When Comparing Orthodontic Fees: Need To Compare Apples To Apples…

Let’s face it. Healthcare is expensive. Lasik surgery can cost $5000 or more for three short visits. A broken arm will cost you $7000 or more at the emergency room. Laser hair removal can cost even more than that! In today’s economy with incomes down and expenses up, it is not uncommon for families to price shop for everything. Is price shopping for orthodontics a good idea? How can some offices provide care for less? Does it really matter who puts on the braces?

Fees in my office are determined by what it costs us to provide the service. We have an accounting firm that keeps a close watch on our cash flow (we are a business after all) and about once a year we evaluate what we’re taking in (fees) and what we’re paying out (overhead). Our fees are about middle of the road for Stockton. Why are we higher than some but lower than others? Here are four variables that affect fees…

Perhaps the most visible difference between orthodontic offices is the physical facility and equipment. Our office is conveniently located, has lots of free parking, and the office and treatment areas are very open, bright, and inviting.  There is plenty of comfortable seating in our reception room. We utilize state-of-the-art in-house digital radiography and diagnostics and have 12 computers throughout the office to enhance treatment.  We have 6 comfortable treatment chairs to deliver our services, and have an on-site dental lab where we can make custom retainers and removable appliances with high-quality, quick turn-around capability.  Admittedly, we could straighten teeth with less, but each one is a gear in our “well-oiled-machine.” 

A second variable that affects our fees is the quality of the treatment we provide. I’ve been in practice for over 11 years now. Many of my team members have been with me most of that time. They are very talented and know what they are doing. They cost more than inexperienced technicians… and they are worth it.   We also use the most efficient braces available. We feature 3M Unitek brackets (both in traditional metal and clear).  They cost us a lot more than mail-order brackets from overseas or from recycled/refurbished ones here domestically. The proven quality, reliability, precision, and consistency provided by our brackets make the extra expense worth it. We also use the latest technology in wires. Wires, more than anything else, determine the position of teeth at the end of treatment. In fact, all our wires and brackets are individually packaged so they remain sterile until the moment we use them in the mouth.  It is impossible to hire the most talented staff, use the best brackets, provide the most efficient wires, and still charge the same as those who do not. Conversely, it is impossible to obtain our results without them. 

 

The third and perhaps biggest difference between treatment costs has to do with what is included in our fee. When price shopping, it is important to make sure that you compare “apples to apples”.  For example, when it appears that our fee for a first phase of treatment is higher, it turns out that our quote includes a lot more (i.e. an expander, upper and lower braces, and retainers while the competing office only recommended an expander or a space maintainer).  Our office includes the costs of the diagnostic records, including intra- and extra-oral photography, digital radiographs, and study models, as part of the treatment fee.  Our fees do not include hidden costs.  Some offices often charge extra fees for broken brackets, when an appointment needs to be rescheduled, or when the doctor needs to perform treatment planning and consulting.  Many offices also charge several hundreds of dollars for diagnostic records on top of the treatment fee. Others do not include retainers and retainer adjustment appointments in the pricing, and if they do often provide temporary or provisional retainers.  Some offices will continue charging monthly payment installments, if treatment takes longer than contracted for, and will do so until treatment is completed.  It is not uncommon in these offices to end up paying twice as much as was originally presented.   The take home message is that it is important to ask what is included in a proposed fee because apples and oranges rarely cost the same.

The fourth and final factor is one that is often overlooked is patient safety.  We pride ourselves on not merely meeting minimum standards but far exceeding them.  To keep us on the vanguard of patient safety, we keep ourselves constantly updated so we can implement new technology and techniques.  For example, we utilize steam sterilization in an autoclave of all our instruments and utilize category 4 sterilization bags.  Standard sterilization bags only measure if an adequate temperature was reached...but they don’t indicate if that heat was maintained long enough, if sufficient pressure was reached, or if the steam penetrated to the surface of the instruments. Category 4 sterilization bags have indicators to ensure that all four elements have been reached:  heat, time, pressure, penetration.

Choosing orthodontic care for yourself or for your child can be a life-changing decision. The quality of the result and treatment experience will not be the same just because the doctor has a license. We understand that orthodontic treatment is an investment for you or your child; we want to ensure the maximum return on your investment.  You may be able to find cheaper orthodontic care elsewhere, but you won’t find better treatment than Wheeler Orthodontics!  

Doc W

Content used with permission by Dr. Greg Jorgensen

http://www.gregjorgensen.com/blog

 

Is All Orthodontic Treatment The Same?

An attractive, healthy smile is an asset that can last a lifetime. Not only will orthodontic treatment influence how you feel about yourself, it will also contribute to how healthy and stable your teeth are in the long run. Selecting the right orthodontist for you and your family is too important to simply accept the lowest bid. All smiles are not created equally and just because a dentist has a license is no guarantee that you will be happy with the results. Here are some points you may want to consider as you choose your orthodontist:

• First, consider the organization of the office and staff. Although you may not understand malocclusions or treatment mechanics, you can tell a well-run office when you see one. Is everything clean and in its place? Is the technology and equipment up-to-date? Is the staff friendly, well-trained, and helpful? If so, it is safe to assume that an equal amount of care will go into the treatment they will provide. The quality of care you will receive will mirror the level of organization and technology of the office.

• Second, what is the doctor’s attitude towards his job? Will the doctor be passionate about your child’s care and can he or she communicate a vision of your treatment plan so that it makes sense? A good orthodontist will examine your child at every appointment to make sure that treatment stays on schedule. Not all orthodontists are “hands-on” and it shows.

• Third, is the orthodontist really a good doctor? How did you find him, a recommendation or an advertisement? Have you actually seen his work? Do you have friends who can vouch for him? There is a misconception that as long as a doctor has a degree, he’ll be able to give you the same results as anyone else. If that was the case, finding the lowest fee would make sense. Unfortunately, not all treatment is the same. A good orthodontist will be very particular about their final results while others are content just going through the motions. A good orthodontist will have an eye for beauty and understands the factors that make up an esthetic smile as well as a functionally sound bite. For something this important, you should ask to see actual examples of their work.  

• Fourth, is your orthodontist board certified?  Board certification is a voluntary examination process of The American Board of Orthodontics (ABO) that allows the orthodontist to present treated cases which will be evaluated by expert examiners of the Board during a Clinical Examination. Involvement in the certification process is a demonstration of the orthodontist's pursuit of continued proficiency and excellence in clinical orthodontics.  In fact, Dr. Wheeler is one of only two board certified orthodontists situated between South Sacrament and Modesto.  Dr. Wheeler also is an Assistant Clinical Professor at his alma mater, University of California, San Francisco, where he helps teach clinically and didactically the next generation of orthodontists.

• Finally, how do you feel when you are in the office? Is it a good fit for you and your family? A good office should be a happy, fun place. Unlike your family physician that you only see when you are sick, you will be visiting your orthodontist and his staff for at least a couple of years, sometimes longer if the treatment is done in two parts or phases. You should feel very comfortable and safe. The doctor and staff should make you feel at home.

All orthodontic treatment is NOT the same. The facilities and technology are a reflection of the orthodontist who will create the smile that you or your child will have the rest of your life. You really need to vet the doctor to whom you will entrust this important care. As with most things in life, you usually get what you pay for. When it comes to your smile, you can’t afford to make a mistake.

--- Doc W

Content used with permission by Dr. Greg Jorgensen

http://www.gregjorgensen.com/blog

X-rays: An orthodontist's friend

Your child just had “X-rays” taken at the dentist last month. Why does the orthodontist need to take another one? In fact, why do orthodontists need X-rays at all?

X-rays, officially called radiographs, are images created when a beam of radiation passes through the body and hits a sensor (or a piece of film in older machines) on the other side. X-rays have the ability to create pictures revealing the differences in the densities of the tissues through which they pass. The “shadows” cast on the digital sensor or film allow doctors to see objects hidden by the skin and bone. The most common X-rays taken by general dentists are called bitewings. In a bitewing, the dentist gets a detailed picture of a small group of teeth that reveals the health of the enamel, inner canals, and roots. Enamel and fillings are dense and appear white in color on the radiograph. The bone around the teeth, the root canals, and decay are less dense and therefore appear darker. Dentists are trained to interpret the light and dark patterns so they can distinguish normal tissues from abnormal ones.

X-rays are essential in orthodontics for many reasons. First, orthodontists are also dentists and, although they are focused on different things, they share the responsibility of identifying pathologies if they are present. These include abscesses, tumors, and other things that are not necessarily directly related to straightening the teeth. Although rare, such pathologies are many times identified for the first time by orthodontists and lives can be saved as patients are referred for treatment.

The second reason orthodontists take X-rays is to help them diagnose and treat orthodontic problems. Orthodontic X-rays focus more on the position and form of the teeth and jaws than on individual teeth like bitewings. Orthodontists are especially interested in missing, extra, impacted, or misplaced teeth, and short, long, or misshaped roots. Problems with the jaws include bones that are too big, too small, asymmetrical (off center), too far apart, too close together, or misshapen. X-rays provide orthodontists with essential information that helps them determine where problems exist and the best way to correct them. The size, shape, and position of the teeth and bone in X-rays dictate if surgery or tooth extraction will be necessary.

Orthodontists also take X-rays during treatment so they can monitor how treatment is progressing. Not all effects of orthodontic treatment are visible to the naked eye. Although very rare, moving teeth in some individuals (about 2%) causes the roots to shorten. Orthodontists must check for this during treatment so they can determine if and how long tooth movement should continue. Sometimes orthodontists observe how the teeth are moving to help them finalize the treatment plan. I prefer not to remove permanent teeth if possible, so in many borderline crowding cases I will begin to align the teeth just to see how the teeth and bone respond. If the progress X-ray reveals that there is not enough bone to accommodate all of the teeth, I can always have some removed along the way.

After treatment, a final X-ray is taken to evaluate the outcome of treatment and make recommendations for other necessary procedures (i.e. wisdom teeth). Ideally then, I take one radiograph at the beginning of treatment, one after about six months, and one after the braces come off. Each of these X-rays exposes a patient to less radiation than they would receive taking a typical airplane flight. All dentists are taught to use the ALARA principle (As Little As Reasonably Achievable) when it comes to radiation. I am careful to take X-rays on my patients only when it is in their best interest, and I assume that my colleagues also do the same.

We are now using faster equipment, more sensitive films and sensors, better collimation, lead aprons, thyroid collars, and digital equipment (which greatly reduces the need for retakes) than ever before. These improvements have resulted in a 60% reduction in radiation exposure since I got my license in 1999. Today’s patients receive the equivalent of only one additional day’s worth of background radiation (from the sun) each time they get a pano.

Don’t be afraid to ask your orthodontist the reason for your next X-ray.

Doc W

Content used with permission by Dr. Greg Jorgensen

http://www.gregjorgensen.com/blog/2012/11/why-does-the-orthodontist-need-another-x-ray/