Background: Fashion braces first appeared around 2006 in Thailand (Vachirarojpaisan 2009). It has been a current dental phenomenon in Thailand whereby people seek to wear a brace for non-therapeutic purposes. They might be provided by qualified and regulated dentists, but often by unqualified, unregulated non-dentists or are attached by the person themselves (i.e. do-it-yourself or DIY dentistry). However, there has been evidence that some people expect treatment outcomes from such non-therapeutic fashion braces. Over recent years, fashion braces have spread to other countries in Southeast Asia, including Malaysia, Cambodia and Indonesia, as well as to other parts of the world, such as Jamaica and Saudi. However, to date, there have been few research studies in this field.
Aim: To explore the informal market for fashion braces in Thailand.
Method: This thesis consists of two qualitative studies. Study 1 was a netnographic study in a Thai online community called Pantip.com where people discussed fashion braces. Threads were retrieved using keywords related to fashion braces in Thai on the community search feature. Threads were included if they talked about fashion braces or were posted by those who sought Fashion braces and/or had experience of fashion braces, resulting in 136 threads in Thai being selected and translated to English. Heading posts in these 136 threads were analysed by structural analysis.
Study 2 involved narrative interviews with 18 participants aged 14 years and above, who had experience with wearing fashion braces (past or present) or had decided against wearing fashion braces. Four recruitment strategies were applied: flyers, gatekeepers, social media and snowballing. Online interviews were carried out via Facebook messenger and Line application; participants had the option to use video calls or voice calls. The resulting data were analysed by thematic analysis.
Results: The findings of Study 1 suggested that users who started threads on the online community for three reasons. The most frequent reason was information-seeking (71%), by those thinking about wearing a fashion brace, followed by help-seeking threads (26%) started by those who were wearing Fashion braces and seeking help. The least common reason for starting a thread was to share experiences by people who had quit wearing Fashion braces (3%). The analysis suggested there were four meanings of fashion braces by those posting to the online community: as a fashion object, as a distraction from body dissatisfaction, an alternative to orthodontic treatment, orthodontic treatment could not meet desires. The analysis divided life with fashion braces into three stages: before, during and after wearing fashion braces. This enabled the researcher to see aspects related to the informal market framework, such as customers and providers, information, and peer and family.
In Study 2 the analysis of participant’s lives with fashion braces was also divided into three stages: 1) Road to the world of fashion braces, 2) Wearing fashion braces and 3) Escaping from the world of fashion braces. Four meanings of fashion braces were found: fashion braces as a fashion object, fashion braces as a tool to hide the appearance of teeth, fashion braces as a tool to improve one’s smile, and cheap braces for treatment. Wearers reported a number of benefits from fashion braces such as, gaining confidence. However, alongside these positive reports, there were a number of negative impacts that participants reported; pain was the most commonly reported impact. Whilst the negative consequences impacted participant’s life, some still kept wearing the fashion brace. Interestingly, some participants who quit wearing fashion braces returned to fashion braces for a second time primarily because they wanted to keep appearance of wearing them.
Conclusion: The findings from the studies in the PhD thesis suggest that fashion braces served a number of purposes for participants; both non-therapeutic and therapeutic. The participants reported many positive benefits from wearing fashion braces including psychological, social as well as functional. However, a number of negative impacts were also mentioned, most notably pain. The findings lend support to understanding customer’s perspectives within an informal market system in Thailand, and as such provide some insights into how dental professionals and dental policy makers in the country may develop educational resources for potential wearers.
