Every year millions of Americans undergo orthodontic care, and whether they're seeking cosmetic enhancement or improving oral health, one thing is certain: Treatment is expensive.
According to a 2013 survey of dental fees by the American Dental Association, the cost for comprehensive treatment to fix problems such as misaligned teeth or overbites for adolescents ranged from $4,685 to $6,500, while such treatment of adults ranged from $4,800 to $7,135.
While some people may dismiss the need for treatment considering the high cost, experts say that fixing misaligned teeth benefits an individual's overall health as well as appearance.
"The goal of orthodontic treatment is the creation of a healthy bite," said Dr. Nahid Maleki, orthodontist and president of the American Association of Orthodontists, in an email. "Having properly aligned teeth and jaws – a healthy bite – is essential to good function (biting, chewing, speaking) and good oral health. Good oral health is an important factor in whole body health."
In addition, straighter teeth can also boost a person's self-esteem, which can have both personal and professional benefits.
"Along with the health benefits from straight teeth are the improvements to the patient's ability to be expressive," says Dr. Joseph T. Hung, an orthodontist at RockCenter Orthodontics in New York. "Often, people with teeth problems keep their upper lip low and don't show too many facial expressions that require teeth to be shown. Smiling becomes something people avoid, and it affects performance at work, school or socially."
Regardless of the outcome people are seeking, managing the high cost of orthodontic treatment comes down to the same principals: planning, research and maintenance. Follow these tips to keep finances in check when trying to achieve better oral health.
Review dental insurance options. Some dental insurance plans offer orthodontic treatment and may pay up to a specific amount for braces. Most policies only cover patients who are 18 or younger, and plans usually contain a yearly or lifetime maximum that only covers a portion of the treatment, according to Maleki. It's important to review your plan's terms and understand the total out-of-pocket expenses you'll have to pay when considering the total cost. In addition, consumers can use pretax dollars from an employer-sponsored flexible spending account or health savings account to pay for eligible expenses, Hung says.
Get a breakdown of the total treatment fee. When reviewing the costs to straighten teeth – whether you're considering braces or clear aligners – ask for a breakdown of the fees and services included in the price. While most orthodontists include everything from the initial consultation to monthly appointments, dental X-rays and a retainer, others may charge separately for each, Maleki says. It's important to request all this information upfront to understand the total cost of care and prepare accordingly.
Start saving early. Parents are advised to bring their children for an orthodontic evaluation by age 7, according to the American Association of Orthodontists. By that age, an orthodontist will be able to evaluate how a child's teeth and jaws meet and identify existing or developing problems, Maleki says. The earlier that families know if their children will need braces to correct overbites or misaligned teeth, the more time they will have to save for treatment.
However, some experts say you should begin saving for this type of big expense even earlier. "This kind of planning really takes place as soon as you know you are having kids," says Chad Smith, partner and certified financial planner at Financial Symmetry, a fee-only financial planning firm in Raleigh, North Carolina. "It's important to set targets in your financial plan to structure your regular spending to save for these types of things."
Parents should aim to save enough to cover the potential cost of orthodontic care – from $3,000 to $7,000, or as much as possible – by the time their kids are of the age to get braces, Smith says. The sooner families start saving, the less they have to put away each month.
Parents can find local orthodontists offering evaluations for little or no cost at www.aaoinfo.org.
Consider treatment from a dental school. Anyone living near a dental school that offers an orthodontic program may benefit from discounted services performed by students in training. Orthodontic residency programs that accept patients for treatment offer lower fees than orthodontists in private practice, Maleki says. Residents or students performing treatment are supervised by an experienced orthodontist. Keep in mind that each school determines its fee schedule and how patients are accepted. For example, the Center for Advanced Dental Education at Saint Louis University says fees for orthodontic care services are generally 30 percent less than those charged at a private practice in their area.
Ask about payment options. While an upfront cash payment may result in a discount negotiated with an orthodontist in advance, consumers who don't have thousands of dollars on hand have other options. Many orthodontists offer flexible payment plans and are willing to work around their patient's budget, which provides parents the opportunity to spread out payments over several months to a couple of years with no interest, Maleki says. Families with multiple kids who need braces should also try to negotiate a better rate for the second child's treatment.
Stay on top of maintenance. To get the best results and value from any orthodontic treatment, it's important to continue proper maintenance following doctor's orders, such as wearing a retainer to keep teeth in place. Otherwise, problems can return and future treatment to correct the issues may be necessary. "Orthodontics is like dieting and exercise, which requires maintenance after results are achieved," Hung says. "Without maintenance, the teeth tend to return toward their original state if the action of wearing an orthodontic retainer is discontinued."
Don't skimp on services to save money. Beware of any companies offering at-home orthodontic treatment without doctor supervision or regular check-ups. While the cost may be significantly less, consumers may not receive the results they're looking for and may lose more money than they stand to save. Moving teeth must be done under the direct supervision of a trained dentist to maximize the outcome and get the most value from the treatment.
"Avoid these types of doctor-less teeth straightening services, as there are no guarantees and nobody to take responsibility," Hung says. "They attempt to straighten teeth without the consideration of health and function. The patients do not get studied thoroughly nor tracked carefully."
Experts also advise against attempting to straighten teeth at home using rubber bands or any other item. This practice can endanger the health of teeth and gums and even lead to loss of permanent teeth, Maleki says.
Apply for financial assistance. Families suffering financial hardship may be eligible for deeply discounted or free treatment. Programs such as Donated Orthodontic Services, sponsored by the American Association of Orthodontists, offers pro bono care to children of low-income families who lack insurance coverage or who do not qualify for other assistance in their states of residence, Maleki says. Other nonprofit programs like Smiles Change Lives and Smile for a Lifetime Foundation also offer discounted or free braces to kids in need.