mathnmusic Posted February 12, 2013 Share Posted February 12, 2013 My son is 8 years old and has an overbite. The dentist referred him to an orthodontist, and the orthodontist called it a 'severe' overbite (measured at an 8mm overjet, to be exact). The orthodontist states that our son would need braces NOW for a year or two, then after a 'resting period', would need braces AGAIN. Total cost for this 2 phase treatment: $9,000 (4k for phase 1, then ~5k for phase 2). Whoa!! Just doing 1 phase of braces costs around 5-6K in my area. I've been doing some research about 2 phase braces, and it seems all the rage among orthodontists, a pretty new treatment in the last few years...every single orthodontist that we went to for a consultation (we went to 3) recommended 2 phase braces without even mentioning the possibility of the traditional 1 phase braces. But when I search online (I admit, I had to search hard for this), I found some articles that state that doing braces in 2 phases, for a vast majority of cases (besides underbite or crossbite), is unnecessary, the outcomes are exactly the SAME as 1 phase treatment, but the cost is much higher & treatment time longer. Check out p.2 of this article: http://orthodontics.com.br/Conteudo/orthodentails/Chapter%2012%20-%20AJO-DO%20v130%20n%20p799-804.pdf and this brave soul who spoke out against 2 phase braces (a reprint of a Letter to the Editor to American Journal of Orthodontics and Dentofacial Orthopedics: http://www.fergortho.com/franklin-tooth-extraction.html I know lots of people who are putting their 7 and 8 year old kids into braces as a 2 phase treatment. But I don't know anybody who has researched this and is wondering if it's really warranted for a straightforward case of an overbite. Anybody here with thoughts on this?? Quote Link to comment Share on other sites More sharing options...
Miss Peregrine Posted February 12, 2013 Share Posted February 12, 2013 I won't do it. I saw a 4 year old with braces. On all of her baby teeth. Quote Link to comment Share on other sites More sharing options...
sparrow Posted February 12, 2013 Share Posted February 12, 2013 Hmm. I think I would be skeptical about 2-phase for an overbite. My son is in phase II, with phase I starting at age 8, but he had a severe crossbite. My dd, otoh, has been seeing the same orthodontist and he has watched her for 2 years with her significant overbite (I think it's also 8mm) and we will start treatment this year-one phase. Quote Link to comment Share on other sites More sharing options...
Seasider Posted February 12, 2013 Share Posted February 12, 2013 We have had three with braces, so far. I would only consider a two phase treatment plan in the event of a cross its or underbite. Quote Link to comment Share on other sites More sharing options...
redsquirrel Posted February 12, 2013 Share Posted February 12, 2013 Have you asked what the difference in outcome is if you wait? What does your family dentist say? You can always just say no. Wait, is his speech compromised by the overbite? I only ask because my younger son also has an overbite and a speech therapist said it was part of his speech problems. She thought we would just have to wait for him to grow a bit more. Our family dentist is pretty conservative, and he agreed with the speech therapist. If his speech was compromised I might be swayed....maybe. Quote Link to comment Share on other sites More sharing options...
Starr Posted February 12, 2013 Share Posted February 12, 2013 Ours waited to have a better idea of the size of ds jaw. I've only heard of the early plan for complicated jaw issues. Quote Link to comment Share on other sites More sharing options...
VeganCupcake Posted February 12, 2013 Share Posted February 12, 2013 My sister's oldest son did phase one and she and my nephew were both pleased with the outcome, so they didn't proceed with phase two. His teeth weren't perfect, but they were good enough for everyone involved. I think they look great, personally. I know that doesn't exactly answer your question, but it's a thought. Quote Link to comment Share on other sites More sharing options...
LucyStoner Posted February 12, 2013 Share Posted February 12, 2013 For an overbite? Yeah, I am not doing that. My orthodontist (I have braces as I type this at age 32) says that braces should be avoided for young kids because of cleaning compliance issues and that 1 phase can take care of the vast majority of issues. When I got braces my teeth were awful. I couldn't even put my teeth together in any sort of a bite. They now look close to perfect and are coming off early this summer! Quote Link to comment Share on other sites More sharing options...
Ellie Posted February 12, 2013 Share Posted February 12, 2013 Well, friends of mine 20 years ago had a daughter whose overbite was so bad that she couldn't make suction in her mouth to swallow, so she had to thrust her tongue against her teeth, which just made the overbite worse. She had two-phase braces. If your ds's overbite is "severe," maybe a two-phase process is warranted. Quote Link to comment Share on other sites More sharing options...
mathnmusic Posted February 12, 2013 Author Share Posted February 12, 2013 I won't do it. I saw a 4 year old with braces. On all of her baby teeth. Whoa! Quote Link to comment Share on other sites More sharing options...
klmama Posted February 12, 2013 Share Posted February 12, 2013 You may need to do some more comparison shopping. There are other standard treatments for overbite. However, with a child as young as yours, the 2-phase does seem to be popular, probably because of the uncertainly of how things will change as they go through puberty. Did any of the orthodontists explain why they needed to do the 2-stage instead of waiting a few years to do 1-stage? Here are other standard treatments: 1) Use of a retainer for 6 months or so to open his bite, followed by full braces. The child will be able to remove the retainer and chew his food while the bite changes before getting full braces. 2) Some sort of "stopper" on the back of his front teeth for 6 months or so to open his bite, with full braces at the same time. The child will have to learn to chew his food between his upper and lower front teeth (not always easy) until his bite opens up enough for the back teeth to meet again for chewing. For some people this option may be quicker overall, as other alignment problems may correct while the overbite is correcting. Quote Link to comment Share on other sites More sharing options...
mathnmusic Posted February 12, 2013 Author Share Posted February 12, 2013 Have you asked what the difference in outcome is if you wait? What does your family dentist say? You can always just say no. Wait, is his speech compromised by the overbite? I only ask because my younger son also has an overbite and a speech therapist said it was part of his speech problems. She thought we would just have to wait for him to grow a bit more. Our family dentist is pretty conservative, and he agreed with the speech therapist. If his speech was compromised I might be swayed....maybe. Dentist's office says to make my own decision (really helpful, huh?). His speech is perfect with the overbite. When he bites, the bottom teeth are touching the palate, but no trauma or irritation there. Thanks for your replies! I hate to go against doctor's orders (or treatment recommendations) but it's crazy how all 3 orthodontists wanted to do 2 phases. They each wanted to do DIFFERENT things in those 2 phases, but 2 phases nonetheless... Quote Link to comment Share on other sites More sharing options...
Truscifi Posted February 12, 2013 Share Posted February 12, 2013 We just finished phase 1 of a likely 2 phase process, but ds had a pretty bad crossbite. The ortho we're working with has been really good about explaining everything, and has actually cautioned me about doing too much before ds's adult teeth are all in. (I had severe TMJ and had facial reconstruction surgery when I was 14, so as soon as I saw the developing bite issues I kinda freaked. :o ) I will say our phase 1 was only about $1k, and the ortho says he can't really give us a plan for phase 2 until ds has his permanent teeth, which makes sense to me. Quote Link to comment Share on other sites More sharing options...
Ali in OR Posted February 12, 2013 Share Posted February 12, 2013 We're doing 2 phases with youngest. I trust our ortho's explanation. Her lower jaw was shorter than her upper jaw. Her lower lip was getting sucked in and forcing her 4 upper teeth to angle out, plus she has an overbite. The first phase (headgear) is to fix the jaw issues which is easy to do now while she is growing (can involve surgery if done after growing has stopped). He told us from the beginning that some people can just do one phase to fix the jaw but she will definitely be a two phase to also fix her bite which is off by a whole mountain/valley--that has to wait for permanent teeth to be in. We could have waited for phase 2 to pull her top teeth back in, but with her soccer activity I was scared her jutting teeth might break off with a ball to the face, so in addition to headgear she had four brackets only on her top center 4 teeth. I trust the doctor's assessment. His explanations made sense to me. I could see the issues with her mouth. My older dd is a one-phaser-she doesn't have the same issues. If 3 different doctors have all said the same thing to you, I'm not sure why it sounds so suspicious. I go to an expert to get an expert opinion, and I guess having grown up in a medical family, I trust them to be professional and to want to do their job to the best of their ability. They know the path that is the most likely to lead to the best result for your child's mouth. Quote Link to comment Share on other sites More sharing options...
sparrow Posted February 12, 2013 Share Posted February 12, 2013 Ohh. I missed that *3* orthodontists recommended 2 phases. I think that's pretty significant. Something else must be going on. Quote Link to comment Share on other sites More sharing options...
mathnmusic Posted February 12, 2013 Author Share Posted February 12, 2013 I'm not suspicious of individual orthodontists, but wary of the widespread use of 2 phase braces. The articles linked in the first post are the ones that gave me pause, and made me question the clinical reasons for doing 2 phases of braces with my son's overbite. I have an appointment with an ortho so that I can better understand what their rationale is and what our options are. Quote Link to comment Share on other sites More sharing options...
Tammi K Posted February 12, 2013 Share Posted February 12, 2013 We have had three with braces, so far. I would only consider a two phase treatment plan in the event of a cross its or underbite. Yippe for us. We have one of each. DS(11) just had had his retainer/expander removed. His crossbite was so severe that one top tooth was pushing the bottom tooth out of the jaw. DD(15) will finish having her sever underbite corrected next year and then when she's 19, she will have her bite reversed in preparation for jaw surgery. That should run about 15-20,000. Fun times..... So, yes, there are times where a two phase approach is best, but I suspect your right about a single phase for an uncomplicated situation. Best of luck with you decision. Quote Link to comment Share on other sites More sharing options...
mathnmusic Posted February 12, 2013 Author Share Posted February 12, 2013 Yippe for us. We have one of each. DS(11) just had had his retainer/expander removed. His crossbite was so severe that one top tooth was pushing the bottom tooth out of the jaw. DD(15) will finish having her sever underbite corrected next year and then when she's 19, she will have her bite reversed in preparation for jaw surgery. That should run about 15-20,000. Fun times..... Thank you for your honest sharing! He's my oldest one and so this is all new territory for us, but I wouldn't be surprised if we have to face this again with the younger ones in a few years. Best of luck to you too. =) (those are braces on that smiley face) Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted February 12, 2013 Share Posted February 12, 2013 Calvin's top front teeth used so sit comfortably on his lower lip - he would shut his lips with effort only. His braces counted as medically necessary (in NHS terms). Despite this very obvious problem, a single stage of braces, started when he lost his last baby tooth, worked well and completely. The process was easy, quick (about 18 months) and his teeth are beautiful. He had one tooth extracted to make room, again - not a big deal. ETA: Hobbes in now in braces: top braces, followed by twin blocks (his bottom teeth are cutting into his palate and his bottom jaw needs to be stretched out) followed by bottom braces. This is pretty major stuff but is all taking place at age 13-14. FWIW, I saw a US-trained dentist in Thailand with Calvin when he was younger than ten. The dentist said that he needed an immediate referral for ortho treatment. When I next saw our regular (New Zealand-trained) dentist in Hong Kong, he said that there was no need for it. He was right.Laura Quote Link to comment Share on other sites More sharing options...
Seasider Posted February 12, 2013 Share Posted February 12, 2013 Yippe for us. We have one of each. DS(11) just had had his retainer/expander removed. His crossbite was so severe that one top tooth was pushing the bottom tooth out of the jaw. DD(15) will finish having her sever underbite corrected next year and then when she's 19, she will have her bite reversed in preparation for jaw surgery. That should run about 15-20,000. Fun times..... So, yes, there are times where a two phase approach is best, but I suspect your right about a single phase for an uncomplicated situation. Best of luck with you decision. Two of our 3 were simple one phase cases. A third was very complicated, two phase, crossbite, congenitally missing teeth, extractions, expander, exposures... Easily $20K by the time all is said and done (thankful for very good insurance, else we could not afford it). However, what we did do averted the need for jaw reconstruction. So yeah, some cases are tougher than others. But I am also raising an eyebrow at how often I hear that 8 year olds with apparently basic cases are going in for two phase treatments. Quote Link to comment Share on other sites More sharing options...
snowbeltmom Posted February 12, 2013 Share Posted February 12, 2013 My oldest had an overbite and we went the two phase route when he was about 8 years old. I don't remember all of the specifics now, but S had some sort of appliance placed in his mouth during the first phase in order to grow more bone in his lower jaw. The 2nd phase did not begin until he had lost all of his baby teeth. He no longer has braces, and his teeth look great. The total cost was $3500. Good luck with your decision. ETA: When my dd was around 8, the dentist recommended that she also see the orthodontist because she also has an overbite. In her case, the orthodontist said that her overbite was not as severe, and she will require only 1 phase once she has lost all of her baby teeth. Quote Link to comment Share on other sites More sharing options...
delaney Posted February 12, 2013 Share Posted February 12, 2013 We pay $6500ish for braces and it doesn't matter how many appliances they out in the mouth. An overbite is not about looks. If the front teeth are not aligned then the back teeth aren't and the molars will wear wrong and the teeth will crack and become compromised down the road. I cringe when I hear people talk about it being just for looks. Orthodontics is about alignment and care for teeth. Looking great is the happy side effect of your teeth being aligned. Once the wisdom teeth move in it will get worse if it isn't taken care of. My younger DD has had 4 baby teeth extracted because in the xrays you can clearly see that the permanent teeth are turning in the gums due to crowding. Now that that is done the change has been remarkable. Fun? no Expensive? yes Worth it to think that as an adult they will look great? Absolutely Quote Link to comment Share on other sites More sharing options...
delaney Posted February 12, 2013 Share Posted February 12, 2013 Two of our 3 were simple one phase cases. A third was very complicated, two phase, crossbite, congenitally missing teeth, extractions, expander, exposures... Easily $20K by the time all is said and done (thankful for very good insurance, else we could not afford it). However, what we did do averted the need for jaw reconstruction. So yeah, some cases are tougher than others. But I am also raising an eyebrow at how often I hear that 8 year olds with apparently basic cases are going in for two phase treatments. Yes! In some case treating early is the only option. If an expansion is needed the window on doing that closes and then you are stuck. Quote Link to comment Share on other sites More sharing options...
Slipper Posted February 12, 2013 Share Posted February 12, 2013 My middle daughter is in phase 1 of 2 part treatment. In her case, her jaw was very small and the teeth were crowding significantly. We went to the first orthodontist who ended up recommending pulling about 10 teeth total (8 baby and 2 permanent). After doing that (and waiting a year) didn't resolve the problem (teeth were still turning sideways out in the front of her gums) and he suggested waiting another year, we went to another orthodontist. She put braces on the lower teeth only for a 6 - 8 month treatment (cost was $600) and her bottom teeth are finally shifting and falling into place. I've forgotten what phase 2 will do. Quote Link to comment Share on other sites More sharing options...
zimom Posted February 12, 2013 Share Posted February 12, 2013 My now adult son went through the 2 phase treatment, in braces for 8 1/2 years, and cost us a small fortune. He was/is missing two of his adult canine teeth. That orthodontist routinely uses a 2 phase treatment. In the end I am bitter about the 8+ years he was in braces as the ortho kept changing the plan. He also now has a bottom tooth that has shifted greatly (one not held by his retainer), I believe due to years of being constantly moved around by braces. Ultimately he will need braces again as an adult. Took older daughter to same ortho, LARGE overbite, of course he recommended 2 phase treatment. Bottom line we opted to not start treatment until her brother was finally out of braces and then some. She finally went into braces at 13 years of age by another orthodontist, treatment will be one phase, less then 24 months. She is almost finished and her teeth look beautiful. Just from our own terrible experience, youngest DD will NOT have early orthodontia either. I will take her for a consult at about age 12 when my siblings and I all had braces. Quote Link to comment Share on other sites More sharing options...
Cinder Posted February 12, 2013 Share Posted February 12, 2013 We're about to enter phase 2 with ds2. The main reason we pursued braces for him was not just his underbite but several teeth were coming in crooked. Ds2 rarely smiled during this time because he was embarrassed about how his teeth looked. Once his teeth were straightened and the underbite corrected he smiled all the time. But the ortho did warn us that once ds2 hit his growth spurt his underbite would resurface and we'd need another round of braces. Dh was questioning whether a second round just for an underbite was really necessary but ds2 has mentioned physical discomfort with his jaw now that he's growing and the underbite is getting more significant. So we're going ahead with round 2. I don't have answers for your situation, just wanted to share ours. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted February 12, 2013 Share Posted February 12, 2013 :grouphug:Hugs for the OP. You have my sympathy. We didn't do 2-phase braces, but palate expander and braces for crossbites and to head off developing underbites. One dd has had a palate expander in for over a year because her crossbite was so bad. Once it comes off, soon, they'll want to go ahead with braces, but we don't have money for that step and couldn't even afford the payment plan. :( Quote Link to comment Share on other sites More sharing options...
FaithManor Posted February 12, 2013 Share Posted February 12, 2013 Two phase was recommended to us for dd by two different orthos to the tune of $6000.00 each phase and another $2500.00 in oral surgery NOT paid for by insurance. We had to have $2000.00 down for the first phase plus pay the $2500.00 out of pocket for the oral surgery. She was eating and speaking just fine and literally, we would have had to get a second mortgage at that time. We'd had some financial issues related to all kinds of things that medical insurance should have paid and refused, so we were just feeling overwhelmed. We refused. As I put it to the ortho, "You can't squeeze blood from a turnip." Both of them were pretty mad that we didn't go get a second mortgage that we really couldn't afford or just stop paying he hospital for the medical bills and be turned over to collections. Very narrow minded folk! At any rate, when she was 15.5 years old, we were in much better shape financially. So, we broached the subject again. Since we'd moved, we saw a different ortho. Much to our surprise he basically said that A. the other orthos were way over priced and over predicting...seriously exaggerating her condition. and B. it's always better to wait if at all possible because the child is so much more mature, handles the procedures better, and is capable of taking much better care of his/her teeth. She had them on for 20 months....off by graduation, and only one tooth needed to be pulled....no oral surgery to extract adult teeth that hadn't descended yet as the original orthos wanted to do. 3.5 years after the original quotes of $12,000.00 plus oral surgery, it cost $4800.00 and since her teeth moved so beautifully and she was out four months early, he refunded a couple hundred dollars to us. We were thrilled and her overbite was solved quite nicely. You know the bad part about it? A slight overbite is great for reed instruments. DD was not only accomplished on her flute, but also clarinet and oboe. Her clarinet and oboe playing have never been the same no matter how much she practices. She just did too much learning early on with that overbite which is great for the omburchure (sp?). At any rate, our dentist really wanted us to start on P's when he was 10. However, it meant a lot of tooth extraction and two phases because they wouldn't be able to complete the work until all of his adult molars came in, evaluated the space, and then decided if any of them needed to be pulled. The kid, at 10, was a nightmare already about brushing with regularity much less actual effort. So, we said no. Not popular with most medical professionals to say NO, but we did. He's now 14 and I'm just getting to the place that I don't have to ride him like a rented mule about hygiene. Therefore, we've decided that one more year will produce enough maturity to do it. His problem is not bite. His bite is actually just about perfect. It's his lower jaw....he has dh's Danish lower jaw...very, very narrow and his teeth on the bottom are ridiculously overcrowded to the point that even as a consciencious adult, he's not likely to keep them clean enough to not have problems. He doesn't have a bunch of cavities yet, but it's a no brainer that he'll have them in his twenties if we can't get that overcrowding taken care of. So, after his 15th birthday, he'll get single phase braces and the doc says he may only have to do them on the bottom because his tops are pretty good and may be able to be moved the little bit they need with just a retainer. He thought we could do the whole thing for $2000.00. Dh starts with a new company March 1st and there is $2000.00 per person ortho coverage on their insurance plan so we might get VERY lucky. Our eldest boy has three teeth slightly crooked, but a nice wide jaw. His overbite is so slight it's not medically necessary to treat it. So, he's not getting them. But the youngest, I can see his overbite from the profile. He's 12 and I can tell you NOT mature enough to really take care of braces. So, again, we definitely want to do them for him however, we will wait until he is going to care for his teeth better and will not be emotional about the procedures. He was treated very, very badly by a pediatrician once - so badly that I lodged formal complaints and the guy lost his medical license due to the myriad of abuse charges against him (twisted ds's arm right up behind his back and shoved him towards the examination table when he started to cry at age 4 about getting an immunization and then swore at me which - well, y'all no me so you can imagine how well this mistreatment went over) - therefore, he has trust issues with medical professionals. He just barely tolerates the very loving pediatric dentist we have now. I'm in no hurry to force him into braces yet. I think by the time he's 14 or 15, he'll be much more mature and able to trust the doc. He's also just a little claustrophobic so docs and techs leaning over him and being right in his face, makes him feel a little panicky. However, I've been assured by our pedo dentist that the ortho can force the issue of the insurance paying for some nitrous if necessary for ds to make getting them on a much less nerve wracking event for him. Faith Quote Link to comment Share on other sites More sharing options...
shinyhappypeople Posted February 12, 2013 Share Posted February 12, 2013 OP, visit a couple more orthodontists and see what they have to say. The consults are free (at least they are around here). You might also run this by his general dentist, since s/he doesn't have a dog in this fight and might be able to give a more objective opinion. When we were investigating braces for older DD (8 yo at the time) the first orthodontist quoted us $4,000+ and that included a palate expander and 2 years of braces for PHASE ONE. Second orthodontist (the one we went with and *adore*) quoted us $1,500, approx 1 yr of braces and no palate expander (said it was totally not needed!). He also encouraged us to wait a few years and do the braces in one phase unless there were specific issues going on (I think he mentioned cross-bite or overbite... can't totally remember). Our "issue" was DD was having significant self-esteem and social issues because of her teeth and so he was fine with doing phase one, since that's what WE wanted. But at no time were we told by him that it was necessary. (p.s. the Hive helped me pick Good Orthodontist - you ladies are never wrong! She's getting her phase 1 braces off either very soon, and it was *totally* worth it. Yay :) ) All that to say: shop around. No, two-phase orthodontics isn't necessarily a scam and am grateful the option is available to us. But it might not be necessary for your kid. Quote Link to comment Share on other sites More sharing options...
rjand6more Posted February 12, 2013 Share Posted February 12, 2013 Sorry, I did not have time to read all the replies. I am a hygienist(I am very conservative with ortho.) You said an 8mm overJET. This is not the same as an overbite-which measures the depth of the bite. An overjet is how far the teeth stick out(aka"buck teeth") This can be the result of a jaw growth issue that can be treated well with 2 phase ortho. In many cases, crowding is "over treated" in my opinion with 2 phase treatment. My nephew had a crossbite which was treated in phase 1 ortho and he does not need phase 2. My other nephew is now in the second phase after cross bite, so you never know. Jaws do grow with the child. Bite issues don't usually resolve themselves, though. It has been my experience that patients as well as parents are mostly concerned with the way front teeth line up. I have recently seen some "train wreck" mouths come out of a local ortho office. He is cheaper and offers shorter duration plans. Patients are happy with the results. Long term complications will arise with the bite issues that have been created/never addressed. I had very straight teeth, but a 6 mm overjet. As an adult, I had to have permanent teeth extracted because I was not treated early. My profile has changed and I don't love it. I wish I had been treated with 2 phase ortho. Quote Link to comment Share on other sites More sharing options...
Paige Posted February 12, 2013 Share Posted February 12, 2013 We are doing 2-phase braces because my son's teeth need to be fixed now or the adult teeth will have to force their way into a bad position. He has to do the 2nd phase because his crossbite cannot be fixed until he has all of his adult teeth. Our phase 1 estimate is only $1,000. I cannot imagine why braces alone should cost $5,000! Our phase 2 is expected to be about $1,000 as well but we need to wait and see what happens. If we're lucky, his adult teeth will come into a better position and require less work. I'm not sure why the overbite needs to be corrected now for your DS but maybe it has to do with helping the adult teeth that haven't erupted to come into a better position. My DS has a slight overbite and they said it was making it appear that his mouth had less room than it really does. They were thinking they needed to pull teeth because he needed more room than an expander could create, but now they said that won't be necessary. Quote Link to comment Share on other sites More sharing options...
Tess in the Burbs Posted February 12, 2013 Share Posted February 12, 2013 My ds got braces at 9. He had sucked his thumb so badly it was literally moving his jaw. It also affected the teeth and they literally were straight out and useless when eating. He rarely opened his mouth for a year when it was the worst. phase 1 fixed the jaw, then moved the teeth to the correct spot . Whether he has a phase 2 depends on his mouth and how his teeth come in. No one can tell you your kid will need that 2nd phase if they did phase 2 right. We have an orthodontist that is watching his mouth but was honest that we won't know until all the adult teeth are in about phase 2. But in our case, phase 1 was needed to correct bone structure. The option to wait would have required breaking his jaw. And his self esteem was shot due to how his mouth looked. So it had to be done now. No regrets. And if he needs another phase later due to a serious issue we will do it. But no one needs perfect teeth....so trust your gut here. If the kid has a problem, fix it. Don't stress about the future. And don't sign anything about costs for phase 2 now. THat would be silly to assume the kid will need more work. If they do it right the first time they may not need phase 2. Sounds fishy to me to just assume the worst and ask for contract to pay that amount. They can't know the cost of phase 2 until they know what needs to be fixed! Quote Link to comment Share on other sites More sharing options...
melmichigan Posted February 12, 2013 Share Posted February 12, 2013 I have four kids in braces right now. Two DD's are finishing phase one (one actually gets her braces off tomorrow). My DS is in phase one for a severe cross bite, he is only wearing the spacer so far, they will be adding braces in the next six month. My oldest DD has an overbite, but only needed one phase of braces. For DD with one phase full braces we opted to put them on a little younger so she has less total time in them. She has minimal cross bite and a small overbite. For DS who will have two phase braces. The options were to wear a spacer and phase one now, and full braces later saves him almost a year and a half wear time. For DD's who have two phase braces. Both will have temporary bonded retainers while the rest of their teeth come in, then the plan is for full braces. One avoids oral surgery because of a palate deformity, the other may not even need phase two because phase one allowed her teeth to come in straight. Either way two phase braces cuts down on the overall time in braces for my DC. My DH has lots of problems with his teeth because he got braces very late and has to wear them for almost four years to get the correction needed. He wore them so long it caused permanent weakness in his enamel. They are slowly putting crowns on many of his teeth. I should have had braces but out of five children, mine took the least priority and I never got them. I may have to get them as an adult yet. Phase one braces can take advantage of the mouth growing and movement is achieved in less time than it takes as kids develop, they also allow permanent teeth to come in properly cutting down on wear time. I don't think that two phase braces are a scam, it depends on the child. I also think it depends on your priority. For us the priority was the least amount of wear time, for others it might be overall cost. None of my kids braces, even those with two phases cost as much as your estimate. $5000 is average around here for full braces, $4000 for phase one seems high. I would get multiple opinions. Quote Link to comment Share on other sites More sharing options...
mathnmusic Posted February 12, 2013 Author Share Posted February 12, 2013 He's now 14 and I'm just getting to the place that I don't have to ride him like a rented mule about hygiene. :laugh: So very descriptive! And true! Quote Link to comment Share on other sites More sharing options...
mathnmusic Posted February 12, 2013 Author Share Posted February 12, 2013 Sorry, I did not have time to read all the replies. I am a hygienist(I am very conservative with ortho.) You said an 8mm overJET. This is not the same as an overbite-which measures the depth of the bite. An overjet is how far the teeth stick out(aka"buck teeth") This can be the result of a jaw growth issue that can be treated well with 2 phase ortho. In many cases, crowding is "over treated" in my opinion with 2 phase treatment. My nephew had a crossbite which was treated in phase 1 ortho and he does not need phase 2. My other nephew is now in the second phase after cross bite, so you never know. Jaws do grow with the child. Bite issues don't usually resolve themselves, though. It has been my experience that patients as well as parents are mostly concerned with the way front teeth line up. I have recently seen some "train wreck" mouths come out of a local ortho office. He is cheaper and offers shorter duration plans. Patients are happy with the results. Long term complications will arise with the bite issues that have been created/never addressed. I had very straight teeth, but a 6 mm overjet. As an adult, I had to have permanent teeth extracted because I was not treated early. My profile has changed and I don't love it. I wish I had been treated with 2 phase ortho. Thank you for sharing this! A different perspective, and something definitely to consider... Quote Link to comment Share on other sites More sharing options...
Night Elf Posted February 12, 2013 Share Posted February 12, 2013 I wish I had followed up with the recommendation when my son was 8 yrs. old. He has braces now at age 16 and the process is not fun. His baby eye teeth never came out due to overcrowding and his permanent eye teeth became impacted in the roof of his mouth. He had to have oral surgery to pull those baby teeth, expose the permanent teeth, place brackets on them, and attach them to his braces. I really wonder if a round of braces years ago would have saved him this procedure now. I don't know what the 2nd round was supposed to have done but I definitely remember the 1st round was to help shift the teeth due to overcrowding. We didn't feel it was necessary and he was such a sensitive child, not yet diagnosed with Aspergers, that we thought it would be more trouble than it was worth. Oh well. Quote Link to comment Share on other sites More sharing options...
bethben Posted February 12, 2013 Share Posted February 12, 2013 I have an 8 year old who will most likely have 2 phases. His palate needed to be expanded on top which needs to happen before age 9 or 10 when it becomes more rigid. If he keeps the overbite but has no other issues, we may just ignore the need for perfection. My 12 year old has an overbite much like my husband's overbite. We didn't care too much about it until he started grinding his teeth because they were misaligned. Now he's getting braces not because of the overbite, but because he's destroying his teeth. He already needs them repaired because they're all chipped. I'm really bummed that I may have 3 kids in braces at the same time because my 5 year old has a cleft palate and she is gearing up to repair that whole mess also. Aaaaarrrrg! I personally would get a second opinion. Beth Quote Link to comment Share on other sites More sharing options...
somo_chickenlady Posted February 12, 2013 Share Posted February 12, 2013 It isnt a new treatment. I am 35, and they had to do that with my teeth. I had braces starting in 2nd grade. The first batch was just the four front teeth, top and bottom. I didn't get full mouth braces until 7th grade. Quote Link to comment Share on other sites More sharing options...
Sarah CB Posted February 12, 2013 Share Posted February 12, 2013 My daughter had a big overbite and very crooked teeth. She had head gear for a couple of years to help move her jaw out as it was growing. Then she got her braces. Her overbite was fixed with the head gear and the braces have straightened her teeth. She should be getting them off in a couple of months. I think our total cost was about $4000. Quote Link to comment Share on other sites More sharing options...
LMA Posted February 12, 2013 Share Posted February 12, 2013 Orthodontics is not a one-size-fit-all service. Everyone's teeth are different. I recommend getting at least three opinions. However, if the opinions are free, you don't get to have access to the x-rays for others to view. I have two in braces. The first was just overcrowding and jaw growth and they are waiting for his last permanent tooth to align. He was only in one set of braces. Thankfully, no permanent teeth had to be pulled. The second son is a phase 2. He had no room and jaw issues and phase I involved the palate expander, top braces, and a Frankel appliance. He will start Phase 2 when more teeth come in. His front teeth overlapped and he looked like he had fangs. Hence phase 1 and results were noted immediately and doing phase 1 will avoid teeth extraction. It is best to use palate expanders when they are younger. Cost for phase 1 was $3600. I live in MA. I did not shop around too much because I did not want to drive far for appointments, esp. in emergencies and we have had a couple of emergencies with the braces. Just remember not all problems are visible to the eye. And most are unique just to one person. In other words, it will be very hard to judge that just because Susie had only one set of braces, that Johnny will only need one set of braces. Likewise, costs depend on where you live and competition. I have to say the results are beautiful. You will have to make the decisions about the braces, but please don't automatically assume it's a ripoff. Yes, some orthodontists may say you need braces just to make money. Quote Link to comment Share on other sites More sharing options...
redsquirrel Posted February 12, 2013 Share Posted February 12, 2013 It's funny that you all mention a younger child having trouble with hygiene and an older child doing better. Younger kids being more compliant with hygiene has been the justification for earlier braces for my kids and their friends. I have found it to be true. Both my family dentist and our ortho said that younger kids are more receptive to parental oversight to brushing and flossing. If we waited until 12 or 14 teens, especially boys, can become resistant. Our ortho was very clear that if the hygiene wasn't up to his standards he would remove the braces. I think getting braces at 9 really helped my son to have excellent hygiene. At 9 DH was still getting him ready for bed. We oversaw the bedtime routine. We were there to monitor the flossing and the brushing. He allowed us to check his technique and let us help with the water pic. We were much more involved in his feeding. He was still asking for snacks so I could make sure to slice his apples etc. At 9 he had playdates and other parents would be more likely to ask about approved snacks etc. Now he is almost 13. He gets his own food, and gets himself ready for bed. He hangs out with friends and god only knows what they eat. I can't imagine having to start overseeing his flossing, telling him not to eat popcorn, or reminding him to brush after lunch. It is second nature at this point for him, so it isn't an issue. I wouldn't like starting over at the beginning, but with a teenager. Quote Link to comment Share on other sites More sharing options...
cin Posted February 12, 2013 Share Posted February 12, 2013 We pay $6500ish for braces and it doesn't matter how many appliances they out in the mouth. An overbite is not about looks. If the front teeth are not aligned then the back teeth aren't and the molars will wear wrong and the teeth will crack and become compromised down the road. I cringe when I hear people talk about it being just for looks. Orthodontics is about alignment and care for teeth. Looking great is the happy side effect of your teeth being aligned. Once the wisdom teeth move in it will get worse if it isn't taken care of. My younger DD has had 4 baby teeth extracted because in the xrays you can clearly see that the permanent teeth are turning in the gums due to crowding. Now that that is done the change has been remarkable. Fun? no Expensive? yes Worth it to think that as an adult they will look great? Absolutely This was us. DD1 had an expander for 6(?)months. Her baby teeth looked perfect, but then her front two permanent teeth started trying to come in and there was no room. We expanded and pulled 4 baby teeth. She is Asian and our dentist said from the first time he saw her that she would need LOTS of metal. When the baby teeth look perfect, that's a problem. There should be gaps. And Asians generally have large teeth. Her teeth DID look atrocious. The top 4 were very bucked. Now they look much better. She will probably have a second set of braces at a later date. The ortho says she will. I say we'll wait and see. DD2 is doing fine. Her baby teeth had gaps and she, so far, has space for her permanent teeth. Hoping for no more than one set on her. (If any!) I tend to be in the camp that braces are great if there are chewing/alignment problems or majorly crooked teeth, but just a little crooked....how about we put that money towards a car or tuition!??? Quote Link to comment Share on other sites More sharing options...
Tap Posted July 10, 2013 Share Posted July 10, 2013 I won't do it. I saw a 4 year old with braces. On all of her baby teeth. Article on the concept of braces on very young children Quote Link to comment Share on other sites More sharing options...
bettyandbob Posted July 10, 2013 Share Posted July 10, 2013 We see a pediatric dentist who is also an orthodontist. Dd did phase 1 at age 8. Her top teeth are beautiful and everything lines up now. We could have done phase 2 a few years ago, but decided it was not necessary. She has some crowding. Her dentist/ortho thinks phase 2 would be helpful, but not essential. Anyway, doing phase 1 worked well for us. Quote Link to comment Share on other sites More sharing options...
kitten18 Posted July 10, 2013 Share Posted July 10, 2013 Pure vanity... I've never heard of anyone dying from an over or under bite. Its the biggest rip off and scam of a medical profession. No. Not dying. Only having a bite that doesn't fit that leads to uneven wear, cracking teeth that will eventually require crowns and jaw problems that end in extremely painful surgery. Quote Link to comment Share on other sites More sharing options...
sparrow Posted July 10, 2013 Share Posted July 10, 2013 Pure vanity... I've never heard of anyone dying from an over or under bite. Its the biggest rip off and scam of a medical profession. I couldn't disagree more. Welcome to the Hive. No. Not dying. Only having a bite that doesn't fit that leads to uneven wear, cracking teeth that will eventually require crowns and jaw problems that end in extremely painful surgery. :iagree: One of my son's front teeth is chipped from his cross bite, prior to treatment. Quote Link to comment Share on other sites More sharing options...
Starr Posted July 10, 2013 Share Posted July 10, 2013 New member finds February post. Quote Link to comment Share on other sites More sharing options...
Ellie Posted July 10, 2013 Share Posted July 10, 2013 I guess it would depend on how much of an overbite there is. A friend's dd had such a severe overbite that she couldn't swallow without thrusting her tongue against her teeth to make a suction, making the overbite even worse. She had two-phase braces. IDK if it could have been done with one phase, but with the first she had head gear and the whole thing. Quote Link to comment Share on other sites More sharing options...
Jenn121 Posted July 10, 2013 Share Posted July 10, 2013 My DD 12 is in the middle of Phase 2 now. She had her phase 1 at 7. She had a large gap that was not closing and her eye teethwere starting to come out pointing straight out. She had them for about 6 months to close the gap. We never had a cleaning problem.She wore a retainer at night for about 18 months, until it cracked because it was now too small. The ortho said not to worry because most of her adult teeth were in at that point and ff the shifted they could fix it in phase two.She is now almost done and we do not have to deal with this during high school. I would much rather spend the money on curriculum in high school than braces. :laugh: We paid about $3650 out of pocket total. Quote Link to comment Share on other sites More sharing options...
saw Posted July 10, 2013 Share Posted July 10, 2013 FWIW, two-phase treatment seems to be influenced by where you live. When we were in NL, no orthodontist would ever do two-phase treatment. I knew ds1 needed two-phase treatment, or at least to be evaluated by someone with an open mind, and could not find anyone who would consider it. We moved to France and found two orthos who recommended two-phase treatment and also had an evaluation by an ortho in the US who recommended the same (and I trusted his recommendation because it was fairly obvious we wouldn't be using him). In the UK I'm finding that opinions seem to vary, although I haven't spoken to as many orthos here. We were in Paris on Monday for an ortho appointment and spoke to the Canadian-trained ortho about this question. He says that many if not most orthos will recommend two-phase because they want to make money. In some cases, as in ds's, it's warranted. DS's teeth were extremely crowded and several of his adult teeth would have erupted below the gum line had braces not created space. Even after phase 1 treatment he easily qualifies for free braces on the NHS. For my dds, he said one-phase was perfectly fine. He did mention a case he's been asked to give a second opinion on in which the other orthodontist wanted to put braces on baby teeth and he just couldn't believe how wrong that was. Personally I think the question would be why two-phase treatment is needed and what exactly will be accomplished that one-phase cannot accomplish. Quote Link to comment Share on other sites More sharing options...
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