Zoe Buontempo explores the impact of social media on female patients’ decision making and whether dental professionals have a responsibility to combat this.
It is almost impossible to walk past a high street dental practice and not notice adverts for cosmetic dentistry filling their windows. From whitening to full mouth rehabilitation, the spectrum of elective interventions is vast but the quality of treatment delivered can be greatly variable.
Social media is one of the forces driving the market for cosmetic treatment, particularly for women who are spending more time on social media than male counterparts across all age groups.
It is likely that the fashion industry, which continues to perpetuate unhealthy narratives around women’s health and beauty, has a trickledown effect into what women are consuming on social media.
Ofcom found that platforms can become a dangerous place for young women who are exposed to content ‘stigmatising certain body types, content promoting excessive exercise… and eating disorder related content’.
Countless influencers have posted to their millions of followers how they have achieved their ‘look’, and their smiles are no exception. Gifted and discounted treatments including orthodontic treatment, veneers and facial injectables are posted with direct links to the treating clinician.
As women seek to embody these heavily filtered personas our waiting rooms are likely to be filled with those seeking similar cosmetic enhancement.
Beauty standards
Studies have shown that self-esteem, self-confidence and social engagement can all increase following cosmetic dental treatment. No one can argue against how good it feels to like what you see in the mirror and to be able to help our patients achieve this can be incredibly rewarding.
However, patients can attend asking for a ‘perfect’ or ‘permanent’ solution to their perceived aesthetic shortfall. As we should all be aware nothing in dentistry is ‘perfect’ or ‘permanent’ and promising to achieve this will lead to inevitable disappointment for both parties, clinician burnout and/or complaints.
So, what happens when women can’t reach this self-imposed but societally encouraged beauty standard? If accessing dental care is challenging or the price point too high, where do they go? What if they are living with body dysmorphia and no treatment would ever reach the desired end-result?
‘Turkey teeth’
The default answer would be that there is little to stop any determined dental ‘consumer’ from hopping on a plane and returning through customs with ‘Turkey teeth’ to declare.
Some patients return from their trip with a well-executed, new and improved smile as well as a tan. However so many come back with poorly contoured restorations, impossible to clean, heavily prepared and often sequentially de-vitalising teeth.
Patients are left in pain with nowhere to turn beyond overstretched NHS emergency appointments as follow-up care with the treating clinician is not an option.
Whilst it is easy to blame the ‘Turkey teeth’ trend on Love Island, the Kardashians and overseas clinics, it is important to remember the beginning of this article. UK dental practices are filled with clear aligner providers, bleaching Black Friday deals and facial aesthetic ‘tweakments’.
It is self-evident that these treatments can be lucrative with a growing market of patients, often young women, striving for a look that is entirely unnatural.
It is crucial to recognise the warning signs of a patient presenting with body dysmorphic disorder (BDD), estimated to be between 1-2% of the population and more common in women. If BDD is missed this can lead to excessive, dangerous treatment for patients and untold pressure on the treating clinician.
Reality vs virtuality
For really young patients who have grown up immersed in the world of filters and selfies it is difficult to determine where the real world ends and virtual begins. Young girls are particularly vulnerable to the pitfalls of the online world, posting more selfies than their male counterparts, which in turn can lead to appearance anxiety, eating disorders and depression.
This may explain the more than 1,500% increase in cosmetic procedures performed on adolescent patients from 1996 to 2022 as they seek to treat their ‘flaws’.
This can manifest in the dental practice from a very young age, for example with parents and patients requesting orthodontic intervention far before it is appropriate.
Serious discolouration and misalignment of the teeth is an understandable concern but this keenness to ‘correct’ must feed into any normal insecurity that the young patient may be feeling, as clinicians we should not prey on these vulnerabilities.
Embracing natural beauty
Instead we should take the opportunity to encourage and empower our patients (emphatically not consumers) to embrace their natural beauty whilst ensuring dental and general health are the priority and not an afterthought in the pursuit of ‘likes’.
Like many other responsible clinicians, I wrestle with the rights and wrongs of meeting patients’ aesthetic demands when, first and foremost, I am a healthcare provider…
We are encouraged by the GDC to put patients’ best interests first, and whilst the benefit to patients self-esteem is proven, arguably we are complicit in creating an artificial beauty standard by advertising, providing and celebrating cosmetic improvement.
Is our public health message diluted when we deliver oral hygiene instruction and diet advice to an impressionable young patient with a massive poster for cosmetic treatment on the wall behind us?
There is a certainly a place for cosmetic procedures within dentistry, but surely one could argue that its pursuit should not compromise long-term oral health.
