Why are Braces So Expensive?

by Dr. Joseph Thompson

Many people don’t go through orthodontic treatment because it is cost prohibited. It’s just too expensive. Quotes for treatment can range from $5,000 to $7,000 for full orthodontic treatment. After the examination and during the consultation visit with an orthodontist, the cost of treatment is discussed.

Orthodontic treatment is expensive because teeth move slowly.

Since tooth movement is slow, treatment times are usually about two years for children and longer for adults. When light pressure is applied to the teeth, they move better than using heavy forces. It is the opposite of what you would think. In certain types of tooth movement, like body translation, teeth move about a millimeter a month. In other types of movements, like tooth extrusion, the tooth can move 4+ millimeters quickly in a couple of days. Intruding teeth is the hardest tooth movement to accomplish as well as root torque.

The main expense of orthodontic treatment is due to the labor costs involved in running the office. It is not due to the materials used in providing treatment, although the cost per bracket is expensive. Orthodontic practices usually have a large number of patients seen per day. They use auxiliary personnel or chair side assistants to help with the appointment. Since every patient is seen per month for adjustments, a large number of people are seen per day. Auxiliary personnel provide all the necessary handling of the patients, preparation of the room, clean up and break down after the patient is dismissed. Orthodontic treatment is very personal and very labour intensive.

Some companies that provide orthodontic brackets and wires will claim that their systems will move the teeth faster. This is not the case. The bio-mechanics of tooth movement is the same regardless of the type of braces used on the patient’s teeth. Therefore, if a dentist says their system of braces will move your teeth faster, remember that the physical movement of a tooth has never changed. Most bracket systems are the same and have the same efficiency.

There are a couple of methods for arranging payment for orthodontic services.

Payment Method #1 – In-House Payment Schedule

Some orthodontists will have a flat fee. They will say, ”For treatment with the braces and follow up care with retainers, it will cost $XXXX.XX amount of money.” The orthodontist will usually offer an in-house payment plan where the cost of treatment is spread out over a period of months without charging interest. This option is used a lot by parents and patients. A large percentage of people use this option and the orthodontist can be flexible with how much is paid at the beginning and how much is paid per month.

Payment Method #2 – Open Ended Payment

This type of agreement is where the orthodontist will say that for every visit it costs a certain amount. An open ended payment plan places a lot of pressure on the orthodontist to try to get treatment finished quickly. Also, there is anxiety placed on the parent to make decisions about how frequent they must go to get the braces adjusted. Of all the methods, I dislike this arrangement the most however there is a place for it in the orthodontic practice. It can be used for college students that are just going to be in town for the summer and then back to school they go. In this situation, the patient is only seen a couple of times.

Payment Method #3 – Paid in Full

This is the best method for all parties involved. The patient decides to pay the full amount before the braces are placed. The orthodontist gets payment ahead of time and usually provides a deduction on the full fee of 5 to 10%. The savings that the patient receives is due to the fact that there is less cost in monthly billing of the patient.

Payment Method #4 – Third Party Credit Companies

This method is where the patient is approved by a health care credit card company. This method hits the orthodontist and the patient in the pocket book. The health care credit card company will pay the orthodontist in full less a certain percentage of the full fee. It is usually a high percentage. Also, the health care credit card company will charge the patient a high interest rate for the amount loaned. Try not to use this method.

Payment Method #5 – Personal Loan

This final method is a personal loan from a local bank. Most banks will not provide this type of personal loan and if they do, they will charge interest.

These are some of the payment methods that are used in the orthodontic practice. Most orthodontic offices want the payment of services to be as “painless” as possible. Ask the office co-ordinator or office financial person about your options for payment.

Making On-Time Payments

Since most people arrange for payments to be made over a period of two years, their situation regarding income and the ability to pay could change. The person could get laid off, benefits can changed or they are going through a divorce for examples.

In situations where you are having difficulty making on-time payments, it is very important to continue communications with the orthodontic office. The patient must be seen on a regular basis even if there is a problem with the timing of payments. Most orthodontic offices want treatment to be a success and will work with you about working up a different payment plan. But again, I’ll say, the most important thing to do is to communicate with the office.

Some of the things that can be done are:

  • Use a third party, like a relative, or a personal loan, or a health credit card company to pay the balance.
  • Renegotiate the terms of the payment plan
  • Discontinue treatment

Discontinuing Treatment

Discontinuing treatment is a viable option when an account is way behind in payments. This sometimes happens and a compromise can be arranged.  Ask your orthodontist if they will remove the braces and discontinue treatment.  Most of the time, they will.  If they don’t remove the braces, they will refer you to another orthodontist to continue treatment.  The orthodontist wants to make sure that the patient is at a good point to remove the braces and that their dental health is not compromised.

Some patients that stop going to the orthodontic office because they’re behind on payments, will try to remove the braces themselves.

This is not a good idea because you can harm your teeth by trying to take your braces off yourself. A heavy controlled force is used by your orthodontist with a special plier to remove your braces. Also, once the braces are removed, the adhesive is still on the surface of the enamel.

This article is contained in The Orthodontic Handbook for Patients & Parents.  You can find out more information about this helpful book written by Dr. Thompson by clicking here.
 

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