BANGKOK, THAILAND – Thai health authorities struggled to curb a dangerous craze for fake orthodontic braces that turned a status symbol into a documented health threat.
Braces as a marker of status, not medicine
In Bangkok, 22-year-old art student Supapich wore brightly coloured brackets as a fashion statement, reflecting a trend in Thailand, Indonesia and Malaysia where braces were seen as symbols of wealth and social status, even for people without dental problems. Professional orthodontic treatment in Bangkok cost between 40,000 and 100,000 baht (about 1,070 to 2,670 euros), posing a heavy burden for average families. The high price helped spur demand for cheap imitations marketed purely as accessories.
Black market ‘fashion braces’ and social media hype
Almost two decades earlier, a black market for so‑called fashion or fake braces had emerged, offering the look of real orthodontics without any medical benefit. These counterfeit sets were sold at flea markets, fitted in beauty salons or shipped as DIY kits bought online for about 40 euros, with designs ranging from Hello Kitty motifs to rainbow colours. Pop stars in Thailand and Indonesia showed off colourful brackets in public, and social media amplified the trend among youth eager to copy their idols.
Documented teen deaths linked to fake devices
Authorities in Thailand directly linked at least two deaths to fake braces. A 17‑year‑old girl from Khon Kaen developed a thyroid infection that quickly led to heart failure. In Chonburi province, a 14‑year‑old girl died after wearing pink fake braces for two months; an autopsy found severe infections in her mouth and gums, and police traced the device to an illegal market stall.
Toxic heavy metals found in seized products
The Thai Dental Council analysed confiscated fake braces and detected hazardous heavy metals including lead, cadmium, mercury and arsenic. Dr. Thongchai Vachirarojpisan, deputy chair of the council, said at a press conference that samples from illegal shops contained cadmium levels that would never be present in approved braces. These metals were absorbed by the body while the devices were worn in the mouth.
From gum disease to organ damage and cancer risk
Reported health effects ranged from bleeding gums, ulcers and infections to liver damage and an increased risk of cancer. Poisoning occurred gradually, meaning many users only noticed problems once serious harm had already developed. Many teenagers glued brackets onto their teeth themselves with ordinary superglue, a product not intended for oral use, which could burn mucous membranes and trigger allergic reactions, while loose brackets posed a choking hazard if swallowed.
Unhygienic fittings raise infection and sepsis risks
Fake braces fitted in beauty salons or by street vendors were often applied with unsterile tools, without proper disinfection. This allowed bacteria and viruses to be introduced directly into the mouth. The Thai Dental Council warned that such practices could lead to blood poisoning, nerve damage and severe infections, risks that were frequently underestimated because immediate symptoms were not always visible.
Children under 15 at the centre of the trend
A 2023 study by the Thai Dental Association on Bangkok youths who wore fake braces found that 93.3 percent of users were under 15. The main motivations were peer influence and the desire to belong to a particular social group. The study identified younger age, the impact of friends and celebrities, limited knowledge of health risks and lower socio‑economic status as key factors.
Braces seen purely as a social badge
Researchers reported that teenagers perceived braces not as medical devices but as status symbols. Unlike patients with real orthodontic treatment, they did not expect any improvement in tooth alignment. The findings highlighted how group pressure and the urge for social inclusion outweighed health considerations.
Harsh 2018 laws and online sales ban
In response to the deaths and mounting health concerns, the Thai government tightened regulations in 2018. The Consumer Protection Board banned online sales of all non‑approved braces and orthodontic materials. Offences were punishable by up to five years in prison and fines of up to 500,000 baht (around 13,400 euros), and Dr. Paisal Kangwolkij, president of the Thai Dental Council, stressed that legal braces could only be prescribed by licensed dentists after thorough examinations.
Nationwide raids uncover illegal clinics
Since April 2017, the Thai Dental Council received more than 308 reports of illegal brace operations. Investigations led to 90 illegal clinics in 19 provinces, including Bangkok, Chiang Mai, Khon Kaen and Samut Prakan. Enforcement remained difficult because many sellers operated via social media and frequently changed locations, forcing investigators to pose as buyers to identify operators and secure samples for quality and toxicity tests.
Lucrative underground business survives crackdown
Despite bans, the market for fake braces remained highly profitable. One illegal online shop discovered in January 2018 recorded almost 20 million baht in sales—about 535,000 euros—within a year. These profits encouraged new dealers to enter the trade despite the risk of prosecution, fuelled by continued demand for cheap alternatives to genuine orthodontic treatment.
Sales shift from street stalls to influencers
With digital platforms on the rise, distribution channels moved from street markets to the internet. Influencers and so‑called net idols promoted fake braces on Facebook and Instagram. Authorities, including the Food and Drug Administration, faced the challenge of monitoring these decentralised networks and carried out raids on production sites, among them a registered factory in Ratchaburi province.
Experts urge treatment only by licensed orthodontists
Health agencies in Thailand and other affected countries issued clear advice to families.
“A brace should only be prescribed and fitted by a licensed orthodontist,”
said Paisal Kangwolkij, president of the Thai Dental Council. Proper treatment included a detailed diagnosis, an individual treatment plan and regular check‑ups under sterile conditions using approved materials.
Cheap fakes can become costly health burdens
Officials warned that the apparent savings from fake braces were misleading. Those who suffered tooth damage, gum disease or systemic illness from inferior materials ultimately faced far higher costs. Some resulting health problems could be irreversible, adding long‑term burdens well beyond the initial purchase price.
Education campaigns to counter peer pressure
Experts agreed that education was the most important tool against the trend.
“Teenagers and their parents must be informed about the real dangers,”
said a spokesperson for the Thai Dental Association. Schools were seen as potential venues for awareness programmes that also addressed peer pressure, celebrity influence and the social meaning attached to braces.
Making legitimate care more affordable
Improving access to professional orthodontics was presented as another way to reduce reliance on illegal products. Some Thai dental clinics began offering instalment payment plans to ease the financial burden on families. Such initiatives aimed to narrow the gap between high demand for braces and limited household budgets.
Persistent popularity despite years of warnings
The Thai Health Ministry issued repeated warnings for more than five years, yet the fashion remained remarkably resilient. The deep‑rooted view of braces as a wealth marker could not be changed by laws alone. Officials argued that a broader social shift in how status and prosperity were defined was needed.
Trend spreads across Southeast and East Asia
What started in Thailand spread to other Asian countries. In Indonesia, where fake braces were less strictly regulated, adults as well as teenagers adopted the colourful brackets, and travellers reported hotel staff with metallic smiles. Similar trends appeared in China and Malaysia, though to varying degrees.
Calls for stronger oversight and social debate
Authorities said they had to intensify enforcement and surveillance of online commerce while society debated beauty ideals and status symbols.
“As long as a brace is seen as a sign of wealth, young people will look for ways to wear this symbol,”
said a representative of the Consumer Protection Board. The challenge lay in creating safe alternatives and questioning the values that drove the demand.
Deaths as a stark warning to families
The stories of the two deceased teenagers in Thailand were cited as a stark warning about the risks hidden behind colourful brackets. What began as a seemingly harmless accessory ended in severe infections, poisoning and, in the worst cases, death. Health agencies stressed that these were not theoretical dangers but documented, scientifically confirmed risks that demanded to be taken seriously.