Issues of Fake Braces: A Review of Literature
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Abstract
The rising trend of fake braces, particularly in Southeast Asia, has raised significant health concerns. Regarded as a fashion statement, fake braces are unregulated orthodontic appliances sold through social media and online marketplaces. Unlike conventional braces, fake braces are often self-applied or installed by unqualified individuals, lacking the oversight of licensed professionals. Adolescents and young adults are drawn to fake braces because of their perception as a status symbol, affordability and potential to be aesthetically customised. However, serious concerns exist around oral health, including periodontal damage, infection, allergic reactions and unintentional ingestion due to the low-quality materials. These risks are further highlighted by reports of mortality and morbidity. According to studies, fake braces exhibit irregular surface textures, encouraging the growth of germs and the creation of biofilms, which exacerbates oral problems such as caries. Despite these risks, research on the toxicity and clinical impacts of fake braces remains sparse. Laboratory analyses indicate the presence of standard alloy components, but the long-term safety of these materials in unregulated devices is unverified. Efforts to regulate the sale and installation of fake braces are undermined by their easy accessibility online. This review examines the sociocultural drivers, material composition, associated risks and regulatory challenges surrounding the use of fake braces. It also emphasises the need for public education, stricter enforcement of medical device regulations, and further research on the detrimental effects of fake braces on oral and systemic health. Robust evidence is crucial for policy interventions to curb this alarming trend.
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References
Abdullah A.A.A., Yasssin Z. ZN. Reasons for seeking orthodontic treatment. Ann Dent Univ Malaya 2001;8(1):13–9.
Sardenberg F, Martins MT, Bendo CB, Pordeus IA, Paiva SM, Auad SM, et al. Malocclusion and oral health-related quality of life in Brazilian school children: a populationbased study. Angle Orthod 2013;83(1):83–9.
Scapini A, Feldens CA, Ardenghi TMH, Kramer PF. Malocclusion impacts adolescents’ oral health-related quality of life. Angle Orthod 2013;83(3):512–8.
Haleem R, Shafiai NAA, Noor SNFM. Metal ions leachables from fake orthodontic braces incubated in simulated body fluid. BMC Oral Health 2021;21(1):1–7.
Kamarudin Y, Zakaria NN, Xinhui VO. Orthodontics on sale: fixed appliances on E-commerce platforms. Australas Orthod J 2022;38(1):22–8.
Idaham NI, Wan Othman WMN, Hassan H. Exploring the experience of klang valley youths on fake braces by bogus dentists. Malaysian J Sci Heal Technol 2021;7(1):69–74.
Alhazmi AS, Al Agili DE, Aldossary MS, Hakami SM, Almalki BY, Alkhaldi AS, et al. Factors associated with the use of fashion braces of the Saudi Arabian Youth: application of the Health Belief Model. BMC Oral Health 2021;21(1):1–9.
Malik S. Deadly fashion braces are big in Thailand [Internet]. VICE. 2012 Apr 11 [cited 2021 Apr 1]. Available from: https://www.vice.com/en/article/nn47z8/deadlyfashionbraces-are-big-in-thailand.
Ministry of Health Malaysia. Annual report [Internet]. 2019 [cited 2024 May 1]. Available from: https://www.moh.gov.my/moh/resources/Penerbitan/Penerbitan%20Utama/ANNUAL%20REPORT/LAPORAN_TAHUNAN_KKM_2019.pdf.
Kumar Rai A. “Zeena” Practice or Malpractice? Prim Heal Care Open Access 2015;5(2):5–6.
Pereira MA, Souza FM de, Queiroz PA de, Vilela DDC, Cardoso JA. Illegal practice of orthodontics exercising and its clinical implications: case report. Rev Bahiana Odontol 2016;7(2):126-31.
Davis G. 38 celebrities who had braces or retainers (and the pics to prove it!) [Internet]. Women’s Health Magazine. 2020 Aug 9 [cited 2021 Sep 12]. Available from: https://www.womenshealthmag.com/health/g33500609/celebrities-with-braces-retainers.
Nasir SH, Abu Bakar N, Samad R. Elemental and microstructural analysis of fake, real, and standard orthodontic brackets. J Phys Conf Ser 2018;1073(5): 052002.
Sorooshian S, Kamarozaman AA. Fashion braces: an alarming trend. Sao Paulo Med J 2018;136(5):497–8.
Hakami Z, Chung HS, Moafa S, Nasser H, Sowadi H, Saheb S, et al. Impact of fashion braces on oral health related quality of life: a web-based cross-sectional study. BMC Oral Health 2020;20(1):1–9.
Azlida N, Nor M, Nurazreena W, Hassan W, Zambri M, Makhbul M. Fake braces by quacks in Malaysia: an expert opinion. Ann Dent 2020;27(1):33–40.
Shahrul Naing AI, Abd Rahman ANA. Orthodontic product sold via online marketplaces in Malaysia. Malays Dent J 2021;1:106–12.
Press Association. Dentists warned of counterfeit equipment following huge haul [Internet]. The Guardian. 2014 Oct 17 [cited 2022 Oct 2]. Available from: https://www.theguardian.com/society/2014/oct/17/dentists-warncounterfeit-equipment-seized-haul.
Zeya DS, Sharma DJB, Chaturvedi DP, Doshi DA, Mathur DS, Shah DN, et al. Dental quacks: liars to the society. Int J Appl Dent Sci 2021;7(3):289–91.
Behrents RG. Adverse responses to products or treatments. Am J Orthod Dentofac Orthop 2014;146(5):541–3.
Lin M-C, Lin S-C, Lee T-H, Huang H-H. Surface analysis and corrosion resistance of different stainless steel orthodontic brackets in artificial saliva. Angle Orthod 2006;76(2):322–9.
Mulimani P, Vaid N. Through the Murky Waters of “Web-based Orthodontics” Can Evidence Navigate the Ship? APOS Trends Orthod 2017;7(5):207-10.
Haleem R, Shafiai NAA, Noor SNFM. Microstructural changes and elemental analysis of fake braces in simulated body fluid. AIP Conf Proc 2020;2267: 020061.
Ramakrishna S, Tian L, Wang C, Liao S, Teo WE. Safety testing of a new medical device. Med Devices 2015;137–53.
Geis-Gerstorfer J. In vitro corrosion measurements of dental alloys. J Dent 1994;22(4):247–51.
Grimsdottir MR, Gjerdet NR, Hensten-Pettersen A. Composition and in vitro corrosion of orthodontic appliances. Am J Orthod Dentofac Orthop 1992;101(6):525–32.
Chakravarthi S, Padmanabhan S, Chitharanjan AB. Allergy and orthodontics. J Orthod Sci 2012;1(4):83–7.
Peltonen L. Nickel sensitivity in the general population. Contact Dermatitis 1979;5(1):27–32.
Ramadan AA-F. Effect of nickel and chromium on gingival tissues during orthodontic treatment: a longitudinal study. World J Orthod 2004;5(3):230–4.
Ahrari F, Tavakkol Afshari J, Poosti M, Brook A. Cytotoxicity of orthodontic bonding adhesive resins on human oral fibroblasts. Eur J Orthod 2010;32(6):688–92.
Mockers O, Deroze D, Camps J. Cytotoxicity of orthodontic bands, brackets and archwires in vitro. Dent Mater 2002;18(4):311–7.
Rongo R, Valletta R, Bucci R, Rivieccio V, Galeotti A, Michelotti A, et al. In vitro biocompatibility of nickeltitanium esthetic orthodontic archwires. Angle Orthod 2016;86(5):789–95.
Wataha JC. Principles of biocompatibility for dental practitioners. J Prosthet Dent 2001;86(2):203–9.
Vidal MNP, Granjeiro JM. Cytotoxicity tests for evaluating medical devices: an alert for the development of biotechnology health products. J Biomed Sci Eng 2017;10(09):431–43.
Menzaghi N, Saletta M, Garattini G, Brambilla E, Strohmenger L. Changes in the yeast oral flora in patients in orthodontic treatment. Prev Assist Dent 1991;17(4):26–30.
Kozmos M, Virant P, Rojko F, Abram A, Rudolf R, Raspor P, et al. Bacterial adhesion of streptococcus mutans to dental material surfaces. Molecules 2021;26(4):1–15.
Wang B-Y, Deutch A, Hong J, Kuramitsu HK. Proteases of an early colonizer can hinder Streptococcus mutans colonization in vitro. J Dent Res 2011;90(4):501–5.
Kreikemeyer B, Gámez G, Margarit I, Giard J-C, Hammerschmidt S, Hartke A, et al. Genomic organization, structure, regulation and pathogenic role of pilus constituents in major pathogenic Streptococci and Enterococci. Int J Med Microbiol. 2011;301(3):240–51.
Jaykus LA, Wang HH, Sl. Food-borne microbes: shaping the host ecosystem. In: ASM Press, editor. Washington (DC): ASM Press; 2009.p.124.
Tamura S, Yonezawa H, Motegi M, Nakao R, Yoneda S, Watanabe H, et al. Inhibiting effects of Streptococcus salivarius on competence-stimulating peptide-dependent biofilm formation by Streptococcus mutans. Oral Microbiol Immunol 2009;24(2):152–61.
Magdy NM, Kola MZ, Alqahtani HH, Alqahtani MD, Alghmlas AS. Evaluation of surface roughness of different direct resin-based composites. J Int Soc Prev Community Dent 2017;7(3):104–9.
Brusca MI, Chara O, Sterin-Borda L, Rosa AC. Influence of different orthodontic brackets on adherence of microorganisms in vitro. Angle Orthod 2007;77(2):331–6.
Barcellos Fernandes R, Bárbara Polo A, Novaes Rocha V, Willer Farinazzo Vitral R, Carolina Morais Apolônio A, José da Silva Campos M. Influence of orthodontic brackets design and surface properties on the cariogenic Streptococcus mutans adhesion. Saudi Dent J 2022;34(4):321–7.
Lazada. Prohibited and controlled products. Lazada Seller Policies [Internet]. 2023 [cited 2023 Jan 15]. Available from: https://sellercenter.lazada.com.my/seller/helpcenter/Prohibited-and-Controlled-Products-List.html.
Nasir SH, Mohamad Amran MS, Abidin Mustaffar MM. Metal release of standard and fake orthodontic braces: an in vitro study. IIUM Med J Malaysia 2021;20(2):75–80.
