FAQPhiladelphia, PA

Frequently Asked Questions

1) I heard that braces hurt. Are they really painful?

I get asked this question at least four times a day but in all honesty the answer varies. Once braces are initially placed there is no pain and no need for injections but your mouth feel as if there is a foreign object resting on the inside of your lips. Soft wax is given to each patient to help adjust to this feeling. Pressure is felt approximately 4 to 6 hours after the braces are placed, I typically tell the patient or parent to give a mild dose of whichever (OTC) pain medication they normally take for a headache after their first meal.

In order for the teeth to move braces must be activated or “tightened” every four to six weeks. After placement or each activation the soreness begins a few hours after and lasts for about 3-5 days. Noncompliance of oral hygiene is also a main cause of pain during active orthodontic treatment. When a patient has poor oral hygiene the gingival swells and gingivitis develops. Once this happens and the braces are activated the pressure

2) What is the average age to have braces?

The average age range for an orthodontic consultation is 8-12 even though the AAO recommends that children have their first visit at the age of seven. Children should see pediatric dentists prior to this for their dental needs who are trained to identify early growth and development problems which may be hereditary or develop as a result of oral habits such as thumb sucking. An orthodontic consultation can actually be done at any age for anyone who would like to improve their smile! According to the AAO approximately 25% of orthodontic patients are over the age of 18 and that number is growing every year! At my office my adult patient population is approximately 35%

3) What is the average treatment time to wear braces?

The average treatment time for most cases is approximately two years. Factors that may change this is age, compliance, and the severity of the case. An adult patient may have a longer treatment time than a child with the same diagnosis. A patient who misses many appointments, has very poor oral hygiene and breaks the braces often will have a longer treatment time than one who does not. Also . a simple case (for example minor spacing) will have a shorter treatment time than a more complex case (such as an open bite).

4) How much do braces cost?

The average cost for a full set of braces in a typical two-year treatment is about $5,000. The cost varies depending on where you live, how long you will be in treatment and the severity of the case. Major cities tend to be slightly higher in cost than rural areas. Metal braces are usually the least expensive. Clear or ceramic braces are usually about $400-$600 more and Invisalign or the use of most clear aligner companies on average starts at about $5000 per case.

5) Does insurance cover the cost of braces?

Many people have dental insurance through their employment as individuals or for their entire family. Now with the Affordable Health Care Act many more children and adults have dental coverage. Most insurance companies cover orthodontic treatment for children up to age 18, but do not cover adult orthodontics. Very few insurances pay either a percentage or a portion of adult orthodontics up to a certain dollar amount. If your plan covers adult braces, consider yourself in the lucky minority.

Keep in mind that most insurance plans or discounted dental plans do not cover treatment that is already in progress. Also, many orthodontists do not like taking transfer cases. So, if you are going to sign up for a dental plan or insurance plan, do it before any treatment begins. And by the way, jaw surgery or extraction is sometimes covered under your medical plan, so be sure to look into this once you have your initial consultation!

6) How do the clear aligner companies work? How do they align the teeth?

During your records visit, which is usually right after your consultation, the doctor will take a set of impressions or possibly take a digital scan of your teeth. This is sent to the company to “recreate your mouth” and analyze the postion of your teeth. The doctor then sets up your treatment plan within their computer system. Once this is done, and the doctor is satisfied with your potential treatment outcome, the case is processed and your alignment trays are produced. The trays are made of a thermoplastic material similar to that of bleaching trays. Each tray has a certain prescription in it that is designed for particular tooth movements. When worn correctly this system is very effective.

With the placement of every new pair of aligners you will feel pressure which results from the forces against the teeth that move them into position. Depending on your case you will receive new aligners every 2-4 weeks. As you progress through the aligners your teeth will begin to align and you will see the difference. The aligners are to be worn 24 hours a day. They are to be removed to clean, eat and drink anything except water. Non compliance will result in undesirable results. Please keep in mind that if an aligner is lost, it may need to be reordered and this can lengthen your treatment time.

7) What are the advantages of metal vs clear aligners?

Advantages of clear aligners

• they are the most esthetic, not noticeable
• they are removable so its easier for the patient to brush and floss teeth you have less orthodontic appointments. Traditional braces need to be activated every 3-4 weeks. Clear aligner visits can be every 6-8 weeks depending on how may sets of trays your doctor gives
• there are no metal wires so there is less irritation
• they are removed to eat which is more comfortable than braces
• there are no food restrictions
• the patient is able to view their treatment outcome prior to beginning treatment

Advantages of metal braces

• less expensive
• possible shorter treatment time, depending on the case
• the ability to change colors of your braces monthly