Is 2-phase orthodontics (braces) a scam?

[G5052]

Naturally there are some orthodontists who are using this to line their pockets, but there are some who are using it to the patient's advantage.  Ours is very thoughtful about it, and only recommends two-phased treatment in a small percentage of cases.  One of mine might have benefited from it if we had been able to afford it then, but treating in the teen years is going fine.  We have about another year.

 

 

[Laura Corin]

Second child now in braces (since this thread began!).  Severe overbite (lower front teeth causing damage to palate) necessitating braces on top teeth followed by a Twin Block appliance and then braces on bottom teeth.  The ortho seems to think it's all doable, despite no earlier phase.

 

L

[Mom0012]

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

But why are so many more people getting braces now than ever before? All my dd's friends have braces. My teeth are very straight on top, a little jagged on the bottom and I have somewhat of an overbite, and it's never caused me any issues. I'm getting old now, but had always been considered very attractive and never had any jaw problems. I jumped on the bandwagon with my dd and regret getting braces for a 3 mm overbite. When I look back on pics of her prior to braces, I have to wonder what on earth I was thinking? I'm not one to usually follow doctor's blindly, so I don't know why I did in this case.

 

And back to the OP, we started braces young -- 9 yo, I think -- but our ortho does not believe in a two phase treatment where many in our area use that as their standard protocol. My dd wore headgear for a year and has been wearing braces for a year. Then she will wear a retainer for a year 24/7, then move onto wearing the retainer at night for the rest of her life!!!

[QueenCat]

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.

 

Yep

[G5052]

This thread is giving me hives.  DD has a crossbite.  I do not want to give the money I need for a car payment to the orthodontist.  *cry*

 

Ultimately you do what you can.  DH has a crossbite and still has all of his teeth.  There was no way his family could afford it, and it was never on his radar as a young man.

[angelmama1209]

i know this is an old thread but we are just entering the world of orthodontics. dd1 is 8.5 and had her first visit today. she is recommended for a tooth extraction (baby tooth blocking a permanent tooth from coming in) and phase 1 braces in 6 months (4 on top and 4 on bottom). the reason is because her 2 top teeth are growing in opposite directions- 1 is growing out and one is growing in. she has a nanny mcphee like look going on right now. ortho is concerned with the bite of her top 2 teeth and trauma probability given their positioning. the bottom ones will also help make space for the permanent tooth behind the baby one being pulled since the permanent tooth already coming in will take up the space created by the extraction. phase 1 is expected to correct her teeth to 65%. i have 0 experience with orthodontics. does this sound unnecessary to anyone?

[G5052]

i know this is an old thread but we are just entering the world of orthodontics. dd1 is 8.5 and had her first visit today. she is recommended for a tooth extraction (baby tooth blocking a permanent tooth from coming in) and phase 1 braces in 6 months (4 on top and 4 on bottom). the reason is because her 2 top teeth are growing in opposite directions- 1 is growing out and one is growing in. she has a nanny mcphee like look going on right now. ortho is concerned with the bite of her top 2 teeth and trauma probability given their positioning. the bottom ones will also help make space for the permanent tooth behind the baby one being pulled since the permanent tooth already coming in will take up the space created by the extraction. phase 1 is expected to correct her teeth to 65%. i have 0 experience with orthodontics. does this sound unnecessary to anyone?

 

You may already be committed, but did you get opinions from several orthodontists?  That might help too.

[Ali in OR]

I remember that my sister had one protruding buck tooth (I think that's what you're describing with your dd). This was maybe 35 years ago, so well before two-phase treatment was common. She did get braces early to bring that tooth back in as it was thought to be pretty likely to break if she had any impact to her mouth. And she had braces again later to fix her bite.

 

My youngest has finished her phase one and we opted to pull in her protruding front teeth at that time though we could have waited. The memory of my sister's issues and the fact that this dd is a soccer player made me want to do what I could to avoid breaking teeth. She took a ball to the face during indoor soccer after we made the decision but before she got the braces. Her teeth were fine but it was enough of a scare to make me feel we were making the right decision. And she was about your dd's age--just turned 9 when she got her braces.

[Plateau Mama]

I have skimmed the responses, but haven't read them all. My FIL is a dentist. He says 2 phase is usually the way to go.

By starting them younger they can get better results. If the jaw needs to be expanded it is much less painful and gets more room if you do it before the to palate of your jaw solidifies. They can also move teeth around to help the adult teeth come in better, which means less brace time in phase 2 and again, less pain. Also it can mean less pulling of adult teeth. My FIL says do not pull adult teeth except as a last resort. Any dentist that tells you to pull adult teeth first you should run.

 

Both my children have done phase 1. My daughter had top braces only. Her top teeth have come in perfectly. The Ortho says she may only have to do bottoms. My son had top and bottom. He will definitely need top and bottom again and may have to pull adults, but my Ortho will only do that as an absolute last resort.

[Mom0012]

I have skimmed the responses, but haven't read them all. My FIL is a dentist. He says 2 phase is usually the way to go.

By starting them younger they can get better results. If the jaw needs to be expanded it is much less painful and gets more room if you do it before the to palate of your jaw solidifies. They can also move teeth around to help the adult teeth come in better, which means less brace time in phase 2 and again, less pain. Also it can mean less pulling of adult teeth. My FIL says do not pull adult teeth except as a last resort. Any dentist that tells you to pull adult teeth first you should run.

 

Both my children have done phase 1. My daughter had top braces only. Her top teeth have come in perfectly. The Ortho says she may only have to do bottoms. My son had top and bottom. He will definitely need top and bottom again and may have to pull adults, but my Ortho will only do that as an absolute last resort.

I understand why you would start braces early if your child needs their palate expanded, but why not just keep going and finish the job at that time? Just curious why you would wait and do a second phase?

[Laura Corin]

I understand why you would start braces early if your child needs their palate expanded, but why not just keep going and finish the job at that time? Just curious why you would wait and do a second phase?

 

As the child's mouth is still growing, and more teeth are coming in, there will be a lot of shifting going on in the teenage years.

 

L

[Mom0012]

As the child's mouth is still growing, and more teeth are coming in, there will be a lot of shifting going on in the teenage years.

 

L

Is this dependent on what shape the teeth are to begin with? My dd had a minor overbite and some crooked teeth, and she got her braces (with headgear) around 9 or 10yo. She'll be 12 in a few weeks and is due to get the braces off very soon and there is no second phase planned.

[Plateau Mama]

I understand why you would start braces early if your child needs their palate expanded, but why not just keep going and finish the job at that time? Just curious why you would wait and do a second phase?

Because they still have baby teeth. While phase one will help the adult teeth come in straight they may still need adjusting.

 

Like I said my daughter had top only or phase 1. Her top teeth have come in beautifully so she may only need bottoms for phase 2. My son by doing two phases we will be able to save adult teeth, but he will absolutely need top and bottom for phase 2. (severe crowding issues). That being said they were able make (and keep) spaces for his adult teeth. Without phase 1 he would have had zero space for his adult teeth.

[kroe1]

We had the exact same problem with our DD, but an opposite orthodontist.

 

DD was 8 or 9 with her adult teeth coming in faster than most. Her 13 year molars came in at age 10, for example. I do not know the grade of her overbite, but some kids had started teasing a little about it. In addition, she was doing a great deal of theater work. Her father and I were starting to notice it from the stage. Her face was starting to look disproportioned to us.

 

We went to a VERY conservative orthodontist who wanted to wait until she was older and all permanent teeth but the wisdom teeth had come in. We said we wanted something done now. She then said she would consider a Herbst appliance, but we were worried it would interfere with her singing.

 

Luckily, the orthodontist was very open to our lifestyle. After hearing that we homeschooled, she recommended head gear. No one uses that much anymore, because it must be worn over 20 hours a day. But it was perfect for DD because she was at home most of the time, and she could take it off for theater work. Plus, head gear is much cheaper than Herbst. We took the extra savings and splurged for the clear braces. The changes were apparent within just a couple of months. She started looking normal. Then, for phase two, she was old enough for Invisilign.

 

So, we had a similar, yet opposite problem than you have. We wanted to be more aggressive and push for a two phase plan. But, we are so delighted with our decision. DD13 has finished phase 2 and only wears a retainer to bed. The drastic results are amazing. Her profile especially is remarkably different. The money was steep, but in the end, her physical appearance has been transformed such that it was worth every penny. I cannot say she chews better although she did grind her teeth before the repair. She may have grown out of that anyway.

[LMA]

Phase 1 is usually done when you have an overcrowding situation, esp. with overlapping teeth. My second son had a palate expander and a Frankel appliance and braces on the top teeth. This was done to avoid pulling teeth, which happened to me when I had braces, and to help his jaw. You need to get seen early for it because the palate expander can only be done while the mouth is still growing. He will have phase 2 of regular braces since he now has an overbite from the expansion and the bottom teeth need to align with the top teeth. The top teeth are very straight, however. They are waiting for permanent teeth to come in to start phase 2. He just lost his last baby tooth.

 

My fourth child will be seen at the end of the month by the orthodontist. She is 8. She has a crowding issue with the x-rays showing that the permanent teeth are going to come in at a slant.

 

Braces are not just about looks, but the results give confidence. I had a bad overbite when I was growing up and I am so glad my parents paid for braces.

[mommymilkies]

That's awesome.  It cost about $2k total to fix my daughter's crossbite.  They recommended a phase 2 later in her teen years, but her teeth are absolutely perfect-her only problem to begin with was a crossbite in the front.  So we'll pass.  I don't plan on paying for orthodontics unless absolutely necessary.  I had them as a teen and they pretty severely messed up my teeth and jaw. 

[texasmama]

I have two kids with train wreck mouths.  They see the same orthodontist, whom I trust absolutely. One kid was on "watch" for five years (at no charge to us) prior to moving into braces.  His xrays are cringe-worthy prior to treatment.  Missing permanent teeth, peg teeth, teeth coming in sideways.  Wow.  What a mess!  His orthodontia will cost us about $5000, all out of pocket.  It was never an option not to do it because his mouth was such a hot mess.  We did need to put off braces for a year until we could swing the payment plan.

 

My 8 year old has a palate expander and tongue tamers.  She has a horrible tongue thrust.  That costs $2500.  She will get a "holder" to keep the palate expansion once it is all finished and most likely go into braces in a few years.  The ortho doesn't believe in putting braces on kids too early when the roots of their permanent teeth are not strong (or some similar explanation which I have forgotten).  I am hoping that she won't need the full braces, but I doubt that will happen.

 

So we are on payment plans for two kids in orthodontics right now.  Ds is done with the payments next April (woo-hoo!), which will help. I could buy a decent car with the monthly outgo for orthodontia. The ortho does not charge extra if it takes longer to correct the issues...and it clearly will in his case.

 

This is a financial sacrifice for us.  We have no orthodontic insurance.  I do believe the treatment is necessary.  I also believe that there is plenty of unnecessary orthodontic treatment going on.  I would be very skeptical of my kids' treatment if I didn't trust this orthodontist absolutely.

[angelmama1209]

I remember that my sister had one protruding buck tooth (I think that's what you're describing with your dd). This was maybe 35 years ago, so well before two-phase treatment was common. She did get braces early to bring that tooth back in as it was thought to be pretty likely to break if she had any impact to her mouth. And she had braces again later to fix her bite.

 

My youngest has finished her phase one and we opted to pull in her protruding front teeth at that time though we could have waited. The memory of my sister's issues and the fact that this dd is a soccer player made me want to do what I could to avoid breaking teeth. She took a ball to the face during indoor soccer after we made the decision but before she got the braces. Her teeth were fine but it was enough of a scare to make me feel we were making the right decision. And she was about your dd's age--just turned 9 when she got her braces.

 

thank you

 

[mathnmusic]

This is the OP - just wanted to give an update.  We waited on braces due to a relocation...a month ago we took ds9 to a nearby orthodontist for another consult who says that my ds had enough of a growth spurt and dental growth that he would only need 1 phase of braces, around 18 months.  The plan is similar to before (first palate expander, then fix crossbite and overjet), but no waiting period in between phases.  It's still expensive, but only 6K vs the 8 or 9K we were being quoted before.  He's got the lower palate expander in now, next week will get the upper expander.

[Julie Smith]

My son is getting braces later this month, and oral surgery. So I’m marking this thread for later reading.

 

 

He has a cyst that grew between his front baby tooth and his adult tooth. The cyst pushed his adult tooth totally out of alignment. So when looking at typical x-rays it's way in the wrong place, and you are looking at the bottom of it instead of the front. I would have to draw a picture to truly explain it. We went from dentist, to orthodontist, (to x-ray specialist for fancy x-rays), to oral surgeon, … Till we reached the oral surgeon everyone said, “I’m not sure how to deal with this, I recommend you go see…â€

 

[TranquilMind]

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.

This.

 

I had one who had to do this.  She kept cutting her lip because her mouth wouldn't close over her teeth. She has just completed orthodontic treatment after TEN years.  There were more than two steps, if you count the palatal expander. 

[Guest tiger123]

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.

I was searching threads about orthodontics and came across this forum. I know the thread is months old but I feel what I have to say is important enough.

 

Do NOT get headgear. A lot of contemporary orthodontic philosophy is predicated on non-scientific and backwards thinking. Many of the new, novel devices that come out are not peer-reviewed, not subject to any kind of oversight, and no amount of vetting.

 

Since the 1960s comprehensive studies have been performed confirming the devastating consequences orthodontic force can put on the face - particularly a child's growing face.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482532/

 

Orthodontists develop treatments based on the goal of achieving a flat occlusion plane. The one-size fits all approach can undermine the natural growth of the jaw and midface. What orthodontists have been doing for decades is stunting the growth of the upper jaw so it can "catch up" with the lower - this is effectively was headgear is designed to do.

 

And it is idiotic. The end result is almost always a recessed up jaw, and frequently a recessed midface, which can A) result in a negative aesthetic by adulthood and B) lead to chronic chewing problems, weak bite force, and muscular deficiencies. 

 

I have been in and out of orthodontic offices for much of my life so I speak from experience. 

 

Extractions is also another scandal. Orthodontists pull teeth under the belief that the jaw needs more space in order to grow properly, or often so they can fit their appliances in that will supposedly stimulate growth of the jaw.

 

Orthodontists DO NOT have the ability to grow jaws. It is impossible. The only way jaws can be moved in a stable way is through natural growth or surgery. 

 

A lot of people simply accept what their orthodontist says without challenge. Don't be fooled by the kind demeanor and superficial professionalism. Many treatments performed by orthodontists is comparable to blood-letting, and thinking hasn't changed at all in the last 40-50 years. Fact is the gold standard of orthodontics is backwards. 

 

Orthodontists are trained to incorporate the growth vectors of children, but if you take the time to read orthodontic text you will learn so far the ability to predict growth and account for it is impossible. The kids that end up normal usually have braces for a very short duration, 1-3 years, and never the heavy stuff like extractions, headgear, etc...that can ruin someone's face.

[Starr]

This thread is old!

[umsami]

We've been following with an orthodontist who feels that it is.  She watches the kids every 4 months (no charge) and then does everything at once…but usually around 10-11.   The other orthodontist in town is known for two phase process.

 

I was worried because they tried to widen my jaw as a 13 year old…and it didn't work…and I ended up having braces in my 20s.  

 

I trust her regarding my son though.  For us, the two phases would have been to widen the jaw….stabilize it….and then correct anything else in  few years.

[Guest tiger123]

We've been following with an orthodontist who feels that it is.  She watches the kids every 4 months (no charge) and then does everything at once…but usually around 10-11.   The other orthodontist in town is known for two phase process.

 

I was worried because they tried to widen my jaw as a 13 year old…and it didn't work…and I ended up having braces in my 20s.  

 

I trust her regarding my son though.  For us, the two phases would have been to widen the jaw….stabilize it….and then correct anything else in  few years.

 

braces cannot advance jaw growth, only undermine it. again, for emphasis, no orthodontic work can widen, lengthen, or straighten the jaw. 

 

look, every orthodontist ive interacted with has been extremely nice, pleasant, nothing malicious or sinister. why wouldn't you be with such enormous profit margins and 4 day work week?

 

but understand nothing can restore or replace a child's growth. this two-phase orthodontics looks like pseudo-science. id be surprised if there are any studies confirming its usefulness. so you may trust the orthodontist, but when your son is 23 and his lower jaw us underdeveloped, and he appears a bit off...you'll know why. even a few mm in abnormal growth can permanently alter a person's appearance as they develop and not even surgery can compete with natural growth. 

[Guest tiger123]

We've been following with an orthodontist who feels that it is.  She watches the kids every 4 months (no charge) and then does everything at once…but usually around 10-11.   The other orthodontist in town is known for two phase process.

 

I was worried because they tried to widen my jaw as a 13 year old…and it didn't work…and I ended up having braces in my 20s.  

 

I trust her regarding my son though.  For us, the two phases would have been to widen the jaw….stabilize it….and then correct anything else in  few years.