Frequently Asked Questions

• Who needs orthodontics, and when?
• Isn't orthodontic treatment expensive?
• Is it true orthodontics can contribute to mental as well as physical health?
• What can happen if orthodontic problems go untreated?
• Do orthodontics treat Temporomandibular disorders (TMD)?
• What are the most commonly treated orthodontic problems?

Q. Who needs orthodontics, and when?

A. Studies show that millions of Americans have oral health problems that could benefit from orthodontic treatment. Without treatment, many of these people could develop serious problems.

Although there is not a universal best age to begin treatment, the American Association of Orthodontics (AAO) recommends that every child see an orthodontist at an early age. This could be as young as 2 or 3, but should be no later than age 7. However, a visit at any age is advisable if a particular problem has been noted by the parent, family dentist, or child's physician.

Orthodontic specialists can improve smiles at any age, but there are benefits to early diagnosis. Early examination enables the orthodontist to detect and evaluate problems and determine the appropriate time to treat them. After the initial evaluation, the orthodontist may monitor facial growth and development by periodic checkups while the permanent teeth erupt and the face and jaws continue to grow.

Early intervention frequently makes the completion of treatment at a later age easier and less time-consuming. In some cases, early treatment achieves results that are unattainable once the face and jaws have finished growing. (Many orthodontic problems can be corrected in adults as well as children, so adults should not hesitate to consult an orthodontist to discuss a problem.)

Q. Isn't orthodontic treatment expensive?

A. Not in comparison with the cost of dealing with untreated problems. Orthodontic treatment may bring long-term health benefits and may contribute to the avoidance of costly, serious problems later in life.

Historically, the average cost of all health services has risen faster than the average cost of orthodontic treatment. In addition, the cost of orthodontic treatment has increased significantly less than the rate of inflation, meaning the public's buying power has gone up faster than orthodontic fees.

Orthodontic insurance is not available on an individual basis, but millions of people are covered by group dental plans including orthodontic coverage which are offered through their employers. Typically, these plans limit the amount any one family member can collect in a lifetime, ranging between $750 and $2,000.

The AAO offers its assistance at no charge to companies interested in offering employees a dental plan that includes orthodontic coverage. The AAO provides Concept DR, a self-funded, direct reimbursement dental/orthodontic benefits program that is generally less expensive and offers better benefits that traditional dental insurance plans.

Orthodontic fees vary widely, depending on the severity of the problem, complexity of treatment, and length of treatment time. Orthodontists routinely discuss fee arrangements after individual examinations. Generally, fees may be paid over and extended period of time during the course of the treatment.

Q. Is it true orthodontics can contribute to mental as well as physical health?

A. First impressions often are based on the appearance of a person's face, mouth, and teeth.

A person with facial deformity or crooked teeth often is judged negatively not only on appearance but also on many other characteristics such as intelligence and personality.

Independent research studies have shown that children and adults who believe their teeth or jaws are unattractive may suffer from lack of self-esteem and confidence. In some cases, the psychological impact of crooked teeth has been found to hamper a person's social or vocational growth.

Although dental health concerns are frequently the primary impetus for orthodontic treatment, it is not unusual for treatment to be initiated for the patient's emotional well-being. In many cases, orthodontics provides both physical and psychological benefits.

Q. What can happen if orthodontic problems go untreated?

A. Untreated orthodontic problems might contribute to tooth decay, diseased gums, bone destruction, Temporomandibular joint problems, and loss of teeth. (More adults over the age of 30 lose their teeth because of periodontal problems than because of decay.) Protruding teeth are more susceptible to accidental chipping and other forms of dental injury. Sometimes, the increased cost of dental care resulting from an untreated malocclusion (bad bite) may far exceed the cost of orthodontic care. In addition, if left untreated, malocclusion may have a negative effect on the psychological well-being of the patient

Naturally, one feels better when one looks better, and a pleasing appearance is a vital asset to one's self-confidence and self-esteem. A person's self-consciousness often disappears as orthodontic treatment brings teeth, lips, and face into their proper positions.

Q. Do orthodontics treat Temporomandibular disorders (TMD)?

A. Disorders of the Temporomandibular joints, which connect the lower jaw to the skull, may be one of the reasons millions of people suffer from chronic headache, earache, and facial pain. No other joints are subject to such precise functioning as those involved in the meeting and biting of teeth.

Symptoms frequently associated with this problem include popping, clicking, or grinding noises of the jaw joints when eating or opening the mouth; soreness and limitation of opening the mouth; headaches; stiffness of the neck and shoulders; and ringing of the ears. The bizarre and seemingly unrelated combination of symptoms, however, makes diagnosis difficult for both medical and dental practitioners because many other diseases can cause similar symptoms.

Q. What are the most commonly treated orthodontic problems?

Crowding: Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. The bone and gums over the roots of extremely crowded teeth may become thin and recede as a result of severe crowding. Impacted teeth (teeth that should have come in, but have not), poor biting relationships and undesirable appearance may all result from crowding.

Overjet or protruding upper teeth: Upper front teeth that protrude beyond normal contact with the lower front teeth are prone to injury, often indicate a poor bite of the back teeth (molars), and may indicate an unevenness in jaw growth. Commonly, protruded upper teeth are associated with a lower jaw that is short in proportion to the upper jaw. Thumb and finger sucking habits can also cause a protrusion of the upper incisor teeth.

Deep overbite: A deep overbite or deep bite occurs when the lower incisor (front) teeth bite too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth.

Open bite: An open bite results when the upper and lower incisor teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear.

Spacing: If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance.

Crossbite: The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.

Underbite or lower jaw protrusion: About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients

Information, courtesy of the American Association of Orthodontists