Braces beyond treatment: Gen Z’s fashion craze and the hidden dental risks

Some years ago, spectacles became an unlikely fashion accessory among young people.

Children would pester their parents for a pair, with some even pretending to have problems with their eyesight simply because they wanted to wear them.

At the time, children who wore spectacles were often perceived as intelligent, affluent or “Dbee” [dada ba] and, depending on whom you asked, more attractive. The stereotype became so entrenched that spectacles were commonly associated with class prefects, school prefects, science students and self-proclaimed serious students.

Today, that craze has largely faded. Although some members of Generation Z still wear fashionable frames to enhance their appearance, attention appears to have shifted to dental braces.

Braces are primarily used to correct orthodontic problems. Yet an increasing number of young people and even some middle-aged adults seem eager to wear them merely for aesthetic appeal, without necessarily having a dental condition that requires treatment.

This raises an important question: Are there sufficiently stringent assessment and regulatory procedures to determine who genuinely requires braces, or has the practice been left to market forces and the demands of fashion-conscious consumers? Orthodontists and the relevant regulatory authorities are best placed to provide a definitive answer.

Braces not accessories

Dental braces are used to straighten teeth and correct orthodontic conditions such as crooked, crowded or widely spaced teeth. They may also be prescribed to correct malocclusion a condition in which the upper and lower teeth do not fit together properly when the mouth is closed.

Braces work by applying gentle but continuous pressure to move the teeth gradually into their appropriate positions. Although they are commonly associated with children and teenagers, adults may also undergo orthodontic treatment where clinically necessary.

There are several forms of orthodontic treatment, including traditional metal braces, ceramic braces, lingual braces, self-ligating braces and clear aligners. The appropriate option depends on the nature and severity of the patient’s condition, as well as the recommendation of a qualified dental professional.

Clear aligners are removable, unlike conventional braces, but they must generally be worn for most of the day to be effective. They are normally removed only when eating, drinking, brushing or flossing.

Orthodontic treatment often begins between the ages of nine and 14 because the jaw and facial bones are still developing and may respond more readily to treatment. This does not mean braces are ineffective in adulthood. Adults can also obtain good results, although treatment may sometimes take longer.

Benefits of proper orthodontic treatment

When prescribed and supervised by a qualified orthodontist or dentist, braces can significantly improve a person’s oral health and quality of life. Beyond producing a straighter smile, they can make the teeth easier to clean, reduce the risk of tooth decay and gum disease, and improve essential functions such as chewing and speaking.

However, even properly prescribed braces may cause temporary discomfort, particularly after they are fitted or tightened. Patients may also experience irritation of the tongue, lips or inner cheeks, difficulty eating and occasional jaw pain. These effects are usually monitored and managed as part of professional orthodontic care.

The critical point is that braces are not harmless decorations. They are medical devices designed to move teeth and alter a person’s bite. Their use should therefore be based on a proper clinical assessment, not simply a desire to follow a trend.

Dangers of unsupervised braces

Wearing braces without a genuine orthodontic need or obtaining them from an unqualified person can expose an individual to serious oral-health risks. Unnecessary or poorly controlled pressure may move otherwise healthy teeth out of position, creating gaps, crookedness or a new bite problem.

Other possible consequences include:

• tooth decay and permanent white or brown marks caused by plaque and food collecting around brackets; 

• swollen or bleeding gums, which may progress to gum disease; 

• gum recession and the loss of bone supporting the teeth; 

• shortening of tooth roots because of unnecessary or poorly controlled pressure; 

• damage to tooth enamel during the attachment or removal of brackets; 

• cuts, mouth ulcers and irritation caused by wires or badly fitted components; 

• infection from unsterilised instruments, unsafe materials or inappropriate adhesives; 

• choking if a bracket, wire or decorative component becomes detached; 

• jaw discomfort, difficulty chewing and headaches resulting from changes to the bite;

• injury to a tooth’s nerve, which may require root-canal treatment in severe cases; and 

The risk may be even greater where so-called fashion braces are fitted outside a properly regulated dental facility. Without an examination, X-rays where necessary, a diagnosis and continuing professional supervision, there may be no reliable way of predicting how the teeth, gums and supporting bone will respond.