DIY orthodontics is a one size fits all approach to reshaping and altering the appearance of your mouth. Often this is done without seeing a dentist and simply by using a 3D scan of your mouth to make aligners, which are then posted to you. This can cause a critical danger to people’s health, according to the latest episode of The Oral Health Podcast.

In the first of a two-part series on the rise of direct-to-consumer orthodontics, the Oral Health Foundation presents the many pitfalls and highlights severe concerns around the growing trend.

Karen Coates, an oral health educator and registered dental nurse describes how DIY orthodontics can cause long-term and irreparable damage to the mouth, jaw, and gums – and often leads to people going away unhappy and in a poorer state of health than before treatment. This can include everything from pain in eating to needing surgery to correct past mistakes.

Karen said: “This is not simple treatment. It cannot be done overnight. Step back and think. Would I let someone who was not qualified do fillings on me? Orthodontics is the same, it really is a feat of engineering. You have to rotate teeth, you are pushing them back and pushing them forward, but you don’t want all of them to move”.

The podcast discussed how orthodontists will give you a realistic look at what can be done and if you go DIY, you will not have the same level of care during and after the treatment. The Oral Health Podcast is available to download and stream on all major platforms.


A team of University at Buffalo (UB) researchers in the US has developed a new strontium-loaded scaffold that can be personalised to fit any size dental implant and could help improve healing and tissue attachment in patients.

The success of dental implants is dependent on the growth and adhesion of soft tissues to the implant surface. Previous research by UB investigators found that strontium, a bone-seeking element that improves bone density and strength, also supports soft tissue function. Strontium, they discovered, can promote the function of fibroblasts – a type of cell that forms connective tissues and plays a critical role in wound healing.

The new study, published in the Journal of Biomedical Materials Research, found that scaffolds loaded with strontium promoted wound healing by stimulating gingival fibroblast activity.

Lead investigator, Michelle Visser said: “Scaffold materials have been explored to promote bone and skin wound healing, but adaptations for the oral cavity are limited. These novel scaffolds represent a system for effective strontium release in the oral cavity”.

To produce the scaffolds the researchers developed reusable, ring-shaped templates and moulds. The flexible hydrogel scaffolds are infused with a range of strontium concentrations that are released in an initial burst over 24 hours, followed by a sustained dosage over four days with minimal toxicity. Tested in the laboratory, the strontium-loaded scaffolds increased the cellular activity of isolated gingival fibroblast cells, while the hydrogel scaffold alone had little effect on the cells.


In a recent study, researchers reported that using removable partial dentures may have long-term benefits in reducing mortality among adults with a non-functional dentition, but cautioned that further research is needed.

The researchers used data from the Third National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics, a division of the US Centers for Disease Control and Prevention, and linked it to publicly viewable mortality files for the period up to 2019. For the purpose of the study, they included 1,246 partially edentulous adults with fewer than 20 teeth whose use of removable partial dentures and dentition status had been determined by clinical examination.

The findings showed that removable partial denture wearers experienced a 26% increase in survival time. Additionally, the researchers observed that for every 7.5 individuals treated with removable partial dentures, one death would be prevented after ten years of treatment.

Discussing the study, lead author Dr Nasir Zeeshan Bashir, a researcher at the University of Leeds in the UK, explained that the study did not specifically assess why dentures have this effect. However, he noted that a few hypotheses were put forward in the discussion section of the study: “Firstly, eating a well-balanced diet is difficult when you are lacking many teeth, as fibrous foods like vegetables can be tough to chew. By restoring the dentition, it has been shown that masticatory efficiency increases and, therefore, it may be that these patients with dentures have an improved diet. Secondly, it could be that those patients who wear and use their dentures regularly are well motivated in other aspects of their general health”.

The study, titled ‘Removable partial dentures and mortality among partially edentulous adults’, was published in the Journal of Dentistry.


A study from King’s College London has shed light on the role that a type of cell plays in the progression of periodontal (gum) disease and how it could provide an avenue for therapeutic intervention.

The research team identified and described the role of a cell known as a telocyte in regulating the inflammatory process that occurs during gum disease. According to the authors, telocytes are thought to be involved in direct cell–cell communication between macrophages, a kind of white blood cell involved in the response to an infection or an accumulation of damaged and dead cells. Macrophages that promote an inflammatory response are known as M1 macrophages, whereas M2 macrophages work to counteract inflammation and encourage tissue repair. The balance between M1 and M2 macrophages is crucial for effectively regulating the body’s immune response.

Using single-cell RNA sequencing and cellular assays, the researchers identified the role of telocytes in regulating the M1–M2 macrophage balance in gum disease and demonstrated their natural ability to shift macrophages from an M1 to an M2 state. This ability to facilitate these transitions could provide a possible strategy for the future treatment of gum disease.

“I hope this study can not only lead to a greater understanding of periodontal disease but also provide an impetus for others to study the potential roles played by telocytes in other tissues,” noted Dr Paul Sharpe, professor of craniofacial biology at King’s College London and co-author of the study.

The study, titled ‘Telocytes regulate macrophages in periodontal disease’, was published online on October 4, 2022 in eLife.


An innovative technology developed at Tel Aviv University (TAU), Israel will enable bone regeneration to correct large defects by means of a special hydrogel. Following successful tests in an animal model, the researchers now plan to move forward to clinical trials.

The study was conducted by researchers from TAU’s Maurice and Gabriela Goldschleger School of Dental Medicine, led by Prof. Lihi Adler-Abramovich and Dr Michal Halperin-Sternfeld in collaboration with other. The paper was published in the Journal of Clinical Periodontology.

Prof. Adler-Abramovich said: “Small bone defects, such as fractures, heal spontaneously, with the body restoring the lost bone tissue. The problem begins with large bone defects. In many cases, when substantial bone loss results from tumour resection (removal by surgery), physical trauma, tooth extraction, gum disease or inflammation around dental implants, the bone is unable to renew itself. In the current study, we developed a hydrogel that mimics the natural substances in the extracellular matrix of bones, stimulating bone growth and reactivating the immune system to accelerate the healing process”.

The researchers explain that the extracellular matrix is the substance surrounding our cells, providing them with structural support. Every type of tissue in our body has a specific extracellular matrix consisting of suitable substances with the right mechanical properties. The new hydrogel has a fibrillary structure that mimics that of the extracellular matrix of the natural bone. Furthermore, it is rigid, thus enabling the patient’s cells to differentiate into bone-forming cells.


A vaping habit could lead to a tarnished smile, and more frequent dentist visits. Research by Tufts University School of Dental Medicine in Boston found patients who said they used vaping devices were more likely to have a higher risk of developing cavities (caries).

The findings of this study serve as an alert that this once seemingly harmless habit may be very detrimental, says Karina Irusa, assistant professor of comprehensive care and lead author on the paper. The study was published in the Journal of the American Dental Association.

Over the last few years, public awareness has increased about the dangers of vaping to systemic health — particularly after the use of vaping devices was tied to lung disease. Some dental research has shown ties between e-cigarette use and increased markers for gum disease, and separately, damage to tooth enamel.

Irusa says that the recent Tufts finding may be just a hint of the damage vaping causes to the mouth. “The extent of the effects on dental health, specifically on dental decay, are still relatively unknown,” she says, “At this point, I’m just trying to raise awareness”.

Irusa and her colleagues analysed data from more than 13,000 patients older than 16 who were treated at Tufts dental clinics from 2019-2022. There was a statistically significant difference in dental cavity risk levels between the e-cigarette/vaping group and the control group, Irusa found. Some 79% of the vaping patients were categorised as having high-caries risk, compared to just about 60% of the control group.


A study by researchers from the University of Hong Kong has shown that “positive stress” can be utilised to enhance the therapeutic potential of tooth stem cells by increasing their resistance to injury and disease. According to the university, the study is the first to show that preconditioning tooth stem cells to stress can cause their adaptive mechanisms to boost the regeneration of tooth pulp tissue.

The research team aimed to develop an approach to regenerating lost tooth pulp in damaged teeth through the use of a preconditioning protocol to genetically modify tooth cells. The modifications caused the cells to mimic a responsive state for low oxygen conditions, activating a protein that induces adaptive changes.

Co-author of the study Dr Yuanyuan Han explained: “As this protein was reported to activate several key adaptive mechanisms, we wondered whether this phenomenon can be applied to improve cell survival following transplantation until a sufficient blood supply is achieved”.

She said: “[These] cells activate a metabolic mechanism to produce energy under low oxygen conditions and scavenge harmful metabolites produced in stress conditions”.

Dr Waruna Dissanayaka, lead author of the study, said: “Interestingly, we also found that preconditioned cells significantly enhanced the dental hard tissue formation within the regenerated pulp tissue”.

Pointing out that prior research has already revealed that cells possess a number of adaptive mechanisms for stress and that these are regulated by genes in our DNA, Dr Dissanayaka posited: “If we can activate these genes, downstream expression of specific proteins can prime the cells [to be] less vulnerable to injury.”

The study, titled “HIF-1α stabilization boosts pulp regeneration by modulating cell metabolism”, was published in the Journal of Dental Research.


The link between periodontal disease and a range of systemic health conditions such as cardiovascular disease, type 2 diabetes and rheumatoid arthritis is well established. Researchers from the University of Birmingham are in the process of developing a rapid test for identifying the presence of periodontal disease.

The device is being developed by Prof. Tim Albrecht from the University’s School of Chemistry, together with Dr Melissa Grant from the School of Dentistry. It consists of a specialised probe and detector that provides a measurement of certain protein-based biomarkers that indicate both the presence and progression of periodontal disease. This biomarker panel was discovered and validated in a study published in the Journal of Clinical Periodontology by a team of researchers led by Dr Grant.

Prof. Albrecht said: “We believe the device we are prototyping will be the first dental probe that can identify periodontal disease in this way. It will detect periodontitis quickly and easily in a variety of healthcare settings, opening up opportunities for monitoring and early intervention in the patients with comorbid disease, who would benefit most from rapid treatment for periodontitis”.

Dr Grant added: “The ability to detect and profile disease biomarkers in real time will allow monitoring for disease severity, and in particular the transition between milder and more severe forms of gum disease. This will benefit not only dental health, but also reduce costs and capture patients for whom periodontal treatment may, in the long run, be lifesaving”.

The researchers recently received funding from UK Research and Innovation’s Engineering and Physical Sciences Research Council impact acceleration account, and they plan to develop a prototype of this device within a year.


An Australian study published in the Journal of Dental Research has provided evidence that exposure to fluoridated water is not negatively associated with child emotional and behavioural development, or executive functioning in adolescence.

The study by Prof. Loc Do of the University of Queensland and colleagues examined the effect of early childhood exposure to water fluoridation on measures of school-age executive functioning and emotional and behavioural development. Children aged five to ten years at the baseline were contacted again after seven to eight years.

Per cent lifetime exposed to fluoridated water (%LEFW) from birth to the age of five years was estimated from residential history and postcode-level fluoride levels in public tap water. Measures of children’s emotional and behavioural development were assessed by a strength and difficulties questionnaire (SDQ), and executive functioning was measured by Behaviour Inventory of Executive Functioning (BRIEF).

A total of 2,682 children completed the SDQ and BRIEF. Those with lower %LEFW tended to have poorer scores. Multivariable regression models reported no association between exposure to fluoridated water and the SDQ and BRIEF scores. Low household income, identifying as indigenous, and having a neurodevelopmental diagnosis were associated with poorer SDQ/BRIEF scores.

The study concluded that exposure to fluoridated water during the first five years of life was not associated with altered measures of child emotional and behavioural development and executive functioning. Children who had been exposed to fluoridated water for their whole early childhood had their measures of emotional, behavioural development and executive functioning at least equivalent to that of children who had no exposure to fluoridated water.


A pioneering study is being carried out across dental practices in Scotland, in which software-driven by artificial intelligence (AI) is helping practitioners locate caries (cavities) more effectively. The programme, AssistDent, was developed by Manchester Imaging, a spin-off company from a collaboration between dentistry and imaging sciences at the University of Manchester.

Aimed at early detection, AssistDent utilises machine learning algorithms to evaluate dental radiographs to note or confirm areas of potential enamel-only proximal caries. With early identification of dental caries, patients can avoid fillings through preventive care such as fluoride treatments.

With more than 65 practices and 200 dentists serving over half a million patients across Scotland, Clyde Munro Dental Group is using AssistDent in a pilot test with five of its dentists located across Scotland. Fiona Wood, the chief operating officer for Clyde Munro, explained the use of AI as a powerful tool for prevention, stating: “The AI is a useful tool to show and demonstrate to patients areas of dental need or concern to give the patient the chance to reverse enamel changes with support from Clyde Munro dentists.”

AssistDent’s capability has been evaluated in peer-reviewed research conducted by experts from the University of Manchester’s dental school and published in the British Dental Journal. In the study, the group that used AssistDent found 76% of the caries previously identified by expert dentists on 24 bitewing radiographs, compared with 44% of the problem areas found by the group that did not utilise the AI software. The researchers concluded that AssistDent significantly improves dentists’ ability to identify enamel-only proximal caries.




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