Online Promotion of DIY Clear Aligners Raises Concerns: Dentists Warn of Risk of Tooth Necrosis in Severe Cases

Having a set of white, well-aligned teeth naturally enhances one's smile, which is why many people consider orthodontic treatment. There are various orthodontic methods available on the market, and in recent times, social media and online platforms have been widely promoting and encouraging the use of self-directed or semi-assisted clear aligner products. Dentists have warned that undergoing orthodontic treatment without the supervision of a dentist or orthodontic specialist not only risks ineffective results, but may also lead to serious complications such as tooth necrosis and gum recession.

Social Media Promotes Self-Directed and Semi-Assisted Clear Aligner Products

The Hong Kong Dental Association and the Hong Kong Society of Orthodontists recently issued a joint statement noting that social media has been widely promoting and encouraging the use of self-directed or semi-assisted clear aligner products. They emphasised that orthodontic treatment is a specialised form of dental care, and that if any part — or the entirety — of the process lacks the professional diagnosis and progress monitoring of a registered dentist, treatment outcomes may be compromised and treatment risks increased, with a direct impact on public oral health.

In an interview, Hong Kong Dental Association President Dr. Tsang Hin-kei noted that orthodontic treatment generally takes anywhere from a few months to approximately two years, with more complex cases potentially requiring around two to three years, depending on the individual case and its complexity. Using clear aligners as an example, he explained that fees charged by dentists typically start from HK$40,000, varying according to factors such as whether the patient is a child or adult, the complexity of the orthodontic case, and the dentist's level of experience. The Association has observed that advertisements on social media feature no supervising dentist, with listed prices ranging from over HK$10,000 to HK$20,000, while actual charges remain unclear.

Orthodontic Treatment Requires Close Monitoring by a Dentist

Dr. Tsang explained that so-called semi-assisted clear aligners — plastic orthodontic appliances manufactured by certain companies using computer-simulated tooth alignment — pose significant risks:

"It is extremely dangerous to use self-directed or semi-assisted clear aligner products without the supervision of a dentist or orthodontic specialist."

He explained that tooth movement is a highly complex process, and the timeline for orthodontic correction differs from person to person. As a result, aligners manufactured based on simulated tooth movements may not achieve the intended repositioning as modelled by the computer. Throughout the entire course of treatment, close monitoring and management by a dentist is essential. Inappropriate tooth movement during the process may give rise to serious complications, including exposure of tooth roots, leading to tooth necrosis and gum recession.

Complications May Not Be Reversible

Dr. Tsang cautioned that seeking dental attention only after complications arise may not be sufficient to restore the teeth to a healthy condition. Furthermore, without a dentist overseeing the process, patients would ultimately have no avenue for recourse. He also noted that overseas cases have already given rise to numerous legal proceedings involving adverse outcomes from self-directed or semi-assisted clear aligners.

Risks Associated with Self-Directed or Semi-Assisted Orthodontic Products

Dr. Tsang stressed that prior to commencing any orthodontic treatment, a thorough examination by a dentist or orthodontic specialist — including X-ray assessment — is essential. He warned that periodontal disease can be difficult to detect, and individuals who already have gum disease may experience a worsening of their condition if they use self-directed or semi-assisted clear aligners. Additionally, issues with the alveolar bone can affect the progress of orthodontic treatment. For example, patients with a protruding lower jaw — commonly referred to as an underbite — may require orthognathic surgery before braces treatment can begin.

Dr. Tsang advised members of the public to seek treatment from a dentist or orthodontic specialist to safeguard their oral health, and to refrain from blindly trusting online promotions. He emphasised that orthodontic treatment must be monitored by a dentist or qualified orthodontic specialist, as proceeding without professional oversight carries substantial risks.

The Hong Kong Dental Association stated that it will closely monitor the situation and work in collaboration with relevant parties. Where necessary, appropriate assistance and public education will be provided to prevent members of the public from receiving substandard or inappropriate treatment and suffering unnecessary harm.

Learn more:Explore the pros and cons of 4 orthodontic methods, the best age to start braces, and pricing

Source: Hong Kong Economic Times