Hold up! They forget to mention that at some point you might be told your “express case” really can’t be fixed as an express case and, sorry, but you need the full case. What will that cost? Oh, about $6,000.
I have a great relationship with my dentist and he was only reporting what Invisalign told him. He did not understand why they couldn’t fix my newly-messed-up bite (and close my gap) in an express case, but he shrugged and said there was nothing he could do. I walked away.
I chipped another tooth a few weeks later while diving into a really cold swimming pool. When I went back to my dentist to have it fixed, I told him it was his and Invisalign’s fault. If they hadn’t done the “bait and switch” of telling me it was going to be $1,200 (my cost) then changing to $5,000 (my cost), I would have been wearing my retainers and not chipped a tooth. So my dentist pursued getting me an “express case” despite the recommendations from Invisalign.
“Step 3: Your aligners are created. The advancements in technology that led to clear aligners were developed by Invisalign. Your aligners are created via precision computer mapping and design, then are shipped to your doctor.”
My Invisalign were numbered sets (1 of 7, 2 of 7, etc.) and my dentist gave me the first three sets. He instructed me to change to the next set every two weeks. They hurt really, really badly that first day, but the next sets didn’t hurt at all. I did not have to return for six weeks when I picked up sets 4, 5 and 6. When I went back to pick up set 7, I asked when I’d get the next set. He says 7 is the last one. I say,
“What?” The brochure says, “Each case is a little different, but on average, treatment lasts about a year. Then you can show the real you with an amazing new smile.” I did not have an amazing new smile. How could I in 12 weeks? I was able to stop grinding because I always have my teeth covered with plastic unless I’m eating or brushing. My little gap is still present. My teeth are infinitesimally straighter, but they were pretty straight going in.
Article comments
1 - SLP
A couple of comments / thoughts. Not to be overly critical but, 1) Some of the "overhead" of becoming an orthodontist is also the opportuntiy cost and expense of 11 years of college to become a specialist. 2) Invisalign is usually more expensive because there is a large lab bill added to the overall overhead cost. 3) Your estimates of the patients being see by an orthodontist is overestimated. The average orthodontist "starts" ~ 200-250 new patients per year citing the Journal of Clinical Orthodontics. 3000 a year is just not accurate or realistic for an orthodontist to manage.
2 - alexandria jackson
Well, I was wondering when an orthodontist would weigh in. 1)I understand education costs because I also earned my doctorate. But I don't describe that as "overhead." Once you pay off your student loans, then do you drop the price? 2) I still would be very interested in an acutal cost breakdown of both orthodonture and invisalign because I have trouble making the figures work out. 3) You may be right, I forgot to figure that those 3000 clients are in braces for a 2 year average so my figure of $15 million was inadvertently doubled. Still, for the service received and the time spent in the orthodontist's office, the cost is difficult to justify. If any orthodontist reading this wants to itemize the cost of an "average" set of braces, I'd love to read it with an open mind.
3 - paul b
I don't think anyone should be held accountable of their fees because of how they spend their money. When my plumber or electrician are in my house for an hour or less and charge me a fee, i don't ask them to justify what they charge. As far as a conspiracy, we have to fill out forms to insurance companies with our fees. I agree that their are some orthodontists that charge a lot, but sometimes you get what you pay for. By the way, I am not an orthodontist. Please respond. I would like to continue this further.
4 - Alexandria
I guess I do think that there should be some justification in the cost of health related items. I one time got quoted $120 for a breathing apparatus, but when I got there, said I had insurance and filled out my insurance forms, the machine ended up costing (my insurance company) $340. I never pursued this because one of my kids was suffering at the time, but it still seems a bit sneaky to me. I DO want to know why orthodontia is so expensive and I AM frustrated by the rising health care costs in this country. But you could also plug in any health care item like "mammograms" or "sonagrams" or even "lab work" and I'd still want to know the cost breakdown and why. One time, when I went for a mammogram, I was asked if I wanted the "comfort pad." I said, "what is that?" and they said, "It's a cushion so it doesn't hurt so much." I said, "Yes please!" and they told me the cost was $5. I was outraged! What about the people who can't afford that? Why would the little piece of cotton cost so much? why wouldn't they just make that standard? So it isn't just orthodontia that I'm frustrated with, that just happened to be my current frustration.
5 - JoAnne
My son lost his lower retainer. A small piece of wire... which my son calls "a piece of paper clip", which is what really looks like. It costs $250 to replace it, which I cannot afford. I want to know how this outrageous price can be justified. Also, I was told that if he had the retainer and needed to be fixed, it costs $150 (still outrageously high). Any suggestions?
Thanks.
6 - JoAnne
I am very concerned about the metal used for retainers. I believe it is Nickel. My concern is having it in the mouth 24/7 for the rest of your life and how this metal leaks into the body. Does anyone know how toxic it is? Thanks.
7 - Geoffrey
I have never met anyone who felt they were paid too much and the "other guy" is paid too little.
It is easy to diminish the work of others whether it is being paid to "say the right words" in counseling (words are free right?) or just "throwing a ball" in professional baseball. What about the CEO of an insurance company that gets $100,000,000 as a "golden parachute upon retirement?
It is really all about the hoops necessary to get into particular line of work and the screening that takes place along the way that naturally limits the number and type of people in a particular profession. Not to knock plumbers or dish washers but how many of them would you want operating on your of your child's brain?
8 - Alexandria
JoAnne, I wish I could help you but I just don't know the answer to your questions. Perhaps an orthodontist can answer you?
Geoffrey - while I do understand about hoops, skills and abilities, you have to admit that in some specialty areas, there seems to be little oversight. Professional sports is certainly one of those areas, too.... The bottom line is the lack of oversight/keeping things in perspective. The cost of orthodontia seems outrageous for what you get. Just one gal's opinion.
9 - candy
i agree completely, Alexandria!
10 - george
if the insurance company paid for it all would you still think it is too much money? ....I did not think so. What you are doing is letting a third party whose only motivation is profit influence your rational thinking, you have been brainwashed.
11 - tomy2tone
my ex wife works for an orthodontist, i can tell you if you new the cost of the invisaline to the doctor, you for sure would have a heart attack, it is in my opinion outragious to have a mark up so extreme, i run a retail store selling recreational power sports vehicles, we struggle to make 10% on our sales of vehicles, i wont reveal what i know exactly about the profit in this product, but it sickens me.
12 - JoeP
The costs of orthodontia are purely sickening. I am convinced that these docs work together to establish something akin to fair market value, which translates loosely into "that's what everyone's charging for this." I'd love to see an orthodontist come along who will charge something far more aligned (pun intended) with the actual service provided. I'm not against someone trying to make a living, but when they conspire to set high prices for moving a few teeth a few millimeters, I get a little cranky.
13 - Amy
No offence, but you shouldnt complain about your children's orthodontic cost. I have a 'thumb suckers smile', and I know first hand how terrible it feels. You shouldnt put a price on confidence!
14 - Meg
Yes, there is a particular cost in doing things and yes Orthodontics will charge more that that. There is reasoning behind prices, just like anything.
My apologies you haven't looked into the prices of dental materials and equipment. Also why not look up the price of University to get into a dental graduate course, followed by the price of dental college, followed by the price of the additional 3 years or so of Orthodontic practice. Also, take into account those assistants that are placing the bands and elastics have taken their education programs and been trained to fulfil those duties in an orthodontic office, and yes, the Orthodontist also has to pay them.
It's nice to think the Orthodontist is just stoppping by the visit your child, they are actually checking and approving the job of the assistant.
Changing your child's face is not just moving teeth a few mm. Try reading up on human embryology and anatomy, aswell as biomechanics. Maybe then you will have a greater understanding of how your body works.
Clearly you do not know much about Orthodontics, or even dentistry as a whole. Gerneral dentists can also help you with orthodontic treatment, if your child's condition isn't terrible. The job is just done better and with more concern when done with someone who has specialized in that field.
15 - DJ
The orthodontist's cost for Invisalign is 300%+ greater than that of the materials used for braces. Of course the cost of materials is only one portion of an orthodontist's overhead.
Most orthodontists are small business people and incur the same frustrations of many small business people in today's climate. Trying to support his family as well as the families of the 10 people he employs is a huge concern for my boss. Have you seen the cost of health insurance these days?
Our fees, while not at all as high as you have experienced, are well justified. A confident smile will last a lifetime and reap its own rewards far beyond that of the price tag to straighten teeth.
And, no, we are not in cahoots with other orthodontists!
16 - Dan
My wife came back from the Orthodontist yesterday in shock. My kid has beautiful teeth--straight, teeth come together well, and no spaces, with a slight crowding/turning of his lower front teeth. Same result: $5,500 after insurance and "discounts." The Ortho used scare-tactics, stating that if left "untreated," he could develop an "underbite" (due to the growth of his jaw--!! will the rest of his face stop growing??!!)
Neither his mother nor I ever had braces and we share his lower front tooth "abnormality." Neither one of us turned into a werewolf. One word: Racket. It's an economic model. Period. They are pulling kids in earlier and earlier--prior to 12 year molar entry or wisdom teeth--he had an answer for that too--it won't change his other teeth after braces (but look out for the growing lower jaw, though!!)
17 - Joe
My brother's friend is an orthodontist and I have spoke with him quite a bit. Just a few comments that I would like to make:
1) Braces are a lifelong investment. Alexandria mentioned that braces cost more than her first car. It’s not like you are buying a $7000 computer that will be obsolete in 12 months. That same confident and attractive smile is as good when you are 60 as when you are 15.
2) Appearance is everything (well, almost everything). We live in a society where you are judged by your appearance. Every time you interact with another human, that person is judging you by the way you look. Straight teeth and a confident smile increase one’s attractiveness tremendously. A potential mate will find you less attractive if you have an unesthetic smile. What happens when your child goes to that first job interview after graduating from college and doesn’t get hired because the employer was thinking to himself, “I can’t have that snaggle-tooth interacting with clients”? Is it fair? No way! Is it reality? Yes sir. Amy said it best. You can't put a price on confidence. Braces have a psychological benefit that can't be measured monetarily.
3) It is a very long, and expensive process to become an orthodontist. It takes 11 or 12 years beyond high school to become one. 4 years of college, 4 years of dental school, many do an intern year, and then 3 years of ortho residency. Not only do you spend 11 years paying tuition (at a cost of approx. $100k college, $150K dental school, $60k ortho school), but you are out of the work force for 11 or 12 years making exactly $0. All the while accumulating debt near $300k.
4) It is very competitive, requires a lot of hard work, dedication and intelligence to become an orthodontist. I could tell you of at least 10 people who said the first day of college that they wanted to be orthodontists. You know what? Those same people dropped biology 101 three weeks in because they were failing. People going to med/dental school have to take advanced science courses such as organic chemistry, biochemistry, calculus based physics to name a few. Your average college student couldn’t even pass those courses, let alone get the A or A- needed to get into dental school. Once you get to dental school it is even more demanding. If you don’t graduate in the top 5% of your class, you pretty much have no shot at getting into ortho school. About 4,400 people graduate from dental school every year and there are only 250 or so spots every year for incoming ortho residents. After you get your degree, you must take licensing exams that run in the thousands of dollars to prove that you are competent.
5) It requires a tremendous amount of money to run a practice. Just the x-ray machine alone costs close to $150K, and each ortho chair is $8,000. Not to mention rent, materials/supplies and the hundreds of thousands of dollars you have to pay your assistants and front desk staff every year.
6) Ortho is not easy. Granted, they’re not splitting the atom, but it’s much more difficult than it looks. If it were so easy, you’d be able to buy a kit from an infomercial and do it in your garage. Trust me
7) They start patients younger these days not to get more of your money, but to try to take advantage of the child’s growth and hopefully prevent the need for surgical intervention down the road. Your jaw growth is pretty much complete by the time you are 15 or 16.
8) I wouldn’t price shop for braces. You price shop for a DVD player, not things related to your health. It is good to get several opinions, but don’t pick an orthodontist based on price alone.
Peace
18 - Lance
Alexandria,
Joe summed up our business very well. 200-250 starts is an average as someone else mentioned. Your math, unfortunately, was way off base. I would venture to say that there is no single orthodontist in the world grossing $15,000,000 per year. In fact, I would be extremely surprised if you could find one that even does $5 million. There is only so much one can do.
$7,000 is a lot of money, but worth every penny paid and then some. How many people are dropping $3-4,000 on plasma tv's right now? Kinda puts it in perspective.
Most orthodontists graduate with $150,000 or more in debt, spent 12 years of their life training, just to have the title. Then they drop another $500,000 minimum to start up their practice(building not included). It takes years to build up a practice and a lot of us make well below 6 figures for several years as we fight to build our practices.
The bottomline is I know it costs a lot to get ortho care, but it is easily justified based on the costs of getting the degree and the ongoing costs of running the business.
Hope this helps. Nice writing by the way.