Warning: DIY orthodontics are here
New campaign highlights threat posed to oral health by straight-to-consumer treatment
[ Words: Will Peakin ]
Between a conference-eve dinner for keynote speakers at The Clydeside Distillery and a gala reception for delegates the following evening, there was plenty to absorb on the first day of the British Orthodontic Society’s 2019 Conference in Glasgow last month.
Ask yourself, what other transforming dental or medical treatment would you undergo without an in-person evaluation or supervision by a medical professional?
Dr Jay Bowman
Lord Winston, the IVF pioneer – and Professor of Science and Society and Emeritus Professor of Fertility Studies at Imperial College London – began proceedings by examining the role of brain imaging, hormone study, sexuality, child development, pharmacology, and psychological research in understanding how science may help us be happier.
It was a typically insightful and thought-provoking start to the three-day international gathering.
The conference featured, among others, Professor Greg Huang, who delivered the Northcroft Lecture (see Scottish Dental, August 2019), in which he presented the results from an adult anterior open bite study conducted by the National Dental Practice-Based Research Network, and former MP Lembit Öpik, who joined Dr Michael Millwaters, the oral and maxillofacial surgeon, to discuss his own orthognathic treatment and experience.
Dr Jay Bowman, the clinician and orthodontic device inventor from Michigan, spoke about improving the predictability of clear aligners and treatments involving the use of mini-screw anchorage.
It was Dr Bowman who led the presentation of what the British Orthodontic Society (BOS) intends to be a campaign engaging the wider dental profession and, ultimately, the public. At the conference, the BOS and the Oral Health Foundation announced their plans for a national campaign to warn patients about the risks of direct to consumer orthodontics, also known as DIY orthodontics.
The joint campaign, supported by a dedicated website launching in December, will advise patients in all circumstances to visit a trained clinician ensuring that they have the various options open to them explained so they can make an informed decision. The website is to be launched in December. The campaign comes as statistics from BOS reveal adult orthodontics continues to rise with three quarters (75 per cent) of orthodontists reporting an increase in adult private patients.
The BOS leadership said it was delighted to announce their partnership with the Oral Health Foundation. Both organisations provide patients with expert information that relates to their oral, orthodontic and overall health.
By bringing the expertise of the two organisations together on this issue it will empower patients to make the right choices, they said.
“In my professional opinion,” said Jonathan Sandler, BOS President, “if you embark on any orthodontic treatment without a suitably trained clinician taking the time to examine you and make appropriate recommendations, you could be in danger of having serious conditions missed, as well as inappropriate and dangerous treatment carried out.
“For me, one of the issues with ‘DIY orthodontics’ is that it offers just one narrow solution when there may be a more appropriate one for the patient. The value of informed choice cannot be over-estimated.” Dr Nigel Carter, Chief Executive of the Oral Health Foundation, added: “As the demand for adult orthodontics increases, so do the options for patients. We are seeing a growth in online companies offering orthodontic treatments at significantly reduced prices. For many patients, it will feel like a sensible consumer-savvy choice. But this may not be the case.
“My clinical view is that orthodontics should always involve face-to-face contact with a trained clinical professional. This is to ensure patient safety and the most effective treatment. When carried out correctly, orthodontic treatment can give patients the straight and confident smile they have always dreamed about.
‘We want to make sure that patients are given the very best advice about the safest and most effective way to have orthodontic treatment. This new campaign will make sure patients have a trusted space where they can see the most independent and impartial information available.”
The American Association of Orthodontics’ long-held position mirrors that of the BOS and the Oral Health Foundation. It states that orthodontic treatment is a complex medical process and that it is in the best, and safest, interest of the public to have that treatment conducted under the direct and ongoing supervision of a licensed orthodontist.
At BOC 2019, Dr Bowman briefed the media on the prevalence of DIY orthodontics in the US. He said: “I share many of the same concerns about direct-to-consumer treatments as have been voiced by the American Association of Orthodontists, the American Dental Association, and many US state dental boards and legislators.”
Dr Bowman added: “It is my opinion that comprehensive diagnostic records and an in-person examination should be performed prior to embarking upon treatment. I am also not convinced that orthodontic progress follow-up and resolution of patient concerns can be handled only by so-called teledentistry.
“In other words, ask yourself, what other transforming dental or medical treatment would you undergo without an in-person evaluation or supervision by a medical professional?”
The BOS and the Oral Health Foundation will jointly develop the website aimed at anyone seeking information about orthodontic treatment. The site will be updated regularly and will be designed to be engaging and informative, said the organisations. It will include testimonials from various experts alongside patients who will talk about their experiences to “bring the issues to life,” said a spokesperson.
In addition to the campaign, the BOS is exploring regulatory options and it said it hopes that the appropriate bodies will take a “patient safety-led approach” to decision-making.