A formal complaint had been submitted to the Dental Council of India against the direct-to-consumer sale of orthodontic treatment with aligners.
WHAT ARE TEETH ALIGNERS?
Aligners are a device that have been used by orthodontists to treat irregular teeth and other tooth position problems since the early 2000s. They are transparent plastic trays that are manufactured to fit snugly on the teeth. They are programmed to bring about tooth movements that the orthodontist desires. Aligners are delivered by domain experts – orthodontists who undergo a three-year specialist training programme after a basic five-year dental training. This enables them to diagnose and treat malocclusion, or the problem of tooth positioning.
WHY DENTISTS ARE WORRIED?
That’s because teeth aligners are not a one-size-fits-all formula. Some people’s teeth and gums aren’t healthy enough to begin orthodontic treatment. They may need separate treatment before braces are placed. For others, traditional braces may work better.
“The approach of any company marketing teeth correcting aligners with direct to consumer approach is unethical. This kind of minimum supervision orthodontic treatment can result in poor outcomes or permanent damage to innocent patients who get influenced by these advertisements,” says Dr Balvinder Singh Thakkar, president,Indian Orthodontic Society. The damage could be anything from gum issues, tooth loss and loose teeth. Sometimes the damage may be detected so late that it might become difficult to repair.
An aligner has limitations which might not permit its use in all cases. In case there is a severe malocclusion, the orthodontist may advise traditional fixed orthodontics or braces. Fixed appliances use extremely sophisticated and advanced materials and are the gold standard as far as control and precision in tooth movement is concerned, according to experts. “The movement of teeth with respect to jaws and joints is an extremely sensitive procedure and care should be taken to ensure the best possible results with minimal damage to enamel, roots, gums, bones and joints,” says Dr Rajaganesh Gautam, senior orthodontist.
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“A wrong diagnosis can result in shoddy outcomes that might result in poor dental fit of the teeth. While the patients might be happy in the short-term with the outcome, unknown to them, a poorly designed D2C aligner might compromise their dental occlusion, exposing them to jaw joint issues in the future,” Dr Siddharth Shetty, chairman of the public awareness committee, Indian Orthodontic Society, says.
An orthodontist also checks for other problems beyond crooked teeth. Your jaw’s bone structure could be the reason your teeth are out of alignment. Knowing the cause can drastically change your treatment plan.
WHY AT-HOME DENTAL TREATMENT IS ILLEGAL?
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A public notice was issued by the Dental Council of India, the apex body of the Central Government, for dentistry in the country that stated companies should not project their aggressive advertisement campaigns to lure the common man for getting dental treatment. “It has come to the notice of the Dental Council of India that some of the private companies, by engaging dentists, are offering home services to the patients bypassing the professional expertise of the dentists and functioning on aggressive marketing violating the Clinical Establishments (Registration and Regulation) Act 2010, Dentists Act,1948 and Revised Dentists (Code of Ethics) Regulations, 2014. Such companies, dentists and the public at large have been advised that dental treatment will be given to the patient by the registered dentists at the clinic/hospital and scanning of teeth performed by a non-dentist will be a gross violation of Dentists Act, 1948.”