DIY tooth filling kits

UPFRONT within endodontics at the present time and verified using robust methodology. It is not possible based on this to only recommend VPT based on current levels of evidence. We also fully agree that S3 methodology aims to be adaptive in nature, but do not believe that there is currently high-quality evidence to suggest modifications. References 1. Duncan H F, El-Karim I. Endodontic S3-level clinical practice guidelines: the European Society of Endodontology process and recommendations. Br Dent J 2025; 238: 580–586. 2. Zanini M, Meyer E, Simon S. Pulp inflammation diagnosis from clinical to inflammatory mediators: a systematic review. J Endod 2017; 43: 1033–1051. 3. Arora S, Cooper P R, Friedlander L T et al. Potential application of immunotherapy for modulation of pulp inflammation: opportunities for vital pulp treatment. Int Endod J 2021; 54: 1263–1274. 4. Takahashi K. Microbiological, pathological, inflammatory, immunological and molecular biological aspects of periradicular disease. Int Endod J 1998; 31: 311–325. 5. Asgary S, Aminoshariae A, Wesselink P R. Apical periodontitis in vital and nonvital teeth: clinical and radiographic features. Iran Endod J 2024; 19: 148–157. 6. Abella F, Patel S, Duran-Sindreu F, Mercadé M, Bueno R, Roig M. Evaluating the periapical status of teeth with irreversible pulpitis using CBCT and periapical radiographs. J Endod 2012; 38: 1588–1591. 7. Duncan H F, Kirkevang L L, Peters O A et al. ESE Workshop Participants and Methodological Consultant. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J 2023; 56 Suppl 3: 238–295. 8. Kanagasingam S, Lim C X, Yong C P, Mannocci F, Patel S. Diagnostic accuracy of periapical radiography and cone beam computed tomography in detecting apical periodontitis using histopathological findings as a reference standard. Int Endod J 2017; 50: 417–426. 9. Taha N A, Abdelkhader S Z. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int Endod J 2018; 51: 819–828. 10. Nair P N R. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med 2004; 15: 348–381. https://doi.org/10.1038/s41415-025-9384-x DIY dentistry DIY tooth filling kits We wanted to bring your attention to the use of DIY tooth filling kits and the harmful damage that can be caused by their use. To show the ill-effects of the use of these DIY kits we wanted to add details about a 41-year-old female patient who presented with pain in the upper anterior jaw region. Clinical examination revealed faulty, bulky, and rough tooth-coloured restorations on the mesial surfaces of both maxillary central incisors, extending into the embrasures and the gingiva (Fig. 1A). Both teeth were tender to percussion. The patient reported using a do-it-yourself (DIY) tooth-filling kit purchased online, which contained beads that were softened in hot water, moulded, and applied to the teeth. She re-applied the same material when the filling loosened or dislodged. She chose this kit due to its affordability, convenience of self-application, the high cost of professional dental care, and dental anxiety stemming from childhood. Intra-oral examination revealed root stumps in teeth 12, 14, 15, 16, 24, 25, and 26, and caries in teeth 34, 35, and 46. The patient admitted to using similar selffilling materials for these teeth and also planned to replace the root stumps with prosthetic teeth purchased online. Existing restorations on the maxillary central incisors were removed with a dental bur, revealing deep caries involving the pulp (Fig. 1B). Root canal treatment for teeth 11 and 21 was planned. The patient was counselled on the risks of such products and agreed to proceed with professional dental care. DIY dental kits purchased online pose significant risks.1,2 Without professional supervision, using unsterilised instruments can increase the risk of infection. These materials often lack regulatory approval and may not meet biocompatibility standards, leading to possible allergic reactions or toxicity.² Additionally, improper techniques employed during self-filling can lead to complications such as overfilling, trauma to the gingiva, and food impaction.1 While such kits may offer short-term relief, they often delay proper treatment, potentially resulting in persistent pain or tooth loss, as seen in our patient.1 Furthermore, complications from DIY kits may necessitate costly, extensive care, increasing both financial burden and oral health risks.3,4 There is a pressing need for patient education and guidance on the use of dental products purchased online without professional supervision. Public health campaigns should highlight the risks associated with DIY dental kits. Since these kits are often promoted via social media, the same platforms should be leveraged for counter-messaging strategies to effectively educate the public about the associated risks.1,2 Furthermore, dental health authorities should monitor and regulate the online sale of DIY dental kits. Only approved products should be made accessible to the public and unregulated dental products on e-commerce platforms should carry clear disclosures or warnings about the potential consequences of unsupervised use and these products does not guarantee safety or protection. This case highlights the consequences of using DIY dental kits which requires an extensive dental treatment that posed a significant financial burden. This underscores the need for patient education on the risks associated with unsupervised use of DIY dental products, as well as the importance of regulating their sale. Additionally, dentists are encouraged to proactively inquire about the use of online dental products during patient historytaking and to provide education to such patients. S. K. Veerabhadrappa, Selangor, Malaysia; S. Selvaraj, Phnom Penh, Cambodia and Pune, India; A. Marya, Phnom Penh, Cambodia References 1. 2. 3. 4. Fig. 1 (A) A faulty filling between teeth 11 and 21 (yellow circle). (B) Deep caries revealed involving teeth 11 and 21 following the removal of the filling (yellow circle) 668 Thirugnanasambandam G, Somashekar G, Rajachandrasekaran Y, Rao S H, Shajahan S F, Ansari M J. Review of do-it-yourself dentistry – time to ring the alarm! IJCBS 2023; 24: 1–4. Westgarth D. The alarming rise of DIY dentistry. BDJ In Pract 2021; 34: 10–14. Costa-Lenis C, Bollu P, Chaudhry K et al. Public perceptions and understanding of risks associated with do-it-yourself orthodontics: a survey study. J Clin Exp Dent 2022; DOI: 10.4317/jced.59911. Behrents R G. Do-it-yourself impressions and clear retainers: A fairy tale. Am J Orthod Dentofacial Orthop 2016; 150: 205–207. https://doi.org/10.1038/s41415-025-9385-9 BRITISH DENTAL JOURNAL | VOLUME 239 NO. 10 | November 28 2025 © The Author(s) under exclusive licence to the British Dental Association 2025. (...truncated)