Advice about Orthodontia & Braces

Parent Q&A

Crozats for youth? Dec 29, 2021 (0 responses below)
Orthodontia Phase Two? Mar 17, 2021 (2 responses below)
Holistic Orthodontist/Dentist for cross bite - Moy or Lawson? Sep 29, 2020 (1 responses below)
ALF or traditional orthodontics? Sep 14, 2020 (1 responses below)
Braces for Teen, Jaw surgery Jul 10, 2020 (13 responses below)
Should my 12 yo daughter get braces? Jan 29, 2020 (15 responses below)
Orthodontist Rec Needed - Necessity of Underbite Treatment May 3, 2019 (3 responses below)
Spacer or retainer for 9 year old? Paying out of pocket Sep 3, 2018 (4 responses below)
Braces or Invisalign for teen's Orthodontal Phase 2 May 29, 2018 (5 responses below)
Adult orthodontia worth it? May 26, 2017 (7 responses below)
ALF vs. braces - advice needed Sep 3, 2016 (3 responses below)
Price of Braces for Teen? Jul 12, 2016 (10 responses below)
  • Crozats for youth?

    (0 replies)


    I am considering crozats either in lieu of - ideally - or in tandem with braces for my 9 year old daughter. The traditional orthodontists we have consulted have suggested the standard expander + braces route, but the two holistic dental professionals we've seen recommend crozats. The treatment protocols are quite different. I am wondering whether other parents have gone with crozats, and if so, what your experiences have been. We would be going through Dr. Hockel's office in Walnut Creek, Life Dental & Orthodontics, so feedback on that practice is also welcome.

    Thank you, Rachel

  • Orthodontia Phase Two?

    (2 replies)

    My daughter had Phase One orthodontic treatment done two years ago. At the time, we were told that she may or may not need Phase Two, and if she does it will be shorter and easier because of the work done in phase one. 
    Today we were informed that not only does she need Phase Two, but it will take 18 months and the cost will be $7300 + the $400 for the updated study models and xrays. 
    Having already paid $5000 for phase one, I am a bit shocked. I didn’t expect the second phase to be so much more expensive than the first. The grand total for both phases comes out to almost 13,000 which seems absolutely unreasonable. 
    Those of you whose children recently underwent two-phase treatment, what was the cost like for you?

    RE: Orthodontia Phase Two? ()

    Our orthodontist said the same thing, that we might not need a phase 2.  But of course now they are saying my child will need a phase 2 which we all know is super expensive. 

    However, we brought my child to my dentist, who is much more conservative and holistically minded, and she said that they did not need another set of braces. She said if we did a phase 2, it would be purely cosmetic, and totally unnecessary.  I have been going to her for over 10 years and trust her and appreciate her honesty.  If you wanted to go to her to get a second opinion, her name is Laura Lawson and is on Solano Ave.

    RE: Orthodontia Phase Two? ()

    Yes, we got the same pep talk with our first  orthodontist. Our phase 1 for our oldest kid was over $6000 and was botched because they made a retainer when a tooth had not grown in all the way and then refused to make another when she could no longer wear it.  Needless to say, we are not returning.

    But,  an advantage of having two phases is being able to spare the kid from having to lose permanent teeth. Two phases allow for palate expansion, which for one of my kids will ultimately help allow him to breathe better. Despite losing his tonsils and adenoids, he is still snoring and lagging in his growth. The second orthodontist for kid 2  said very clearly “99% chance of phase 2, and it will be more expensive than phase 1”.

    My husband had braces, but only one phase that lasted from age 12-20!  Luckily, there are many more options these days, that allow for treatment to be staggered,  broken into stages, which end up costing more, but ultimately will protect teeth and gums and correct much more than just the cosmetics.

    Yes, sticker shock, but there are reasons and advantages for  sucking it up and doing it. Best of luck!

  • My 16.5 year old son has just been told by his dentist that he needs braces. He is planning to move overseas for college at 18, but the treatment plan calls for two years of treatment. Both of the orthodontists we have consulted are offering us a "package" plan where the price for braces and follow up is all inclusive. They are telling us that they do not offer services pro rata so we must pay for it all up front  (or sign a contract agreeing to pay for the entire treatment in payments) and abandon treatment with them at 18, and find a new orthodontist who is willing to take him for the last six months. This does not make sense to me as we would be paying twice for the last six months of treatment. Does anyone know of a reputable orthodontist who will offer pay as you go treatment?

    If his situation is not too complicated, maybe he can do it without an office.

    The paperwork from Dr. Immi Song seemed to indicate maybe a $300 transfer/abandonment fee (my terminology) but otherwise some amount representing the uncompleted portion of the treatment will be returned if already paid.  If your teen is fairly disciplined, Invisalign treatment might work even remotely since the 6-8 weeks worth of trays are provided at a time.

  • Hi BPNers,

    I have an 11-year-old who was recommended for ALF due to a crossbite at 9 but we couldn't afford it at that time. We are luckily in better financial standing now and need to find an orthodontist/dentist ASAP who will look at whole health (airways, sleep) in addition to the straightening, which needs significant attention.  Has anyone worked with Mona Moy or Laura Lawson for this? I think ALF is no longer an option, I'm afraid we've missed the window for when things are pliable enough for that, but I'm looking for someone who is conscious about toxicity of products and who will think whole health. 

    All recommendations appreciated! 

    HI there. Both my daughters saw Dr. Mona Moy for an ALF and regular dental treatment and we have been very happy with her and with the ALF process. So much healthier, all-around. It is worth calling her office as they are very knowledgeable and helpful. I also have seen Dr. Lawson and her holistic approach to dental care is really compelling. Both great options.

  • ALF or traditional orthodontics?

    (1 reply)

    My eight year old daughter has a crossbite, and her pediatric dentist has recommended a consultation with an orthodontist.  Does anyone have experience with ALF (Advanced Lightwire Functional Appliance Therapy)?  It sounds more humane, and possibly healthier in the long run, but is it as effective as traditional orthodontics?  Thank you!

    Hi there. We did ALF for our two daughters, now 12 and 14, and are so glad we did!  With the ALF, both of our daughters' teeth have straightened beautifully and even more importantly than I realized at first, their overall mouth/facial structure is optimized for breathing and chewing, etc. I am SO glad we went this approach. They started at around 6 years old and we couldn't be happier. Good luck!

  • Braces for Teen, Jaw surgery

    (13 replies)

    My 16 year old has been diagnosed with a significant overbite. His pediatric dentist had not recommended braces or any interventions. When we switched dentists (he aged out), the new dentist was surprised this was not recommended earlier. We met with an orthodontist and he recommends jaw surgery (!) to correct his overbite, and that his jaw is already formed as he said, we stop growing at 16. Has anyone else experienced this?  Had I been informed earlier I would have gotten my son into the care of an orthodontist sooner and could have avoided surgery altogether. I think my son is still growing per my kitchen wall growth chart (!), but would like to try traditional methods before moving to this extreme measure. If this had been a "normal-ish" time, it would be better. With everything going on in the community and the world, my kid is a bit fragile these days, feels overwhelmed and depressed, and I do not want to add surgery to his list of concerns.  My son has anxiety and has had therapy for about 1.5 years. This kid never has even had a filling.  We are really caught off guard by this news. Any words of advice, other than getting another opinion (I am on that) . Thank you.

    RE: Braces for Teen, Jaw surgery ()

    Feeling for you and your son in this time.

    I don't know if this will be helpful to you, but I was also diagnosed with an overbite and had jaw surgery recommended to me as a teen. I had been seeing the same orthodontist throughout my youth, and into my teens. Unlike your son, I had LOTS of dental and orthodontial woes by that time. I had surgeries, removals, fillings, braces and more. I guess when my jaw stopped growing they felt this was the next step. We didn't pursue any treatment at the time because surgery seemed pretty extreme for something that wasn't causing any pain or real distress in terms of my self-esteem.

    Later in my 20s I thought I'd revisit the idea, so I saw maxillofacial surgeon, and another dentist and orthodontist, to discuss. It sounded to me like they would have to undo all of the previously done orthodonture, move my teeth back to where they were before, THEN do the surgery, THEN do another round of braces. For a 25 year old it was too expensive, too much of a commitment, but I could have done it then. I asked an orthodontist again just last year, and they said I could still do it, but it would be a cosmetic thing, not covered by insurance if I don't have TMJ. Could have done it then, too.

    I don't know the level of urgency with which this was recommended, it may be that your son is in pain, or can't stand the look of the overbite. Maybe that's a good conversation to have with him. You can talk through the benefits and risks together. It may turn out you have time to decide if it's the right thing. And maybe if it is, you can wait a year.

    Sending peace and a big smile--with an overbite! 

    RE: Braces for Teen, Jaw surgery ()

    Hi there! I'm not a dentist or orthodontist - but I do have 2 kids one almost out of braces and one about to get them, and here's what I've learned about orthodontics - in MANY cases it's subjective. The first ortho I took our dd to said she needed 8 teeth pulled. I wanted a second opinion. Guess what? The second ortho said NO teeth would need to be pulled. Now, an overbite can be a big deal, but the fact that your old dentist never mentioned it seems odd, and surgery seems extreme. So my advice is get another opinion from a different ortho. We love ours (Dr. David Johnson) but if you want someone close to where you are you might look in the archives for recommendations. Don't give up yet! Good luck!!

    RE: Braces for Teen, Jaw surgery ()

    My son is 9. He was diagnosed with a small crossbite when he was 8, and so I got a crash course on this whole "pre-braces" thing, which wasn't a thing when I was young. The thinking is, before the age of 10, kids' skulls are soft and malleable so if you want to move things around, you should do it before the age of 10. For my son, this involved a palate expander and a short stint of braces that is still continuing. And it's true, everything moved so quickly it was like he was made of playdough. When he is a teenager he might have to get braces again, but for now, we have moved things around to make space so as to prevent more drastic intervention as a teenager. I also got a crash course on how every single dentist and every orthodontist has a different idea for how to treat a person's teeth. I've read posts on BPN that accused dentists of negligence by not treating something, or conversely, trying to cheat you of money by overtreating. The truth, I believe, is that there isn't ONE prescribed way to correct someone's teeth, and a LOT comes down to the provider's experience and preferred way of doing things. One orthodontist we saw suggested these huge head gear things for my son, one said we should do nothing, and the third suggested something in between. The oldest (and I think the wisest) of the orthodontists was the one that told me that if you ask a hundred orthodontists what to do, they will give you a hundred different answers. Your son might truly be too old for a light intervention (I was told the skull stops being as flexible at 10, and 16 is much older than that), but maybe his overbite isn't that bad? Go see a few more orthodontists and get more opinions before you rush forward to do something. I definitely would not rush into surgery, especially not during a pandemic.

  • Should my 12 yo daughter get braces?

    (15 replies)

    My 12 year old daughter's dentist has recommended that she get braces.  Her teeth are slightly crooked, and she has a moderate overjet.  She would probably need them for 2 years, and then has been told she will need a retainer forever to keep them straight.  We are torn over whether we should go down this road.  Neither my husband or I had braces, so we have no first hand experience.  When I was a kid this was never a possibility, as it was clearly cost prohibitive. The cost is a significant factor, but I think the biggest concern is if it is worth the short and long term efforts associated with having braces, then keeping the teeth straight after they are removed.  Our daughter also has mixed feelings, think she will be ok either way. It seems like it is mostly cosmetic, although the dentist did say that the overjet will make her at increased risk for tooth injury (from sports, etc.)  The dentist obviously has a vested interest, so a little difficult to fully trust their assessment.  What have been the deciding factors that you considered when weighing this decision?

    Ask one or more orthodontists, not your dentist.  We see Straty Righellis in Montclair, although he is only there part-time now, and has sold the practice to Remi Ikeda.  The orthodontists have a good idea of how things will progress, in terms of functionality.  Good luck.  

    I'd do it. My daughter really needed braces, gappy overbite, but even if her situation were not as bad, I would still have gone with braces. It was not bad having braces in elementary and middle school because almost all kids had them. Sleeping with the retainer every night for 8 years now hasn't been a problem either. Although it is not fair, adults are judged by their teeth; I know several people who have gotten braces as adults because they felt their "poor" teeth impacted their job and social life. I don't understand why you feel the dentist has a vested interest, can't you go to any orthodontist you want? How does that benefit the dentist?

    Maybe I'm totally superficial, but I think straight teeth are really important.  Even someone who is otherwise pretty plain, or even homely, looks so much better with a great smile!  In my opinion, you can skip makeup, skip doing your hair, and schlump around in old sweats as long as you have beautiful teeth.   And maybe this is really horrible to say, but besides making you more attractive, it also sends a message about social class.   

    Also, teeth get more crooked as you age.  

  • Hello, our 10-year-old was recently referred to an orthodontist for overcrowding issues.  The orthodontist is recommending reverse-pull headgear to correct what he perceives to be potential for a future under-bite; my son does not have an under-bite now, but apparently his x-rays suggest he may develop one in the future (when he reaches puberty).  Can anyone recommend an orthodontist who can provide a second opinion on the certainty / uncertainty associated with this type of prognosis?  Specifically I'm hoping the second opinion will help us understand whether X-rays are really a good predictor of future potential to develop an under-bite, and if any other information can improve that prediction.  Thanks!  

    I have no idea what his take on your specific issue would be, but Dr. Righellis (510-482-0600) in Montclair was who we went to for a second opinion with our first kid, and we were so impressed we've used him for both our kids, and have always been very pleased.  Good luck.

    my daughter had a SEVERE underbite since birth and went to Dr. Ferrari in Kensington.  She is AMAZING.  she has been very conservative in her treatment and my daughter's bite is already fixed without any headgear or major intervention, just braces and rubber bands. 

    Straty Righellis , you can google him.  In Montclair / Oakland.  Both my kids went/are going to him.

  • We are entering a new phase of parenting: the Ortho Years. His pediatric dentist referred him for a consult, we can pick the practice. We have terrible dental insurance which doesn't even cover ortho, so we are price sensitive. He's only 9 (about to turn 10) so who knows where this journey will take us. Our first visit was to Dr Barrett, who is recommending a retainer for now; second opinion with Solano Smile dr. who is recommending a spacer for now. Obviously we don't want to buy more than our son needs but it's confusing, not being dental experts ourselves, and we're not sure how to proceed. Do we ask our adult dentist (who we love and trust) for a third opinion? Do we go with the practice recommending the currently-less expensive option? (spacer) That would send us down the road with Solano Smile, which feels like a lifetime commitment.

    As a side note, we do think the child does need or will need ortho work - dad did, and kid's smile is a bit wonky. Basically, we're braced for braces, but have no idea how to navigate when, or with what practice.

    thanks for any advice!

    We had a similar issue with my 8-year-old, not knowing which treatment plan was the right one.  We got a consultation with the orthodontic faculty clinic at UCSF. Because they are a university, I felt confident in their recommendations and especially that they weren’t trying to upsell us. They were only a little bit cheaper than private practices, but the peace of mind I got from having a consultation with a non-profit was invaluable. We did go with them for the treatment, which is not convenient but we’ve been very happy with them and the interest-free monthly payment plan.

    We had a wonderful multi-year experience with Orthoworks in Hercules. It is not as far as it seems because we scheduled all appointments for Saturday mornings when there is no traffic. If you do not have insurance, they may be able to negotiate with you on the price. Basically our 5 years with Orthworks had the $6000 total cost spread out monthly with no interest (downpayment and then $100 per month). I feel it was completely worth the cost and Orthworks has a great, caring, professional staff.

    I think if you love your dentist ask their opinion - we had a similar situation including paying out of pocket with kid #1, 2 VASTLY different opinions (6 extractions vs. none!) Ultimately what I've come to understand is that ortho work is like a melding of the medicine and art - not to be too out there about it, but it's not a one size fits all thing for sure. Different doctors see the face/smile in different ways, and you really need to just go with your gut and what seems to make sense to you. In our case we went with the no extractions and it's been a great ride, we trust our ortho pretty well and everything has always felt above board and not like they're just trying to milk us. It helps if both your opinions gave you the entire picture about why what they're doing now will effect what they will do in the future. Good luck!

  • Our 14 year-old now needs to start phase 2 of his orthodonture and the orthodontist says we have the option of braces or Invisalign. The cost (close to $6K Yikes!)  is comparable and my son would prefer the less painful and visible Invisalign but I'm concerned about whether the outcome with Invisalign is as good as with braces. The orthodontist himself felt like braces were old technology but I would love to hear from parents who have had to make this decision and what your experiences with Invisalign vs. braces were and if you had any problems with your teen wearing or keeping track of all the Invisalign retainers. Thanks!

    I was about to submit this exact same question! Can't wait to hear the answers - my research thus far seems to show little to no difference, but would also appreciate anecdotal evidence.

    My son had the invisilign and it went very well.  I was amazed at how quickly they worked on his teeth.  He's at the very end of wearing them now and it's hard to get him to keep

    going in the homestretch but overall I would highly recommend them.

    I recently got Invisalign for myself.  After a month of wear, I strongly advise against it - especially for a teen.  First and foremost, you cannot eat or drink with the liners in (except water).  This turned out to be a big problem for me, as I am constantly removing the liners in order to have tea or eat a snack. You have to clean them each time you take them out and put them back in.  For a teen, I can't imagine the inconvenience of this being tolerable.  I hate it.  The liners pool saliva; it is gross and they have to be cleaned several times a day to avoid a smell.  Regarding the aesthetics, your kid's liners may not be invisible at all.  I thought mine would be, and imagined a clear retainer-like thing.  But, in order to grip my teeth, the ortho had to punch out bumps into the liner to allow it to grip.  It turned out to look like a lumpy and visibly shiny plastic piece over my teeth.  I would rather just have gotten clear braces.  Hindsight is 20/20.

  • Adult orthodontia worth it?

    (7 replies)


    My dentist is bugging me to get orthodontia done due to a messed up bite. Only some of my teeth meet and only on some of their edges. However, I eat food fine and my teeth don't hurt except some sensitivity to cold and heat. I don't grind my teeth. I do have receding gums. My dentist says my teeth will crack eventually and this will help. I've consulted with one ortho and he recommends invisalign with rubber bands for 20 months and many thousands of dollars. I'm in my 50s with lots of other expenses...what do you think? Is it really worth it? Are my teeth going to crack out of my head when I'm 70? What about having plastic in your mouth for years? That doesn't seem like a good idea. Thanks, wise ones!

    RE: Adult orthodontia worth it? ()

    I am not a dentist or a dental professional but did have orthodontia in my adult years (and as a child). It is worth the money to fix and will actually save you money as you get older since the teeth will continue to move and your gums will continue to recede.  It is not a cosmetic thing- thought that it is an advantage. It is actually preventive so you don't have to have oral surgery later in life for pockets forming and developing gum disease which can lead to grafting, root canals, and losing teeth. In my opinion, it is definitely worth it to have invisalign which is much better than braces. Good luck.

    RE: Adult orthodontia worth it? ()

    I would not do it.I had braces as a child and I had TMJ problems later.I know people who only bite down on a few teeth and they have been fine.Unless you are having problems,I feel like you could make things worse.

    RE: Adult orthodontia worth it? ()

     I can't say if this is worth it for your bight, but  I can tell you my mother's and my experience. I had braces when I was 13 to 15 years old to hopefully correct my bite.  My bite was structurally the same as my mother's, meeting in one spot on each side at the back molars.  We were told that without orthodontia the bight would get worse, the jaw would really start hurting and having problems. In my 20s, I was told  that I should have orthodontia on and off for the rest of my life. My mother was about 50 at the time and her jaw did not hurt and her bite hadn't gotten worse. I opted not to do orthodontia.  Fast forward, my mom died at the age of 87 with no additional problems with her jaw or bight. I am now 62 and have had no additional problems. For me,  if I was in my 50s and told what you were told, I would take my chances and not do orthodontia. I guess I'd be saving that money for dentures.  But of course every bite is different.

  • ALF vs. braces - advice needed

    (3 replies)

    My 7 1/2 year old has a very narrow pallet, a bit of an under bite and teeth that have seen alot of movement because of her narrow jaw and thumb sucking. Her old pediatric dentist recommended an ALF appliance. Does anyone have experience with an ALF and/or braces at this age?  

    And if you have a dentist you can recommend for the ALF, please share the info. Thanks so much!

    I would make a trip out to Walnut Creek to have a free consultation with Dr. Hockel. ( He is a sleep apnea specialist, general dentist who does amazing cosmetic dentistry and orthodontics. He is gifted at clearly explaining the reason for the treatment and how it works and would be fabulous for a second opinion. He really loves what he does and is an upstanding trustworthy person with a lot of specialized knowledge. He has worked magic with my two kids doing palate expansion so they didn't need any teeth pulled. He takes into account the whole person with special attention to jaw function and airway preservation. What a difference that makes.

    I will be interested in the replies on ALF. But in the meantime, you might see if your child is tongue-tied. 7 1/2 is old enough to tolerate the procedure and the after care of stretching. While releasing the tongue now can't make up for the fact that it wasn't widening the palate by resting their earlier, she can be taught to rest it there now and help maintain what any appliance accomplishes. It could also free her chin and lower jaw to grow and help with underbite. Dr. Yazdi in Castro Valley may consult. He mostly focuses on releasing breastfeeding infants but he is the best in the Bay Area for tongue tie. It is likely that body work and Oral Myofunctional Therapy will assist your daughter in 'waking up' and strengthening underused oral muscles as well.

    My daughter just completed her treatment with Dr. Claire Ferrari in Kensington/North Berkeley. From the serene office environment, to the warm and friendly staff, Dr. Ferrari has a way with kids and adults. My daughter sucked two fingers each night until she was 9 years old and the braces helped create space in her jaw to accommodate her growing palate. Of note is that Dr. Ferrari uses 3D imaging that I didn't see in other offices I visited for 2nd and 3rd opinions before I chose to have her treated by Dr. Ferrari. This imaging gives a much more comprehensive look at not only dental alignment, but jaw movement and even airway breathing. Good luck!

  • Price of Braces for Teen?

    (10 replies)

    Hello parents of kids who have had braces once all their adult teeth are in,

    I'm trying to get a sense if $7-8,000 is a typical East Bay rate for the usual course of top and bottom standard braces (about 1 1/2 years) when a teen has all their teeth in, including retainers after the braces.  It may be hard to compare if there are other corrections being done, but it would be helpful to get some comparison for this basic treatment.  We love our orthodontist, but this price was surprising to us.


    RE: Price of Braces for Teen? ()

    We took our daughter to an orthodontist when she was 7/8 who recommended all kinds of expensive work.  I got a second opinion from a wonderful orthodontist in Oakland who recommended we wait until her adult teeth were in.  He said that often the younger children have to have additional work done when they are older.  I love this orthodontist and the kids seem to like him too.  His name is Straty Rhigellis. 2220 Mountain Blvd.  Oakland 94611.  510 482-0600

    RE: Price of Braces for Teen? ()

    I recently got my braces off, and had all my adult teeth. I bought DeltaDental's private insurance option, the cheapest California plan, and ended up paying $2500 for my braces(including retainers), plus $120 for the insurance. We went with Orthoworks in Hercules (but they have offices all over), and I was very pleased. They offered interest free financing, and we paid them monthly until the bill was paid. I had your basic brackets and wires, and now have an invisalign top retainer, and a classic bottom retainer. 

    RE: Price of Braces for Teen? ()

    For complicated reasons, our 16-year-old didn't have her braces installed until this past February.  On the recommendation of a friend, her work is being done at the UCSF Benioff Orthodontic Clinic on Parnassus Street in San Francisco.  Why?  Because you can get top-of-the-line treatment there for half the price of a private orthodontist. The work is done by young orthodontists who already have their degrees (they are all called "Dr."), but who must work as "interns" for two years before becoming credentialed.  

    Their work is always checked -- at each visit -- by a senior orthodontist, and so you you know that you are in good hands.  Our teen is being treated by Dr. Campbell, and we could not be happier with her, or with how her treatment is progressing at the six-month mark.

    FYI, once the work is underway, the appointments are (nearly) always on a Friday.  I choose 11:00 a.m., because that way our kid doesn't have to miss her 1st period class.  I pick her up at 9:30 a.m. and we get there in plenty of time to find free parking on one of the nearby residential streets.  (I could pick her up as late as 10:00, or even 10:15 a.m., as I've never had a problem with traffic.  However,  you never know what might happen on the bridge.)  She does homework or snoozes in the car while we wait for the appointment.  

    After the appointment -- which lasts from 20 to 40 minutes, depending on what needs to be done --  it's become a tradition to stop by the Jamba Juice on Irving Street for a smoothie -- a deserved reward! -- and then we drive back to Berkeley with almost no traffic at that hour.  

    So... don't let the "distance" put you off -- except for perhaps one initial appointment, you'll never going during rush hour traffic, and it's fun to have a regular opportunity to drive across beautiful San Francisco Bay in the middle of the day.

    Feel free to email me with any questions you may have.  I've taken a lot of photos so that you can get an idea of how wonderful the facilities are! 

    lmorland [at] 

Archived Q&A and Reviews

Questions about Kids Under 10 Questions about Adults Questions about Teens & Pre-Teens See Also

Questions about Kids Under 10

ALF Orthodontics for 7 year old: Effective?

June 2013

Our dentist (not an ortho) is recommending an ALF appliance (Advanced Lightwire Functional) for our 7 yr old son. I'm unsure about this and one consult with an Orthodontist told me that it was not effective or 'evidence based'. In my research, it appears to be a cranial-osteopathy type of appliance. If you've had this treatment or know about it, can you tell me whether it was effective and worth it for a child? I'm having a lot of issues with the dentist and feeling pressured into this. She is not an orthodontist and I want to feel like I'm making the correct decision for my child's dental health. I appreciate all input in helping us make this decision. susan

I will be curious to see the responses. My 7 yr-old was given the same recommendation, and I am also skeptical. A friend said the old way of going about this was to wait until all the adult teeth were in. I can't imagine my wiggly guy with a retainer, he'll lose it in a flash! Let me know how it goes, and I hope you find a better dentist! dental mom

My 10 year old daughter currently has an ALF appliance, for about 2 years. I've seen a huge improvement in her jaw alignment and straighter teeth. She has not had any braces yet. Our dentist too is not an orthodontist, but believes in a more holistic approach. Rather than put braces on young kids for 2 rounds, she says this is a much more gentle, non invasive approach, that works from the source...subtly pushing out the bones rather than simply moving the teeth, which could cause your skull to be out of alignment. (In fact, learning about this made me wonder if I had this rather than all the braces I did as a kid, I wouldn't have so many migraines as an adult..) Keep in mind this is my layman's interpretation. In my opinion, its so much better than a retainer because it stays in your mouth all the time, and you don't feel it, and its on the inside of your teeth so you can't notice it at all. My daughter's teeth were very crooked and crowded, and I was worried about her not getting braces. But I recently was looking at an old photo and was shocked to see the huge improvements, they are so much straighter. She still may or (or maybe not) need braces after this treatment, but not for as long as she would have otherwise. There is a website you can google to read more about it. happy with ALF

Braces at 8?

April 2011

My daughter is just turning 8. Her dentist referred her to an orthodontist because she has an underbite. The underbite is significant and has been noticeable to me for a long time, even with her baby teeth. We went to the orthodontist today and he recommended braces now rather than later because the pressure of the underbite causes the lower teeth to be pushed out by the top teeth, causing the lower gums to thin and receede and the jaw to be pushed forward and out of alignment, all of which is already happening and will only get worse if not treated. Everything the ortho said made sense, he answered all of my questions competently and was not pressuring me. We are going to do it, I just can't shake the feeling that braces on an 8 year old seems strange. This is so different than in ''my day'' when braces were reserved for teens. It is hard for me to accept what I perceive as a teenage experience for my little girl. This is my issue, my daughter is thrilled to be getting braces and excited about the colored rubber bands. I am interested to hear about the experiences of parents whose kids had braces this young. Thanks in advance

My daughter got braces when she was 7, had them (and retainers) for about a year, and she sees the orthodontist once a year for a checkup to make sure everything is still ok (she's 11 now). The early braces were great - she was excited to have them (they come in cool colors now), I guess her teeth adjusted quickly - maybe because she is younger?, and now she doesn't have to have braces as a teen, which I can tell would be a more negative experience (socially). Money well spent, problem solved early! Good luck! anon

I also got my braces at age 8, for the opposite reason, an excessive overbite. You couldn't see my bottom teeth at all when I smiled. I had my braces from 5th (1989) to 9th grade (1993). I was so excited to get my braces because I would have something to show off at school. Actually most kids in school with me got their braces at this time or soon after. I really liked going to the office because it was decorated so colorfully and I could change the color of bands each time. Although it hurt for the next day after tightening for the most part I liked the special attention I got from my parents and peers. The day that I got them off was also really amazing and to this day my dentist tell me I have exceptionally beautiful teeth! - anon

My son got braces at eight years old and many, many of his classmates have or have had them. Thank goodness we did, because his problem could not have been corrected later without pulling one or two permanent teeth. Glad we solved the problem early

Yeppers. As an old timer with the teen- ''4 on the floor''(yank the first molars to make room)-style orthodontia, and now two 9-year-olds in palate wideners and braces, I know both routes. The early application style braces are FAR FAR superior to our old yank-to-make-space-after-all-the- damage-is-done system.

As an old timer, I can tell you that the teeth want to drift back to their old positions. I have gaps where they pulled teeth to make the rest fit, and I have horrendous bite issues. Pulling teeth changes the pressure that the other teeth must bear. Not a good thing. It's a giant PIA to live with. If you start early, the teeth will more likely not drift to old positions. The outcome will be better since the jaw will not be pushed around. Bad ''habits'' like teeth grinding due to misalignment will be halted while those habits are still forming.

I also urge you to have them assess your daughter for space available. A disturbing number of orthodontists here still advocate pulling teeth. If you wait until the teen years to assess for that, then she'll HAVE to have teeth pulled. You want to avoid that. Wendy

I understand it might seem odd to have braces so young but I think it is great that you were referred by your dentist to an orthodontist at a young age.

I knew at young ages that my 2 children would need braces, but we waited (at our dentists recommendation) to see an orthodontist until their last molars were in. I wish that we had visited an orthodontist for a 2nd opinion when they were younger. By the time we saw the orthodontist my daughter already had an impacted molar, that had to be pulled, due to over crowding. Luckily her wisdom tooth has filled that space nicely, as planned. My son had to have his palate widened. That process is easier the younger you are so starting sooner would have been preferable. Both children were in braces for longer than they would have needed if they had been seen at a younger age.

The other thing to consider is the attitude of an 8 year old vs a 13 or 14 year old. It is great that your son is so excited. My children we accepting, at best. It was a real power struggle to get them to take proper care of their teeth and to wear their rubber-bands and retainers. At a younger age the treatment would have been more under my control and their willingness to receive assistance would have been much greater. I now know several kids who did braces between 6 and 10 years old and they all seem much less resentful of the experience than my children. I think that this new trend of braces at a young age is due simply to new understanding of how teeth work and when certain corrections can be made. It makes sense that if you make changes younger when bones and teeth are still developing that it will be easier and have a better outcome.

The one other piece of advice I have is to get multiple opinions on the treatment and have the entire process explained (the why, how, who, where). It is worth it to choose an orthodontist that you are 100% comfortable with and who is willing to take the time with both you and your child to explain what is happening. Live, Learn, Share

I had braces when I was 8 (it did seem uncommon 35 years ago, but not now) and it was nice to have it taken care of before the awkward teen years! I don't remember being teased, etc. The only thing was that because I had it done so early, some of my teeth moved back. I would just help your daughter be vigilant about follow up care. I was not! Again, I think it's more common now to have braces earlier...a friend's son is getting them at 8 also. I wouldn't worry about it!

I had braces when I was 8 (it did seem uncommon 35 years ago, but not now) and it was nice to have it taken care of before the awkward teen years! I don't remember being teased, etc. The only thing was that because I had it done so early, some of my teeth moved back. I would just help your daughter be vigilant about follow up care. I was not! Again, I think it's more common now to have braces earlier...a friend's son is getting them at 8 also. I wouldn't worry about it!

This is an anecdote, and, as they say, an interesting story proves nothing. Still, here we go.

By the time I hit 20, I had had braces or para-braces (retainers, spacers, etc.) in my mouth for 12 years. My orthodontist (A creepy older guy with a Gull Wing Mercedes that only hired female staffers and rarely appeared to do anything personally) gave my parents and I the ''Well, the braces got his teeth straight but they moved so we have to start all over again. Make an appointment up front.'' speech. Four times. The ''Hang in there, baby!'' poster of a kitty gripping a tree branch on the ceiling of his office is now burned into my brain like a cattle brand. Finally I wound up getting an operation to shorten my jaw. Now part of it is permanently numb.

To be honest, I would have rather they waited. I get the whole ''There's a risk of this or that if we don't get right on this!'' thing, but there are quality of life issues for the kid too. No, ''Dental Wax'' doesn't do squat to protect your cheeks. My two cents. Former Braceface

I had braces for a severe underbite, but this was in the 80s... so they didn't put them on until I was 11 or 12. That meant I had them through the awkward preteen/teenage years. Looking back, I would have rather had them earlier! But from what I hear these days the thing is to do braces twice... once around 8 and again in the teenage years. Personally, I don't get that and as the kid getting the braces, would rather have just dealt with it once rather than twice! Keri

Our child's pediatrician recommended we see an orthodontist, and our daughter had braces at 8. They worked well, although she needed some form of retainer through her teen years, when the cheekbone area and jaw grow so much. ''Early orthodontia'' has been around since the '90s in Berkeley, at least for kids who have noticeable underbites. The rationale is to treat them early so that nature can take its intended course. I hope you'll get comfortable with it. Mother of a 35-yr.-old

Hi, my two cents is to not get orthodontics for your 8 yr. old. I feel very strongly that these days health services are geared towards sales, and that this is wrong. Even when I was a kid, my childhood dentist talked my parents into getting orthadonture for me-- I was also 8. I had yet to have a mouthful of adult teeth. The excruciating pain, and inability to fully understand what the heck was wrong with me in the first place, really scarred me. I also had to have braces and wear a retainer as a young adult. The horrible, maddening pain of braces and spacers--completely immune to all but the most deadening and excessive pain killer use--is something that I feel should not be put upon a child. Unending, inescapable, unrelenting physical pain for long periods of time is seriously damaging to a child's pysche. Please hold out, wait and see how the teeth develop, and when all adult teeth are in and your child is more self reliant...Then maybe your child can determine how the teeth feel and if it is necessary. Kids' teeth move an incredible amount!! It is all related to overall body and bone growth, habits, etc. There are more factors at play- - take a holistic view. At 14, my teeth were grown in completely different than predicted. And I had to go through the whole thing again. Thanks for posting your question--I wish my parents had been able to get advice from someone other than the dentist! Children should be able to control what happens to their own bodies.

I am 45, just to give you context on the ''back in my day''...and I got braces when I was 7. I had a severe under-bite and a cross-bite, but my teeth were for me, I had braces on my front 2 teeth and back tooth on either side with holes in them to hold a headgear. I think that working on a ''bite'' when one is young makes sense. I think that if you are trying to straighten teeth...then you might wait until the ''adult'' teeth come in. Just my best guess

My daughter got braces when she was in first grade (six years old), also for an underbite. At the time, I got a second opinion from my own dentist, who confirmed that this is a problem they like to fix at this age so it doesn't affect the other teeth when they come out. She wore the braces for seven months and now her teeth look great, though depending on how things go, we may be in for a second round later. She was a total celebrity at school for being the only first grader with braces so no issues there, and she liked changing colors every month--often she went with seasonal themes (red and green at xmas, orange at halloween, etc). Overall, I'm glad we did it. Aside from looking so much nicer, the realignment of her teeth also fixed her chewing issues: she was so used to having the severe underbite that even with correction she would often jut her lower jaw out while eating because that's what she was used to. Good luck! Braces at 6

My daughter got braces at 8 for a crossbite and crowding. She is now 10 and it was one of the best decisions we ever made. The results were fast and dramatic and now beautiful adult teeth are straight. I accept that she made need them again in middle school because as the rest of her teeth come in they may not be straight. But had we not done the braces at 8 I can't imagine what she would look like and at 10 I bet she would not want to smile and it might have affected her selfimage. Also my dentist told me that if you wait to correct the ''bite'' issues later its much harder because the bones are more sokid and harder to move. anon

YES! Braces at 8. Follow the professional's advice. We did and I am thrilled that my son only had to wear braces for 6 months & retainers for one year. (Not all results may happen so fast) but it was better than my personal experience years ago as a teenager. Now he is going to be a teenager and has beautiful straight teeth!! I know it seems odd, but it really does work this way. Surprised parent of braces for 8

It does seem really early, doesn't it? Especially if all the baby teeth aren't out. That said, my now close to 12 yo had a terrible cross bite and an overbite and the braces went on at 9. Scary bottom teeth, too. Braces are now 'cool' in elementary school and 24 months after the whole thing started, her cross bite and overbite is gone and she's faithful about using the upper retainer. Not all of the baby teeth on the bottom are gone; this has become a problem as othodont cant fit the lower retainer till they drop out. The theory now is that starting earlier means the jaw, palate and other structures are more plastic and move into shape more easily. However, you may be better off waiting a bit longer so that all the adult teeth are in best position. good luck with your decision. daughter's beautiful smile

My daughter has had braces twice. She had her first set when she was about your child's age. I also was surprised at the seemingly young age of onset. I sent all of the paperwork and diagnoses etc to my oral surgeon father who completely agreed with the decision. So she had braces at a young age and then she had her second set in middle school. She has gorgeous teeth and i am happy with our decision to follow what the professionals recommended. Good luck. anon

It's wonderful that your daughter is so enthusiastic about getting braces. My children are a lot younger, so I don't have to worry about them getting braces just yet. I had braces at 8 years old, in 3rd grade. I had an overbite and very crooked teeth on the top and bottom. I think it was okay for me to get braces at a younger age because most of my permanent teeth had grown in.

I wore my braces for two years and then was pretty disciplined about wearing a retainer all day and night for another 2 years. By 7th grade, I was done and have had straight teeth since.

At times it was hard being one of only a few students with braces in elementary school, but by junior high I was so glad I didn't have to wear them anymore while most of my classmates did. Braces are a lot tinier and even cuter now than they were 25 years ago, so your daughter probably won't have too hard a time adjusting. Just remember to give her some Tylenol or Motrin for the pain/soreness just after getting them or having them adjusted. - Easy Smile

I don't know if this has anything to do with your reluctance but I want to tell you that NOTHING is more important to appearance than a smile full of clean white straight teeth. Appearance does matter, like it or not. And with a great smile, you can wear cheap clothes and you will still look terrific.

My kids had orthodontic treatment in elementary school. It worked out great! They are adults now, and their teeth are beautiful. I think in some cases the problems are easier to correct if they get braces early. Also, children are less resistant than teens. If I had it to do over again, I would do exactly the same thing. anon

Yup...this is the age they start braces now. My daughter is 9 and got a retainer (spacer) at 8 1/2, and braces a few months ago. Her teeth were very crooked with a big gap in the front top teeth. They look nearly perfect now, just 3 months after putting the braces on. At this age the mouth and teeth are MUCH more pliable and move quickly with orthodonture. We've been warned this may just be Phase 1, and she may need more at an older age, but I'm very impressed with the improvement orthodonture has had on her young mouth. heidilee

Braces for younger kids are much more common these days. My son got them when he was 9 and at least 3 other kids in his class already had them. I too remember kids getting braces in Jr High- not 3rd grade! It seems like your daughters case is more than just cosmetic and I'm sure you've discussed all the reasons for early treatment with your orthodontist (bones are more malleable,bite is more easily corrected,etc). Keep in mind that she'll likely have 2 phases of treatment- braces on for 1-2 years now and again when she's 12 or 13. My son had a noticable overbite and crowding but within 2 months there was dramatic improvement. You'll be shocked at how quickly her teeth and jaw will move. Overall we've been very happy with our decision to get braces for our then 9 year old. He's glad that his teeth are nice and straight now as he enters Middle School and I think his confidence has improved too. Your daughter will thank you later and I'm sure she won't be the only one is school with braces. Besides, braces are cute

Orthodonture at 7?

May 2010

Hi there, We just got a recommendation for extensive orthodontics for our nearly 8 year old, (18 months, retainers and whatnot, 4k) and while I'm going to get a second opinion etc, I'd also like to ask the community the following questions: 1. If you went ahead with braces, retainers, etc at this early age, did your child have a reasonable experience or was it a fight all the way? When I had braces as a child (4000 years ago in medieval England) it was extremely painful. I remember crying myself to sleep. My kid is a sensitive plant already, I'm not sure I have the emotional strength to deal with it, to be honest. 2) Having done a lot of work with your younger child, did you still need to do braces in their teens, and in retrospect, do you think the first round of work was worth it? When I check the archives I read a lot of posts about teeth moving back, or the second round (in early puberty) being not really helped by the first. And finally, 3) if you DIDN'T do the orthodontics at 7 or 8, what do you think of your decision now? I am not in any way looking for perfection, hollywood style, I just want her to have straight teeth and not the gothic graveyard of her british ancestors. The money is irrelevant if it works, and not if it doesn't, if you follow me. Thanks in advance for your advice

I will offer my 2 cents. At 7, my son had a crossbite. The orthdontist recommended braces just accross the top 4 front teeth and extraction of one baby tooth to correct the problem. I was hesitant to start at such a young age, and if the issue had been solely cosmetic, I would not have done it. That said, I was convinced that doing a smaller amount of orthodontia early would prevent the need for a greater (more painful) amount later because a) at 7 the palette hasn't hardened yet and the teeth move more easily and b) we would be able to prevent adult teeth from coming in crooked.

He had the braces on for 8 months, his teeth straightened up beautifully, and now he is in a retaininer with checkups every 6 months. I think we made the right decision. If you are not comfortable or convinced about the course of action recommended, you should either wait and see, or get a second opinion.

From my experience, orthodontics at around 7 is pretty common. My daughter was one of the first in her class, but over the school year many followed. We visited two orthodontists; they differed a bit on how many teeth to pull to get started. The point of starting early is to limit the amount of time she has to wear braces later. We'll see. A mom

Please OH PLEASE get a second opinion, and a third, and a fourth before getting braces for a 7 year old! My parents did this and many dentists I have had have told me that it was a complete mistake. The 7 year old can't argue- I can! All of my baby teeth were pulled, plus adult molars- leaving me with four molars on top and bottom. This caused the jaw to develop incorrectly. We shall NEVER know what my face was supposed to look like. I have a tiny mouth and pointed chin, but the understanding now is that the jaw grows to accommodate the teeth, so taking the molars out before the jaw had developed CHANGED my bone structure. My former husband's jaw grew well into his 20's (normal male growth is until around age 23), his early braces set his bite for his small adolescent mouth- 10 years ago he was told that the only way to correct it, would be to break his jaw and start over. So he has an under-bite. Maybe there have been more advancements since he looked into treatment, but that's the last I heard. Teens have a greater understanding of pain, and tools to deal with it. At 7, I didn't. Treatments HURT! Tooth extractions HURT!! Why were my parents doing this to me? Didn't they love me? Why did I have to go and sit still while the orthodontist stuck his GIANT male fingers in my mouth every other month? As an adult I have overcome fear of dental treatments, but TMJ that I'm sure was exacerbated by having my mouth open large enough for his hands to get into will never go away. Please don't do this. Many orthodontists are just trying to make a buck. My current dentist was trained at the California Pacific School of Dentistry, where they advise STRONGLY against early orthodontics. Please take your child there for an evaluation before proceeding. There may be a reason for doing this, but I really doubt it. Abused for an aesthetic ideal

Does early intervention lead to better long-term outcomes?

Jan 2010

My son has a cross bite and two teeth that an x-ray shows are coming into the roof of his mouth. The orthodontist we went to recommended a palate expander, oral surgery (to access the as-yet-erupted teeth) and then braces to use to pull the teeth into place. My question is, why go in and get the teeth when they will erupt later? And what's up with ubiquitous use of palete expanders? And why do children generally seem to start orthodontia so early these days? I guess what I'm looking for is an experienced or perhaps alternativey (less-is- more-type) East Bay orthodontist who has been around for a while and get give me a second opinion about how to proceed with my son. And also any wisdom/reflection on the shift of orthodontic care to pre-double digits. Is there any research saying early treatment leads to better long-term outcomes? Doesn't time heal some things?

We would recommend a second opinion from Dr. Righellis,510- 482-0600, my daughter's Orthodontist. She has a different problem but he's always been honest and given us straight advice. He's in Oakland, Montclair, and sees many, many kids. He was highly recommended to us when we did our search. Susan

My daughter got her braces off three days ago, so I am equipped to answer this question. First, earlier braces is good. The kid's mouth is developing during the 9 and 10 year old period, so braces will help it develop in the right direction. The alternative is more braces, for longer, when the kid is a teenager. The palate expanders improve the look of the face very dramatically and allow teeth to get into place evenly, without crowding. Crowding looks awful and leads to difficulty with gums later on. I've also dealt with periodontics in adults- you don't want to go there either. Please go ahead with the braces, palate expanders and all. Orthondontics Mom.

I do recommend that you try to get another opinion and obtain information on the implications of not doing anything at this point. I don't have a specific orthodontist to recommend, because like you, and just about every parent I know in the East Bay, have 2 kids who went through all kinds of orthodontic treatment. We did not follow the more invasive recommendations from our orthodontist. We did not extract our younger son's teeth (we did do it for our older son) and did not surgically expand our older son's lower jaw. These were both recommended to prevent problems in the future. I have the benefit of having parents who are both dentists (including a pediatric dentist) so we did have someone we could run our options by. The older school approach is to be less invasive and to do less extractions. One of the reasons is that teeth actually help bone growth and extracting teeth may inhibit bone growth. Another is the ''wait and see'' and do when you really need it approach. The current style is more invasive and there are arguments on this side as well (earlier intervention is better and prevents more problems, like TMJ, later on). Personally, I wonder if the financial benefits for those recommending the procedures also influence the recommendations. had it with orthodontic treatments

Run, don't walk to Robert Iezman's office in Berkeley (around the corner from Peets on Walnut St. (510) 845-3511. He will give you a complete evaluation and tell you what needs to be done now, what can wait, what does/doesn't need to be done. He will give this to you in writine, with a full plan written out. I think he is conservative yet does right by the children (and adults) that he sees. He will not pull adult teeth to ''make room'' as many others will do and has now been shown to cause problems down the line. My daughter also had a challenging mouth and she is now beautiful with a beautiful smile. former patient

Sounds like you're ambivalent about orthodontics. That being the case, I would wait and see. I've decided to try to avoid orthodontics with my kids. I went through the usual orthodontics stuff when I was a kid, and I ended up with a bad outcome: my jaw shut down and moved to a new position, such that my front teeth couldn't meet anymore, and I ended up getting upper and lower jaw surgery and having my jaw wired shut for 7 weeks when I was 17. I used permanent and removable retainers for a decade after that, to keep my teeth in their pretty, lined-up positions, and still, when I stopped using the retainers, the teeth inevitably moved back to crookedness. And now I have serious jaw joint issues from the repositioning of my jaw. In other words, what a disaster. I'm sure a lot of people have better outcomes, but to my mind there need to be benefits beyond aesthetics for the risks to be worth it. Also, thanks to my German husband, I have a wider perspective on orthodontics now. This obsession with straight teeth is an American thing. In Europe, getting braces is the exception, not the rule. So they have crooked teeth, so what? My husband has really crooked teeth, but I couldn't care less. So orthodontics are not in my plan for my kids. If they want to do orthodontics as adults, that's up to them. orthodontics is optional

8-y-o's mouth too small - OK to leave it alone?

May 2008

My 8 year old daughter has been seen by two general dentist practitioners who have differing opinions on what to do about her teeth. Apparently her jaw is too small for her teeth. One view is to pull teeth out and the other is to put appliances in to open her jaw up more. I'm not excited about pulling teeth but I'm also not crazy about her having appliances in her mouth until she is a teenager. We were told that once you stop using the appliances the jaw will move back into place. At this point her teeth are a bit crowded but not terribly. My inclination is to wait and see and if we still have to do something when she is a teenager, we can do it at that time, rather than starting now and doing it for so many years. Curious about others experiences and advice.

I don't know if our situation is the same as yours but I thought I'd share our experience. When our daughter was about 8 we visited an orthodontist for the first time. He said her palette was too small to accommodate all her teeth and a crooked jaw prevented her teeth from aligning. On his recommendation, we had a device installed in the roof of her mouth that was adjusted periodically to open the palette as she grew. I hope I'm describing this correctly--He said that the tissue in the middle of the palette is malleable when children are young and that the device allows for the palette to widen as the child grows. If you wait till the child is older, that tissue fuses and at that point widening the palette would involve breaking the bone. I think this is why now days it seems so many young children are seeing orthodontists before they are teens. Our daughter's treatment consisted of two phases--the first being the widening of the palette when she was young and the second bei! ng more conventional braces when she was 12+. Additionally, she did have to have a few teeth pulled, which didn't seem to be too painful for her. Her braces came off a couple of months ago and she now has a beautiful smile. Good luck. maria

I needed about 5 teeth pulled as a child d/t a small mouth - I think I had it done around age 11 or 12. They seem to do dental work a lot earlier now though. I remember it really wasn't a big deal, I didn't have any problems with it physically or psychologically. I think it would be much more difficult for a kid and their self-image to have to wear appliances all the time. Pulling teeth is a little uncomfortable, but you heal in a week or so. You may want to get a few opinions as I've found dentists vary widely in the procedures they think are ''necessary''. good luck

Let me tell you about my personal experience with this. I also have a small mouth. As a kid, I had four teeth removed and then I got braces. Even after two years with braces, once they came off, my teeth moved again because there still wasn't enough room in my mouth. (so some teeth went behind others.) Now, 30 years later, I have gum problems. The dentist told me that having the teeth removed and having the teeth move so much to fill in the gaps basically made my teeth fit looser in my gums. So I am more prone to pockets and that means deep cleanings and more risk of periodontal disease. I have often wished the expanders were around when I was a kid. I feel like I might have avoided these gum problems if I had done that instead. As for when to do them, just this last weekend an orthodontist told me that you have to do expanders when kids are young because that is when the bones in the mouth are more malleable. She said its like the soft spots on a baby's head. You ! have similar soft spots in the roof of your mouth, but they do harden up by the teen years. So you want to do the expanders while the bones are still soft. Maybe ask your orthodontist about that and see if its true. just my experience

Our experience: At 8, daughter got a jaw-stretching appliance, as well as short-term braces (just for a couple of months) just to straighten a few upper teeth. Despite not wearing it as much as prescribed, the appliance seems to work remarkably well. Over the next couple of years, her teeth looked great. When we temporarily went to another ortho (because we were out of town), they were amazed at the results. Then, she started her pre-pubescent growth spurt, and grew a lot. My impression (completely non-professional) is that the appliance began to seem small, and should have been changed or adjusted or something. The ortho never suggested this - just saw her every one in a while, waiting for the ''next phase''. Finally, he said the teeth were too crowded again, and she'd need several teeth pulled. We went for second opinions - one said only jaw surgery would help in the long run, and pulling teeth would have bad effects (can't remember the details). Another thought that maybe braces an! d/or teeth-pulling would help some, but agreed that jaw surgery was the only way to get everything right. However, neither thought the surgery was essential to function at this time. In the end, we decided to leave her teeth as it (some crowding is evident), and if she started to get any jaw pain, address it then. That was about 5 years ago. So far (age 18), no problems. I always suspected that the too-small appliance wrecked the early progress, but then, what do I know... former ortho mom

I have a small mouth but also happened to be the fifth child in a single parent home. My mother could not afford orthodontia for me. I am now 40 years old and still suffer the ill effects. My jaw placement is highly screwed up. I have TMJ. I suffer from chronic headaches that can get quite severe. I have neck and facial pain and chewing issues. Whenever I have work done on my teeth (i.e. fillings, root canal, etc) I have bite issues that seem to take forever to resolve. I have had my jaw lock.

I don't know if the answer is to wait until she's a teen or start the process now, but I would highly recommend that whenever you decide to do it, that you do do it. I really wish that my issues were taken care of. I don't like the chronic pain and the knowledge that there really is no resolution for me at this age. I would think that pulling teeth would be the last consideration, that creating more room with apparatus would be a good place to start and then you can decide if teeth still need to be removed. anon

My son's dentist reccomended an orthodontist for the same reasons. The orthodontist has pulled 3 baby teeth so far(on 2 separate visits) to make room for the permanent teeth to come in straight. The xrays clearly showed the teeth were on their way down crooked and they came in straight after the baby teeth were out. One of them dropped into place (full sight) the very next day! Personaly, when I was 12, I wanted / needed braces. My dentist pulled a permanant tooth to make room for the others to spread out. I still have one very crooked tooth and have trouble getting floss in & out...but you can't see where that tooth was & it is all tight in there. Maybe he should have pulled 2? I think preventing them coming in crooked is wiser. Less $ too! BTW, my son was sore for a day but he could eat and he is big tooth 9 now! I think we may not need braces...whhheeew! annie

I had to wear appliances when I was young due to a very narrow overcrowded mouth (A Frankle and some other kind). It was annoying at the time, but it really helped things a lot. My mouth did not revert back to its narrower size after I stopped wearing the appliance. (And I stopped wearing my retainer post-braces pretty quickly too, without major consequence. I wore mine mainly in middle school-- but my teeth were insanely late (lost first baby tooth at 7, lost last baby tooth the day before I started high school!) One advantage to waiting until she's a bit older is that she may be more responsible with taking care of it (I expensively lost mine). One disadvantage is that wearing the appliance, depending on the type, can be pretty unflattering-- one of mine gave me ridiculous chipmunk cheeks. Having to wear something like that in high school, when at the age to maybe start dating, etc., might be really tough. good luck! Molly

I already posted once (the growth-spurt-messed-things-up post), but wanted to clarify that the ''appliance'' my daughter wore fit entirely inside her mouth, and she only used it at home - never at school, etc. It made her look like her mouth was a little large/puffy, but you couldn't actually see it unless her mouth was wide open. She was supposed to sleep with it, but that made it hard to breath, so she often didn't. So it's not like the ones that are visible on the outside and worn at school. I don't know which kind is being suggested, but that might make a difference in your decision. anon.

Palate expander for 6 year old?

Oct 2007

Hi, Has anyone researched how effective palate expanders are compared to traditional braces? My six year old has a normal bite but his incoming adult teeth are a little bit crowded so our new dentist wants to install palate expanders. I am wary of this since it seems an extreme measure for such a small problem (my son has no headaches or breathing problems) and because I read some articles that said that braces would still be needed in the teen years even with the Stage 1 expanders. If you have any information or advice on this issue, I would be most grateful if you would share it - Thank you! Patrick's Mom

Both our kids were fitted with Stage I expanders. My younger son had expanders with the hopes that it might improve his breathing capacity. He has a small jaw and a deviated septum and allergies. There is no guarantee that Stage I will alleviate the need for Stage II braces. Despite the Stage I work, my elder still required braces for one crooked tooth; too early to tell with the second. I was told that with Stage 1 expanders, one can expect that braces will be in a shorter time (1yr) and usually not necessary to remove any teeth since the jaw has been enlarged. If you can afford it, any orthodontia work you do now, rather than later, will be easier and less painful while the child is still growing. It's important to have an orthodontist that you can trust. Hope this helps. Signed, Stage I Orthodontia Twice Over Parent Paying for ''Big Smiles''

Both of my children have had retainers at young ages (5, 8) and the benefits seem worth it. My son wore his for six months primarily for a crossbite but also to make more room for adult teeth. My daughter used one for more of the expander reasons you state. It worked miracles for my son and now four years later he has the room for all his teeth. For my daugher, it was also great - no need for pulling teeth or there not being enough room. She did go on to have braces, and it is unrelated, though went more smoothly because of the expanded mouth. We go to Berkeley Orthodontics and think they are great. jv

I don't know if palate expanders have changed much but I had to write and say when I was a child I had one (25 years ago) and it was a TERRIBLE experience-I mean TRAUMATIC. My mother had to sit on me and hold me down while she turned the key thing and it was painful and horrid. I would border on saying it was PTSD worthy. AND my teeth went back to exactly the way they were so it did nothing. Sorry for the terrible story-I hope, REALLY hope, your child does not really have to get this thing! mw

Our 6 yr old also has a palate expander for a crossbite correction and also to help with crowded teeth though the crossbite is the main issue for our son. My understanding is that the better the teeth grow in to begin with, the less correction they will need as a teen, which means fewer braces, less time with braces, or both, as a teen (eg: possibly braces for just one year instead of two!). I also have heard that even after braces, teeth always want to migrate to where they grew in, which means use of a retainer. But a lot of teens and adults never use their post-braces retainers so their teeth migrate. If the teeth grow in better to begin with, there is less potential for migration (because less correction was needed via the braces). I don't regard palate expansion as drastic at all. The bones in the palate are not fused until.... I forget, age 8 or 9 or 10 or something like that --- so they are maleable. So the palate expander is making use of an opportunity to shape the mouth to receive the adult teeth better. I like the palate expander approach. After 6 months we are seeing positive results already with the palate expander. Our son has been extremely cooperative in wearing his retainer and brace. I can only wonder if he would be so cooperative as a teen! anon

Orthodontia for 7-year-old with overbite?

June 2006

Today at our 6mo cleaning our dentist recommended taking my son in to an orthodontist to be checked because he has an over bite. I have no doubt he will need braces... both my husband an I had them, and all of our siblings (that is 8 kids total)... I just wonder if 7.5 years old is too young to begin orthodontics. He only has 6 adult teeth. When I was a kid we all started in 4th grade... but I thought that people were beginning treatment older now days (pendulum swing and all that). Am I off base, is it common to start treatment this young? How young is too young? concerned mom

Actually, it's quite the opposite. Orthodontics generally takes place at YOUNGER ages than when we were kids. They kind of figured out the obvious - -- if you correct the problem while kids are growing, it's easier than correcting after most of their growing is done. Good luck! I bet it's easier than it was for you.. Sabrina

Hello, Your question brought a smile to my face as I remembered how jealous I was of my 7 year-old brother's braces many moons ago. It wasn't truly a full set of braces but a preventive sort of brackets-on-the-front only rig. It was on briefly and he never needed actual orthodontics as a teenager because the teeth had been helped to grow in straight in the first place. He's now 34 with a beautiful smile really wanted braces

I can't speak to whether treatment can start at 7 years old, but our orthodontist sees children at 7 (when they have lost, at least, the two top and two bottom teeth in the middle) to evaluate. He says that he is looking for things like signs of crowding, palette size, tongue-thrusting, and jaw malformation. I trust his judgement - he is considered an excellent orthodontist - and he definitely not looking for income Earlier the better

My son started his orthodontic journey right around his 8th birthday, also with only 6 permanent teeth. In his case, he had an overbite and crowding. Starting early can be a benefit for some situations. We went to the orthodontist that our dentist recommended and we were able to get a free evaluation. It's not unusual to start early and it wouldn't hurt to just check it out. You can always decide to wait Ruth

Our daughter, who had a pronounced underbite, started seeing the orthodontist at age 6, during kindergarten. In her case, the orthodontist said that although she didn't yet have all her adult teeth, they did not yet need the adult teeth for their strategy, which had nothing to do with straightening her teeth (in which case you do want all the adult teeth present) but everything to do with getting the alignment of her jaw corrected while in the ''malleable'' stage. They did profess that with the underbite it is always monitored throughout the body's growth stage (which extends through the late teens) but their opinion was that she was ready and able to benefit from early treatment.

I imagine treatment for an overbite might have a similar rationale. In our case her molars were fitted with bands and her palate expanded with a fitted retainer, both of which were quite manageable even at her young age. THe retainer needed daily manual adjustment, but that was easy once we got used to the process. Today she is almost 9 years old, has a normal bite and is in a holding pattern with her ortho treatments-- once all her teeth come in we will start to straighten them. During this holding pattern we are not paying anything--we have essentially paid for the work done to date, a ''pre-Phase I'', and see her ortho about once a quarter for 15 minute checkups.

I would recommend you get at least three opinions, ask many questions about your options (later treatment vs. earlier) and come up with something that will also suit your child's maturity and individual personality. Be sure you understand the financial obligations and the doctor's willingness to time them with medical spending account if you plan to use one. good luck! carolyn

I am glad to hear that your dentist is sending you to an orthodontist now instead of having you wait. I wish our dentist had not said, \x93You can wait to see an orthodontist until all their adult teeth come in.\x94 For my daughter this advice led to an impacted 12-year molar that had to be pulled and several cavities due to crowding. For my son it meant a longer time expanding his pallet to correct his cross bite and he has some irregular ware on some of his permanent teeth due to the untreated cross bite. It is hard to know the true cost of waiting but there is no doubt that early intervention would have

I certainly recommend getting treatment plans from several different orthodontists. We go to Berkeley Orthodontics and chose them, despite the high price tag, mostly because they didn\x92t want to pull a bunch of my daughter\x92s permanent teeth. Only the impacted molar was extracted. We are half way thru treatment with both kids and are very happy with the care we have received. There are also many other orthodontist recommendations on BPN and I am sure your dentist has someone to refer you to. ----- Wish I knew then what I know now.

These days some kids get orthodonticsin mid elementary school cuz (from what I hear)their palette isn't set yet and moving the palette (expaning it, etc.) sets up the teeth better for later work. However, you should get at least three recommendations from three different orthodontic offices. Does your dentist like one or two in particular? It helps to have your kids two tooth proessionals get along. Opinions may varry as may expected costs Anon

Palate stretching or not?

Aug 2003

My son has had a consultation visit with two diferent orthodontists in Montclair and we had received conflicting advice. One says that he should have his palate stretched and then get traditional braces, the other says no, he does not need that step. My personal dentist says that palate stretching is a common precedure these days, and leads to a stronger arch. But he is not an ortho, and can not advise me on whether my son needs this done. The other ortho says that she can stretch the palate a little bit while having traditional braces on. Palate stretching will add about one year onto his wearing braces and of course add on many more appointments and discomfort. Traditional braces for two years will be about 30% shorter, but will the outcomes be of the same quality? This question nobody seemd to be able to answer. Has anyone gone through is who can give me advice about what they would or would not do over again? Thanks inadvance. Helene

We did do palate stretching with our daughter when she was 8. In retrospect, I don't think some of it was necessary, so much as cosmetic. I also felt that it changed her face in a way - hard to describe, but I miss the more childish look she had before. My son has had braces, retainers, etc. and I felt that his were more necessary - big overbite, ''buck'' teeth, etc. I had braces for years as a kid, and I hate to subject my kids to the same experience, but I don't feel that parents are given much information about the consequences of waiting or skipping it altogether. similar perspective anon

I had my palate stretched as a child and for me also, it changed the way I look. Because of it I have an overbite and my chin looks weaker, and the crowded tooth they were trying to straighten went back to being crooked anyway. Of course I don't know how my mouth would look if I hadn't had the procedure done. My friend's daughters (now adults) had teeth extracted instead and they look great. good luck

I agree that palate stretching may change a child's jawline, but that may be a good thing in the future. My orthodontist recommended palate stretching for my son because his jaw was so small that the orthodontist would have had to pull many teeth. He explained that when my son reached adulthood, his jaw would look too small because of the loss of teeth in childhood. My husband, who passed this small jaw problem onto my son, had traditional orthodontia when he was a child. His jaw is definitely too small for his face. I believe he would have a much stronger jawline today had the palate stretching option been available to him. I suggest talking with the orthodontist again and finding out why he has suggested palate stretching. If it means losing fewer teeth, your child may end up with a much nicer looking profile. Maria

Orthodontia for 9yo - cosmetic? too early?

August 2003

My son (nearly 9) is about to begin a course of orthodontic treatment. I have no doubt about the need for it -- it's easy to see the permanent teeth are not coming in right. However, I have a few questions, which I'm hoping someone out there can help me with. Neither my husband nor I ever needed any orthodontic work.

I have a feeling that the orthodontist may be inclined to go beyond what is necessary for the fixing and do cosmetic work (to make things ''perfect'') that we wouldn't otherwise elect. I've heard California is actually unique in the country in terms of the high rate of orthodontic work. How can I tell if this is happening?

my second, and MAJOR question is: I've also heard that orthodontic work done early can be responsible for major headache problems later. Does anyone have more information about this? Anonymous

I do not know if early orthodontic causes headaches or similar problems. when I was 8 my orthodontist recomended that I get braces and head gear. my mother said no, so I got the braces when I was 12 (most of my friends got them around this age too.) However I asked my dentist as an adult if there was anything I could do for my overbite (I have nice straight teeth, but an unsightly overbite) he told me that that the only way I could have truly fixed my overbite would have been to get orthodontic work around the age of 8 or 9 when the bones are still soft. Once the bone hardens some procedures are impossible. get a second opinion and find out exactly how they plan to shift and straighten his teeth, and wich procedures can wait or are mabey not necesary.

Conflicting orthodontic advice about treatment

Sept 2002

I have taken my 9 year old on 2 ortho consults with 2 different recommendations. The first (Nelson/Meyer) was to use a spreading type of retainer to make more room (althought he already has fairly good spacing), and then braces for a short time to pull the front teeth back together. The second recommendation (Brennan)was to only use a retainer to pull in the 2 front teeth since they are slightly flared and would be better protected. When I told the second about the first recommendation, he stated that that dentist follows a theory/philosophy started by an orthodontic dentist in the mid- west and that he doesn't necessarily agree. He feels that you really have to wait to see how the permanent teeth come in. Has anyone gone through this process? Any thoughts or ideas would be greatly appreciated. Did I mention that the first path was almost double the price? Gratefully, nancy

I had a ''retainer'' that split my upper palet in the late 1970s when I was 13 years old. Basically, it splits your upper jaw apart and skull apart and, if held in place for 6 months, cartiledge fills in and the retainer can be removed. My front teeth were split apart far enough to fit lunch money in between them (which was 60 cents back then !) If this is what the first orthodontist is suggesting (and I couldn't quite tell if it was), let me tell you how excruciatingly painful it was. Now that I have beautiful, healthy teeth and gums and the likelihood of keeping those into old age, it was worth it. However, I really needed to have it done. If your son doesn't really need to have it done (and usually it is because the permanent teeth are too big for the jaw), I wouldn't do it. Get a third opinion and have each of them explain to you in great detail exactly what is involved, how it will help, why it is or is not needed, and how painful it is. While orthdontia is likely to have changed since then, the pain might not have. anon

How does orthodontia affect 8yo's whole body?

April 2002

My daughter (almost 8) is about to start an orthodontic treatment in dr. Iezman's office in Berkeley. I was surprised how extensive the treatment is: stretching her upper and lower jaw with braces and wearing a ''head gear'' at night to stretch her lower jaw to stop an overbite. I looked at the web site and didn't find answers to what exactly I'm uneasy about. How does such treatment affect the whole body? Is there anything that can help the body to deal with this kind of stress (homeopathy, cranial sacrum therapy etc.) How does it affect the child's self image and self esteem? (Right now she's excited about having braces) Any advice or shared experience is appreciated, as I've had just a retainer. Thanks. Lucia

I had exactly the same things your daughter will be going through beginning when I was 7 years old. It was painful, but I quickly realized that having beautiful straight teeth and a jaw that would not give me migraines when I'm older was MORE important. Because I started so young, all my orthodontia was completed by the time I was 13 years old. If you have a good doctor, who's friendly and fun to have appointments with it's a lot easier on the child. Otherwise, my belief is that the child fairs pretty well with the ordeal (it's the parents who have a tougher time emotionally and financially). Let your daughter know that all the work/pain now really pays off later when she has beautiful teeth. All my orthodontia(and the expense to my parents) gave me an appreciation for keeping my teeth very clean and cavity free through my teens into adulthood. Good luck. Anonymous

I have used the services of a cranial-sacral osteopath for about seven years, now, because of migraine headache pain. He is convinced that the orthodontic treatments, especially headgear, that I had as a young teenager contributed (and possibly caused) my migraine problems. There is no telling what would have happened if I DIDN'T have braces, etc., but it is a concern of mine for my kids. My daughter is eight and will, I'm sure, have to have braces. I would highly recommend taking your child to an osteopath trained in cranial-sacral treatments once he/she has braces and head gear. anonymous

Is the trauma of braces worth it for 9yo?

I just took my 9.5 yr old son to an orthodontist, at the recommendation of his dentist. After reviewing my son's mouth, history, xrays, etc. we were told that my son has: a crossbite, a gap between his front teeth, questionable room on the bottom, tongue thrust, and large tonsils (possibly causing his mouth-breathing). He recommended: 1) braces on the top; 2) a device on the bottom (this is like a retainer that doesn't come out for the 2-yr period of the treatment); 3) a retainer 2 years later; 4) a tongue execise program and 5) referral to an ENT specialist about possible tonsilectomy since mouth breathing can change the shape of the jaw (!!).

It's not really the money ($2500 for phase 1) that's making me balk (though that will be alot for us). It's all of the intervention and trauma. My son broke down in tears in the chair when the orthodontist first mentioned braces (he was hoping to get by with much less).

Both my husband and I have cosmetically standard-looking teeth (straight, etc.) and neither had braces (though my husband had a series of retainers that kept getting chewed by the dog so his parents quit before he had completed the entire program). We both had tongue thrust as kids (and I suspect still do). My husband is a mouth breather, has a crossbite and a small gap between his front teeth. He's absolutely fine!

Does anybody know the downside of not correcting things like crossbite? mouthbreathing? tongue thrust? Have you heard of tonsilectomy to prevent mouth breathing? I thought those went out in the 60's! What is the risk of mouthbreathing compared to the risk of undergoing general anesthesia (if they still do that)? And isn't there some presumed health-role for the tonsils? We are going for the consultation with the orthodontist soon, and I will ask these things. But I figure that's like asking a surgeon if you need surgery. What additional questions should I ask? Is there a Consumer's Reports type resource for assessing the import of specific orthodontic inventions?

Any experience or information appreciated! -- a Mom

Several weeks back I posted a message looking for other parents who have questioned the need for orthodontic treatment. No responses were posted. I've been asking all parents I know and have yet to find a single one who opted not to follow the recommendations (in total) of their orthodontist, (though I've talked to several who questioned it in hindsight, now that their kids are young adults). I've searched on the web and found mostly things posted by orthodontists--no objective consumer information. One pretty good site ( provides many specific questions you can ask to determine whether an orthodontist is using state-of-the-art practices, discusses risks to be aware of, and answers many questions--but it never *questions* the need for orthodonture or suggests alternate/more conservative approaches. It, too, is the site of an orthodontist. The overall message I've read everywhere is that you'll be sorry if you put off the decision to undergo treatment. I'm going for the full consultation soon with my 9 year old. My concerns are not about money, but rather about the need for such a high degree of intervention (physical, emotional, social) and of knowing the risks of not following the recommendations from someone who will not be profiting from the decision. Thought I'd give one more try to see if there's any good advice or leads out there. Thanks!

You don't mention the opinon of your child. I had braces, as did my brother. My teeth were not that bad, but his were. I know that it's painful and braces aren't all that attractive, but since it was happening when all my friends were going through the same thing, it made it that much easier. (Peer support) Today, I am very happy that I had it done (though it wasn't my choice), and I know adults who now are going through it, and finding it more troublesome that it was for me as a teenager. I think it might be a good idea to seek the opinion of your child, but know that their overall health is of top importance. Orthodontia can help with many dental problems that could appear later on (teeth grinding, migraines, etc). Good luck! Melissa

Regarding orthodontia - My daughter had a retainer at about seven years because her tongue wasn't fitting in her mouth and she was developing a speech impediment. It did the trick but now they say she should have four teeth pulled and get braces and, when I questioned the doctor further, he kind of said it wasn't really necessary unless we wanted the perfect smile. I opted NOT to go ahead with that barbarism. I watch her teeth daily, though, and try to decide if they are getting worse or if it is affecting her bite or speech. It would take quite a bit to get me to continue with the process, although my parents did that to/for me as a child because of buck teeth. Ask me again in a year. Barbara

Am also questioning the idea of braces. We are using a retainer but braces are supposed to be in the future. The retainer is to create space for a tooth that the ortho wanted removed by surgery. My idea worked! My hygienist says that my lousy tooth enamel (and poor color therefore) may be due to years of braces. Since teeth often move back when the braces are removed, I am going to ask lots of questions about the need. Peggy

My older son, now 16, was advised by Orthodontist X at age 9 to wear a retainer for 3 years to keep space open for the braces he'd need at age 12. (I think they wait till 12-13 because all the teeth aren't in yet) Orthodontist X also told me he'd have to pull some teeth before putting in braces. We got the retainer and it was lost within a month. We never replaced it, due to a combination of negligence, procrastination, and tight finances. Three years later, at 12, he did get braces from a different orthodontist - John Merchant in Berkeley, whom I like a lot. He wore them for about a year and a half. No teeth were pulled. His teeth look great now. (Unfortunately he forgot to wear the after-braces retainer at night as advised, and his teeth shifted back out of alignment a few months after the braces came off. So, the braces went back on for 6 more months and he got some sort of glued-in retainer behind his teeth after that. A word to the wise.)

My younger son has much worse teeth. For a while he had a double row of teeth all the way around - baby teeth behind the adult teeth. When he was 9, I asked Dr. Merchant about a retainer because our regular dentist was bugging me about it. Dr. Merchant said it's too early to tell. The teeth are still shifting around a lot at that age. Sometimes everything gets sorted out on its own. But at 12, we visited the ortho again, and it was time for braces. In a big way. Dr. Merchant told me he'd have to pull a tooth to make room. I asked him if there were any way to avoid that. He thought for a minute and worked out another fix that didn't involve tooth pulling. So I concluded that:
1. a retainer at 9 isn't necessarily necessary
2. you don't always have to pull teeth
3. get a second opinion

In response to the mom who's questioning getting the orthodontic work being recommended for her son, I wanted to relay a quick story about my husband. When he was a young teen, orthodontics were recommended to both straighten his teeth and to correct the curve in his gum line (which is quite noticable when he smiles). His parents decided that it was mostly cosmetic and way too expensive, and did nothing to correct his teeth. For many years after he was extremely reluctant to smile broadly, and was in general, embarassed about the way his teeth looked. I convinced him that it was OK to smile (and be happy!), but he still hasn't fixed his teeth. The crookedness of the gum line affects the way his upper and lower teeth line up which has caused him some problems and pain. I doubt very much that he'll ever get it taken care of because it seems too adolescent to have braces now (plus it is pretty expensive). I sure wish his folks had taken proper care of it when he was of an age where it's not uncommon and not that big of a deal. (I had braces for two years and didn't find it that traumatic.) Of course, your son's situation may be entirely different. You seem to be putting a lot of thought into the whole thing which I think bodes well for him. Sarah

Regarding orthodontia - to look at my smile, people think that I have perfect teeth when in fact I have a cross bite - my back teeth don't line up properly. Despite my dentist diagnosing this in childhood, my parents never went ahead with the braces because my teeth looked great. However, now at 40, I've had 5 crowns on my molars and due for another. All the crowns are due to the way my upper and lower teeth hit each other. So know that what you choose to put off now could have a payback time when your child is older!

I would like to confirm two things that I were mentioned in other posts.

#1) Getting braces, retainers, etc. is not too bad when everyone else is doing it. I started seeing an orthodontist when I was in the 4th grade. Everyone else was going at the same time so even if you had to wear the ugly head gear, you were not alone... I remember we all thought it was cool to have retainers too. I know that my friends who didn't get the work done until High School were a lot more self conscious about their appliances because they were a lot more focused on their looks by then.

#2) It is a lot harder to do it when you are an adult. My husband was the youngest of 5, and his parents never quite got around to taking him to the orthodontist as a kid. By the time we met he was 16, and so self conscious of his teeth that he never smiled for pictures and rarely would smile in public. About 2 years before our wedding he finally got around to asking his parents to take care of his teeth. Because all of his teeth had grown in and were set he had to have 6 pulled... the dr said if he had been younger and still growing he may have been able to make corrections without the extractions. Also, because he was already 20 by then he was very self conscious of his teeth. Fortunately he was able to have the clear braces so they would not be as noticeable, but he hated to wear his rubber bands... when you are 10 and a rubber band shoots out of your mouth while you are talking it is cool, when you are 20 it is just plain humiliating. Now that all the work is over he is happy, and glad that it was done, but he says he would have rather gone through it when he was a kid. (Just a note... he also had the permanent wire installed instead of a retainer after the braces were removed... not because he lost one but because the dentist was trying to be sensitive to his need as an older patient to not have extra stuff hanging out of his mouth. It seems to be working great, nothing has moved back.)

Despite all of this I think it is great to question the orthodontist about the whys and hows of his treatment plan. I think they often want to get your mouth to be perfect when you would be satisfied with just straight teeth and not care about your bite, or whatever else they want to correct. I have a friend who had to take anti tongue thrusting classes from her orthodontist for 2 years... she never could figure out what he was talking about.

As I understand it, the reason so many folks have to have orthodontics is because often the size of the jaw is too small for the teeth. This is sort of an evolutionary miscalculation. It is also why we generally have our wisdom teeth out. Orthodontia has advanced a lot since most of us were kids. They can do projections that will show how the kid will look with and without treatment--this would be helpful in making the decision to do it, especially if you think the treatment is only for cosmetic reasons. You can see how cosmetic. You can try to consider how your kid might feel about it. If you travel to countries where treatment is not common, there are very clear examples of the type of thing that results. With these highly accurate projection models, they can now treat kids at an earlier age, when the size or shape of the jaw can be influenced. This prevents the need for extraction of crowded teeth and long-term braces later on -- also a lot of jaw and dental problems. I really suggest that if a dentist or someone else suggests an orthodontist, you at least go as far as the point where you have a precise diagnosis and projection. It is really not fair to your kid to do otherwise, in my opinion. Lynn

Questions about Teens & Pre-Teens

How much should it cost to replace lost retainer?

Sept 2011

My son lost his retainer so we have the replace it. The orthodontist is charging us $350 even though he still has the original mold. This feels like gouging to me. Is this a reasonable charge? Should I shop around for another orthodontist to replace the retainer? Frustrated

I feel your pain re: the high cost of a replacement retainer. We recently had to replace our 8-year-old's the tune of $350. Seems that's the going rate. And guess what? Just two days ago I was informed at my daughter's checkup that if she keeps shifting the retainer around in her mouth, we're in for another broken retainer and $350. Best advice I can give you: breathe deeply and try to address what caused the problem. Best of luck! Jennifer G.

Since the original doc has the molds to make the new retainer, I can't imagine a new doc would charge less. Claire

That's not too much for a replacement retainer. They take a lot of work to make correctly. It would be a bad idea to switch orthodontists at this point. anon

My son recently broke his retainer and I had to pay to have it replaced. Cost of replacing it (and this was without insurance): $175 Marta

10 year old keeps losing his retainer

Jan 2011

My son lost his 4th retainer within 6 weeks. Each costs $200 to replace. He lost one while sick (vomited in the toilet and flushed it away). He lost another on vacation. The most recent replacement was picked up today then lost within 6 hours. The whole family spent an hour looking for it and haven't found it. My son was recently diagnosed with ADHD. We're considering starting meds. I'm wondering if they will help. I don't know if the ADHD is contributing but I'm exasperated. Can I request permanente retainers? We honestly can't afford to keep replacing them. I'd appreciate any advice. Thanks.

I hope that you are talking about dental type retainers. If the option of not buying another retainer isn't something you are willing to consider, perhaps teaching him a routine of where (a retainer keeper, inside a back pack, a clip attached to his shirt - similar to the ones attached to pacifiers) to place his retainer each time he removes it would help and become a habit, but if he does have ADHD, then I do not know how difficult doing that would be.

I was 16/17 when I finally got my braces removed and received my retainer...2 weeks later, I lost it! I searched everywhere and enlisted friends even. I was so panicked but my parents did not and could not afford to fork over money to replace it but asked if I wanted to with my own money I had saved and worked for. I of course didnt, but my teeth are fairly straight, I floss & brush my teeth regularly. I often object to Orthodontists who agree to put on braces younger than 14. It just doesn't make sense. If anything - in order for teeth to be and remain straight, one would have to wear a retainer practically forever well into adulthood. And, is having a child with straight teeth really a priority for you? I think assessing what your needs and wants are for your kids would be helpful. If its costing you too much money, worry, stress and energy, then maybe it's time to ask yourself if its truly worth it. After all having good dental hygiene doesn't mean having straight teeth. lost a retainer too

gee you have my total sympathies. My son began braces around this time and I dont' REMEMBER how many retainers he lost!!!!And he certainly couldn't blame any ADHD stuff - he still loses everything! What to do? perhaps emphasize a routine & a specific place to put it every single night. Good news - my lose-everything 10 year old is a fabulous UCLA grad with a generous, compassionate heart and a fabulous son/young man/citizen. Good luck! sandra

How do I know my teens truly need braces?

April 2011

How do I know if braces are truly needed? My children, ages 13, 13 and 14, have all been recommended for treatment by an orthodontist. Two of the three need to have teeth pulled first. None of them have any extreme issues-- overbites, and in one case, a bite that doesn't quite line up.

After each exam, I asked the orthodontist about the likely consequence of not doing the treatment. In each case, the bottom line answer was that down the line as adults, they might have problems with their gums which might lead to problems holding the teeth in place. Of course, the orthodontist couldn't predict when or say with certainty if this was the case. I did let him know that we were interested in medical, rather than small cosmetic reasons, for doing treatment.

I got a second opinion, and the costs varied wildly, but not the ''diagnoses''. My husband has a similar overbite to our kids, but has not had any teeth fall out yet!

So, given that most of us are born without perfectly straight teeth and perfect bites, and I can see this is the case with my kids, how do I judge if this is something we ''need'' to do vs. something that many American families that can afford it are doing it these days? Part of what rubs me the wrong way about the orthodontist's take home materials is talk about the self-esteem benefits of a great smile. I am thinking the money might be better put toward the kids' college funds. That said, we would certainly invest in treatment if it would improve the health of our kids in the future. Thanks in advance for any insight into the world of orthodonture. Melissa

I have 4 kids - all now in dental programs that are holistic rather than simply focussed on ''straight teeth'' which frankly was my sole objective at first. Rather than write a tome in an attempt to convince you of the benefits of attending to your kids' mouths I will direct you to two extremely well-respected professionals who achieve straight teeth and also consider the important role the mouth plays in all aspects of health ( breathing, posture, mobility, speech) when we do not attend to overbites , down the line on life, this misalignment can result in tmj as well as some other structurally influenced ailments. We consult with a myofunctional facial therapist who has greatly reduced all 4 kids' overbites through mouth devices made of silicone ( no braces) she directs the kids in some exercises as well. She's phenomenal and effective and far cheaper than traditional ortho. Kathy Winslow (650)712- 1615. She travels around the bay area serving kids and adults she is in Berkeley 2 Wednesdays per week. We are also using Dr. Sandor Hites in Berkeley 845-6494 for braces for one kid, and a different sort of gentler device called an ALF lightwire device. Dr Hites treats patients from a holistic perspective, he's interested in your kids' diets, posture, functional breathing and mood. He's a kind man, father of 5!, and excellent dentist/ orthodontist. I would suggest meeting both practitioners to get another take on what dental work of any kind does to/ for kids. They have each opened my eyes to so much about our bodies and my 4 kids are all functioning and looking better too. Good luck! Ask around and do you research ! Anon

I completely agree with your stance. Let the kids figure out how they feel about their own teeth later. They can always opt for braces as adults if they feel they need them. College money is KEY, though, not optional. Go the pleasant, painless route of education and self esteem will follow. Any smile is beautiful, as long as it is genuine.

Melissa, Our daughter just finished up the braces and I had them as well years ago. Kids are usually steered towards orthodontics when the family dentist observes a problem or concern. Those concerns generally have involved issues of adult teeth threatened of not coming in right, impacted wisdom teeth pushing things the wrong way, crowding, and over or under-bites. My daughter and I had teeth pulled first before braces. In her case she was born with a small mouth and too many teeth to fit in it so she needed a couple adult teeth taken out of the picture as well. There is a lot to be said about a smile being your most important asset and you can try it out yourself. Next time you are on a busy sidewalk try going a few blocks with a beaming smile and a few blocks with a non-smile. You will see a huge difference from those you pass by. A great dentist to see for an initial opinion is Robert Peri in Berkeley. He refers to a good orthodontist, Dr. Eisman both near Alta Bates. My dad had 5 children, 3 of us got braces, two didn't so it wasn't decided just for perfection. Around 13 is a good time to get things on the right track as it is supposedly more problematic to try to fix things later in life after all the adult teeth have come in compromised. Good luck sorting your children out. happy with nice teeth

My husband and I also questioned the need for our older child to have braces, being unwilling to subject her (and us) to the long procedure and the pulling of 4 of her healthy teeth. Her teeth were fine -- not perfect, but fine. In our parents' generation, she would have had ''a beautiful smile'' without braces. In today's day and age however, unless all her teeth are 100% in line, that would not be considered true.

We visited 3 different orthodontists and heard from each one of them how important it was to have that ''perfect smile''. Of course, we understand that their livelihood depends on it.... but we wanted to know how important it really was to her health as opposed to her looks. In the end, we (reluctantly) went ahead with her treatment because it seemed that it may seriously affect her bite in the future if we didn't. Along with the significant monetary issue, the braces also were a substantial amount of time and effort for the child and the parent for about 2 years!

However, a similar issue came up recently when her wisdom teeth started to come in a few years later. Both the dentists that we consulted said that her wisdom teeth (growing in perfectly in line with her other teeth, and with enough room in her jaw) ''might cause trouble later in life if they were difficult to floss''. We (and she) thought that was not reason enough and decided not to have her wisdom teeth removed, understanding that if she has a problem later, removing them then would be an option, more difficult than right now. We were also swayed by the fact that both my husband and I still have our wisdom teeth, and they haven't been a problem yet

In the end, I think that it is your decision and your child's ... some children feel ''left out'' if they don't have braces, others may feel embarrassed about their slightly less-than-perfect teeth compared to their friends'. See what works best for you and your child. ''perfect smile at what cost??''

Orthodontics is not just about ''the perfect smile''. I had some orthodontic work as a child (a retainer, mostly), but should have had braces. I was left with teeth that are so out of alignment, I can only chew on one side of my mouth, and my face is visible crooked. I am now looking into getting braces--in my 40s. Wish I'd had braces when I was young

Is $3200 reasonable for 11yo's braces?

May 2009

We are ''new'' to the braces world - our 11 yr old son has an adult lower canine that is growing at a 40 degree angle, so the plan is to remove his baby canine and put braces on his lower 4 front teeth(14-16 months) - all to make more space for his adult canine to hopefully come in straight. Price tag is $3200. Wondering if this is a reasonable cost? A neighbor has said that this is what she paid for her daughter's full set of braces. They (oral surgeon)also might have to put an anchor on the canine and coax it straight via a ''chain''...not included in the $3200. Thanks

Braces are very expensive. I would also look into getting a few opinions too. I love my daughter's orthodontist. Dr. Gary Fredrickson. He's in Berkeley, here's the number, (510) 526-7546. He does ''Functional Orthodontics,'' which is a slightly different approach to it. It looks at the whole health of the jaw and teeth, not just getting the teeth straight. My daughter had TMJ when she started braces and he found ways to relieve the pain while continuing the treatment. best of luck. anon

Orthodontia - dentists pushing braces

Jan 2009

Are there any dentists out there that don't recommend braces for every child that comes through their office? I know I'm not an authority on orthodontistry, but I really feel like I'd like to go to a pediatric dentist that was open to a parent's decision against having their kids get braces. My parents and my husband's parents didn't have braces, my husband didn't have braces, I had braces twice (yes, twice, I had an orthodontist who tried putting them on me when I was in 2nd grade & then realized I needed them again in 6th grade -- all out of pocket for my parents too!) and I honestly can't see why my daughter needs them. She doesn't have any type of overbite and this whole notion of that they aren't biting down properly seems ridiculous. If they can chew food, I think they're fine! Plus, lately everyone I've talked to about their kids' braces says that the ortho keeps telling them that they need to stay on longer than originally told. I've yet to hear a story about someone getting them off earlier. It sounds to me like a nice way to keep the income going for the ortho office. Lastly, I've heard that the rate of cavities and tooth decay goes up after having braces -- all those teeth squeezed together I guess makes it harder to get clean in between. Anyway, thanks for letting me rant. I'm all for toothcare. We all brush and floss. I'm just very hestitant about the braces. Any suggestions? Anti-braces mom

If I were you, I would relax around the braces issue. Get a couple of opinions and just go with one. The orthodontists are REALLY not out to milk you. The ones we saw (two kids) charge a set fee at the beginning and will see your kids forever - they're not charging a fee every time you go in. Our kids had braces put on in middle school, off in high school, and now the eldest is 21, finishing college, and they're STILL calling to make follow-up appts. for her. I'm about to say, Alright, already. Believe me, we've gotten MORE than our money's worth out of them. Relax. mom of beautiful girls

Another $5100 after 5 years of orthodontia?

June 2006

We have been going to the same orthodontist for 5 years. My daughter had braces on the front teeth and a retainer. Yesterday, we went to the orthodontist and they had us fill in a bunch of paper work. We were just there 3 months ago and go about every 3-6 months. They treated us like we were new to the practice. They then had us sit down with a financial person and said that the treatment would be $5100 and that we'd exhausted our previous insurance and would likely need to pay cash! We are really surprised by this because our previous payment we thought covered the entire treatment! Is this usual and customary? Thank you anon kid with braces mom

After our daughter had full braces and a retainer when she was around 12, the orthodontist said that she probably would have to do the braces again in her late teens, and we should keep coming every 6 months. Instead, we quit cold turkey. That was 5 years ago. If you don't want to do that, I'd recommend a second, if not a third opinion. Anonymous

I've had the same experience with both of my sons. We have no orthodontic insurance, so we paid around $5000 for each boy to have braces and/or a retainer, only to be told at the end of treatment that more work was needed for an additional $5000 or so for each boy. With the first son, we decided to go ahead with the treatment after we got a second opinion from another orthodontist, but we're hesitating with the second son. I'm skeptical about the level of perfection sought with orthodontia these days, which is certainly greater than when I was younger. I'm also concerned where there is no insurance involved, because there's no third party with some expertise evaluating the necessity of the treatment. I feel a little taken advantaged of. So, I suppose my response would be only to echo your concern on this matter. Imperfectly Smiling

Sounds like we have the same orthodontist. Same thing happened to us, same price quoted. We have also used up our ortho allowance through our dental plan. Are there any parents out there who've been through this, gotten a second opinion, and found a less expensive alternative? Bracing myself

Orthodontist using assistants to do all the work

March 2006

My daughter just got braces today. I had assumed that the orthodontist would be doing all of the work, but his assistants actually did about 80% of the actual fitting of the braces. Is this what should I expect? Do most people have this experience or should I switch orthodontists? He had about seven chairs in a row lined up, filled with patients and would spend about a few minutes with each patient just checking the assistant's work. This makes me very nervous.Should I just chill, or are my concerns valid? The orthodontist with whom we had an appointment to see wasn't even there. He had another Dr. there who we were not even introduced to. Thanks for sharing any of your experiences new to braces

The orthodontist's office you describe matches exactly the place my son got his braces: multiple chairs, assistants doing most of the work, dentists not introducing themselves, and sometimes a different dentist than had been expected. I, too, have no other experience with orthodontists and got used to everything (after the initial surprise) except their not introducing themselves. The first time it happened, I asked, ''And you are...?'' and he introduced himself. Someone should tell them they (the dentists) should introduce themselves the first time and wear name tags anyway (not just the assistants). This office was recommended by my son's dentist, whom I trust completely, and my son's teeth are perfect, so if it's the same place (write me privately) I don't think you have anything to worry about. Judy

Your concerns are valid - trust your instincts about this! I went to such an orthodontist set up like that during my teen years, and if you saw my teeth now - you, like every dentist who has worked on my teeth, would say: Have you ever considered having orthodontal work? In other words, that lack of consistency and commitment led to a very poor outcome. I truly fell through the cracks. ...Many orthodontal offices practice like you have described (Hersey factory style)...... Needless to say, when it was time for my daughter to get braces, I merely opened my mouth (literally, and figuratively) and said that due to what happened to me, I wanted her to consistently see just one of them, and everytime I set up an appointment, it was on a day when THAT orthodontist was present. And, he did review what the assistants had done. I spoke to him almost every appointment.

And, when all was (said and) done: my daughter's teeth are straight, and I feel good that unlike my mom who didn't listen, or look, at what was happening, I advocated for her and got a good outcome. anonymous

My child just went through 5 years of orthodontia and her braces came off last month. That was the teetch-moving phase and now she'll be in a stabilizing phase for 2+/- years. Not having had braces myself, I was inquisitive and had to ask questions about process and progress and expectations. Don't be afraid to ask these questions of your orthodontist or to get a second opinion before you sign a contract for treatment. You will become a better custodian and you will build confidence in the ortho.

Anyway, the orthodonist she goes to always had an assistant do much of the work. I was okay with that. It's like having a dental hygenist clean your teeth. Assistants are trained for this job.

ALWAYS, the orthodonist should inspect the work and check/notate the chart. Regardless of how many orthodontists are in the office, they need to keep accurate, detailed records on your kids chart. I can't imagine even the same ortho. keeping track of a patient's progress over a couple years without keeping records.

A bit of an aside, I did change her dentist because she would go in for a twice-year cleaning and only see the dental hygenist. They said the dentist only needs to look at her once a year. I didn't like that response. I have ALWAYS had my dental cleaning followed by a brief dental checkup. It has always seemed to me, an important part of dental care for my teeth and health. Plus, how is a dentist to know if their employees are doing their job? Essentially, you need to build trust with your ortho by asking questions when you are uncertain about something. Lisa

Corrective surgery & braces for 14yo seems extreme

June 2004

My 14-year-old daughter's orthodontist has recommended jaw- lengthening surgery involving a year of braces, followed by a three-day surgery (the jaw is cut, lengthened and screwed back together) and another year of braces. This is intended to correct an anomaly in her bite, because her bottom molars don't seem to be aligning with the top. This seems particularly drastic and met with a resounding refusal from my daughter, not surprisingly. I'm looking for advice from anyone who has had any experience with this procedure. Strangely enough, the alternative course of action according to the orthodontists was to do nothing at all.

I think you are doing the right thing right now - asking others for advice. Seems like every child needs braces right now. I needed braces as a child, and did not have the work done until I was in my late twenties. It just so happens that I was also recommended for jaw lengthening surgery - so the procedure has been done for a while - this was over twenty years ago. My orthodontist need two opinions from oral surgeons for my insurance to pay for it. The second one said I did not need it, I had just enought room for everything to work.

My teeth came out fine but I think my jaw would have had better alignment if I had had a successful surgery. Poor alignment has meant jaw tension, excessive wear on one side and other problems.

I recommend seeking more opinions from orthodontists and oral surgeons - often there is no charge for consultation - always ask to make sure.

Discuss the information with your child, if it really looks like surgery is the best route, maybe you will find someone who had the surgery to talk about it with your child. Often the orthodontist will provide patient/parent as well as parent time for questions. Sometimes information can help the decision process.

Any surgery has risks especially from anesthesia so finding out what would be gained vs missed is important.

We had a great experience with Dr. Brennan (formerly Brehnan) DMD, MS , 591 San Pablo Ave, Albany, CA 510 525-1772. cc

Projections to show with and without treatment?

May 2003

Hello, I found this in the archives: ''Orthodontia has advanced a lot since most of us were kids. They can do projections that will show how the kid will look with and without treatment--this would be helpful in making the decision to do it, especially if you think the treatment is only for cosmetic reasons. You can see how cosmetic. You can try to consider how your kid might feel about it. If you travel to countries where treatment is not common, there are very clear examples of the type of thing that results. With these highly accurate projection models, they can now treat kids at an earlier age, when the size or shape of the jaw can be influenced.'' Can anyone tell me a place (or places!) that does these projections? My sitution is the one described in this post--I need to understand ''how cosmetic'' the proposed work is for my child's teeth. I really appreciate any further information on this. L T R

Brad Irving, in Montclair, did this when we went in with my son. I think most orthodontists have the technology to do this now.

Just a piece of advice: Go to more than one ortho for a quote. The first guy we saw recommended taking out multiple teeth and full braces. Brad used a series of retainers graduated in size which has worked amazingly well. Much easier on the kids, much, much, much less expensive. In fact, we are fortunate to have the entire thing paid by dental insurance. Anon

$5400 for 12yo's mild overbite?!

January 2002

My 12-year-old daughter has been advised that some of her new permanent teeth are too tight and that she should possibly have four bicuspids pulled and definitely get braces, followed by retainers: a three-to-four year project costing about $5400. When I asked how her teeth would benefit by this process, I was told that 1) it would at least partially correct her mild overbite, 2) there would be less uneven wear on her teeth in future, and 3) it would look better.

I want her teeth and gums to be healthy, now and in future, but I distrust the American obsession with perfect, even, Osmondesque teeth. Any thoughts/advice out there about this fascinating topic? And would anyone recommend a good orthodontist--one you've worked with and really trust, preferably in the Berkeley area--from whom we could get a second opinion? Thanks, Melanie

Hi Melanie -- I wasn't aware that any of us actually want to look like the Osmonds (eewwww!) but I can tell you that Dr. Iezman, on Walnut Street near the North Berkeley Peet's is an Orthodontist we trust, and that we're doing braces because he came up with logical dental reasons for it, not just cosmetic. (One of the conditions he mentioned explained to me why my molars have cracked one-by-one over the last 15 years ...and crowns cost more than braces... but of course its me paying and not my mom.) His number is in the book, and he would look at your daughter for free (as I recall). His office is busy enough that he wouldn't take you on just to pay the rent... Heather

To the parent who wanted orthodontia information: I would speak to a number of other orthodontists before you have any teeth pulled. There is research out now that shows having teeth pulled will/may cause problems later on. If at all possible, you should look to someone who can do the work without pulling any teeth. At age 12, it may be too late to have work done to create room without pulling teeth. My daughter and several others we know see Dr. Iezeman in Berkeley. He gave us a thorough written treatment plan and has kept to it. The costs were explained, they worked with us so we could maximize the medical spending account offered by my employer and my daughter really likes him and his staff. Several others we went to did not feel this good, one in fact just wrote Phase I, Phase II on a piece of paper with amounts as his extimate and treatment plan, he wasn't a certified orthodontist and his prices were more than Dr. Iezeman (don't remember his name, on Gilman, across from ! Ti! ddlywinks). So look around, see if you can find someone who can create room without pulling teeth. My husband has very crowded teeth, his family did not have money for orthodontia, it looks awful, and he wishes now he could do it. As an adult it would be very painful and expensive. So think long and hard before you choose to not do so. Hallie

I checked out the Berkeley orthodontic scene about a year ago. The issue also was too crowded teeth and overbite. There a two schools: one thinks pulling teeth is necessary, the other thinks it's more or less a crime. Out of the four orthodontists I checked I picked Dr. Broderson on Hopkins. He has a very gentle and unique approach, different from all the others. He was the most expensive though, but I think it's worth it after a year of treatment so far; and with the payment plan they offered, it's doable for us. It's working well so far. Another 'low key' on aesthetics orthodontist seemed to be Dr. Merchant on Regent St., he was less expensive too, but we wanted to go for the best fix possible. Helga

Orthodontists recommended that my daughter have 4 of her teeth pulled, but I objected and they were pulled. Her teeth look beautiful now and I can't see why they wanted to pull those teeth. I am also anti everyone in America has to have perfect teeth, but we went ahead with the whole braces routine anyway and now she has perfect teeth. We go to Dr. Iezman, who supported our decision. Toby

Questions about Adults

Braces...what should I be paying?

Feb 2007

I've noticed in the past 5 years that one of my front teeth has been slowly moving forward. My dentist confirmed it, and I've decided to look into braces to stop the shift. I need 6 braces across the top front for anywhere from 9mos to a year (bot my dentist and the ortho I consulted said this). But, the price-- $3800! For not even a complete this outrageous, or am I just in denial? There's no removal of teeth needed or anything. I guess I'm wondering what I should be paying? Is there some sort of guideline? Are there major differences between orthos? The estimate for treatment I received was from Seth Osterman in Berkeley, if that helps. Any advice would be appreciated, since I'm clueless here. --The Tooth Fairy

That is just about what I paid for bottom braces last year (and I already had braces in high-school!!) My daughter's (top braces) were 2900.00 and when I asked why mine were so much more my orthodontist said it was because as an adult, this was a ''permanent'' alignment vs. children who are growing and seem to often need a 2nd set when they're teens. It's so expensive but I too was trying to prevent bigger problems down the road. Cost included 1 retainer and all visits and follow-up but not the x-rays. Out Serious Money After Braces

Braces for Mom in her 30's?

Dec 2005

hello, i am considering braces for myself. initially, i hoped to have invisalign braces (friends of mine have had great success with invisalign), but after my initial consultations with two orthodontists, i was told that braces would be most effective for me. actually some dentists are willing to do invisalign for part of treatment then place traditional braces on in the end. so i have opted to go with braces only. apparently, invisalign braces can only rotate teeth -- my teeth will require more shifting. i am considering using dr. tanner and reichold in concord versus dr. lieber in walnut creek versus dr. timothy pearson in walnut creek. do any of you have recommendations, positive or negative, on these dentists? was treatment as stated, were there major ''bumps'' along the treatment road?

and on a more general note, was having braces as an adult manageable? did your teeth tolerate braces well? as a busy parent, did you honestly have sufficient time to perform the oral hygiene necessary to keep your braces clean? did you require having your teeth shaved to make room for your straighter teeth? how was that experience? and was the cosmetic and functional outcome to your liking? basically, was the experience worth it to you overall? hoping to take the plunge

No knowledge of the orthodontists you mention, but, yes, having braces as an adult was manageable, my teeth tolerated braces easily, and I'm very, very glad I did it. It wasn't really all that hard to find the time to keep teeth and braces clean. Regarding the appearance (since I assume that was why you were looking into invasalign), I had clear brackets and even though my doctor used the regular silvery wire, the clear brackets meant less of a ''metal mouth'' look. My only question for you would be that, since you asked about having the time for oral hygiene, do you have the time for the appointments? At one point, I was going in weekly for 5'' tuneups/tweaks as the doctor was rotating & shifting teeth. You might want to consider travel time, frequency of visits, and doctor's tolerance for children (unless you have alternative childcare arranged) in choosing who to use. But, go for it!

I am almost 30 and about 1 year into my braces treatment. I had them put on when my son was 2 months old and I've found that although I do have the time to floss every day, I often choose not to (don't tell my ortho!!). Instead of shaving my teeth, I had a few teeth pulled which was fine. I had the braces on for about 6 weeks and then had my teeth pulled, and on a day when my husband was out of town so I was alone with the baby. The worst part for me was getting the bands put on around my molars in the back. That was paaaaainful. It was the only time I remember thinking ''whyyyy did I decide to do this??'' But now I'm very happy that I did. My teeth are looking great (not done yet!) and I'm planning to be very responsible in their upkeep since I know exactly how much this all cost me. :) I teach classes to adults (almost always older than me) and at first I was a little self concious that they would think I'm soooo young (given my young look and now braces!!!) but ! nothing has really been different. -almost 30 and finally with straight teeth!!

YES, do it! I couldn't be happier since I got braces. I am a high school teacher, and had braces for two years a few years ago, when I was 29-31. My students were incredibly supportive (they had braces, too!) and honestly, I think no one thought it was weird at all. I eventually got used to them and they didn't disrupt my life that much. The occasional toothaches were relieved by ibuprofen, so it really wasn't a problem. And my orthodontist also said what yours did: get the ''real thing,'' forget about the invisible ones. They take longer, they're not as effective, and no one but you cares about it, anyway. And it's SO WORTH IT! I am never self-conscious about my smile, and in fact am told all that time how attractive my smile is with straight, white teeth. (Thanks to Crest Whitening Strips, too!) Go for it -- it's totally worth it. And the added benefit is that now you will have more compassion for your kids and friends who go through similar situations. You can even get cool colored rubber rings for an extra kick! Happy Smiling

i can't comment about the doctors you mentioned, but i'm 29 yrs old in the midst of orthodontic treatment for the 2nd time. i had braces 15 yrs ago but didn't wear my retainers much afterwards -- so my bottom teeth crowded. as a result, i need braces on both arches. i consulted with 5 different orthodontists who gave me vastly different plans (one involved creating extra space on top then adding veneers or bonding to fill in gaps -- i nixed this b/c i didn't need this the 1st time around).

i ended up going w/dr. robert quinn b/c he mainly treats adults. he didn't want to mess w/my so-called class I (good) side bite, so i have braces on my front 6 top & bottom teeth only. several orthos wanted to put braces on all teeth in case my back teeth do happen to move during treatment. there's some risk of root-shortening during treatment, so i'm happy w/dr. quinn's approach. i did have my lower teeth shaved and balked at the idea (i'd still avoid it if i could), but dr. quinn spread it out over 6 teeth and did it in two sessions. he said that doing it all at once can result in taking too much and then having extra space. not all the orthos i talked to shared the same approach -- one wanted to shave a huge amount off just 2 teeth! if you will be moving all your teeth it's possible that you could get the job done w/out shaving -- my first braces treatment didn't involve shaving and my teeth looked great.

as far as care, flossing takes a long time w/ braces, but it's a must if you want to prevent both cavities & bad breath! i find that coating floss w/tea tree oil (can get at trader joe's) kills more bad breath bacteria than brushing & flossing alone -- just don't swallow the oil! i think a rotating electric toothbrush is essential. i can't get my braces clean enough w/a manual brush. my dentist seems to think the oral-b round rotating head plus skinny brush head is better than a sonicare; her office also pushes the rotadent brand toothbrush for problem gums &/or braces. i didn't properly care for my teeth the first time around and i have suffered the consequences: decalcified areas on teeth, some of which resulted in cavities (even worse on my back teeth...make sure you get a small brush head to get back teeth clean!). straight teeth the second time

I had braces pre-kid in my early 30's. It was not as bad as I thought. I began to notice the other folks at work with braces, and we shared a lot of encouragement. Little kids would stare at me and wonder at the stuff on my teeth, so I would smile more broadly and show them. Keeping my teeth clean then was easier than keeping up with dental apointments with a newborn around. So you may have to really work on keeping the appointments with both your dentist and orhtodontist. These days, cleaning is far easier with those new instuments. THe one thing I wished I had done diferently was to get a real cool color for my retainer. Sigh. But it was worth it. My teeth look better and most importantly, they are far easier for me to keep clean. - Smiley

Retainer for an Adult?

March 2005

I am wondering if there are retainers for adults to halt the crowding forward of lower teeth. I heard from a friend in LA that there are orthodontists that do not charge too much for this. I guess what I'm also wondering if it's effective and how expensive it is. -- - Really don't want braces

About a year ago I began going to Berkeley orthodontics for a similar problem. Their number is 849-2434. I had braces as a kid and I began to notice that some of my teeth were moving. I ended up with a top and bottom retainer that I only wear at night (my decision since things would go faster if I wore it 24/7) to correct one problem and stabilize the other teeth. The entire cost was a little over $1,000 and my insurance paid for almost half. I go in every 2-3 months for checkups and have not had to pay anything else since. All in all very satisified. I'd say, go for it! anon

I don't know much about orthodonture, but a friend is taking his daughter to the University of the Pacific dental school in SF because the cost is about half. You could check it out. Also, many orthodontists don't charge for a first consultation, at least for kids. anonymous

Hi. I had braces over again as an adult. They know a lot more than when I was a teenager, and were able to do different things to correct problems in my mouth. I now have retainers which I wear about every other night to sleep in. The whole process was much faster and easier than when I was a kid. I recommend you see Dr. Iezman on Walnut in Berkeley. He does a free initial consultation. You can tell him what you do and don't want, and he will explain things clearly. He is an orthodontist who sees both adults and children, so, now I am also taking my kids there. I have been very happy with him and his staff.