DIY Dentistry Is the Risky, Inevitable Result of For-Profit Healthcare

A discolored incisor gripped between a pair of pliers. A loose wisdom tooth extracted with a wooden dowel and a piece of twine. A rubber band wrapped once, twice, around two front teeth. An emery board scraping against the ragged edge of a chipped tooth.

It’s easy to find all of this and more—all of this, and worse—among the annals of YouTube’s DIY dentistry content. Less a trend than a permanent fixture, these clips are pimple-popping content taken to an extreme: They're occasionally gory excavations that are hard to look away from, but even harder to absorb head-on given the fact they’re performed entirely by amateurs.

Why risk dental trauma by going the DIY route and following a YouTube tutorial made by a layperson? Money, of course: Good dental care is expensive as hell. As the chairman of the Senate’s subcommittee on primary health and aging, Senator Bernie Sanders published a report in 2012 titled, “Dental Crisis in America: The Need to Expand Access.” The report found that, despite the fact that low-income adults were more likely to suffer from chronic dental health issues, they were twice and likely to have forgone dental treatment in the past year than their high-income counterparts. Black, Mexican and Indigenous Americans were all more likely to suffer from untreated dental ailments than white Americans were. The report also found that a third of Americans lacked dental insurance.

VICE spoke to a few people who altered their oral composition without professional help—or, they said, any negative consequences.

Chimdi, who declined to give her last name for privacy reasons, posts lifestyle-oriented YouTube videos for fun while teleworking full time. The 29-year-old told VICE she’d considered closing the gap in her front teeth for years, but that it didn’t bother her enough to shell out “thousands of dollars” for braces. So, when she stumbled across a YouTube video where another woman closed her tooth gap with clear Goodie hair ties, she was intrigued.

“Cheap and DIY? Perfect,” she said. Plus, she already knew rubber bands were sometimes involved in dental work. “I was like, I 've also seen this in life before, it's not like this far-out, radical idea.” After doing a little more of her own research, she decided to give the gap-closing method a shot. Within a few weeks, she was happy with her results.

At a friend’s suggestion, she made a short video about her experience. “Immediately, I was like, Oh, this is gonna be my most successful video. It got so much traction so quickly.”

Chimdi said she often receives comments concerning the dangers of amateur dental work, but that she’s also had defenders point to the potential savings involved. “A comment that really resonated with me was like, 'Yeah, the healthcare system is set up to profit, so of course it wouldn't be in [the system’s] best interest to widely share an alternative method,'” she said. “It seems so strange that something we know costs thousands of dollars could be done so cheaply.”

To max out on “that algorithm money,” Chimdi put out a follow-up video a year later that elaborated on her gap-closing process and answered the most common questions her initial upload sparked; the first video, posted in November 2017, has received more than 180,000 views, and the second, nearly 30,000. Chimdi said she understands the high volume of interest. “If you’re planning on doing this, you’re watching these videos again and again and again,” she said. “You’re like, OK, let me just zoom in on this one part where she showed the picture and compare it… Maybe you watch it once and you’re like, Oh, that’s wild, but it stays in the back of your head.”

Despite this kind of anecdotal evidence, there is still serious potential for harm when it comes to DIY dentistry. “Orthodontic treatment is a complex medical procedure that involves living tissues (bone and gingiva), and forces that move teeth through these tissues. It can be very dangerous if not done by someone with the proper training,” Gary Inman, president of the American Associations of Orthodontists, told VICE.

Inman cited one particularly gruesome example of DIY dentistry gone wrong that he personally witnessed during his 40-year career as an orthodontist: “I [once] examined a young lady once who had attempted closing a large space between her upper two front teeth by placing one of her classmates' orthodontic rubber bands around the teeth.” (It’s worth noting that this is extremely similar to the procedure Chimdi performed on herself.) The effect, according to Inman, sounds like something ripped from an urban legend. “The rubber band had worked its way under the gum tissue and essentially she extracted her own teeth,” he said. “She had no idea why her teeth were so loose. The results were disastrous and, unfortunately, she lost her two front teeth.”

But graphic potential consequences aside, YouTube’s dental hack content consists largely of success stories. 23-year-old beauty YouTuber QueennJasmine, who declined to provide her real name, said she’s worn orthodontic rubber bands around her two front teeth since she was in high school.

“I HATED my gap,” she told VICE. “I love how it gives other people character to their face, but for me, I felt (and still feel) like it looks horrible.” After some preliminary research, she settled on her solution. “The main two [options] were teeth bonding and rubber bands,” she said. “I needed the cheaper option because I didn't have any money, so rubber bands were the best [choice] for me.”

Initially, she wore the rubber bands for a maximum of eight hours a day. Now that her gap has closed, she’ll wear them occasionally for shorter durations. A video she made detailing the process, posted in January 2016, has received more than 120,000 views.

A 2019 report in The Atlantic outlined the subjectivity of dentistry as a field, particularly cosmetic procedures like the ones QueennJasmine and Chimdi performed on themselves. “Excessive diagnosis and treatment are endemic,” dentist Jeffrey Camm told The Atlantic. “I don’t want to be damning. I think the majority of dentists are pretty good.” But many have, he said, “This attitude of ‘Oh, here’s a spot, I’ve got to do something.’”

This tendency to overtreat is particularly troubling given that dental procedures are still often priced like luxury goods; without insurance coverage, dental fillings can set patients back a few hundred dollars each, as can tooth extractions. On average, a set of braces costs anywhere between $5,000 and $6,000. Because of this, serious financial incentive exists to find an alternative treatment route, even if it’s a dangerous one—a desperate measure for undoubtedly desperate times.

Experts continued to raise alarms about the dental health crisis well into the late 2010s. In 2017, the American Dental Hygienists’ Association released a report on dental healthcare access that called for “local, state, and federal stakeholders to join forces to take advantage of the existing dental hygiene workforce, utilize innovative delivery models, improve license reciprocity, reduce prohibitive supervision, and expand the dental hygiene scope of practice.”

In 2018, a public health professor pointed out the ties between dental health and overall health in a New York Times op-ed and argued for the expansion of Medicaid to cover dental benefits for adults. In 2019, the Washington Post profiled a pop-up dental clinic, run by a non-profit, that provided free services to people in need; prospective patients showed up as early as 3 a.m. hoping to receive care. Within a three-hour span, volunteers tended to more than 200 people, per the report.

While teledentistry aims to increase access to dental care, it’s still part of the for-profit healthcare system, which makes it more of a stopgap solution than a permanent fix. And according to Buzzfeed News, multiple state dental boards have lodged complaints (and launched investigations) against teledentistry company SmileDirectClub for unsafe, “illegal” practices—which calls into question just how safe professionally guided at-home dentistry might be. (As of 2020, the state dental authorities of New Jersey and Florida resolved their investigations in favor of SmileDirectClub.)

Gabriel Lopes, 24, is a Belgian YouTuber who also made a pair of videos about his gap-closing experience. The first, posted in August 2017, has been viewed nearly 180,000 times and the second, a follow-up titled “DIY: CLOSE GAP TEETH AT HOME || My Update” more than 440,000 times.

Lopes said he too found the rubber band method while browsing YouTube, and was inspired to try it because he was unhappy with the way his smile looked. Initially, he was hesitant. “I’m a very nervous guy,” he told VICE. “The thing that gave me a bit more confidence is the other people that I saw online telling the audience that it was working. I was thinking, OK, if it worked for them, I’m not the first person trying it out.”

It feels safe to assume most people don’t want to do their own dental work. They want to feel better about the way they look and save cash. All three YouTubers who spoke to VICE about posting DIY dental tutorials said they want to help people gain some confidence about their teeth.

Chimdi was initially hesitant about uploading her rubber-band video, because she wanted to maintain a level of privacy, but changed her mind when she thought about how she came across the method in the first place. “I realized I was only successfully able to close my gap because of someone else’s video,” she said. “It felt very much like paying it forward.”

“I always say in my videos that I did this experiment at my own risk,” Lopes said. “I share that it can work, but I always say that you have to be very vigilant, very careful.”

Update (5/12/2020): Some cases brought against SmileDirectClub by state dental authorities reached resolution earlier this year. We have updated this piece to reflect this information.

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