At what age should a child be seen for orthodontic assessment?
A: The American Association of Orthodontists recommends that children see an orthodontist as early as age seven. Early assessment of a potential problem allows for better timing of treatment. Often preventive measures can be taken which will reduce the severity of the future problem and/or shorten the treatment time.
Am I too old for treatment?
A: Teeth will move at any age, as long as the gums and supporting bones are healthy. However, adult treatment tends to be slower and more uncomfortable than treatment for growing individuals. Approximately 60% of my patients would be considered adults (including teens who are no longer growing). My oldest patient was 65 years old at the start of her treatment. She did really well with surprisingly little discomfort, and was really pleased with her result. Two other patients, one lady and one gentleman, were 62 years old at the start of treatment. Both had full treatment—including jaw surgery—and did just fine.
How much does treatment cost, and are there any payment plans?
A: Treatment fees can range from a few hundred dollars for minor problems to several thousand dollars for more serious problems. The fee will depend on the severity of the problem, the type of appliances needed for the correction and the length of time required for treatment. The patient must be seen before fees can be quoted.
The fees are normally broken down into an initial fee on appliance placement, then monthly payments. While we have certain standard payment plans, it is possible to work out a custom plan to suit individual circumstances. View our methods of payment.
How do you handle dental insurance?
A: As in most orthodontic offices, we do not accept direct payment from the insurance company. You pay the receptionist, and she issues a receipt and a dental claim form which you must send to the insurance company for reimbursement.
If you have orthodontic coverage, once the diagnosis of the problem is made and a treatment plan is agreed upon (after your third appointment), Dr. Chou will write a pre-determination for the insurance company describing what is wrong with the teeth, what will be done, how long it will take and how much it will cost.
This form will be mailed to you so that you can read it and make sure that you understand everything before sending it to the insurance company. It usually takes two to three weeks for a reply. The insurance company normally writes directly to the policy holder; often we never hear from the company. It is your responsibility to ensure that your treatment plan is approved before treatment commences.
Do you charge for the initial consultation?
A: Yes, there is a fee for the initial consultation. We reserve 30 minutes exclusively for you or your child so that Dr. Chou can assess and discuss the orthodontic problem in detail. Dr. Chou does not believe that she should raise her treatment fees to pay for “free” consultations.
What type of braces will I have?
A: The type of braces will depend on the problem. Sometimes a removable appliance (retainer or clear aligner) will achieve the necessary correction. However, in most situations, metal rings (bands) and small squares (brackets) are cemented onto the teeth. The brackets may be metal or tooth-coloured ceramic. While the ceramic brackets look much less obvious, they break more easily and are more expensive. Dr. Chou does not recommend ceramic brackets for younger patients. Auxiliary appliances such as headgear may be necessary. They are usually worn at home.
How long will treatment take?
A: This depends on the severity of the orthodontic problem. Simple corrections can take less than six months. The average treatment time is around two years, followed by a retention period of variable length.
Why do some people need to have teeth removed?
A: When the teeth are too large to fit into the supporting jaw bones, teeth must be removed. Attempts to squeeze the teeth in when there is inadequate space will result in damage to the supporting bone and recession (shrinkage) of the gums around the teeth, and can contribute to early tooth loss.
Why do some people need jaw surgery?
A: Some orthodontic problems involve incorrect relationships of both the teeth and the jaw bones. They often affect the facial appearance (for example, a small or too large chin, a gummy smile, or inability to close the lips comfortably). Such problems may not be correctable by braces alone, particularly if growth is completed or almost completed. In order to achieve a stable and aesthetic result, jaw surgery may be needed in conjunction with the orthodontics.
Does treatment hurt?
A: The act of placing the braces, while often uncomfortable, does not hurt. What causes pain in orthodontics is the actual tooth movement. Pressure on the teeth from the braces puts pressure on the gums and bone, and this causes inflammation which results in pain. The pain usually starts a few hours after the appointment and is mostly felt when the patient tries to eat. Soft foods and mild analgesics such as ibuprofen (Advil®) or acetaminophen (Tylenol®) will reduce the pain. While there is a certain amount of discomfort or pain after every adjustment of the braces, patients seem to experience less discomfort as their treatment proceeds.