Hundreds of women in townships around South Africa who are fed up with failed diets are resorting to the drastic measure of wiring their jaws for a few weeks and consuming only liquids.
The practice is so popular that one dentist claims to have performed the procedure at least 80 times in the past two years. This despite the fact that it produces negligible weight loss and that lost kilos are soon regained.
The procedure, commonly known as amadraad (wire) or ubopha amazinyo (tying your teeth), is called inter-arch dental fixation, where special wires are woven between teeth on the upper and lower jaw, leaving eyelets to which joining wires are attached. It is normally used to immobilise fractured jaws. Some dentists leave space between teeth for a straw, while others expect patients to drink through gaps in their teeth.
Maria, a teacher from Tembisa on the East Rand who would not give her full name, heard a colleague bragging that she had lost weight by wiring her jaw. Impressed by the results, she decided to get a local dentist to wire hers. She says the process was very sore and the pain did not subside for four days.
“I couldn’t eat or sleep. After four days I asked my husband to cut the wires with a scissors,” Maria says.
The following day she went back to the dentist to remove the wiring. He said that the pain was part of the procedure and that she had to endure it if she wanted to lose weight. Maria “didn’t lose a single kilo after four days”.
Crash diets don’t work because they don’t teach healthy eating accompanied by lifestyle changes, says registered dietician Carlette Julius.
“Food can be an addiction. In some cases a ‘rehabilitation’ process is necessary to wean yourself off these difficult destructive eating habits,” she says. “Often when a crash diet is stopped, dieters haven’t been taught behavioural changes to maintain long-term weight loss.”
She says the wiring of jaws should only be prescribed by physicians in extreme cases, where a patient’s weight is a health risk. Even then, the success is short-term and patients usually return to their old weight or gain even more.
One reason for this is that the body learns to store fat more efficiently to make it through the next “starvation” after interpreting a strict diet as a time of starvation.
Dentists are also aware that wiring doesn’t work and often tell their patients this but this doesn’t stop them from requesting the procedure. The practice is so widespread in the townships that many dentists know that if they don’t do it the patient will find someone else who will.
“I advise them that it does not work and is doing more harm than good but if they still insist, I do it,” a Tembisa dentist says.
He charges R150 for the procedure and usually takes the wires out after two weeks so that the jaws can rest. The wires are then put back for another week.
But most of his patients return within a few days because the pain and discomfort are too much to bear. The dentist estimates that only 5% of patients keep the wires in for the full term, but they don’t achieve significant weight loss.
The longest a patient can stay “wired” is six weeks.
While the medical and nutritional dangers of wiring are not severe (the most serious threat is constipation or choking), patients risk long-term dental complications.
If the wires are inserted incorrectly, it could lead to premature loss of teeth, demineralisation (weakening) of the enamel and if they aren’t smooth they could cut into gums and teeth. The gums could become inflamed and patients risk developing gingivitis.
The procedure also raises serious ethical questions.
Julius says it is best to seek the advice of a registered dietician when embarking on a diet.
“I don’t go around pulling teeth and putting in fillings,” she says.
Dr Neil Campbell, executive director of the South African Dental Association, says doing the procedure on people who want to diet is unethical unless accompanied by a letter requesting wiring from a psychologist or psychiatrist. But it isn’t illegal. He says the responsibility of policing the practice lies with the Health Professions Council of South Africa via the Medical and Dental Professions Board, who will react to a complaint only. However, they have “far more important issues in health care to worry about”.