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Dr Neil Peppitt comments on the dangers of DIY orthodontics

Dr Neil Peppitt comments on the dangers of DIY orthodontics


DIY dentistry: industry booming but experts warn of dangers
Sydney Morning Herald 16 September 2018


It seems too good to be true – straighter teeth for a fraction of the price and without ever needing to hop into the orthodontist's chair. Dentists say it is.

Australian dentists are urging the public to steer clear of online, do-it-yourself orthodontic services, such as EZ Smile, saying they may exacerbate dental problems and lead to costly remedial treatment.

EZ Smile, which is based in Warriewood, Sydney, offers "orthodontist prescribed" clear aligners from a laboratory using "world class" technology for "only $2149" with "no face-to-face dental visits".

The Australian Society of Orthodontists (ASO) said the absence of clinical examinations, X-rays and ongoing supervision was concerning.

"If there are gum issues, gum disease or broken fillings, they won't be detected, and when you start moving teeth, those problems can become worse," ASO vice-president Howard Holmes said.

"Even if the immediate results seem good, the teeth and bite may not be in a stable position and move back, and there could also be muscular and jaw problems."

After passing a quick dental history quiz, customers can buy an impression kit, make moulds at home and send them to a lab, which will then create a set of plastic aligners, similar to Invisalign.

The website gives the impression that everything is done locally, but Fairfax Media has discovered the lab and the orthodontists are located in Shiyan, China.

This means that if something goes wrong, it may be harder for disappointed customers to find recourse.

EZ Smile founder Ed Ambrosius said the lab made braces for dentists around the world and the orthodontists were fully qualified. It has 5000 applications so far and turnover is $2.5 million.

"We are simply doing the most minor cases of teeth movement and would never consider treating anybody that requires complicated dental techniques," he said.

"The dentists are scare-mongering. The risks are extremely low. We have rejected many more cases than we've taken on."

Asked whether consumers were adequately protected, Mr Ambrosius said: "No, I guess not, but the fact is they can get it from other businesses based overseas, so at least with us, we're here and they can deal with us through normal legal channels."

Competitors include Irish start-up Your Smile Direct and Hong Kong company Easy Smile.

Dr Holmes said these mail-in services did not provide value for money, with orthodontists able to treat minor cases for a similar price. Invisalign-branded aligners usually start from $3500.

He said the ASO wanted tighter laws to protect the public.

Mr Ambrosius said he wanted to discuss the issues with the Australian Health Practitioner Regulation Agency (AHPRA) so that laws keep up with technology.

NSW opposition health spokesman Walt Secord urged the state government to investigate this new phenomenon and to close legislative loopholes.

“Unfortunately, there is a section of the community which cannot afford the spiralling costs of dentistry and, sadly, such services prey upon them," he said.

NSW Health did not answer questions on whether state laws were strong enough, whether it would address the dental profession's concerns and its position on online DIY dental offerings.

However, changes would most likely need to be made at a federal level, with all dental practitioners registered with and complying with codes issued by the Dental Board of Australia, which works with the AHPRA.

AHPRA said it was aware of the growing number of online-based dental businesses and considering the issues they may raise with respect to laws that protect the public.

The Health Care Complaints Commission said it could accept complaints about such businesses, having already received one.

Dr Neil Peppitt, president of Australian Dental Association NSW, said it didn't support DIY dentistry.

"If treatment relies on imprints and records without the patient being personally examined, there’s a much greater risk that the treatment will not be successful," Dr Peppitt said.

Read the Sydney Morning Herald article