Please tell me if this is completely insane (estimate from orthodontist)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Two of my kids had palate expanders and then braces - between $4500 & $5000 per child.

Mine too.

Mine three. This is the cost for phase I orthodonture work regardless of what is needed to get the bite lined up correctly. In our case that has included expander, face mask and upper and lower braces. This phase appears to be going on forever for one child in particular [4-6th gade]. I was told a phase II may be needed and that would involve additional costs.

PP here, I'm in MoCo and use Dr. Thomas Horton, in whom I have a lot of confidence. My child had a very crowded mouth and my pediatric dentist did emphasize that she would require someone "thoughtful" and recommended Dr. Hort0n.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Two of my kids had palate expanders and then braces - between $4500 & $5000 per child.

Mine too.

Mine three. This is the cost for phase I orthodonture work regardless of what is needed to get the bite lined up correctly. In our case that has included expander, face mask and upper and lower braces. This phase appears to be going on forever for one child in particular [4-6th gade]. I was told a phase II may be needed and that would involve additional costs.

PP here, I'm in MoCo and use Dr. Thomas Horton, in whom I have a lot of confidence. My child had a very crowded mouth and my pediatric dentist did emphasize that she would require someone "thoughtful" and recommended Dr. Hort0n.

So the expander and braces are phase1? What does phase 2 consist of?

I was told by a different doc, that phase 1 is the expander and contraption thing that pulls the jaw forward and then phase 2 is the braces.

[Anonymous]

OP here - thank you, everyone, for the responses. The consensus seems to be that the price I was quoted is inflated. I knew getting braces was not going to be cheap, but I was a bit startled to be quoted nearly 10K for pre-braces work (which I'm guessing means the whole thing will top out at 20K+ ?). I will shop around. I've also heard good things about Dr. Gerlain. Has anyone used Darlene Byrd? She's been recommended, but I'm told she's expensive, too.

Thanks again.

[Anonymous]

Anonymous wrote:Two of my kids had palate expanders and then braces - between $4500 & $5000 per child.

Mine is getting a palate expander and lower lingual holding arch for $4500. Braces will be another $6000. We are in moco.

[Anonymous]

NOVA here, the fancy part of it even. Arch was $2700 and braces were $5000. You all in DC and MOCO are getting hosed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Two of my kids had palate expanders and then braces - between $4500 & $5000 per child.

for both palate expanders and braces?

My kid has had a palate expander followed by a retainer, and I think it was $4k or so.

I just looked up the exact costs - $4200 for first child (boy) with palate expander and plain metal braces that he only wore for little more than a year, followed by a retainer. $4800 ($4500 after sibling discount) for second child (girl) with palate expander and colored plastic braces that get changed every appointment - she will wear braces longer as her teeth need more straightening. We are in NOVA.

[Anonymous]

I've used Dr. Byrd for both my kids and we all love her. She is actually the person I sought out after getting a jaw dropping number from another orthodontist when I was looking for my older child. She charged several thousand less than what I was quoted from the first ortho we saw. Older child had a crazy crowded upper jaw and an underbite, among other things. He got a palate expander at about age 8, and one round of braces. Then another round of braces at around 12 and now at 14 his teeth look great.

[Anonymous]

Is it normal to get braces so young? I think of braces as a middle school/high school thing?

[Anonymous]

In our (parent's) age, braces were done during/after puberty. What is now known as "phase 2". Also the trend then was to pull teeth that didn't fit the mouth/jaw. Lots of kids had teeth pulled.

The newer thinking/trend is to make room for the teeth you have. So this involves expanding the palate of some kids because do to various issues many kids have a crossbite which can lead to a narrow palate. Not as much a problem with baby teeth, but adult teeth are much larger and then there isn't enough room for them. You can only use a palate expander before about 11 years old. After that the top of the palate hardens and it can no longer easily be manipulated to encourage new bone growth and could require surgery to change.

So the current thinking for kids with narrow palates is to use a palate expander around 8-10 years old. This spreads the palate along the top middle of the roof of the mouth and creates space among the teeth. But usually the spaces end up in the front and then you have to use some short-term bracketing (braces) to shift the space to where it will be needed for the adult teeth.

Then this sets up for an easier (or possibly avoidable) second phase later on after the adult teeth are all in. No way to 100% predict how that will go, but phase one generally shortens the 2nd phase substantially.


If your kid just needs a lingual arch placed, I would start with your children's dentist first. In that way it could possibly be covered by dental insurance which has higher reimbursement rate than orthodontics (many people have no orthodontic coverage, we have 50% coverage up to $3500 and then we are on our own for the rest). My daughter had a lower primary molar pulled last year at 9 and the adult tooth doesn't emerge until 11-12 so she had an arch placed by the dentist at that time to preserve the space until the adult tooth comes in. The lingual arch is a standard dental treatment and if that's all your kid needs 9/10 times it will be way cheaper through the dentist vs the orthodontist.

[Anonymous]

If you don't have orthodontic insurance through your employer/dental plan and can't add it on (for me it was worth waiting for open enrollment and waiting period), you can get stand alone orthodontic coverage that will greatly reduce your out of pocket costs.

[Anonymous]

Here's a link to one plan I was considering:
https://www.afspa.org/home/pdfs/DentaQuest_OptOrthodontiaBenefit.pdf

[Anonymous]

Anonymous wrote:

Anonymous wrote:We spent a lot of money with an upper NW ortho. If you know your dc may need future work with another specialist, go spend the $175 consult fee and they may tell you the early ortho work is a waste of money.

The early ortho work is NOT a waste of money. My ortho has given free consultations and advice (she doesn't charge until she puts something in their mouths) and the extractions my kids have had have been 100% preventative towards having braces.

How old are your kids? This is a very archaic method. They no longer pull teeth to make room for other teeth, as they have begun to understand the value of having all teeth and the issues with bone loss that occur with extractions.

[Anonymous]

I think some of the kids getting expanders and such prior to middle school are getting hosed. My child needs braces, but dentist said he wouldn't recommend it until most if not all of DC's adult teeth are in. Dentist is very well respected and recommended pediatric dentist in NOVA. 8 -10 years old for anything- expanders, braces, etc., is just too young for orthodontics in my book.

I never got braces as a kid, and eventually straightened them as an adult. 4 months of an expander, 12 months of mental braces on upper jaw, 8 months on lower jaw, and a permanante retainer on the bottoms once the braces came off. Teeth were really jacked before I got the braces, and now they are still straight 8 years later. Every circumastance is unique, but I'm highly skeptical of this "phase 1 and phase 2" approach orthos are pushing on parents, especially at such young ages when jaws and teeth are still growing.

Also- find an dentist that also does ortho. When I had my teeth done as an adult, my regular dentist did them. I'm sure this helped cut costs. Think it ended up costing $3200, with the expander (granted, I had the work done back in 2006, so costs may be 4K or more now).

[Anonymous]

PP here- and no, expanders can be used beyond ages 8-11. As mentioned, I had one as an adult for 4 months (maybe longer) before my braces were put on. Any dentist or ortho saying otherwise is lying and just taking advantage of a parent who doesn't know any better and is fearful if they don't purchase the expander now, it will forever affect their child's teeth.

[Anonymous]

Don't fall for the the two-phase BS:

http://www.ncbi.nlm.nih.gov/pubmed/15179390

"After a second phase of fixed appliance treatment for both the previously treated children and the untreated controls, however, early treatment had little effect on the subsequent treatment outcomes measured as skeletal change, alignment, and occlusion of the teeth, or length and complexity of treatment. The differences created between the treated children and untreated control group by phase 1 treatment before adolescence disappeared when both groups received comprehensive fixed appliance treatment during adolescence. This suggests that 2-phase treatment started before adolescence in the mixed dentition might be no more clinically effective than 1-phase treatment started during adolescence in the early permanent dentition. Early treatment also appears to be less efficient, in that it produced no reduction in the average time a child is in fixed appliances during a second stage of treatment, and it did not decrease the proportion of complex treatments involving extractions or orthognathic surgery."