My teeth mean a lot to me. I’ve been blessed with strong, mostly white, mostly straight teeth. I’ve always had a small gap in between my two front teeth, but it never really bothered me. I have only one small filling. Going to the dentist is not a traumatizing experience for me emotionally, however, it has come to be financially traumatizing.
My kids did not inherit my “I don’t need braces or fillings” teeth. My oldest sucked her thumb until she received her driver’s license (just as her father did). If you’ve never seen a thumb-sucking mouth before, I caution you – it is not pretty. Ever hear the expression, “she could eat a corn cob through a knot-hole”? Well, she could have.
When someone sucks her thumb that much, the roof of the mouth is pushed upwards, the front teeth protrude, and the jaw can be misaligned. I knew this was going to be an expensive mouth to fix. My youngest inherited teeth that looked like tombstones in the moonlight. Where he got all the room in his mouth for all the spaces, I’ll never know. I have a small, sweet mouth.
I needed to find an orthodontist. Lucky for me, there’s one on every street corner these days – and now I know why. What a racket!
The first step is to go to the orthodontist. While there, you will have pictures of your child’s mouth taken, and then they put it on a computer where you get to see the teeth visibly move until the last frame when your child’s smile is complete. Very clever, because how can you take your child away from that beautiful, computer-enhanced smile and say, “No thanks, we’ll keep looking”? Well, it’s hard.
I tried to shop around. My habit is to get three estimates before I agree to purchase anything. My child permitted me two before she said, “It’s my mouth and those bitewings hurt and I’m not going anywhere else.” I couldn’t really argue since both estimates were the exact same price. How they managed to quote the same thing, I’ll never know, but my conspiracy theory voice whispers that there are some underhanded shenanigans in orthodontia.
Both offices (I secretly went to a third without her and got the same spiel) so really, all three offices were eerily similar. All three had an arcade section, a TV area, cookies (Yes, junk food – it is a conspiracy!) and beautiful “after” pictures on the wall.
Now to the price: two years of braces cost $6,700 for each kid. The first time I heard the price I almost passed out from the force of the air entering my lungs in an enormous gasp. The second time I was steadier, but the voice in my head screaming, “What the f—?” did not stop for days. My insurance only paid $2,000 per kid. At the risk of sounding incredibly old, do you know how much I paid for my first car? Nine hundred dollars. My current car is only worth half of the cost of one set of braces.
The cost is explained as orthodontists needing to pay for “a lot of specialized, expensive equipment and to pay their staff and their rent. The Orthodontists need to pay for all of their materials and the operation of their sterilizers. Then there is the cost of malpractice insurance. Most of an orthodontist’s fee goes to paying their fixed cost.”
If they just added in a sentence here about also paying for their three homes and the yacht, I’d feel less violated. My kids’ orthodontist takes almost every Friday off to go sailing, or so I’ve heard. Nice work if you can get it.
We take out a home equity loan and get the braces. The orthodontist put on the brackets and the assistant placed the rubber bands and, voilà, the children are braced. Every six weeks for the next two years, they had a 15-minute appointment to get the rubber bands changed and the wire tightened. I wonder why I couldn’t have done some of it myself. One time, when a bracket popped (on a Friday of course), I took my needle-nosed pliers out of my tackle box (just kidding, sort of) and fixed the loose wire. It wasn’t all that difficult.
When I asked my dentist pal why it was so expensive, in solidarity with his brethren, he said, “Knowing where to glue on the brackets takes education and expertise.” Yeah – and $7,000 per kid. Could this explain the cookies in the orthodontists’ waiting rooms? The orthodontist-dentist connection?
To this day, I don’t understand how they can justify the cost. Every time we went, all 10 chairs were filled every 15 minutes. The assistants handle all the banding and the orthodontist “visits” each child for five minutes. I used to try to calculate what his income was via having roughly 40 children every hour, five hours per day (to account for some longer appointments and lunch), four days per week (to account for sailing time), which is 800 kids.
The kids seen in one week don’t generally have to return for six weeks, so theoretically this orthodontist could have up to 4,000 clients a year. Using a conservative 3,000 clients per year, at an average cost of $5,000 per child (since my kids’ mouths were probably not “average”), my estimate is $15,000,000. I’d go sailing, too.
So, if the cost of braces is due to “overhead,” then Invisalign should be cheaper, right? The creation of the retainers is done at a lab somewhere else, so there should be only minimal overhead and cost, right? Wrong.
I started grinding my beautiful teeth at night when my kids became teenagers. I’m sure there is no connection. I could tell my teeth were shifting and I began to have jaw pain. I ignored all that until one day I chipped a front tooth while grinding as I listened to yet another reason why my teenager didn’t do what she was supposed to do.
I knew I was going to have to get a night guard. My dentist asked me to consider Invisalign to fix the problems inherent in constant grinding. It was also his mission to close my gap.
The steps seemed easy enough.
“Step 1: See a certified Invisalign provider.” I did. He told me that, due to my “medical condition” of grinding and jaw issues, my insurance would pay for up to $1,000 for Invisalign. He also told me I would qualify for an “express case,” which is half the cost of the full treatment. Great!
An express case only cost about $2,100, and with my insurance paying $1,000, I thought this was much more reasonable than braces. Plus, you can take them out to brush and floss which is very important and (almost) ritualistic to me. I assumed an express case was a year-long procedure because he told me the full case takes approximately two years. This is important later.
“Step 2: Map out a treatment plan. You and your doctor develop a treatment plan specifically for you. Then the doctor takes bite impressions of your teeth, which Invisalign will use to custom-mold a series of clear, removable aligners that will gradually move your teeth into an incredible new smile.” Great, again!
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.
My dentist was also not happy about how little my teeth had moved. He wanted my gap closed. He tells me you can get three more sets for “refinement” on an express case. Of course, there’s an additional charge. I tell him, “No way.” I have my very expensive bite guard now and I don’t care about my gap.
Somehow, he sees my gap as mocking him and he wants it gone. I think because he told me Invisalign could easily fix it, he pursues getting my “refinement” and he pays the penalty fee. He won’t tell me how much it costs because he’s a great man who takes responsibility for promising something that Invisalign couldn’t or wouldn’t fulfill.
I have seen how little my teeth moved in the past 14 weeks and I don’t hold any hope that three more sets (six weeks) will refine my teeth enough to close the gap or make any noticeable change. So far, no one has noticed any change in my smile. Including me.
I originally saw Invisalign as a cheaper way of fixing my bite so I would stop grinding and possibly close my gap. I wish now that I had just gotten a bite guard and not been seduced by wanting “a perfect smile” because, after two sets of braces and my own Invisalign cost, I find it harder to eke out a smile these days.