Author: Ask Dr. Reynolds

Orthodontic treatment is an investment in health, self-confidence, and the future. It’s a significant monetary investment as well. After doing all the research and asking all the questions to find the right orthodontic provider, navigating the payment arrangements comes next. Think braces.

Now more than ever, do your due diligence to save money where possible.

Insurance

Approximately 50 percent of those seeking orthodontic treatment do not have coverage. If you have orthodontic insurance, congratulations!

A few tips for getting the most benefit from your orthodontic insurance:

• Some insurance policies require a one-year waiting period, so you may have to sign up now for benefits next year
• If you may be interested in orthodontics in the future, get a free exam and check with your insurance supplier about coverage as soon as possible
• Beware of DHMO insurances.  Although these may look good at first glance and provide little out-of-pocket expense for treatment, they pay very little to the doctor.  This virtually guarantees you will receive lower quality materials and cost-cutting measures, which could provide a less-than-ideal result or experience.  All braces and all doctors are not created equal, so be sure to do your homework if you are looking at an office that accepts DHMO insurance for treatment.
• Find the doctor you like because, for almost all orthodontic insurance, you will still get the same insurance benefit for in- or out-of-network doctors
• Ask your orthodontist for a complimentary benefits check

Flexible Spending and Health Savings Accounts

FSAs and HSAs allow the use of pretax dollars for qualified health-care expenses, which include orthodontics. Both types of accounts are a significant tax advantage and can be the most powerful way to save money on orthodontic treatment.

A few things to remember:

• FSA funds expire each year, so pay attention to your company’s deadlines
• Most companies require you to let them know ahead of time how much you would like to set aside
• If your employer does not provide access to an FSA account, ask a financial planner if you can participate in an HSA account.  These accounts actually allow you to save significantly more money per year toward health care expenses and also do not expire at the end of each year.
• Know your enrollment periods; failing to sign up in time could cost you significantly more in after-tax dollars to pay for your treatment

Flexible Financing

Most offices will offer several options to pay for treatment, which may include:

1. Paying in full to receive a certain percentage off
2. Making a down payment and taking on one to two years of monthly payments
3. Opting for an extended financing plan

Avoid Hidden Fees

If you opt for an extended financing plan, watch for missed payment fees or surprise charges. You also shouldn’t need to pay higher than a 7 or 8 percent APR for an extended payment plan. Shorter payment plans are available with a 0 percent APR.

When comparing orthodontists’ prices, look closely at the cheapest. Many offices offer low prices up front but hit you with fees later in treatment, making the total cost much higher. Fees for broken brackets, missed appointments, and cancellations and extra charges for retainers and the like can dramatically increase your total cost.  Also, it is safe to assume that cheaper treatment fees are made possible by cheaper materials, lesser trained orthodontic team members, and other cost-cutting.

Also beware of any office that charges additional monthly fees after a certain point. For example, many lower-priced offices will charge extra if treatment extends beyond twenty-four months—creating an incentive for them to keep your braces on longer.

Fixing Bad Treatment

Not all braces are not created equal. Many cheap braces are made of cheap metals and lower-grade metals are much more likely to create irritation and sensitivity in patients.  Cutting corners in manufacturing makes braces inconsistent in their dimension which makes treatment take longer or will compromise the quality of the results.

Consider quality while shopping because the cheapest orthodontic treatment in town may come with a significant hidden cost in dollars, time, comfort, and your end-results.

The time, energy, and dollars you are spending for dental health, a new smile, and a healthy bite are investments that should last a lifetime. Use insurance, spending/savings accounts, flexible financing, while wisely avoiding hidden fees and the cost of fixing bad treatment, to maximize your investment.

When is the right time to start orthodontic treatment? The best timing for treatment varies for every person. These four questions will help determine a good timeframe for you or your loved one.

Do You Have a “Bad Bite”?

Orthodontic treatment not only moves crooked teeth so they are beautiful and straight, it corrects major bite problems. Although “bad bites” can seem subtle, and may not present noticeable symptoms, a bite that doesn’t fit well together can result in long-term consequences. A few symptoms of bite problems are:

• Tooth Pain – When it comes to your bite, even a fraction of a millimeter can irritate a nerve and cause tooth pain.
• TMJ Pain – If you have a hard time opening your mouth or have significant pain during jaw movement, you may have TMJ problems.
• Muscular pain –Headaches with an unexplainable source may be caused by bite issues.
• Tooth wear – Significant wear can occur if teeth do not fit together properly.
• Gum wear – If your bite is off, the gums and supporting bone can prematurely wear.

Prevention by correcting your bite early is the best option. Even if these symptoms are not present now, your bite is something that can be off for a while and not cause a lot of problems—until it does. Dealing with bite issues proactively is much less painful, may take less effort, and can be less expensive than dealing with bite problems later.

What is Your Sleep Like?

Sleep apnea is catching the attention of more and more medical professionals. Sleep apnea is a condition in which a person will temporarily stop breathing while he or she is sleeping. Repetitive bouts of not breathing, called episodes, can cause serious health problems. Sleep apnea left untreated over time is now believed to be a significant factor in premature death as well as many other health issues.

There are several types of sleep apnea, the most common and most treatable being obstructive sleep apnea, or OSA. A very common symptom of OSA is snoring. If snoring is present with repeated bouts during which it appears the person is holding his or her breath, seek an evaluation for obstructive sleep apnea. An expander can be a very effective, and sometimes life-changing, treatment for obstructive sleep apnea.

How Many Teeth Do You Have?

The correct number of teeth for an adult is thirty-two, and it is not unusual for people to have missing or extra teeth. Both the presence and absence of the correct number of permanent teeth are important factors in orthodontic treatment.

Missing or extra teeth are often diagnosed for the first time in the orthodontist’s office.

X-rays used by general dentists do not provide as wide of view as a panoramic x-ray or a 3-D cone-beam computed tomography scan (CBCT) used at the orthodontist.

Having extra teeth causes the other teeth to develop out of place and often leads to crowding, rotations, and impacted teeth. Because extra teeth can cause lots of unwanted trouble, early screening is key. Two-phase treatment is oftentimes necessary to undo the issues caused by extra teeth.

Missing teeth are more common than extra teeth. While it is very important to identify that teeth are missing, treatment is typically not initiated until all other permanent teeth have grown in. The management of missing teeth is a difficult and complicated topic, so early identification and management will help with developing an appropriate treatment plan to achieve the best results.

How Old Are You?

If you have young children, I recommended having them screened at age seven or eight so an orthodontist can look for some of these problems that require early intervention. Most of the time, your child will be told to wait until they are older to start treatment. But, some may have the above-mentioned problems calling for earlier help.

If you are an adult considering orthodontic treatment, it is never too late. More and more adults are seeking orthodontic treatment to help create the smiles they have always dreamed of. And, fortunately, modern orthodontics offer many cosmetic options.

Choosing the best orthodontic provider, office and treatment plan for you or your loved ones can be a difficult decision. With an infinite amount of information available to consumers at the click of a button, the choices of care are endless. One Google search may leave your head spinning.

Here are the five things you need to do when visiting an orthodontist and considering treatment:

1. Check their credentials and experience.
   It takes years of training to be able to treat orthodontic cases well. It’s important to find a provider who consistently and continually—over the course of years, not days or weekends—pursues education and training.  A qualified provider will have gone through a full-time, accredited residency. They will provide the highest possible level of orthodontic care. During your visit, ask to look at before-and-after photos. Most doctors who have treated many cases will keep books of before-and-after photos and can show you photos of cases like yours. The goal is to determine the training level of your future orthodontic provider.
2. Pay close attention to the numbers.
   It may not be wise to choose the cheapest provider out there, but it is important to analyze the cost of treatment.
   Most offices will offer several payment options, so make sure to ask the office manager about flexible financing. If you’re able to pay in full, you’ll typically save a small percentage. If you choose to make a down payment and take on one to two years of monthly payments, watch for surprise charges for missing a payment.
   Be wary of other hidden fees. Many offices offer low prices up front but hit you with fees later in treatment, making the total cost much higher. Fees for broken brackets, missed appointments, and cancellations and extra charges for retainers and the like can dramatically increase your total cost.
3. Ask more about their treatment plan.
   In addition to straightening crooked teeth, the treatment plan should be focused on correcting your bite. Many patients, and unfortunately many dental providers, do not have a concept of how important the bite is to overall dental health. If you have crooked teeth, you likely also have a bite problem, and you will benefit greatly from having any bite problems corrected. You may not notice an issue now but, sooner or later, unnoticed bite problems will catch up with you. Although “bad bites” can seem subtle, and may not present noticeable symptoms, a bite that doesn’t fit well together can result in long-term consequences like tooth pain, TMJ, muscular pain, tooth wear, and gum wear.
   When talking about their treatment plan, if your doctor recommends pulling any permanent teeth, you should seek to understand why and if there is a better option. Removal of permanent teeth is more of a last resort than a treatment of choice. And, unless this is a “last resort” case, a doctor may be recommending extractions when modern orthodontic techniques could treat equally or better, without removing your permanent teeth.
4. Get a second opinion before you start treatment.
   When shopping for an orthodontist, many people think they are all exactly alike, but they absolutely are not.  There are different levels of skill, commitment, and expertise and there is a spectrum of orthodontic cases, from simple all the way to very, very difficult. Not all doctors are created equal. Most orthodontic exams are free, all you invest in a second opinion is your time, so it is wise to get a second opinion. Once you have visited several orthodontic specialists and get opinions that are consistent, chances are that the treatment plan is in your best interest.
5. Most importantly, use your gut!
   Orthodontic treatment doesn’t have to be a scary or unpleasant experience. In fact, I believe it can be fun! Look for personal touches, a helpful staff, and a well-run office to see how much they truly care about making your experience special. Each visit should leave you with something to smile about.

Throughout my years of practice, I have put serious thought into trying to make my patients as comfortable as possible during an orthodontic visit. The environment is set up just the way we want it to be: welcoming, free from stress, and, believe it or not, fun. But I know that everybody has different feelings about a dental visit so I will try and share some of my experience about stress points.

Why do we get nervous?

I think most of what makes us anxious about orthodontic visits is what might happen. In particular, wondering if it’s going to hurt. Kids fear the unknown. They might be wondering what it’s like, ‘are they going to get a shot’ or something else bad. Adult patients have past experience to draw on. Either because of painful visits to their general dentist or because of friends who recount exaggerated stories of horror, we can get a bit apprehensive about what could happen. It is important to keep in mind that orthodontic visits and dental visits are very different. Especially if the orthodontist provides high-tech treatments like the Damon System that are much more comfortable than traditional orthodontics

Regardless of why you might be uneasy about your visit, I want to make something perfectly clear to everyone. We focus on the available technologies that provide the most comfortable experience possible. In fact, I want you to have amazing teeth and I will not do anything I don’t need to that might cause you any discomfort. Also, remember, trips to the orthodontist are much less invasive than general dental visits. We don’t have shots and we don’t really do the procedures that you are worried about in anticipation of a ‘regular’ dental visit.

Let’s go back to how a lot of the anxiety starts. People tend to anticipate things that may or may not happen. And, if this is your first visit with us, it’s completely natural. But before you get really stressed about it, remember that orthodontics is not what it used to be. Like all medicine, orthodontics has gotten much better at treating issues and doing so with less invasiveness, less pain. For example, many adults who have had braces remember the ring shaped bands that fit around the back teeth and are uncomfortable to place. We don’t use those anymore except in very rare circumstances. There are better ways. We have amazing equipment at the office and we are able to perform procedures here that were a big deal just 15 years ago. Looking back at old films from the 1950s that portray dentist appointments as traumatic experiences, it is easy for me to laugh. Comparing the two experiences is like comparing comparing the television people in the ‘50’s watched vs today’s 4K high-definition flat screen TV. The difference is pretty dramatic.

What to say to kids

When you are taking your children to their first visit, you have the opportunity to help them feel relaxed. Remember, if you are relaxed when you go for a visit, we’re likely to continue throughout our lives and we know by now that that is a good thing. It is great groundwork to take an active role in forming good oral hygiene habits as early as possible. When kiddos are 6 or 7 years of age it is great timing to form daily habits like “Two minutes, twice a day.” Being comfortable with doing good maintenance on your own teeth can translate into, “Dr. Reynolds is going to see what a great job you did brushing your teeth.”

We work with children every day at Spillane & Reynolds Orthodontics and know how to put them at ease. We encourage parents to join with us in making an office visit a normal part of day-to-day life. Even if you as a parent have had less than stellar experiences at the dentist’s office, focus on how good it is for a great smile and how proud you are of them. It really makes a difference. Of course, if you want to feel better yourself, schedule an appointment with us and we will make you feel much better about it, regardless of your past experience.

Again, our promise to you is to provide you with the most carefree experience possible. If you have anxiety about your office visit, contact us. We will explain everything to you with an eye toward making your next visit a walk in the park.

One of my missions in life is to get as many people as I can to buy into making oral health a priority in their life. I will tell you that some days, it’s hard. To me, I see the problems that people face because they didn’t work on good dental hygiene. Avoidable problems. So I sat down and began asking myself, “What’s the simplest way to get people to take care of their teeth and gums?” I thought about talking about all of the benefits. Then I thought about and wrote about all of the problems you could face. Both approaches were too wordy and nerdy.

I decided to promote a message that was more of an advertisement than an admonition. Does anybody remember the 1997 Apple ad campaign “Think different.”? It was two words but won many awards and used creativity by associating the computer with creative, rebellious figures from history. Well, I can tell you that I’m not going to relate someone like John Lennon with oral hygiene. Not in the budget.

But I liked the simplicity. Easy to remember. Really sticks with you. Might make you want to do something. So I came up with the Two-Step Teeth Philosophy.

Two-Step Teeth

Step 1: Brush and floss when you wake and when you sleep

Step 2: Less sugar

Just these two things if applied daily would reduce dental problems a lot. No, really. A lot. Best of all you get the side benefit of setting the example for your children. You are virtually assuring them of a much easier time for their teeth over their lifetimes. There are only two things you need to elaborate on.

How to brush and floss

This is covered in so many articles, I’m not going to cover it here. The only think I’d add is that you should emphasize how little time it takes. After that, for people who think flossing is a drag, make a deal with them to start out flossing one tooth. It sounds crazy but you’ll see.

Foods and drinks to avoid

By foods and drinks, we mean sugar. Show yourself and your family how much sugar sodas have. Show them how much food and drink packaging really stretches the truth with words like “natural flavoring” and “from real fruit juice”. Regular soft drinks like colas and the like are terrible for your teeth and your entire body. Need evidence? Search for “high fructose corn syrup” on your favorite search engine and get ready to for an eye-opener.

Clean and nourish

The Two-Step Teeth philosophy works because it keeps your attention focused on two giant pillars in dental health. The big problems with teeth and gums is keeping them free of debris and not pouring acidic food and drink over them. Super easy to remember, I think Two Step Teeth is headed for greatness. Let’s work to make all those visits great ones too.

A smile is a reflection.

Eyes.

Mouth.

Teeth.

As an orthodontist, I tend to focus on the role that teeth play in a great smile. But, I understand that a beautiful smirk is a combination of factors that communicate a sense of well-being to those who see it. There have been volumes written on the power of a smile on both the wearer and those that see it. The bottom line is that a smile works on both the physical and emotional level to transfer positive feelings between the parties involved.

Just what is transmitted when someone is smiling at another? First, that the smiling person is genuinely happy at that moment. That the person they are smiling at is welcome, unthreatening. The receiver is told that they are accepted and welcome to converse. The person smirking also reinforces to themselves on a deep subconscious level that they are happy and creates a positive feedback loop for their mood. Lifehacker, the renowned online magazine of self-help hints has almost 8,200 articles about smiling.

Follow along and see the main players in a great smile and how they work together to put out more positivity than you could imagine possible.

The Eyes

People who are honestly happy, smile from their eyes. You can see the mouth turn up at the corners but it’s the slight squint of the eyes and the little wrinkles in the corners that give away a honest-to-goodness smile. Also called a Duchenne smile, it involves contraction of both the zygomatic major muscle (which raises the corners of the mouth) and the orbicularis oculi muscle (which raises the cheeks and forms crow’s feet around the eyes). I had to get some anatomy jargon in. There, I feel better.

The Mouth

Most basically, people believe that a smile originates at the corners of the mouth. The upturn of the corners of the mouth is the basis of all smiles. Ah, but not all smiles are created equal. Some writers have proposed that the easiest way to detect a “fake” smile is to look for one where the mouth is smiling but the eyes give away that the feeling is only half-hearted. Interestingly, some other psychologists believe that even a forced smile can have a positive effect if it is back by an attitude of trying to improve one’s mood. It seems that no one can resist getting in a better mood if they smile an mean it, even if meaning it can take a bit.

The Teeth

Finally! My favorite part. Remember that Duchenne smile we talked about earlier? Well all of the additional muscular movement ends up showing your teeth! And what a great feeling to flash that winning smile. Having worked with patients now for over 14 years, I have seen the incredible effect having great teeth can make on someone. It’s no surprise that if you have teeth that you are proud of, it’s a pleasure to show them to others. Aside from well aligned teeth looking good, properly aligned teeth feel better. There isn’t the pain in your teeth, jaw or face that poorly aligned teeth have. Talk about a reason to smile.

I want to see my patients giving honest, heart-felt smiles and I work hard to make sure they have every reason to. Schedule an appointment and let’s see what we can do to give you the best teeth your smile could ever hope for.