Orthodontics/Orthodontics

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Question
Hello Dr Supan,

I saw an Orthodontist today.  She diagnosed me with having a class 2 occlusion and mild crowding.  She said my entire mouth is in excellent shape, other than plaque behind my 2 bottom teeth.  Treatment will be between 20-22 months for a grand total of $6300-$6600 in Canadian dollars.  Does this amount sound right?

Also, I forgot to ask her, and she didn't mention to me, but after surfing the web, I read that I will have to wear a retainer for the rest of my life after treatment?

Thanks,

SK in Ottawa, Canada

Answer

Dear SK,

I uploaded a reply to your question earlier, but apparently it crashed as the site shows I still have not relied. Indeed odd, so here it goes again.


What I write here are only my opinions based on very limited information. My comments should not be viewed as any form of diagnosis, definitive or otherwise,  or any form of  treatment recommendation.  Indeed, in the ultimate analysis all final decisions, particularly clinical ones, should  only be made by qualified doctors who have had a chance to see you in person and who have had an opportunity to take and analyze proper diagnostic records.

Okay… having said  that…  your  questions focused on managing a Class II case with orthodontic treatment..  You  wrote:

"  Treatment will be between 20-22 months for a grand total of $6300-$6600 in Canadian dollars.  Does this amount sound right?

Also, I forgot to ask her, and she didn't mention to me, but after surfing the web, I read that I will have to wear a retainer for the rest of my life after treatment?  "

The following two links at braces.com will help answer some of your questions.

http://braces.com/6001.html  cost for braces

http://braces.com/47601.html  retainers

The cost for orthodontic treatment varies widely, and if you are in Toronto for example expect higher fees than if you were in Sydney Nova Scotia. There are no set "proper" fees, and if you think the fee is high or are curious to see if you might be able to find equal quality treatment else where at a more affordable price, then I would encourage you to seek several opinions.

The treatment times can vary as well depending on whether the Orthodontist is treating a Class II case via extractions, Herbst Appliances, growth modification orthopedic appliances such as head gear, etc. 20-22 months seems reasonable.

Finally, regarding retainers. For my patients I recommend full time wear for 3-6 month and then night time wear thereafter. For cases where I fear for the stability and/or patient compliance, I often will bond a small wire on the inside of the incisors. This is called a bonded lingual retainer and i use it to supplement the regular removable retainer, much like an automotive airbag acts as a supplemental safety restraint to a seat belt.

Ask you Orthodontist what he/she recommends.  I hope SK that the linked information and the few paragraphs here have helped.  

Orthodontics

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Paul Supan, DDS, MA, MPH

Expertise

First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

Organizations
American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Publications
Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

Awards and Honors
Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

Past/Present Clients
Available upon Request

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