What to Know Before Starting Orthodontic Treatment

May 31, 2019

At Somerville Orthodontics, it is our goal to do everything we can to educate our patients. Lets work together as a team to help create your best smile. The purpose of our blog is to provide information so that you, the patient can make an informed decision.

If you’re thinking about orthodontic treatment there are some important things that you need to consider. Here are 4 topics you need to understand before starting orthodontic treatment:

1. Understand there’s a difference between a dentist, pediatric dentist, orthodontist and board certified orthodontist.

Dentists earn a dental degree (either a DMD or DDS) after completing 4 years of training at an accredited dental school. As part of their curriculum, all dentists receive some education in orthodontic treatment.

Pediatric Dentist

A pediatric dentist is a dentist who, after completing dental school, receives additional highly specialized training. Part of their training as a pediatric dentist includes craniofacial growth and development, and orthodontic treatment.

Orthodontist

An orthodontist is a dentist who, after completing dental school, receives additional highly specialized training. Orthodontic residencies are two or three years in length.  The sole focus of these programs is to train residents to become orthodontists. Orthodontists are experts at understanding craniofacial growth and development, diagnosing dental and skeletal malocclusions, and treating various types of orthodontic cases.

Board Certified Orthodontist

A board certified orthodontist is an orthodontist who has decided to complete a voluntary board certification process. This process involves a detailed didactic examination and completed case presentations to a panel of board certified orthodontists. You can find more information about board certified orthodontists at www.americanboardortho.com.

It is important to know that all dentists, pediatric dentists and orthodontists can perform orthodontic treatment as part of their practice. Above all, it is up to you, the patient to decide where you want to receive this treatment.

2. Understand your dental insurance and orthodontic benefit.

I can’t emphasize enough that dental insurance is NOT like medical insurance. And to make things even more confusing, some dental insurance plans have an orthodontic benefit while others do not. If you have dental insurance but are unsure about your orthodontic benefit, make sure you call your insurance company to find out.

An example of a common orthodontic insurance benefit is a $1000, lifetime max benefit. This means that your insurance will cover $1000 towards the total orthodontic treatment fee. Once this benefit is used up, you cannot access it again, hence the “lifetime max benefit.” You, the patient would then be responsible for the remaining balance of the treatment fee. To be sure you and your treating doctor fully understand your insurance benefit, doctors will often submit a prior authorization claim to the insurance company to confirm the exact amount of coverage that you have.

Insurance can get even more complicated with in-network and out-of-network benefits, but we are not going to get into that. Just make sure you ask your insurance company about your orthodontic benefit.

3. Understand the various types of orthodontic treatment.

There are many different ways orthodontists can give you a beautiful, healthy smile, and functional occlusion/bite. Lets go over a few of the most popular treatment options:

  • Metal/Stainless Steel Braces: Stainless steel braces are the most common and are usually the appliance of choice among teens and adolescents.
  • Ceramic Braces: Ceramic braces are clear or translucent and offer a more esthetic treatment option compared to stainless steel braces. Adults and older teenagers often prefer this treatment option.
  • Clear Aligners: Clear aligners are plastic trays that fit on top of the teeth. The most recognizable company that manufactures clear aligners is Invisalign. In order to be effective, these aligners must be worn nearly full time and only removed to eat or brush. This is a popular treatment option for adults and older teenage patients.
  • Lingual Braces: Lingual braces are like metal braces, but instead of being bonded to the front surface of the teeth, they are bonded to the back, or lingual surface of the teeth. Lingual braces are the only treatment option that is truly “invisible.”

Recently there have been many start-up companies offering direct to patient clear aligners. You may have seen their ads on TV or the subway. I’m not going to get into discussing the benefits and pitfalls of this type of treatment here, but we can explore it further in a future blog post.

4. Understand treatment time, fees, and second opinions

As an orthodontist, there are two questions that I get asked all the time. Patients want to know how long do I have to be in braces, and parents want to know how much is it going to cost. And honestly, the answer to both questions is: it depends.

How long do I have to be in braces?

Let me give you a quick lesson in the biology of tooth movement. Teeth move because we use braces and wires, or clear aligners to apply a force. Prolonged application of the force triggers the tooth movement. Therefore, if there is more movement of teeth that needs to occur, the longer it is going to take. Conversely, if there are only minor tooth movements that need to occur, the time of treatment will be shorter.

There are a whole host of other factors involved of course, including biology, compliance, whether teeth need to be removed, and oral hygiene. Your orthodontist will estimate the length of your treatment based on the amount of tooth movement that you require. The average treatment time for most patients is 18-24 months. However, keep in mind that this is an estimate and there are many factors that could make your treatment shorter or longer.

How much is this going to cost?

Most offices will charge for treatment based on the length of time and complexity of the treatment. Treatment fees obviously vary widely depending on which part of the country you live in, but in general, it’s safe to assume that the more complicated the treatment, the higher the fee.

Getting a second opinion is a great idea. As the patient, you should do everything you can to educate yourself and make an informed decision about who you want to complete your treatment. Ask your friends, classmates or colleagues if they could recommend somebody. Check Facebook and Google. Above all, do what you have to do so you can be happy with your decision to move forward with treatment.

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If you have any other questions about orthodontics, or have a suggestion regarding a blog post, please contact us at 617-227-2421 or [email protected].

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