How do I choose an Orthodonist

[emzhengjiu]

My almost 13 yo DD needs braces. I have no idea what to ask an orthodonist other than price. So what critical information will I need to make a good decision? I have the feeling a lot is involved. Thanks so much,

[AngieW in Texas]

You need to interview several orthodontists and have them lay out a plan for your dd. Before you can do this, you will need some type of preliminary pictures/xrays/molds done so that orthos have a better idea of what they might be dealing with.

 

I interviewed three orthos. I started off with two in my area that my dentist had heard good things about (one of them was the one who had been "observing" my dd since the first round of tooth-pulling to make room at 7yo). Both of them wanted to pull 4-6 adult teeth and also have her in a retainer with headgear after the braces. The dentist was pretty sure that pulling adult teeth from the bottom would be a bad move, but agreed that she might need two teeth pulled from the top. He suggested that I interview one more ortho who was 45 minutes away (the others were about 15 minutes away).

 

This ortho uses damon fastbraces. It expands at the same time that it straightens and is supposed to be less painful than other types of braces (don't know about that because this dd has heightened pain response). He was able to do everything with the braces without pulling any adult teeth. She was in the braces for 2 years and has been in her retainer for almost one year. The first 6 months she had to wear the retainer all the time, but she was able to switch to night time only after that. She will see the ortho again in July.

[Beth S]

Usually the initial consultation is free.

So you can visit several orthodontists before agreeing to the plan

Our (now-beloved) ortho knew we were concerned about underbite problems.

He laid out his opinion of treatment.

We were content with what he suggested.

You can just go to a 2nd ortho for a 2nd opinion.

You can also wait 6 months, and come back when the timing is better.

 

But I would only go to those who are recommended by friends.

 

Then you get to decide if you want payment plan OR lump sum payment . . . .

[Night Elf]

Braces were recommended by our dentist so I knew what he had in mind. When I consulted different orthodontists, I was looking for one who wouldn't try anything extra. All of them quoted prices in the same range so that wasn't a consideration for us. The ortho we chose sent a copy of the plan to our dentist and I liked that he wanted to work with our dentist. We got the best vibes from him. He's been great so far.

[Lanny]

If you have a Dentist that you like and you trust, ask him or her for recommendations for an Orthodontist. If you have an Orthodontist you like and trust, and you are looking for a Dentist, ask the Orthodontist. They see the work of lots of dentists. Where we lived, before we built this house, the next door neighbors daughter was an Orthodontist. She recommended a Dentist to us and we became his patients.

[Pegasus]

We've had good luck getting recommendations from our dentists. They see the results of orthodontia treatments after all. Really, you just need to visit and get a consultation from a few orthodontists. You'll get a good feel for their approach and bedside manner.

 

The orthodontist that both my DDs have used has a large office with just the one orthodontist. He oversees everything but his assistants do most of the actual hands-on work. His treatment room is a large open room with several treatment chairs in a row. Each patient has an assistant working on them and the orthodontist visits from chair to chair to check progress and decide how the treatment will progress. He is very open and friendly and will take the time to answer any questions that the patient (or parent) has to ask. Parents are welcome in the treatment room.

 

I had adult orthodontia a couple years go and the orthodontist I saw had a completely different set up. He was older with a smaller office and did almost all of my treatment himself. He had an assistant but she did not do much of the hands-on treatment. Instead, she readied the room and supplies for him.

 

We were comfortable with both arrangements and feel the treatment we received was excellent. Prices were very similar (around $5K) You definitely want to find an orthodontist who will listen to your questions and concerns. The type of braces they use isn't critical, you can get good results with Damon or conventional braces. The ortho actually gave my younger DD a choice between the two. We ended up choosing conventional braces because the brackets don't stick out as far AND DD has fun picking colors for the ligatures each visit.

[Karen in CO]

I like and trust my dentist, so I asked him for recommendations. I narrowed that list down to the ones that took my insurance then went for free consultations. I am happy with who we ended up with.

[Kipling]

Our dentist recommended two orthodontists, so I made appointments with both of them for a consultation. The consultation was free and included digital photos and a panoramic x-ray. The orthodontists then sat down with me and discussed what they thought should be done. We made our choice based on which one we liked the best (both personality and suggested course of treatment).

[WTMCassandra]

We went through this last year. We started with recommendations from our dentist and our local homeschooling email loop. We learned a LOT by getting free consults from three different orthos. We went with the ortho who:

 

1) had a smaller practice (more individual attention)

2) my dd personally connected with (poor ds has just had to go along for the ride, LOL, although he likes the ortho also)

3) we felt explained things the most clearly

4) was less focused on electronics (waiting room not full of blaring TVs and iPads to use while you wait--that drives me crazy and I knew I would be spending a lot of time in the waiting room, LOL)

5) a balanced view of incentives--not over-the-top, Disneyland-like

 

The price was similar for all three we checked with. Two of the practices recommended similar treatments--the third lost my vote when they minimized the issues and felt that less was needed (we were pretty sure this was not the case).

[Harriet Vane]

Start with a recommendation from your dentist. The dentist understands the resulting work in a clinical way. Then ask your friends to see if any of the recommended orthos are also nice to work with.

 

One other thing to consider is the ortho's availability. Ours claimed to be available "more" because he has a partner and they have two offices. We have found that to be untrue, however. This ortho takes large swaths of time off without notice (like 2-4 weeks in a row), expecting his partner to cover. What that means for patients is a long drive to the partner's office (45 minutes in good traffic), and a VERY difficult time scheduling because they have a caseload for two orthos but often only one is available. I truly HATE working with this ortho specifically because their schedule is booked so much. After we move, I am specifically looking for an ortho with only one office, and I will specifically ask around extensively about how much time he spends actually IN the office.

 

Two other frustrations I have with our current ortho:

 

--When there are issues with the hardware in my kids' mouths, they are subjected to extensive and often sneaky or tricky questioning to get them to admit to some sort of dietary sin. My son had extensive problems with his lower space maintainer. It has repeatedly broken in the same spot. The ortho has made all kinds of idiotic statements about there being something about the tooth itself that rejects the bonding agent or about my ds' eating habits. I suspect that the reality has to do with ds' grinding his teeth at night, but ortho is very dismissive of this. I get really angry about the suspicious diet questioning (though I truly never show them my irritation) because I know just how careful my kids are about eating. Ds has always had to give his food a lot of scrutiny due to being lactose intolerant and due to a heart condition he had when he was younger and due to his fake teeth. He knows perfectly well that sneaking forbidden food will make him horribly sick or result in the fake teeth breaking, and he doesn't want to have to deal with that, so he is VERY responsible about his food choices, bless him. Bottom line--I don't mind them asking or expecting honesty about food, but I truly hate the grilling we get about this and think the finger-pointing is unfair.

 

--I hate that they don't make ANY effort at all to tell me, the parent and the person paying the bills, what they did or what they expect from my kids. They really think it's fine to only interact with the kid. Kid goes back for work and emerges an hour later, and no one wants to give me even 2 sentences about what was done. They feel that I signed a contract and trust them to do whatever is necessary. They don't tell me when they are changing the hardware or wires. They didn't tell me ahead of time that they were going to file dd's front teeth down to make them line up with the others. They just did it. I find it unnerving to have so little communication. I don't expect to be able to direct the course of treatment but I do expect to know more than this great vacuum of silence. I always ask and they treat me like I am some helicopter parent for wanting to know.

 

The final thing I will look for is an ortho who will allow parents to sit with their children if the child wants this. My kids go back to the ortho or dentist's chair willingly. Most times I do not go with them. I am comfortable with the "open" concept office the ortho or dentist have and feel the kids are safe, plus my kids are old enough to claim that autonomy if they want it. However, when they were younger they both (esp my son) wanted me with them because they were nervous. Even though my kids go back alone most times, there have been one or two times just in the last year that my ds was nervous about getting hurt and wanted me to sit with him. I don't do anything at such times but sit by his knees with my hand on his ankle or leg and read a magazine. If my presence helps ds feel calm and safe, then I am happy to sit there. Even so, the ortho objects to this and recently changed his policy to forbid parents to go back, ever. This is unreasonable and frankly, idiotic.

[WTMCassandra]

Wow, Harriet, that's awful!

 

That whole post, OP, is a lesson in what ortho NOT to choose.

 

It didn't even occur to me to check about how welcome parent involvement is. No way on God's green earth would those kinds of restrictions/lack of communication been acceptable to us.

 

Our experience has (blessedly) been the complete opposite. Parents are welcome anytime, anywhere. Questions are always answered. If I don't go back with my child, the tech who worked on my child comes with him/her afterwards and briefs me. If necessary (something more important), the ortho briefs me. Every. Time.

[G5052]

Yes, ask your dentist (only if you like them of course) and ask your friends. I got an earful from those I asked, good and bad. So I knew who to avoid too.

 

We visited three, and went with the one that our dentist and four friends recommended. They're the furthest away, but we only go every 6-8 weeks. They're very good about trying to match appointments if you have more than one kid being treated.

 

And no regrets. The office isn't fancy, but they are very attentive. Sometimes I sit with them during the entire appointment. and sometimes I send them back. When they go back alone, the technician always has the receptionist tell me to come back and see what they did that time.

[emzhengjiu]

Thank you all for great information, I have a name from our dentist and will start there. Even though my daughter is 12, I want to be allowed in the room with her if she wishes. That's non-negotiable for me. I have the feeling this process is going to be a challenge.

[plansrme]

Thank you all for great information, I have a name from our dentist and will start there. Even though my daughter is 12, I want to be allowed in the room with her if she wishes. That's non-negotiable for me. I have the feeling this process is going to be a challenge.

 

 

This was non-negotiable for me as well. I walked out of an initial appointment with one of the most popular orthos in our area for this very reason. My son was SIX, and has crazy teeth, and they did not want me back for his very first appointment. I just said, "This doesn't work for us," and left.

 

If your child's treatment is pretty straightforward, you will not get much variety in the treatment plan. If there is weirdness going on, and I have one of those, you may get three completely different answers. I went with the one that made the most sense to me.

[zoobie]

I asked my dentist, a parent from school who works as a hygienist, parents with kids in braces, parents of kids with great teeth... Literally every single person I asked recommended this one orthodontist who is less than 2 miles from my house. His online reviews were all 5 star. We met with him and didn't bother meeting with any others.

 

His office is newly built and gorgeous. All of the exam chairs are out in the open. The only room I wasn't allowed in was the x-ray room as I was pregnant at the time. Parents can stay in the waiting room (which is semi-open to the exam area) or sit on low bench-like stools near the foot of each exam chair.

 

My DD had a wire pop out in the back on a Saturday, and we called to leave a message to get her seen ASAP on Monday. In about half an hour, I got a call on my cell from one of the assistants saying she could meet us in the office in 5 minutes because no one wants to be poked all weekend. So nice! :)