Two completely different orthodontist evaluations. How to decide?
September 4, 2020 9:06 AM   Subscribe

Any insight would be appreciated. I am adult who felt that my bottom teeth were becoming crowded and have been thinking of getting braces (i.e. invisalign) for some time. I got two orthodontic consults. Both orthodontists are highly rated or highly reviewed by two different online sources. They had completely different assessments; how do I discern to make sure I am getting good oral health and a cost effective treatment?

Orthodontist A: Listed out all my problems, and recommended invisalign. Took photos, examined my teeth briefly and said my case was "mild." My incisors are too small, and my bite is a bit misaligned to cause grinding and wearing down of my teeth. Listed out all my problems on paper. The invisalign and a small amount of shaving would be done to change the shape of my front and bottom teeth to make them more aligned. Length of time would be approximately 5 months and the cost would be around $5300.

Orthodontist B: Took more time to examine my teeth and gums, and did not list out all my problems on paper. Took photos as well and told me that similarly, my incisors are too small, that possibly the space in them would have to be made larger. My incisors could be fixed with veneers since they seem too small to match the size proportion of my front teeth. Recommended either option of traditional braces or invisalign. Mentioned my bite was also misaligned, I would need at some point a rubber bands in the back. Did not usually do shaving as they prefer to preserve teeth. Length of time would be 12-15 months for invisalign or traditional metal braces and cost would be $7400 to $7800.

I am also having a general dentist appointment who does cosmetic dentistry next week. How do I discern how to make a well informed decision? Go to another orthodontist for a 3rd opinion?

Live in the city FWIW. Any advice would be appreciated so that I don't make a costly or incorrect decision about my oral health.
posted by anonymous to Health & Fitness (4 answers total) 2 users marked this as a favorite
 
You are starting up with an entirely new general dentist next week? They may have an orthodontist they work with. My orthodontist was recommended by my dentist and they kept in communication and I think that's really valuable. In my case, I was waiting on orthodontia to be done so I could get some restorative work. In your case-- you're thinking of maybe getting veneers and stuff? I would think it would be better to work with a team.
posted by BibiRose at 9:18 AM on September 4, 2020 [1 favorite]


I'm a general dentist. If I were you I would continue to research and learn before you commit.
You say you got two entirely different assessments, but what I read is that you got different styles of exams, but the same conclusion (your lower incisors are undersized and crowded), and then two different treatment plans. The first one met your expectations (here's what invisalign can do) and the second included the more traditional approach.

Some practitioners are happy letting the patient guide the approach. You came in asking to have your lower front teeth fixed with invisalign, so here's how we do it. (dentist A?)

While others cover more bases: your bite is misaligned and a full round of braces is advised, you'll likely need crowns or veneers to fill the spaces between the teeth after everything is in its final position.

Orthodontists don't do the veneers or crowns, so it's necessary to have a GD in the mix anyway, so take your two assessments to your next appointment and have this discussion with them.
posted by OHenryPacey at 9:43 AM on September 4, 2020 [7 favorites]


I am not a dental professional of any kind, but I think the difference could be that Ortho B is giving you the recommendation for a more cosmetically "perfect" outcome (matching proportionally and such), which some patients feel is more important than others do.
Update: I see a dentist has answered with good advice.
posted by Glinn at 9:45 AM on September 4, 2020


I am an adult with traditional orthodontic braces and a ton of problems to be fixed. I'm not eligible for Invisalign and can really only get partial success without surgery (which is what I went with, its always been suggested but i'm not going down that path). I would get a a third opinion (and second on traditional braces), not sure where in the world you are but that sounds high (more than I paid for a longer and more complicated treatment, anyway and I know I could have paid less elsewhere). Rubber bands are pretty common with traditional braces, they're nothing to fear.

Traditional vs invisalign - are you good with remembering to put your trays in after you eat? My brother had invisalign and there's no way I could be as diligent as was needed; I like traditional braces because there's no way to forget to put them back in (the elastics though are another story!)
posted by cgg at 11:23 AM on September 4, 2020


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