I think part of the issue with anorexia and Invisalign is the focus on taking them in and out for meals which could be a trigger. My children had stages of their Invisalign treatment where (per the doctors instructions) they were only wearing them after dinner till morning (and changed retainers less frequently.) maybe it’s worth discussing with the orthodontist if Invisalign would be possible with an altered/longer timeline that allowed them to be worn part time.

Thanks all. And again, Invisalign will never be an option, at least if I’m paying for anything.

We had previously talked about eventually getting braces. I think most recently, we talked a few months ago. Her reaction took me by complete surprise. I agree that I want her to have agency over her body (except for the starving yourself part). I just don’t know that she can make a mature decision right now.

I’m now thinking maybe a consultation would give us information about whether this is merely cosmetic or not (assuming the ortho will be completely honest).

The other possibility is that she isn’t mature enough for braces right now.

Anonymous wrote:As a parent of a child with mental health issues and a parent who had three kids in braces, there is no way I would force it. It's mostly cosmetic. It can be done later.

And, oh, the ways she can sabotage your decision. You can certainly try to force her, but if she doesn't cooperate, they will not put them on her.

And, if she cooperates and gets angry and/or her mental health issues flare and she backslides into anorexia again, you would only have yourself to blame -which, seriously, having been through institutionalization with mine, I would avoid this at all costs.

And, then there is all of the things they can eat that get stuck in them and cause you extra time for extra orthodontist appointments. And, all of the things they can do to break the wires, which also causes you extra time for orthodontist appointments.

Not in a million years would I force a recovering anorexic child who continues to suffer from anxiety to undergo a two year process that can be done later in life and that is mostly cosmetic. It is just asking for trouble.

This!!

Anonymous wrote:

Anonymous wrote:She has very high anxiety (gets treatment) and she’s bull-headed. It is a tough combination!

I'd bring the therapist and orthodontist into the discussion more. Find out from the orthodontist how necessary braces are, and what possible consequences of refusing treatment might be. Talk to the therapist about the possible impact of forcing her to get braces (good, bad, indifferent). As others have said, orthodontia without buy-in is not going to be helpful. (Wearing a retainer at least at night is now a lifetime proposition, according to our orthodontist.)

+1 definitely get input from the therapist.

Anonymous wrote:She has very high anxiety (gets treatment) and she’s bull-headed. It is a tough combination!

I'd bring the therapist and orthodontist into the discussion more. Find out from the orthodontist how necessary braces are, and what possible consequences of refusing treatment might be. Talk to the therapist about the possible impact of forcing her to get braces (good, bad, indifferent). As others have said, orthodontia without buy-in is not going to be helpful. (Wearing a retainer at least at night is now a lifetime proposition, according to our orthodontist.)

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would try to make it a non-negotiable medical type issue if the issues are noticeable. With her history she could end up obsessing abt her teeth when everyone else is post orthodontia and she realizes her teeth stand out. Try treating it like you would treat refusing allergy shots or vaccinations or pt or dyslexia tutoring. Empathize with her hating it or whatever but yet, she has to do it.

Except it's not like allergies. You're saying that the way she looks is unacceptable, which, for a kid who already has body dysmorphia, could trigger some real problems. Don't make looks a medical issue if they aren't. She's only 15 -- she still has a few years before college. Dropping the rope on this might actually make her come around faster than making it non-negotiable.

And since braces often cause problems eating, be prepared for a relapse of the anorexia. Have your resources already lined up.

Crowding and misalignment is not purely cosmetic though.

Yeah, but is it urgent? Does she have to have braces NOW, or can she put it off for six months or a year? Or two? Or three? Talk to an orthodontist about the various options and how actually imminent any non-cosmetic problems are.

As a parent of a child with mental health issues and a parent who had three kids in braces, there is no way I would force it. It's mostly cosmetic. It can be done later.

And, oh, the ways she can sabotage your decision. You can certainly try to force her, but if she doesn't cooperate, they will not put them on her.

And, if she cooperates and gets angry and/or her mental health issues flare and she backslides into anorexia again, you would only have yourself to blame -which, seriously, having been through institutionalization with mine, I would avoid this at all costs.

And, then there is all of the things they can eat that get stuck in them and cause you extra time for extra orthodontist appointments. And, all of the things they can do to break the wires, which also causes you extra time for orthodontist appointments.

Not in a million years would I force a recovering anorexic child who continues to suffer from anxiety to undergo a two year process that can be done later in life and that is mostly cosmetic. It is just asking for trouble.

Op, it sounds like you have a really complicated situation here. Good luck navigating it - I hope the best for your daughter!


My dad had Invisalign at 66 to prevent jaw surgery, and it worked. If medical ortho issues aren’t imminent, there’s always time for invisalign in future years — hopefully before she’s 66!

Anonymous wrote:

Anonymous wrote:I would try to make it a non-negotiable medical type issue if the issues are noticeable. With her history she could end up obsessing abt her teeth when everyone else is post orthodontia and she realizes her teeth stand out. Try treating it like you would treat refusing allergy shots or vaccinations or pt or dyslexia tutoring. Empathize with her hating it or whatever but yet, she has to do it.

Except it's not like allergies. You're saying that the way she looks is unacceptable, which, for a kid who already has body dysmorphia, could trigger some real problems. Don't make looks a medical issue if they aren't. She's only 15 -- she still has a few years before college. Dropping the rope on this might actually make her come around faster than making it non-negotiable.

And since braces often cause problems eating, be prepared for a relapse of the anorexia. Have your resources already lined up.

Crowding and misalignment is not purely cosmetic though.

I mean...unless she has some sort of real issue that waiting will exacerbate, then yes, she DOES actually get to decide if she wants braces. As a parent, if I couldn't afford braces financially until now, I would put the money aside and tell her that if she decided she wanted them later, you will contribute what it costs now (and she has to make up the difference).

I would also explore options that are not so obvious, like Invisalign or lingual braces.

Anonymous wrote:I would try to make it a non-negotiable medical type issue if the issues are noticeable. With her history she could end up obsessing abt her teeth when everyone else is post orthodontia and she realizes her teeth stand out. Try treating it like you would treat refusing allergy shots or vaccinations or pt or dyslexia tutoring. Empathize with her hating it or whatever but yet, she has to do it.

Except it's not like allergies. You're saying that the way she looks is unacceptable, which, for a kid who already has body dysmorphia, could trigger some real problems. Don't make looks a medical issue if they aren't. She's only 15 -- she still has a few years before college. Dropping the rope on this might actually make her come around faster than making it non-negotiable.

And since braces often cause problems eating, be prepared for a relapse of the anorexia. Have your resources already lined up.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How significant is the issue the braces would correct and how long is she likely to have them? I would be cautious given her anorexia history however in general I agree 15 year olds don’t make this type of call.

I’m imagining 18 months for braces, though we haven’t done a consultation. If she were particularly mature and really into her being her authentic self, then I would really listen if she didn’t want them. Instead, she has severe social anxiety, body dysmorphia (still), and she’s very focused on her appearance, as many girls her age are. The anorexia itself, plus treatment, sort of interrupted normal adolescent development, and I don’t feel like she understands a lot about the world. The pandemic hasn’t helped.

I agree with an above poster about job and relationship prospects with crooked teeth, but I’m not sure how or whether to convey that to her. Like, it’s okay for a young teen to have crooked teeth, but people will judge you as a young adult. Judging based on appearance is kind of a touchy subject...

Her body image issues are why I would NOT force her to get braces. You would be telling her that she did not have control over her own body, which could be really stressful and even triggering. I wouldn't get into a contest of wills with a recovering anorexic.

I would see if she could consult with an orthodontist, without you in the room, so she could ask questions and have the pros and cons explained to her. Make sure they know not to be overbearing or pressure her, but give her an opportunity to get some information and consider it on her own. Then let her make the call. If she's in control of the process, she might be more amenable than if it feels like something being pushed on her (because you think she's not good enough the way she is).

And people with imperfect teeth date and get jobs and do just fine in life. Slightly crooked teeth aren't really a big deal. And it's not like it's now or never -- she can get Invisalign in college or later if she decides that her teeth are actually causing problems.

I get where you are coming from but a lot of anorexia treatment actually focuses on the teen NOT having an iron grip of control in everything. Anorexics tend to be control hounds and it is not helpful to indulge that tendency

I would try to make it a non-negotiable medical type issue if the issues are noticeable. With her history she could end up obsessing abt her teeth when everyone else is post orthodontia and she realizes her teeth stand out. Try treating it like you would treat refusing allergy shots or vaccinations or pt or dyslexia tutoring. Empathize with her hating it or whatever but yet, she has to do it.

Anonymous wrote:

Anonymous wrote:How significant is the issue the braces would correct and how long is she likely to have them? I would be cautious given her anorexia history however in general I agree 15 year olds don’t make this type of call.

I’m imagining 18 months for braces, though we haven’t done a consultation. If she were particularly mature and really into her being her authentic self, then I would really listen if she didn’t want them. Instead, she has severe social anxiety, body dysmorphia (still), and she’s very focused on her appearance, as many girls her age are. The anorexia itself, plus treatment, sort of interrupted normal adolescent development, and I don’t feel like she understands a lot about the world. The pandemic hasn’t helped.

I agree with an above poster about job and relationship prospects with crooked teeth, but I’m not sure how or whether to convey that to her. Like, it’s okay for a young teen to have crooked teeth, but people will judge you as a young adult. Judging based on appearance is kind of a touchy subject...

Her body image issues are why I would NOT force her to get braces. You would be telling her that she did not have control over her own body, which could be really stressful and even triggering. I wouldn't get into a contest of wills with a recovering anorexic.

I would see if she could consult with an orthodontist, without you in the room, so she could ask questions and have the pros and cons explained to her. Make sure they know not to be overbearing or pressure her, but give her an opportunity to get some information and consider it on her own. Then let her make the call. If she's in control of the process, she might be more amenable than if it feels like something being pushed on her (because you think she's not good enough the way she is).

And people with imperfect teeth date and get jobs and do just fine in life. Slightly crooked teeth aren't really a big deal. And it's not like it's now or never -- she can get Invisalign in college or later if she decides that her teeth are actually causing problems.

Anonymous wrote:

Anonymous wrote:Does she not want them because of the way they look? I'm not saying you should let her go without for that reason, but I sympathize with a teenager not wanting the look of braces in HS when most of her peers are done with that. Is Invisalign or clear braces an option?

I’m sure it’s because of the way they look. She’s a freshman, and her best friend just got them 6 months ago. I don’t know what she’d think about clear braces. I personally think they look like crusty teeth.

She couldn’t get them when she was younger because she had anorexia. She is now far enough into recovery (which I have pulled her through, kicking and screaming) to allow braces. Invisalign is contraindicated with anorexia, unfortunately.

Believe me, I wish we could have done them earlier. I feel like she should do them now (like, even asking to start now instead of waiting), with the idea that they’d be off before senior year.

I wouldn't force anything on her. She's had a rough life already. Perhaps she would agree to a consultation to find out what may be possible? No pressure, just so she can hear a professional opinion. I know some kids have trouble eating while adjusting to braces and this could trigger a relapse of her illness.