Importance, and cost, of braces for an adult?

June 23, 2007 7:07 AM

How important is it for me to get braces as an adult? If it's critical, how much would they cost, and how could I afford them?

As a kid I was told I needed braces, but it was completely out of the question for us financially (this was transient/subsistence living). Now I'm in my 20s, still struggling a lot financially but wondering again how critical it is to get braces. I don't care about any cosmetic aspect, only about whether braces are needed to help my teeth last a long time. (I'm hoping to live at least 60 more years.)

Here's a pic of me showing as much of my teeth as I can. If you have an opinion about the pic please express yourself in factual terms (like "You have problems X and Y," rather than "Yuck, that looks bad").

Clearly my teeth have some crowding, but they're not crowded enough to interfere with flossing, which I know is a big factor in tooth longevity. The top teeth overlap, resting slightly more forward than the bottom teeth. (Also, I don't know if this affects braces, but in the middle of the lower teeth, you might see I have one artificial tooth, which I've had since childhood; it never developed correctly so they filed down the real tooth to a narrow pillar and put the cap over it.)

If I need braces, is there such a thing anywhere as low-cost braces for low-income patients? Is there such a thing as dental insurance I could get that would cover braces? (I assume not, since "a need for braces" is practically the definition of pre-existing condition.) Currently I don't have dental or medical insurance. I exceed Medicaid qualifiying income but not by much.

posted by anonymous to Health & Fitness (20 answers total)

I don't think you need braces from an aesthetic point of view. While not perfect, your teeth don't look that bad.

I used to think that straight, white teeth were a pre-requisite for attractiveness, but I have changed my view. I know lots of people with very imperfect teeth, that nonetheless look fine and whose overall appearance is not notably diminished by their teeth. To me, being fit and dressing well are far more important to a person's appearance than their teeth.

But if the appearance of your teeth bothers you a lot, then save the money for braces.

I understand that overlapping of teeth and so forth can be a cause of dental problems. If the appearance of the teeth don't bother you, then consult a dentist about whether you really need braces.
posted by jayder at 7:38 AM on June 23, 2007

My teeth are way more crooked than that. I go to the dentist regularly, and only once has a dentist mentioned that I could use braces. It was more of a suggestion than a recommendation, and he didn't try hard to sell me on them. So no, you probably don't 'need' braces. Whether you want them or not, is a different question.
posted by happyturtle at 8:13 AM on June 23, 2007

I'm in the process of getting braces, so I can tell you about cost. I've been quoted $6000. This is in Berkeley, CA. This does not include the initial consultation ($450), several procedures w/oral surgeons to remove extra teeth ($700) and add'l x-rays they need to do ($150). I bet I don't get out for under $8500 when all is said and done. The upside is that my insurance pays $1500 (this is a pretty common amount I think), and I get to pay it monthly over 3 years. So $225 a month spreads out the pain.

Speaking of pain, braces hurt. I wouldn't be doing it if I didn't have this weird shark teeth condition.
posted by apostrophe at 8:17 AM on June 23, 2007

I think you would only need braces for aesthetic effect. They don't seem crowded or crooked enough to be causing any jaw pain or headaches.
posted by headspace at 8:45 AM on June 23, 2007

I had braces twice, once as a kid and once as an adult. (I also had jaw surgery as an adult to completely correct my bite, which the braces alone wouldn't accomplish). The braces came off about 8 months ago. Yes, they hurt at times, but nothing some Tylenol or wax on the brackets didn't help.

From your pic, it does seem more an aesthetic concern, though I can't tell anything about your bite (for example, it looks a little to me like you might have a cross-bite, but there's no way to tell from that photo, and IANAOrthodontist, anyway). When I was orthodontist gave me a free consultation, in which he explained the entire rundown of my issues, and the options available for correcting them. I'd be surprised if you couldn't find an ortho to do the same.

As for insurance, some dental insurance does indeed include a benefit for adult orthodontics (mine did -- it didn't pay for them all, but it did pay a bit towards them, plus got me a discount overall from my ortho), but it's not very common, I don't think. Even with insurance, mine cost about $5000 (this is from a great ortho in Los Angeles), which was paid in monthly installments over the course of two years. Some orthos may have a sliding scale, and most (I would expect) would allow you to pay in installments.
posted by scody at 8:54 AM on June 23, 2007

Don't worry about it - forget the braces. Me, I have a gap between my teeth big enough to shove a wooden matchstick through.... hasn't caused my career to suffer. I figure if someone ever has something to say about it, I'll spit water at them through my big ass gap.
posted by bradth27 at 9:06 AM on June 23, 2007

huh. "When I was orthodontist gave me a free consultation" should be "When I was considering braces, my orthodontist gave me a free consultation."
posted by scody at 9:09 AM on June 23, 2007

The price of braces varies wildly from place to place and condition to condition. When it's just for straightening, it can be rather cheap, but add in different treatments for crowding and reorienting, and you start to get up there in price. It also depends on how fast your teeth move. For instance, I was told my braces would be on for 1.5 years. They stayed on for 3, because my teeth moved slowly. I was paying 80 dollars a month, plus some huge upfront fee, but my orthodontist, being a true gentleman, reduced the monthly fee to 10 dollars when he realized the braces would remain on past his estimate. I doubt many orthodontists now live by that honor code.

So yeah, internet people using one blurry photo of only your front teeth can tell you nothing except their own personal experience.

Personally, I think your teeth look just fine. But hey, you're the one looking in the mirror.
posted by nursegracer at 10:45 AM on June 23, 2007

Braces will not make your teeth last more years. My teeth are crowded and at 77 years old I think I got good service from them without braces. It is only cosmetic. Only you can decide if it is of importance. To me they look fine.
posted by JayRwv at 11:11 AM on June 23, 2007

Braces will not make your teeth last more years.

Sometimes yes, sometimes no. If a bite is badly off (like mine was), then the "incorrect" pressure and wear & tear over decades can actually damage teeth and create the risk of premature loss. My braces fixed most of the initial cosmetic side of my problems in about 6-8 months. It took another 2 years to get the bite right, even after I'd had surgery to realign my jaws. (Of course, not all bite problems require surgery.) Bite problems are sometimes obvious, but often can only be diagnosed by an orthodontist.

Of course, it's entirely possible that the OP's bite is fine, in which case, braces would be pretty much a cosmetic concern.
posted by scody at 11:43 AM on June 23, 2007

Removing wisdom teeth definitely causes the molars to spread out a bit. Anyone know if it might effect this kind of crowding in front?
posted by Chuckles at 12:25 PM on June 23, 2007

I have exactly the same tooth twisted the same way; it runs in the family from having impacted wisdom teeth. I had a lot of dental work in the course of which they bonded the front four teeth, and I specifically told the dentist to leave it alone when he mentioned he could minimize the appearance of the thing.
I was incredibly angry when I discovered he had filed down the front and back points to "make it look normal". It was a reminder of now-gone family members, and I was attached to it. I figured it gave my teeth character, and if I ever need dentures, I'm going to make them put it back.*

I would certainly want to get an opinion (or two) from an orthodontist before deciding, but if they aren't worried, I wouldn't be either. If those were my teeth, I'd buy a Sonicare toothbrush, because teeth that are less than straight can be harder to keep clean and if the cosmetics bother you, you might consider whitening them a little, not enough to make them look fake. As long as they are reasonably clean and tooth-colored, you'd be surprised how little most people notice about the arrangement.

*That's just to point out a different vantage point on the issue.
posted by unrepentanthippie at 12:39 PM on June 23, 2007

Find an orthodontist who will give you a free consultation. Then you'll get an idea of what all the issues are.

You don't have to pay the total cost of braces upfront. I wouldn't be able to afford mine if that was the case. My dental insurance didn't cover adult braces, so I'm paying for the whole thing. I gave my orthodontist an initial payment, and now pay $200/month. And there's no interest on top of that.

I don't know where you're located, but I get money back when I do my taxes (under medical expenses). My ortho gives me receipts when I make my monthly payments and I send those in with my tax form.
posted by quoththeraven at 1:02 PM on June 23, 2007

"Hey, Mr/Ms Orthodontist, do I need to spend $8500 with you or not?" It might be better to say you are about to move across country, and so you certainly won't be able to buy the braces from them -- how necessary do they think they are when they won't see a penny's profit? (Though I suspect fellow-feeling for other orthodontists might still skew their scale a bit.)

Note also the most recent question tagged "braces" had at least a couple of people saying that their teeth were damaged because they wore braces, and people have also recently talked about the difficulties of flossing round braces.
posted by Idcoytco at 3:21 PM on June 23, 2007

Here's my teeth. I had adult braces. So my teeth were really wildstyle. So your teeth look great.

BTW, I can hardly believe all the MeFi all-stars are missing this opportunity to reveal our collective choppers!
TeethFilter, ho!
posted by humannaire at 3:31 PM on June 23, 2007

I can't get your picture to open. Are you happy with how you look? When I was in late middle school, my dentist said I needed braces for aesthetic reasons. My parents disagreed and I was okay with my teeth. When I was in high school, I got a new dentist, who also said I needed braces. Again, my parents disagreed and I couldn't really see anything wrong with my teeth. During my 20s, I saw two other dentists. I asked them if they thought I needed braces. Both said no. They said that they suspected previous recommendations must have been based on an arrangement of teeth that have mysteriously worked themselves out. I took that to mean that the dentists were looking to put their children through college. Last year, I mentioned the braces situation to an acquaintance who works as a dentist. He said that he felt the response was code for "they wanted to put their kids through university". Obviously, YMMV and I haven't seen your photo.
posted by acoutu at 5:32 PM on June 23, 2007

Just to clarify. The initial consultation was free, but I had to pay $450 for the diagnostic appointment, where they take xrays and casts of your teeth, plus photos from all angles and measurements of mysterious things like bones and jaws. They gave me a basic idea of what I would need in the free consultation, but they can't give you the full-on estimate until they get in there.
posted by apostrophe at 6:31 PM on June 23, 2007

You need to see a dentist. A real plain regular old (or young, you know) dentist. Get a full set of x-rays and a panoramic xray. This will give your dentist an idea of what's going on that can't be seen by the naked eye and certainly can't be diagnosed by your friends in the computer. A regular dentist can write you a referral to an orthodontist that he or she trusts to do work on adults with whatever condition you have.

No orthodontist worth his or her salt will put on braces unless you're cleared by a regular dentist as having a current cleaning and preferably a plan of care for your ortho treatment.

I am not a dentist and I don't want to be a dentist. I managed dental offices but am not in school to be an anthropologist. Please, I beg of you, go get your teeth professionally cleaned and evaluated.
posted by bilabial at 8:38 PM on June 23, 2007

Seconding bilabial, a good dentist can tell you exactly what problems will develop (or not) without braces. For me, I could get away with it from a teeth perspective, but my TMJ joint will deteriorate over time. If you have that kind of problem, I'm not sure it can be identified from a photograph. Also, uneven wear on one side of the mouth or the other.
posted by BrotherCaine at 8:09 AM on June 24, 2007

My lower teeth are a little more crowded than yours, and while my dentist told me I should get braces I couldn't afford it either. Now i am looking at getting braces. I know here in Richmond, VA there are two places for those who are above the poverty level, but can't afford dental insurance. VCU medical center, and a low income medical center (which VCU has a part in I believe.)

You may just need to search online, or you could call your local college. Usually dental schools need patients, and they do very good work, for very little money (a $800 job costs $200-300 at the college) The only downfall is that you better take off enough time, because you may need to wait hours after you appointment time has past.
posted by slc228 at 4:50 PM on June 25, 2007