Sir,- Lost anterior teeth can be a real aesthetic problem for patients, and are now typically substituted by removable dentures, bridges or implants placed by professionals. However, in most circumstances, and particularly where professional dental care is accessible, do-it-yourself (DIY) dental treatment would usually be regarded as at the very least, inappropriate. We recently saw a bizarre case where a 63-year-old Brazilian male patient, a heavy smoker, consuming two packs of cigarettes a day for 45 years, and a very poorly controlled diabetic presented with severe periodontitis. Examination revealed PVC-type plastic strips each carrying the crowns of three natural teeth and bent to adapt to the dental arches, fixed with superbond to the palatal and lingual surfaces of the canines, rather along the lines of Maryland bridges (Figures 1 and 2).
Having extracted his own maxillary and mandibular incisors, he had constructed the bridges by removing the crowns from the roots of his own newly-extracted teeth with a saw. Though the patient could not use the bridges for mastication, and the devices needed to be recemented daily, he was otherwise quite happy with the aesthetics. He chewed mainly on his canines and on his posterior alveolar ridges, the remaining standing upper premolars on each side and one standing upper left molar. The mandibular posterior alveolar ridges were irregularly white, due to frictional keratosis caused by the trauma of mastication.
The patient was of a low income group, and in such instances, or where access to dental professional care is difficult, the need for self-care (DIY) can be readily appre-ciated. In the distant past however, devices were sometimes constructed by the patient or by non-professionals, but nowadays these self-made devices are rare, as in this instance. Though many clinicians will have encountered patients who carried out such DIY procedures such as the occasional self-extraction, denture or appliance adjustments and relines, denture and tooth repairs, and particularly tooth-whitening, there are surprisingly few formal reports of such DIY dentistry in the literature. Reports include the self-adjustment of a partial prosthesis where the remaining standing teeth had been lost1, and self-extraction of teeth2. Others have commented on the self-re-cementing of prostheses and the possible disadvantages and even occasional dangers of such DIY dentistry, such as the inhalation of material3,4.
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Di Hipolito, O., Ajudarte Lopes, M. & Paes de Almeida, O. Do-it-yourself dentistry. Br Dent J 194, 531 (2003). https://doi.org/10.1038/sj.bdj.4810189