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Advice about Orthodontia

Berkeley Parents Network > Advice > Advice about Health > Advice about Orthodontia



Palate expander for 6 year old?

Oct 2007

Hi, Has anyone researched how effective palate expanders are compared to traditional braces? My six year old has a normal bite but his incoming adult teeth are a little bit crowded so our new dentist wants to install palate expanders. I am wary of this since it seems an extreme measure for such a small problem (my son has no headaches or breathing problems) and because I read some articles that said that braces would still be needed in the teen years even with the Stage 1 expanders. If you have any information or advice on this issue, I would be most grateful if you would share it - Thank you! Patrick's Mom


Both our kids were fitted with Stage I expanders. My younger son had expanders with the hopes that it might improve his breathing capacity. He has a small jaw and a deviated septum and allergies. There is no guarantee that Stage I will alleviate the need for Stage II braces. Despite the Stage I work, my elder still required braces for one crooked tooth; too early to tell with the second. I was told that with Stage 1 expanders, one can expect that braces will be in a shorter time (1yr) and usually not necessary to remove any teeth since the jaw has been enlarged. If you can afford it, any orthodontia work you do now, rather than later, will be easier and less painful while the child is still growing. It's important to have an orthodontist that you can trust. Hope this helps. Signed, Stage I Orthodontia Twice Over Parent Paying for ''Big Smiles''
Both of my children have had retainers at young ages (5, 8) and the benefits seem worth it. My son wore his for six months primarily for a crossbite but also to make more room for adult teeth. My daughter used one for more of the expander reasons you state. It worked miracles for my son and now four years later he has the room for all his teeth. For my daugher, it was also great - no need for pulling teeth or there not being enough room. She did go on to have braces, and it is unrelated, though went more smoothly because of the expanded mouth. We go to Berkeley Orthodontics and think they are great. jv
I don't know if palate expanders have changed much but I had to write and say when I was a child I had one (25 years ago) and it was a TERRIBLE experience-I mean TRAUMATIC. My mother had to sit on me and hold me down while she turned the key thing and it was painful and horrid. I would border on saying it was PTSD worthy. AND my teeth went back to exactly the way they were so it did nothing. Sorry for the terrible story-I hope, REALLY hope, your child does not really have to get this thing! mw
Our 6 yr old also has a palate expander for a crossbite correction and also to help with crowded teeth though the crossbite is the main issue for our son. My understanding is that the better the teeth grow in to begin with, the less correction they will need as a teen, which means fewer braces, less time with braces, or both, as a teen (eg: possibly braces for just one year instead of two!). I also have heard that even after braces, teeth always want to migrate to where they grew in, which means use of a retainer. But a lot of teens and adults never use their post-braces retainers so their teeth migrate. If the teeth grow in better to begin with, there is less potential for migration (because less correction was needed via the braces). I don't regard palate expansion as drastic at all. The bones in the palate are not fused until.... I forget, age 8 or 9 or 10 or something like that --- so they are maleable. So the palate expander is making use of an opportunity to shape the mouth to receive the adult teeth better. I like the palate expander approach. After 6 months we are seeing positive results already with the palate expander. Our son has been extremely cooperative in wearing his retainer and brace. I can only wonder if he would be so cooperative as a teen! anon

Braces...what should I be paying?

Feb 2007

I've noticed in the past 5 years that one of my front teeth has been slowly moving forward. My dentist confirmed it, and I've decided to look into braces to stop the shift. I need 6 braces across the top front for anywhere from 9mos to a year (bot my dentist and the ortho I consulted said this). But, the price-- $3800! For not even a complete set...is this outrageous, or am I just in denial? There's no removal of teeth needed or anything. I guess I'm wondering what I should be paying? Is there some sort of guideline? Are there major differences between orthos? The estimate for treatment I received was from Seth Osterman in Berkeley, if that helps. Any advice would be appreciated, since I'm clueless here. --The Tooth Fairy


That is just about what I paid for bottom braces last year (and I already had braces in high-school!!) My daughter's (top braces) were 2900.00 and when I asked why mine were so much more my orthodontist said it was because as an adult, this was a ''permanent'' alignment vs. children who are growing and seem to often need a 2nd set when they're teens. It's so expensive but I too was trying to prevent bigger problems down the road. Cost included 1 retainer and all visits and follow-up but not the x-rays. Out Serious Money After Braces

Another $5100 after 5 years of orthodontia?

June 2006

We have been going to the same orthodontist for 5 years. My daughter had braces on the front teeth and a retainer. Yesterday, we went to the orthodontist and they had us fill in a bunch of paper work. We were just there 3 months ago and go about every 3-6 months. They treated us like we were new to the practice. They then had us sit down with a financial person and said that the treatment would be $5100 and that we'd exhausted our previous insurance and would likely need to pay cash! We are really surprised by this because our previous payment we thought covered the entire treatment! Is this usual and customary? Thank you anon kid with braces mom


After our daughter had full braces and a retainer when she was around 12, the orthodontist said that she probably would have to do the braces again in her late teens, and we should keep coming every 6 months. Instead, we quit cold turkey. That was 5 years ago. If you don't want to do that, I'd recommend a second, if not a third opinion. Anonymous
I've had the same experience with both of my sons. We have no orthodontic insurance, so we paid around $5000 for each boy to have braces and/or a retainer, only to be told at the end of treatment that more work was needed for an additional $5000 or so for each boy. With the first son, we decided to go ahead with the treatment after we got a second opinion from another orthodontist, but we're hesitating with the second son. I'm skeptical about the level of perfection sought with orthodontia these days, which is certainly greater than when I was younger. I'm also concerned where there is no insurance involved, because there's no third party with some expertise evaluating the necessity of the treatment. I feel a little taken advantaged of. So, I suppose my response would be only to echo your concern on this matter. Imperfectly Smiling
Sounds like we have the same orthodontist. Same thing happened to us, same price quoted. We have also used up our ortho allowance through our dental plan. Are there any parents out there who've been through this, gotten a second opinion, and found a less expensive alternative? Bracing myself

Orthodontia for 7-year-old with overbite?

June 2006

Today at our 6mo cleaning our dentist recommended taking my son in to an orthodontist to be checked because he has an over bite. I have no doubt he will need braces... both my husband an I had them, and all of our siblings (that is 8 kids total)... I just wonder if 7.5 years old is too young to begin orthodontics. He only has 6 adult teeth. When I was a kid we all started in 4th grade... but I thought that people were beginning treatment older now days (pendulum swing and all that). Am I off base, is it common to start treatment this young? How young is too young? concerned mom


Actually, it's quite the opposite. Orthodontics generally takes place at YOUNGER ages than when we were kids. They kind of figured out the obvious - -- if you correct the problem while kids are growing, it's easier than correcting after most of their growing is done. Good luck! I bet it's easier than it was for you.. Sabrina
Hello, Your question brought a smile to my face as I remembered how jealous I was of my 7 year-old brother's braces many moons ago. It wasn't truly a full set of braces but a preventive sort of brackets-on-the-front only rig. It was on briefly and he never needed actual orthodontics as a teenager because the teeth had been helped to grow in straight in the first place. He's now 34 with a beautiful smile really wanted braces
I can't speak to whether treatment can start at 7 years old, but our orthodontist sees children at 7 (when they have lost, at least, the two top and two bottom teeth in the middle) to evaluate. He says that he is looking for things like signs of crowding, palette size, tongue-thrusting, and jaw malformation. I trust his judgement - he is considered an excellent orthodontist - and he definitely not looking for income Earlier the better
My son started his orthodontic journey right around his 8th birthday, also with only 6 permanent teeth. In his case, he had an overbite and crowding. Starting early can be a benefit for some situations. We went to the orthodontist that our dentist recommended and we were able to get a free evaluation. It's not unusual to start early and it wouldn't hurt to just check it out. You can always decide to wait Ruth
Our daughter, who had a pronounced underbite, started seeing the orthodontist at age 6, during kindergarten. In her case, the orthodontist said that although she didn't yet have all her adult teeth, they did not yet need the adult teeth for their strategy, which had nothing to do with straightening her teeth (in which case you do want all the adult teeth present) but everything to do with getting the alignment of her jaw corrected while in the ''malleable'' stage. They did profess that with the underbite it is always monitored throughout the body's growth stage (which extends through the late teens) but their opinion was that she was ready and able to benefit from early treatment.

I imagine treatment for an overbite might have a similar rationale. In our case her molars were fitted with bands and her palate expanded with a fitted retainer, both of which were quite manageable even at her young age. THe retainer needed daily manual adjustment, but that was easy once we got used to the process. Today she is almost 9 years old, has a normal bite and is in a holding pattern with her ortho treatments-- once all her teeth come in we will start to straighten them. During this holding pattern we are not paying anything--we have essentially paid for the work done to date, a ''pre-Phase I'', and see her ortho about once a quarter for 15 minute checkups.

I would recommend you get at least three opinions, ask many questions about your options (later treatment vs. earlier) and come up with something that will also suit your child's maturity and individual personality. Be sure you understand the financial obligations and the doctor's willingness to time them with medical spending account if you plan to use one. good luck! carolyn


I am glad to hear that your dentist is sending you to an orthodontist now instead of having you wait. I wish our dentist had not said, “You can wait to see an orthodontist until all their adult teeth come in.” For my daughter this advice led to an impacted 12-year molar that had to be pulled and several cavities due to crowding. For my son it meant a longer time expanding his pallet to correct his cross bite and he has some irregular ware on some of his permanent teeth due to the untreated cross bite. It is hard to know the true cost of waiting but there is no doubt that early intervention would have

I certainly recommend getting treatment plans from several different orthodontists. We go to Berkeley Orthodontics and chose them, despite the high price tag, mostly because they didn’t want to pull a bunch of my daughter’s permanent teeth. Only the impacted molar was extracted. We are half way thru treatment with both kids and are very happy with the care we have received. There are also many other orthodontist recommendations on BPN and I am sure your dentist has someone to refer you to. ----- Wish I knew then what I know now.


These days some kids get orthodonticsin mid elementary school cuz (from what I hear)their palette isn't set yet and moving the palette (expaning it, etc.) sets up the teeth better for later work. However, you should get at least three recommendations from three different orthodontic offices. Does your dentist like one or two in particular? It helps to have your kids two tooth proessionals get along. Opinions may varry as may expected costs Anon

Braces for Mom in her 30's?

Dec 2005

hello, i am considering braces for myself. initially, i hoped to have invisalign braces (friends of mine have had great success with invisalign), but after my initial consultations with two orthodontists, i was told that braces would be most effective for me. actually some dentists are willing to do invisalign for part of treatment then place traditional braces on in the end. so i have opted to go with braces only. apparently, invisalign braces can only rotate teeth -- my teeth will require more shifting. i am considering using dr. tanner and reichold in concord versus dr. lieber in walnut creek versus dr. timothy pearson in walnut creek. do any of you have recommendations, positive or negative, on these dentists? was treatment as stated, were there major ''bumps'' along the treatment road?

and on a more general note, was having braces as an adult manageable? did your teeth tolerate braces well? as a busy parent, did you honestly have sufficient time to perform the oral hygiene necessary to keep your braces clean? did you require having your teeth shaved to make room for your straighter teeth? how was that experience? and was the cosmetic and functional outcome to your liking? basically, was the experience worth it to you overall? hoping to take the plunge


No knowledge of the orthodontists you mention, but, yes, having braces as an adult was manageable, my teeth tolerated braces easily, and I'm very, very glad I did it. It wasn't really all that hard to find the time to keep teeth and braces clean. Regarding the appearance (since I assume that was why you were looking into invasalign), I had clear brackets and even though my doctor used the regular silvery wire, the clear brackets meant less of a ''metal mouth'' look. My only question for you would be that, since you asked about having the time for oral hygiene, do you have the time for the appointments? At one point, I was going in weekly for 5'' tuneups/tweaks as the doctor was rotating & shifting teeth. You might want to consider travel time, frequency of visits, and doctor's tolerance for children (unless you have alternative childcare arranged) in choosing who to use. But, go for it!
I am almost 30 and about 1 year into my braces treatment. I had them put on when my son was 2 months old and I've found that although I do have the time to floss every day, I often choose not to (don't tell my ortho!!). Instead of shaving my teeth, I had a few teeth pulled which was fine. I had the braces on for about 6 weeks and then had my teeth pulled, and on a day when my husband was out of town so I was alone with the baby. The worst part for me was getting the bands put on around my molars in the back. That was paaaaainful. It was the only time I remember thinking ''whyyyy did I decide to do this??'' But now I'm very happy that I did. My teeth are looking great (not done yet!) and I'm planning to be very responsible in their upkeep since I know exactly how much this all cost me. :) I teach classes to adults (almost always older than me) and at first I was a little self concious that they would think I'm soooo young (given my young look and now braces!!!) but ! nothing has really been different. -almost 30 and finally with straight teeth!!
YES, do it! I couldn't be happier since I got braces. I am a high school teacher, and had braces for two years a few years ago, when I was 29-31. My students were incredibly supportive (they had braces, too!) and honestly, I think no one thought it was weird at all. I eventually got used to them and they didn't disrupt my life that much. The occasional toothaches were relieved by ibuprofen, so it really wasn't a problem. And my orthodontist also said what yours did: get the ''real thing,'' forget about the invisible ones. They take longer, they're not as effective, and no one but you cares about it, anyway. And it's SO WORTH IT! I am never self-conscious about my smile, and in fact am told all that time how attractive my smile is with straight, white teeth. (Thanks to Crest Whitening Strips, too!) Go for it -- it's totally worth it. And the added benefit is that now you will have more compassion for your kids and friends who go through similar situations. You can even get cool colored rubber rings for an extra kick! Happy Smiling
i can't comment about the doctors you mentioned, but i'm 29 yrs old in the midst of orthodontic treatment for the 2nd time. i had braces 15 yrs ago but didn't wear my retainers much afterwards -- so my bottom teeth crowded. as a result, i need braces on both arches. i consulted with 5 different orthodontists who gave me vastly different plans (one involved creating extra space on top then adding veneers or bonding to fill in gaps -- i nixed this b/c i didn't need this the 1st time around).

i ended up going w/dr. robert quinn b/c he mainly treats adults. he didn't want to mess w/my so-called class I (good) side bite, so i have braces on my front 6 top & bottom teeth only. several orthos wanted to put braces on all teeth in case my back teeth do happen to move during treatment. there's some risk of root-shortening during treatment, so i'm happy w/dr. quinn's approach. i did have my lower teeth shaved and balked at the idea (i'd still avoid it if i could), but dr. quinn spread it out over 6 teeth and did it in two sessions. he said that doing it all at once can result in taking too much and then having extra space. not all the orthos i talked to shared the same approach -- one wanted to shave a huge amount off just 2 teeth! if you will be moving all your teeth it's possible that you could get the job done w/out shaving -- my first braces treatment didn't involve shaving and my teeth looked great.

as far as care, flossing takes a long time w/ braces, but it's a must if you want to prevent both cavities & bad breath! i find that coating floss w/tea tree oil (can get at trader joe's) kills more bad breath bacteria than brushing & flossing alone -- just don't swallow the oil! i think a rotating electric toothbrush is essential. i can't get my braces clean enough w/a manual brush. my dentist seems to think the oral-b round rotating head plus skinny brush head is better than a sonicare; her office also pushes the rotadent brand toothbrush for problem gums &/or braces. i didn't properly care for my teeth the first time around and i have suffered the consequences: decalcified areas on teeth, some of which resulted in cavities (even worse on my back teeth...make sure you get a small brush head to get back teeth clean!). straight teeth the second time


I had braces pre-kid in my early 30's. It was not as bad as I thought. I began to notice the other folks at work with braces, and we shared a lot of encouragement. Little kids would stare at me and wonder at the stuff on my teeth, so I would smile more broadly and show them. Keeping my teeth clean then was easier than keeping up with dental apointments with a newborn around. So you may have to really work on keeping the appointments with both your dentist and orhtodontist. These days, cleaning is far easier with those new instuments. THe one thing I wished I had done diferently was to get a real cool color for my retainer. Sigh. But it was worth it. My teeth look better and most importantly, they are far easier for me to keep clean. - Smiley

Palate stretching or not?

Aug 2003

My son has had a consultation visit with two diferent orthodontists in Montclair and we had received conflicting advice. One says that he should have his palate stretched and then get traditional braces, the other says no, he does not need that step. My personal dentist says that palate stretching is a common precedure these days, and leads to a stronger arch. But he is not an ortho, and can not advise me on whether my son needs this done. The other ortho says that she can stretch the palate a little bit while having traditional braces on. Palate stretching will add about one year onto his wearing braces and of course add on many more appointments and discomfort. Traditional braces for two years will be about 30% shorter, but will the outcomes be of the same quality? This question nobody seemd to be able to answer. Has anyone gone through is who can give me advice about what they would or would not do over again? Thanks inadvance. Helene


We did do palate stretching with our daughter when she was 8. In retrospect, I don't think some of it was necessary, so much as cosmetic. I also felt that it changed her face in a way - hard to describe, but I miss the more childish look she had before. My son has had braces, retainers, etc. and I felt that his were more necessary - big overbite, ''buck'' teeth, etc. I had braces for years as a kid, and I hate to subject my kids to the same experience, but I don't feel that parents are given much information about the consequences of waiting or skipping it altogether. similar perspective anon
I had my palate stretched as a child and for me also, it changed the way I look. Because of it I have an overbite and my chin looks weaker, and the crowded tooth they were trying to straighten went back to being crooked anyway. Of course I don't know how my mouth would look if I hadn't had the procedure done. My friend's daughters (now adults) had teeth extracted instead and they look great. good luck
I agree that palate stretching may change a child's jawline, but that may be a good thing in the future. My orthodontist recommended palate stretching for my son because his jaw was so small that the orthodontist would have had to pull many teeth. He explained that when my son reached adulthood, his jaw would look too small because of the loss of teeth in childhood. My husband, who passed this small jaw problem onto my son, had traditional orthodontia when he was a child. His jaw is definitely too small for his face. I believe he would have a much stronger jawline today had the palate stretching option been available to him. I suggest talking with the orthodontist again and finding out why he has suggested palate stretching. If it means losing fewer teeth, your child may end up with a much nicer looking profile. Maria

Orthodontia - cosmetic? too early?

August 2003

My son (nearly 9) is about to begin a course of orthodontic treatment. I have no doubt about the need for it -- it's easy to see the permanent teeth are not coming in right. However, I have a few questions, which I'm hoping someone out there can help me with. Neither my husband nor I ever needed any orthodontic work.

I have a feeling that the orthodontist may be inclined to go beyond what is necessary for the fixing and do cosmetic work (to make things ''perfect'') that we wouldn't otherwise elect. I've heard California is actually unique in the country in terms of the high rate of orthodontic work. How can I tell if this is happening?

my second, and MAJOR question is: I've also heard that orthodontic work done early can be responsible for major headache problems later. Does anyone have more information about this? Anonymous


I do not know if early orthodontic causes headaches or similar problems. when I was 8 my orthodontist recomended that I get braces and head gear. my mother said no, so I got the braces when I was 12 (most of my friends got them around this age too.) However I asked my dentist as an adult if there was anything I could do for my overbite (I have nice straight teeth, but an unsightly overbite) he told me that that the only way I could have truly fixed my overbite would have been to get orthodontic work around the age of 8 or 9 when the bones are still soft. Once the bone hardens some procedures are impossible. get a second opinion and find out exactly how they plan to shift and straighten his teeth, and wich procedures can wait or are mabey not necesary.

Projections to show with and without treatment?

May 2003

Hello, I found this in the archives: ''Orthodontia has advanced a lot since most of us were kids. They can do projections that will show how the kid will look with and without treatment--this would be helpful in making the decision to do it, especially if you think the treatment is only for cosmetic reasons. You can see how cosmetic. You can try to consider how your kid might feel about it. If you travel to countries where treatment is not common, there are very clear examples of the type of thing that results. With these highly accurate projection models, they can now treat kids at an earlier age, when the size or shape of the jaw can be influenced.'' Can anyone tell me a place (or places!) that does these projections? My sitution is the one described in this post--I need to understand ''how cosmetic'' the proposed work is for my child's teeth. I really appreciate any further information on this. L T R


Brad Irving, in Montclair, did this when we went in with my son. I think most orthodontists have the technology to do this now.

Just a piece of advice: Go to more than one ortho for a quote. The first guy we saw recommended taking out multiple teeth and full braces. Brad used a series of retainers graduated in size which has worked amazingly well. Much easier on the kids, much, much, much less expensive. In fact, we are fortunate to have the entire thing paid by dental insurance. Anon


Conflicting orthodontic advice about treatment


Sept 2002

I have taken my 9 year old on 2 ortho consults with 2 different recommendations. The first (Nelson/Meyer) was to use a spreading type of retainer to make more room (althought he already has fairly good spacing), and then braces for a short time to pull the front teeth back together. The second recommendation (Brennan)was to only use a retainer to pull in the 2 front teeth since they are slightly flared and would be better protected. When I told the second about the first recommendation, he stated that that dentist follows a theory/philosophy started by an orthodontic dentist in the mid- west and that he doesn't necessarily agree. He feels that you really have to wait to see how the permanent teeth come in. Has anyone gone through this process? Any thoughts or ideas would be greatly appreciated. Did I mention that the first path was almost double the price? Gratefully, nancy


I had a ''retainer'' that split my upper palet in the late 1970s when I was 13 years old. Basically, it splits your upper jaw apart and skull apart and, if held in place for 6 months, cartiledge fills in and the retainer can be removed. My front teeth were split apart far enough to fit lunch money in between them (which was 60 cents back then !) If this is what the first orthodontist is suggesting (and I couldn't quite tell if it was), let me tell you how excruciatingly painful it was. Now that I have beautiful, healthy teeth and gums and the likelihood of keeping those into old age, it was worth it. However, I really needed to have it done. If your son doesn't really need to have it done (and usually it is because the permanent teeth are too big for the jaw), I wouldn't do it. Get a third opinion and have each of them explain to you in great detail exactly what is involved, how it will help, why it is or is not needed, and how painful it is. While orthdontia is likely to have changed since then, the pain might not have. anon

Dealing with the stress of orthodontia

April 2002

My daughter (almost 8) is about to start an orthodontic treatment in dr. Iezman's office in Berkeley. I was surprised how extensive the treatment is: stretching her upper and lower jaw with braces and wearing a ''head gear'' at night to stretch her lower jaw to stop an overbite. I looked at the web site and didn't find answers to what exactly I'm uneasy about. How does such treatment affect the whole body? Is there anything that can help the body to deal with this kind of stress (homeopathy, cranial sacrum therapy etc.) How does it affect the child's self image and self esteem? (Right now she's excited about having braces) Any advice or shared experience is appreciated, as I've had just a retainer. Thanks. Lucia


I had exactly the same things your daughter will be going through beginning when I was 7 years old. It was painful, but I quickly realized that having beautiful straight teeth and a jaw that would not give me migraines when I'm older was MORE important. Because I started so young, all my orthodontia was completed by the time I was 13 years old. If you have a good doctor, who's friendly and fun to have appointments with it's a lot easier on the child. Otherwise, my belief is that the child fairs pretty well with the ordeal (it's the parents who have a tougher time emotionally and financially). Let your daughter know that all the work/pain now really pays off later when she has beautiful teeth. All my orthodontia(and the expense to my parents) gave me an appreciation for keeping my teeth very clean and cavity free through my teens into adulthood. Good luck. Anonymous
I have used the services of a cranial-sacral osteopath for about seven years, now, because of migraine headache pain. He is convinced that the orthodontic treatments, especially headgear, that I had as a young teenager contributed (and possibly caused) my migraine problems. There is no telling what would have happened if I DIDN'T have braces, etc., but it is a concern of mine for my kids. My daughter is eight and will, I'm sure, have to have braces. I would highly recommend taking your child to an osteopath trained in cranial-sacral treatments once he/she has braces and head gear. anonymous

$5400 for a mild overbite?!

January 2002

My 12-year-old daughter has been advised that some of her new permanent teeth are too tight and that she should possibly have four bicuspids pulled and definitely get braces, followed by retainers: a three-to-four year project costing about $5400. When I asked how her teeth would benefit by this process, I was told that 1) it would at least partially correct her mild overbite, 2) there would be less uneven wear on her teeth in future, and 3) it would look better.

I want her teeth and gums to be healthy, now and in future, but I distrust the American obsession with perfect, even, Osmondesque teeth. Any thoughts/advice out there about this fascinating topic? And would anyone recommend a good orthodontist--one you've worked with and really trust, preferably in the Berkeley area--from whom we could get a second opinion? Thanks, Melanie


Hi Melanie -- I wasn't aware that any of us actually want to look like the Osmonds (eewwww!) but I can tell you that Dr. Iezman, on Walnut Street near the North Berkeley Peet's is an Orthodontist we trust, and that we're doing braces because he came up with logical dental reasons for it, not just cosmetic. (One of the conditions he mentioned explained to me why my molars have cracked one-by-one over the last 15 years ...and crowns cost more than braces... but of course its me paying and not my mom.) His number is in the book, and he would look at your daughter for free (as I recall). His office is busy enough that he wouldn't take you on just to pay the rent... Heather
To the parent who wanted orthodontia information: I would speak to a number of other orthodontists before you have any teeth pulled. There is research out now that shows having teeth pulled will/may cause problems later on. If at all possible, you should look to someone who can do the work without pulling any teeth. At age 12, it may be too late to have work done to create room without pulling teeth. My daughter and several others we know see Dr. Iezeman in Berkeley. He gave us a thorough written treatment plan and has kept to it. The costs were explained, they worked with us so we could maximize the medical spending account offered by my employer and my daughter really likes him and his staff. Several others we went to did not feel this good, one in fact just wrote Phase I, Phase II on a piece of paper with amounts as his extimate and treatment plan, he wasn't a certified orthodontist and his prices were more than Dr. Iezeman (don't remember his name, on Gilman, across from ! Ti! ddlywinks). So look around, see if you can find someone who can create room without pulling teeth. My husband has very crowded teeth, his family did not have money for orthodontia, it looks awful, and he wishes now he could do it. As an adult it would be very painful and expensive. So think long and hard before you choose to not do so. Hallie
I checked out the Berkeley orthodontic scene about a year ago. The issue also was too crowded teeth and overbite. There a two schools: one thinks pulling teeth is necessary, the other thinks it's more or less a crime. Out of the four orthodontists I checked I picked Dr. Broderson on Hopkins. He has a very gentle and unique approach, different from all the others. He was the most expensive though, but I think it's worth it after a year of treatment so far; and with the payment plan they offered, it's doable for us. It's working well so far. Another 'low key' on aesthetics orthodontist seemed to be Dr. Merchant on Regent St., he was less expensive too, but we wanted to go for the best fix possible. Helga
Orthodontists recommended that my daughter have 4 of her teeth pulled, but I objected and they were pulled. Her teeth look beautiful now and I can't see why they wanted to pull those teeth. I am also anti "everyone in America has to have perfect teeth", but we went ahead with the whole braces routine anyway and now she has perfect teeth. We go to Dr. Iezman, who supported our decision. Toby

Is the trauma of braces worth it?

I just took my 9.5 yr old son to an orthodontist, at the recommendation of his dentist. After reviewing my son's mouth, history, xrays, etc. we were told that my son has: a crossbite, a gap between his front teeth, questionable room on the bottom, tongue thrust, and large tonsils (possibly causing his mouth-breathing). He recommended: 1) braces on the top; 2) a device on the bottom (this is like a retainer that doesn't come out for the 2-yr period of the treatment); 3) a retainer 2 years later; 4) a tongue execise program and 5) referral to an ENT specialist about possible tonsilectomy since mouth breathing can change the shape of the jaw (!!).

It's not really the money ($2500 for phase 1) that's making me balk (though that will be alot for us). It's all of the intervention and trauma. My son broke down in tears in the chair when the orthodontist first mentioned braces (he was hoping to get by with much less).

Both my husband and I have cosmetically standard-looking teeth (straight, etc.) and neither had braces (though my husband had a series of retainers that kept getting chewed by the dog so his parents quit before he had completed the entire program). We both had tongue thrust as kids (and I suspect still do). My husband is a mouth breather, has a crossbite and a small gap between his front teeth. He's absolutely fine!

Does anybody know the downside of not correcting things like crossbite? mouthbreathing? tongue thrust? Have you heard of tonsilectomy to prevent mouth breathing? I thought those went out in the 60's! What is the risk of mouthbreathing compared to the risk of undergoing general anesthesia (if they still do that)? And isn't there some presumed health-role for the tonsils? We are going for the "consultation" with the orthodontist soon, and I will ask these things. But I figure that's like asking a surgeon if you need surgery. What additional questions should I ask? Is there a Consumer's Reports type resource for assessing the import of specific orthodontic inventions?

Any experience or information appreciated! -- a Mom


Several weeks back I posted a message looking for other parents who have questioned the need for orthodontic treatment. No responses were posted. I've been asking all parents I know and have yet to find a single one who opted not to follow the recommendations (in total) of their orthodontist, (though I've talked to several who questioned it in hindsight, now that their kids are young adults). I've searched on the web and found mostly things posted by orthodontists--no objective consumer information. One pretty good site (@bracesinfo.com) provides many specific questions you can ask to determine whether an orthodontist is using state-of-the-art practices, discusses risks to be aware of, and answers many questions--but it never *questions* the need for orthodonture or suggests alternate/more conservative approaches. It, too, is the site of an orthodontist. The overall message I've read everywhere is that you'll be sorry if you put off the decision to undergo treatment. I'm going for the full consultation soon with my 9 year old. My concerns are not about money, but rather about the need for such a high degree of intervention (physical, emotional, social) and of knowing the risks of not following the recommendations from someone who will not be profiting from the decision. Thought I'd give one more try to see if there's any good advice or leads out there. Thanks!
You don't mention the opinon of your child. I had braces, as did my brother. My teeth were not that bad, but his were. I know that it's painful and braces aren't all that attractive, but since it was happening when all my friends were going through the same thing, it made it that much easier. (Peer support) Today, I am very happy that I had it done (though it wasn't my choice), and I know adults who now are going through it, and finding it more troublesome that it was for me as a teenager. I think it might be a good idea to seek the opinion of your child, but know that their overall health is of top importance. Orthodontia can help with many dental problems that could appear later on (teeth grinding, migraines, etc). Good luck! Melissa
Regarding orthodontia - My daughter had a retainer at about seven years because her tongue wasn't fitting in her mouth and she was developing a speech impediment. It did the trick but now they say she should have four teeth pulled and get braces and, when I questioned the doctor further, he kind of said it wasn't really necessary unless we wanted the "perfect" smile. I opted NOT to go ahead with that barbarism. I watch her teeth daily, though, and try to decide if they are getting worse or if it is affecting her bite or speech. It would take quite a bit to get me to continue with the process, although my parents did that to/for me as a child because of buck teeth. Ask me again in a year. Barbara
Am also questioning the idea of braces. We are using a retainer but braces are supposed to be in the future. The retainer is to create space for a tooth that the ortho wanted removed by surgery. My idea worked! My hygienist says that my lousy tooth enamel (and poor color therefore) may be due to years of braces. Since teeth often move back when the braces are removed, I am going to ask lots of questions about the need. Peggy
My older son, now 16, was advised by Orthodontist X at age 9 to wear a retainer for 3 years to "keep space open" for the braces he'd need at age 12. (I think they wait till 12-13 because all the teeth aren't in yet) Orthodontist X also told me he'd have to pull some teeth before putting in braces. We got the retainer and it was lost within a month. We never replaced it, due to a combination of negligence, procrastination, and tight finances. Three years later, at 12, he did get braces from a different orthodontist - John Merchant in Berkeley, whom I like a lot. He wore them for about a year and a half. No teeth were pulled. His teeth look great now. (Unfortunately he "forgot" to wear the after-braces retainer at night as advised, and his teeth shifted back out of alignment a few months after the braces came off. So, the braces went back on for 6 more months and he got some sort of glued-in retainer behind his teeth after that. A word to the wise.)

My younger son has much worse teeth. For a while he had a double row of teeth all the way around - baby teeth behind the adult teeth. When he was 9, I asked Dr. Merchant about a retainer because our regular dentist was bugging me about it. Dr. Merchant said it's too early to tell. The teeth are still shifting around a lot at that age. Sometimes everything gets sorted out on its own. But at 12, we visited the ortho again, and it was time for braces. In a big way. Dr. Merchant told me he'd have to pull a tooth to make room. I asked him if there were any way to avoid that. He thought for a minute and worked out another fix that didn't involve tooth pulling. So I concluded that:
1. a retainer at 9 isn't necessarily necessary
2. you don't always have to pull teeth
3. get a second opinion
Ginger


In response to the mom who's questioning getting the orthodontic work being recommended for her son, I wanted to relay a quick story about my husband. When he was a young teen, orthodontics were recommended to both straighten his teeth and to correct the curve in his gum line (which is quite noticable when he smiles). His parents decided that it was mostly "cosmetic" and way too expensive, and did nothing to correct his teeth. For many years after he was extremely reluctant to smile broadly, and was in general, embarassed about the way his teeth looked. I convinced him that it was OK to smile (and be happy!), but he still hasn't fixed his teeth. The crookedness of the gum line affects the way his upper and lower teeth line up which has caused him some problems and pain. I doubt very much that he'll ever get it taken care of because it seems too adolescent to have braces now (plus it is pretty expensive). I sure wish his folks had taken proper care of it when he was of an age where it's not uncommon and not that big of a deal. (I had braces for two years and didn't find it that traumatic.) Of course, your son's situation may be entirely different. You seem to be putting a lot of thought into the whole thing which I think bodes well for him. Sarah
Regarding orthodontia - to look at my smile, people think that I have perfect teeth when in fact I have a cross bite - my back teeth don't line up properly. Despite my dentist diagnosing this in childhood, my parents never went ahead with the braces because my teeth looked great. However, now at 40, I've had 5 crowns on my molars and due for another. All the crowns are due to the way my upper and lower teeth hit each other. So know that what you choose to put off now could have a payback time when your child is older!
I would like to confirm two things that I were mentioned in other posts.

#1) Getting braces, retainers, etc. is not too bad when everyone else is doing it. I started seeing an orthodontist when I was in the 4th grade. Everyone else was going at the same time so even if you had to wear the ugly head gear, you were not alone... I remember we all thought it was cool to have retainers too. I know that my friends who didn't get the work done until High School were a lot more self conscious about their "appliances" because they were a lot more focused on their looks by then.

#2) It is a lot harder to do it when you are an adult. My husband was the youngest of 5, and his parents never quite got around to taking him to the orthodontist as a kid. By the time we met he was 16, and so self conscious of his teeth that he never smiled for pictures and rarely would smile in public. About 2 years before our wedding he finally got around to asking his parents to take care of his teeth. Because all of his teeth had grown in and were set he had to have 6 pulled... the dr said if he had been younger and still growing he may have been able to make corrections without the extractions. Also, because he was already 20 by then he was very self conscious of his teeth. Fortunately he was able to have the clear braces so they would not be as noticeable, but he hated to wear his rubber bands... when you are 10 and a rubber band shoots out of your mouth while you are talking it is cool, when you are 20 it is just plain humiliating. Now that all the work is over he is happy, and glad that it was done, but he says he would have rather gone through it when he was a kid. (Just a note... he also had the permanent wire installed instead of a retainer after the braces were removed... not because he lost one but because the dentist was trying to be sensitive to his need as an "older patient" to not have extra stuff hanging out of his mouth. It seems to be working great, nothing has moved back.)

Despite all of this I think it is great to question the orthodontist about the whys and hows of his treatment plan. I think they often want to get your mouth to be "perfect" when you would be satisfied with just straight teeth and not care about your bite, or whatever else they want to correct. I have a friend who had to take anti tongue thrusting classes from her orthodontist for 2 years... she never could figure out what he was talking about.


As I understand it, the reason so many folks have to have orthodontics is because often the size of the jaw is too small for the teeth. This is sort of an evolutionary miscalculation. It is also why we generally have our wisdom teeth out. Orthodontia has advanced a lot since most of us were kids. They can do projections that will show how the kid will look with and without treatment--this would be helpful in making the decision to do it, especially if you think the treatment is only for cosmetic reasons. You can see how cosmetic. You can try to consider how your kid might feel about it. If you travel to countries where treatment is not common, there are very clear examples of the type of thing that results. With these highly accurate projection models, they can now treat kids at an earlier age, when the size or shape of the jaw can be influenced. This prevents the need for extraction of crowded teeth and long-term braces later on -- also a lot of jaw and dental problems. I really suggest that if a dentist or someone else suggests an orthodontist, you at least go as far as the point where you have a precise diagnosis and projection. It is really not fair to your kid to do otherwise, in my opinion. Lynn
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