Getting braces can be a daunting experience, for both parents and kids. Some kids can’t wait to get braces, while others are concerned with how they’ll look and what it will feel like. To help answer your questions, we talked with two top orthodontists about the topic. From what you should ask on your first visit, to the cost of having braces, and even what age parents should take their kids to an orthodontist for the first time, here’s what two orthodontists had to say.
What questions should I ask the orthodontist before starting treatment?
First, you should make sure they are an orthodontist, by verifying that they do only orthodontics in their office (no fillings, cleanings, extractions etc). You should ask them if they have treated a case similar to you or your child’s situation and ask to see some before and after photos. Of course, you should make sure that their hours and location will work with your schedule, and find out how frequently your child will have to come for appointments.
What is the best age to get braces? And when should you take your child for their first orthodontist visit?
The American Association of Orthodontists recommends that all children see an orthodontist by age 7. While most children will NOT need treatment at this age, it is important for an orthodontist to assess the growth of the child’s jaws, take a screening x-ray to make sure that all of the adult teeth are developing properly and are in line to come in, and identify any harmful dental habits that may affect the development of the teeth and jaws. In our office, only 20% of kids in the age range of 7-9 require “early treatment”, and that’s only when there are large growth discrepancies or there is damage occurring to the developing teeth and jaws.
What can parents (and their kids) expect on their first visit?
We know that most kids (and adults!) can be nervous before a trip to the dentist, but it’s generally a very easy and pain-free visit. They can expect to have some photos and x-rays taken and have a clinical exam where the orthodontist counts their teeth, measures their bite, and asks about dental habits (for example, thumb sucking). They don’t need to prepare and they don’t need to be scared! No needles, no pain.
Generally, how many appointments will children have per year? And how long does the entire process take?
The technology has improved so much over the years. With the modern braces and wires that we use, the wires stay continually active for longer periods of time, making visit intervals longer. We see patients roughly once every 2 months, so 6 times a year. An average time for a typical orthodontic treatment is about 2 years. Of course, a simpler case can be shorter, and a more complex one (like an impacted tooth) can be longer.
How will your child feel after a visit (a tightening of braces visit) and how can parents help with the pain?
Our favourite prescription is “Advil and ice cream”! You can generally expect to feel some soreness after an orthodontic adjustment, for an average of about 2-3 days. Usually, the most discomfort is after the first visit when you get the braces, with milder discomfort at future adjustments. We recommend softer foods like smoothies, eggs, pasta, soft meats and soups, and also cold foods like popsicles and ice cream. Both the soft foods and the cold foods will make the teeth feel better. Of course, parents can give their children an analgesic (like Tylenol or Advil), just as they would for a headache or other discomfort.
What foods will children need to stay away from stay away from while they are going through the braces process?
Hard foods and sticky foods should be avoided while wearing braces. The reason is that these can cause breakages to the braces and also distort the wires. Frequent breakages and wire distortion can be irritating to the patient, but can also delay the progress of treatment, as you are constantly trying to repair/catch up rather than moving forward.
What is the rough cost from start to finish?
Orthodontics by a specialist in Toronto usually ranges from $6000-$8500. Most orthodontists offer flexible, interest-free payment plans to make treatment accessible, and the cost is usually spread over the length of treatment. You should always ask the orthodontist what the fee includes. Some orthodontists do not include all emergency appointments, x-rays or retainers as part of this cost. At our office, the fee includes all treatment appointments and appliances, all records, any extra appointments that are needed, retainers and retainer checks for 1 year after treatment.
Do all children need braces?
Of course not! Braces have become a lot more common than they used to be due to the increased knowledge gained from leaving an improper bite long term, and also a societal desire for straight teeth. We always educate the family on the benefits of braces and what may happen if they do not move forward with treatment, such as increased wear on the teeth over time, or damage to some teeth and gums if an improper bite is left. We also see some patients with a beautiful bite and alignment, for whom treatment is not necessary or is elective.
Are there any ways to make having braces feel fun?
We definitely try to make the experience as enjoyable as possible. Kids love picking the colours to decorate their braces with. We also run monthly contests to keep the children engaged. We make a concerted effort to keep treatment as concise as possible, which means starting and finishing treatment at the right time. When kids are in treatment for 4 years it’s hard for them to keep their enthusiasm and cooperation strong the whole time.
How do you feel every time you see a child/teen get their braces off?
That is by far the best part of our jobs! What makes us the happiest is the whole change in their confidence when they see their beautiful smile for the first time. It is so good to know that they can now smile confidently. We also love taking a trip down “memory lane” and showing the kids and their parents the before and after photos- it is so easy to forget how far they have come, and that always astonishes them!
My dentist also offers braces or Invisalign. How come I should go to an orthodontist for my treatment instead?
All orthodontists are dentists first, but general dentists are not orthodontists. An orthodontist has 2-3 years of advanced training that focuses on braces, retainers, and aligners, and teaches us how to create a beautiful smile and a healthy bite. Just as you would go to a cardiologist to have a heart problem taken care of, you should go to the person with the best training and experience to get an optimal orthodontic result. Most general dentists send their own children to an orthodontist to have their braces done.
Dr. Bruno Vendittelli and Dr. Tracey Hendler are certified orthodontists practicing in Toronto. In addition to the private practice, Dr. Vendittelli is on staff at the Hospital for Sick Children where he treats children with cleft lip and palate. He also lectures to dental students at the University of Toronto about Invisalign and esthetic orthodontic appliances. In his spare time, Dr. Vendittelli loves spending time with his wife and teenage sons, and driving fast cars.
In addition to practicing at Forest Hill Orthodontics, Dr. Tracey Hendler is an Associate Professor at the University of Toronto where she teaches orthodontics to dental students. She is dual board certified in both Canada and the US as an orthodontist. When not at the office, she enjoys being active and trying the latest restaurants with her friends and family. Chasing after her two young daughters also keeps her very busy.
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