Braces: Are dental surgeons adequate, or do I need an orthodontist?

May 28, 2007 3:28 AM

Is there a significant difference in quality when it comes to getting your braces put on by a dental surgeon as opposed to an actual orthodontist?

I had a consult with an orthodontist on the weekend, and afterwards I cried because my dentist had led me to believe braces would cost in the ballpark of 2-3000$. I was quoted $5000.

I have now realised that my dentist must've been mistaken, because anywhere between $3500-6000+ is standard in Australia.

However, I e-mailed a few other orthodontists to ask if they offered even slightly lower prices. I got one phone call from one ortho who assured me that $5000 for fully fixed braces on top and bottom teeth (ceramic on top) was reasonable. She also told me that my dentist might have said $2000 because some dentists may have done a few courses in orthodontics, but weren't anywhere near as qualified as an orthodontist -- and that if I got my braces done by a dentist, I would notice the difference.

Mefites, do you know if this this true?
Is it worth footing 1-2 extra thousand dollars for this difference in quality?
Will I regret letting a dental surgeon do this work?

Because I got a phone call just now from a lovely sounding dental surgeon who has been working in private practice for 24 years (checked his website) and he said he was happy for me to come in for a quick (free) consult where he would check if he could save me any money.

In case it's relevant to whether a dental surgeon would be sufficient, my bottom teeth are moderately crowded, my top teeth are only slightly crowded, and my molars are almost perfectly aligned. The orthodontist who quoted me $5000 said I would wear the braces for 18 months or possibly less.

posted by mjao to Health & Fitness (11 answers total)

Well, most certainly an orthodontist will have the training necessary to properly install the braces, monitor the movement of your teeth, and make the appropriate adjustments. A dentist would not have received this specialized training (generally speaking).
I suspect the ortho will also be more knowledgeable as to the latest techniques and materials. The dentist may well have bought into one company's orthodontic product and that's what he installs.

That said, I had my orthodontic work done by my dentist and the results were quite good. He was an old guy who had been around a long time and seemed to know how to do everything right.

You should try to get in touch with people who have had orthodontic work done by the two different doctors and judge the work.

Do the dentists and orthodontists let you pay in installments, as they do here in the states? That really helps soften the blow when you can stretch the payments over time.
posted by Thorzdad at 5:52 AM on May 28, 2007

Response by poster: Yes they do let you pay in installments here in Oz. $5000 spread out over 18 months is still fairly undoable for a full-time student though ... it's $70 a week. I'd have to literally live on ramen -- which I'm considering, but then I think, are braces really worth the sacrifice? It feels sort of superficial. I'd rather buy nice food, I think.

Thanks for your advice Thorzdad ... I'd like to hear what others have to say as well. I'm unsure how to get in touch with old patients of this dentist! Maybe he has some photos up on his wall or something.

Good point about this dentist possibly having bought into one company's product ... I'll look out for signs of that.

Generally, as long as he offers the newer ceramic braces I will probably go with the dentist ... unless enough people reply here and say it will likely be a substandard result.

The fact that you're happy with your results is comforting ...
posted by mjao at 6:39 AM on May 28, 2007

If your teeth are crooked and you keep eating like that, it might cause other type of problems. Get it fixed ASAP since you're still young.
posted by PowerCat at 7:12 AM on May 28, 2007

Have you looked into Invisalign "braces"? I'm not sure it would save you money (they're still pretty expensive), but it might.
posted by amtho at 8:04 AM on May 28, 2007

look at it this way: while it sucks wearing braces and shelling out the dough to pay for them, you WILL NOT regret getting them once you view the end result. i have never met a person who has.

i think obviously an orthodontist will do a better job and be more concerned about "perfecting" your teeth. a dental surgeon probably not so much.

my orthodontist was so overzealous about perfecting my smile that my teeth started to suffer (i had them on for so long that i developed some serious cavities under the brackets). i imagine a dental surgeon would have probably been more fastidious about making sure my teeth were healthy instead of just concentrating on how my teeth fitted together perfectly.

so it comes down to you. how important is having that "perfect" smile? unless you're going into entertainment or a related field, it's probably not all that important. plus, and most people can't tell if your mouth is really all that properly aligned or not.

also, if you have some serious bite problems (which will cost you more in dental work later on if you don't have it fixed properly), you may also want to lean towards choosing an orthodontist. but it doesn't seem like that's your case.
posted by tastycracker at 9:14 AM on May 28, 2007

tastycracker, I've met so many people who didn't think their braces were worth it! I grew up in southern CA where the vast, vast majority of kids were put in braces as a matter of course. Many of those kids had teeth that would have worked perfectly well as they were and had to put up with years of braces for minor cosmetic alterations. And now many of them are going back in their mid-20s because either they didn't wear their retainers, or their orthodontist missed something that only was noticed when they got their wisdom teeth out. OP, I'd do whatever I could to save money. Make sure you get to talk to some of the surgeon's old patients, and it might be a good idea to get your wisdom teeth out if you haven't already. This is all anecdotal, but I do NOT have all that much faith in orthodontia.

Literally every dentist who's seen my mouth since I got my braces off - including one who saw me the week after - has immediately said "We should get some braces on those". This after almost six years in braces from an orthodontist. Yeah, I'm bitter. No, I don't intend to get braces again.

I also agree that orthodontists can overlook the health of your teeth. While I didn't develop cavities under my braces, I do have a weak spot on one of my teeth from them and tons of bad stains. A dentist might have more concern, but I think in some cases, it's unavoidable.
posted by crinklebat at 11:42 AM on May 28, 2007

"my bottom teeth are moderately crowded, my top teeth are only slightly crowded, and my molars are almost perfectly aligned" -- straightening that lot doesn't sound like something that demands only the most highly trained expert.

It also doesn't sound as though they are so crooked that no-one would ever hire you. I would wait a couple of years until you are earning. Three thousand dollars in your pocket now should let you eat a healthier diet than ramen and get you better grades if it lets you cut back on paid work. (Hmm, would a healthier diet benefit your grades anyway, or just let you party harder?)
posted by Idcoytco at 2:57 PM on May 28, 2007

I can't speak on the ortho vs dentist debate. I'm seeing an ortho for my braces and I never thought of seeing a dentist.

But if you're concerned about cost, why bother with the ceramics on top? Why not go all metal since it's cheaper (don't know about Australia). I've read quite a few times on the archwired.com forums that people who opted for partial ceramics would've just went all metal if they did it over again. You get over the novelty and self-consciousness of having metal in your mouth. I used to wonder constantly what people would think of my braces, but I don't give a crap now. Some with ceramics even opted to go crazy after awhile and use colored elastics.

I haven't checked out the Archwired site since I started my treatment, but maybe you'll get more feedback there. Good luck.
posted by quoththeraven at 3:15 PM on May 28, 2007

Response by poster: Hi quoththeraven! The reason I'm getting ceramic on top is because I'm told metal ones would only be $350 less. If there is a greater difference in price btwn ceramic vs metal with the dental surgeon, I may consider getting metal.
& Thanks for alerting me to the Archwired page!

amtho -> I think Invisalign are lots more expensive, but I'll try and get some ballpark figures from the Archwired forums.

tastycracker (& crinklebat), thanks for highlighting what the different "priorities" of a dentist vs an ortho are likely to be. That makes sense. You are right, "the perfect smile" isn't that important to me, I just want them to not be crowded. I'm sure I'll be happy with Good as opposed to Excellent results.

Question -- if I was to go with the dentist, and then wish that I had gone to the ortho to get them just that bit straighter (humour me here), there's nothing to stop me from getting Invisaligns at a later date is there? I could afford them by that stage.

On that train of though, Idcoytco, your point is a good one. I could, obviously, wait until I'm no longer a student and just get Invisaligns. However (and I know this sounds silly) I was really looking forward to getting proper braces. By the way, were I not to get braces installed, the extra money would definitely go to food, not partying :)

It's not like I would literally live on ramen. My boyfriend would take pity on me, so I would at least eat nutritious dinners. The rest of the day, I'd be on my own though.

Thanks for all the food for thought, guys! Especially the personal experiences -- I welcome more. I haven't quite made up my mind yet. Need more data!
posted by mjao at 5:58 PM on May 28, 2007

Response by poster: Oh, and PS, I am definitely going to get some x-rays done to check what's happening with my wisdom teeth, i.e., if they need to be removed, and when. There's no use spending so much money on braces if those guys are going to come along and ruin it!
posted by mjao at 6:00 PM on May 28, 2007

crinklebat, every orthodontist will tell you, very firmly after you get your braces off, to wear your retainers (or they should anyway!). hence, any relapses in tooth position after treatment can only be the wearer's fault, not the orthodontist's (unless there is a strong force like wisdom teeth coming in or constant tongue pushing). also, since wisdom teeth extert such strong force against other teeth inside the mouth, often come in at odd angles, and leave gaping holes after removal, it is not unreasonable to expect more orthodontic treatment afterwards to set things in place.

i'm from so cal too but perhaps i should have been clearer.
did i hate wearing braces? hell yes! have i met people who hated wearing braces? heck yea! but i still have yet to meet anyone who was unhappy with the end result: nice straight teeth!

mjao, i don't think invisaligns are cheap at all. if you read about them they're basically a system of retainers which require frequent visits to the dentist/ortho. because you can take them out so easily, you're going to have to be really vigilant about wearing them all the time if you want to make progress on your teeth. if you're going to be happy with having a "good enough" set of teeth, i don't think you'll need to waste more time and $$$ getting more orthodontic treatment on top of your original.
posted by tastycracker at 10:26 PM on May 28, 2007