When the orthodontist tells you your child needs braces…
I didn’t want to hear this. The orthodontist leaned forward, smiled and told me my 12-year-old son, Tom, needed to wear braces for two years. After that, retainers. Probably for another two years. He also recommended a palate expander, a device placed in the roof of the mouth to make it wider and give the teeth more room. The cost: $5,600.
Tom was reluctant to go ahead. So was I. It seemed like a lot of intervention, especially since Tom’s teeth looked pretty normal to me. Naturally, I didn’t like the idea of spending $5,600, but I had another reason to hesitate. Despite my nagging, Tom wasn’t good about brushing his teeth. I worried that braces might cause worse problems than we already had.
When I told Tom’s pediatric dentist about our reluctance, he said Tom would be fine without braces. I breathed a sigh of relief and thought that was the end of it. But then almost two years later, I took him to Dr. William Scott in Vancouver—my own trusted dentist. He suggested Tom revisit an orthodontist. Tom’s teeth were now crowded and a bit crooked, and therefore more difficult to clean. He was thus at higher risk of developing cavities or inflamed gums.
Seeking a second opinion, we went to Dr. Michael Wainwright. He too recommended braces, but said Tom would probably need to wear them only for a year. Retainers would also be necessary for another two years, but the palate expander wasn’t needed. Wainwright said he would recommend one only if a patient’s jaws were not harmonious—if, for example, his upper jaw was narrower than the lower.
This time we decided to go ahead. The cost, unfortunately, was not much less—$5,500. However, Tom was now much better about brushing his teeth, and Wainwright was recommending less intervention. But I still wondered whether I had made the right choice.
Talking to other parents, I found many were equally confused, and I decided to investigate. When are braces really needed? What treatments work best? And when is the best time to begin?
An estimated 300,000 Canadian children are currently seeing an orthodontist, and the numbers have risen in recent years. The American Association of Orthodontists reports that the number of North American kids and adults getting orthodontic treatment nearly doubled to 4.4 million in 1996, from about 2.5 million in 1984.
Are our teeth getting worse? Probably not. But we are an increasingly looks-conscious society. And the availability of dental insurance has made orthodontics more affordable for some. As a result, orthodontists are making more money.
A study in the Journal of Clinical Orthodontics found that the average net income of American orthodontists who own their practice rose to $300,000 in 1998, from $102,000 in 1980. That shows a 50 per cent increase when inflation is taken into account.