Sir, in view of the reported rise in DIY dentistry, we thought it would be useful to apply some quantum to this and provide a snapshot analysis of patient presentations at a new patient clinic over a two-day period at Peninsula Dental School.
We recorded whether patients had carried out self-administered dentistry, and of the 38 patients attending over two days, 13 reported doing so. This figure of 34% of patients (with its limitations) is an increase on the reported 25% of households across the UK attempting at least one form of DIY dentistry in late 2020.1
There was a wide range of treatment modalities attempted with five patients carrying out temporary restorations, using materials and instruments purchased from a pharmacy. Two patients had adjusted their dentures, one with a nail file and one with some sandpaper.
A patient who presented with necrotising periodontal disease had brought a scaler online and tried to manage the condition (unsuccessfully). Another patient, rather than purchasing a scaler, had used a dart to remove gross deposits of calculus.
There was a range of oral surgery procedures evidenced. One was a failed extraction with pliers of an upper right first molar, with the patient applying the pliers but finding it too painful when the procedure commenced. One patient reported that they had treated a friend by trying to extract the affected tooth by tying string around the tooth, attaching it to a door and slamming it shut akin to a cartoon - and again unsuccessfully.
The patient in Figure 1 had attempted to extract 13, drinking enough vodka to dull the senses, then quickly using standard pliers to extract the tooth, with further vodka to relieve the post-operative pain. The patient was aware the root was left in situ but found this had relieved pain sufficiently to warrant repeating the procedure three further times, over an approximate two-year period.
While this is just a snapshot analysis, we are increasingly finding that patients accessing our services have attempted to access dental care elsewhere unsuccessfully and we are observing a worrying rise in DIY dentistry. The risks to patient safety from these attempts are not insignificant, and while dental access problems persist, more public information is required on the risks of DIY dentistry.
Reference
Association of Dental Groups. Dentists set for post-Covid 'horror show' as millions of Brits pull own teeth out during lockdown. 2020. Available at www.theadg.co.uk/dentists-set-for-post-covid-horror-show-as-millions-of-brits-pull-own-teeth-out-during-lockdown/ (accessed August 2022).
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McColl, E., Witton, R. & Mathews, A. Vodka-assisted extraction. Br Dent J 233, 441 (2022). https://doi.org/10.1038/s41415-022-5045-5
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DOI: https://doi.org/10.1038/s41415-022-5045-5
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