Patients Get What They Pay for with Do-it-yourself Dentistry

September 27, 2016
Sarah Handzel, BSN, RN

As so-called "do-it-yourself" dentistry becomes popular online, dental experts warn the dangers far outweigh the potential cost savings.

It’s becoming a disturbingly common trend in dentistry: patients who take matters into their own hands and try their luck at do-it-yourself (DIY) dentistry. Just running a quick Google search brings up all sorts of options for home dentistry kits that promise to help patients take perfect teeth impressions to make their own full sets of dentures and other dental devices. There are online instruction manuals for everything from constructing and implanting fillings to tooth extraction. What patients don’t realize is the real danger they put themselves in by performing these dental procedures on themselves at home.

So why are patients taking matters into their own hands? One major reason is economics. Since the recession in 2008, many people seem to consider dentistry to be an “optional” part of their healthcare. A huge part of this problem, even today, is that people can’t afford to purchase dental insurance if they don’t have coverage offered by an employer. They also can’t afford to pay the out-of-pocket costs for dental treatment. According to the

US Department of Health and Human Services

, about 108 million Americans have no dental insurance.

It’s not just money that’s a factor in people forgoing dental care. In today’s busy world, many people skip dental appointments simply because they don’t have the time. This is a problem that’s been noticed by Greg M. Vallecorsa, DDS, who thinks that “some patients seem to have a lot of other things going on in life and don’t feel that it’s important enough to get in to be seen.” He thinks patients might also put off visits to the dentist because they aren’t in pain or having any other noticeable symptoms of dental problems.

One big area of DIY dentistry involves patients taking their own teeth impressions for the creation of custom dentures and other devices. But there’s not a whole lot of information available as to the actual quality of DIY tooth impressions.

Consumers can order impression kits from several online companies

. They receive the impression material, plastic trays, and instructions. But even though this seems simple enough, experts say it’s dubious to claim that inexperienced consumers can create dental impressions matching the quality of a product produced by a professional who’s been through two or three years of orthodontic training. Some consumers have reported using impression kits only to have the finished product fit improperly. Other patients have used retainers made from impressions that did not extend to the second molars, resulting in super-erupted teeth.

Examples of DIY dentistry extend far beyond teeth impressions. It’s possible to purchase DIY filling kits on

Amazon

that claim to supply the buyer with enough material for up to 15 tooth repairs. This is only supposed to be a temporary measure until a licensed dentist can see the patient. Many people choose to skip the dental appointment and live with temporary fillings as permanent solutions, often for months, and often by reapplying some of the mix to the temporary filling as needed.

But there’s a huge risk in using temporary fillings as a permanent treatment. Leaving these fillings in place can trap bacteria, resulting in infection and decay of the affected tooth and surrounding gums. In his private practice, Vallecorsa saw this first-hand with a new patient who’d filled her own cavities with what appeared to be a “temporary, putty-like material, clearly not done by another dentist. It looked like the temporary filling had been in place for a couple months, but it was hard to know the exact amount of time it was in place.” This filler was purchased from a local pharmacy, and the patient installed it herself in a few of her teeth.

Upon removal of the temporary material, Vallecorsa saw the decay was a “lot worse than if she’d just come in and let us do it in the first place. (The patient) had just sealed in the decay, sealed in any sort of infection, which just made it worse when (she) did come to see us.” While the patient’s outcome was positive — she’s now doing well after other work was completed – Vallecorsa stressed the patient’s “cavities were to the point where…they were already wide open and she’d just kind of filled them herself. It creates more work for us when we have to go in. If she’d let it go for another few months, eventually she’d have symptoms on the tooth and we’d probably be doing more extensive treatment rather than just replacing and cleaning out and doing the filling.”

Perhaps the most alarming trend in DIY dentistry is involves tooth extraction. This is a dangerous procedure when attempted at home — patients can break off part or most of their tooth, leaving the root behind and possibly exposing the nerve or causing severe infection. Another quick search online results in a

complete set of instructions for tooth extraction

, written by an “old country doctor”.

Another person recommends using a flathead screwdriver and a pair of pliers to remove a tooth

, even though he then discourages the original poster from attempting to remove a tooth using this method.

As Morris N. Pool, DDS of the American Association of Orthodontists says

, “anytime a dental procedure is undertaken by an untrained individual there is a substantial risk for irreparable damage.” Dentists are in a unique position to education patients on the dangers of DIY dentistry when patients are seen for treatment. It’s hard to know what people are reading online, but having discussions about what people are reading can help influence patients toward more positive outcomes. As Vallecorsa advises patients, “(we) are getting much more questions, which is good. It generates good conversation. Bring your questions to us - you’re going to save yourself a lot (more trouble) than if you try to do something yourself at home and end up with a much bigger problem.”

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