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Ted Rothstein, DDS PhD
Determination of Orthodontic fees
The following factors are very important when determining a fee for treating an orthodontic problem:
The most important of these factors include:
The complexity of the problem (some case may require only braces while others require braces, removing teeth and jaw surgery or "orthopedic" devices to enhance the development of under-grown jaws.
The number of months to treat the problem
The type of braces
The type of insurance you have.
Here are some specific guidelines that I use when determining the fee for your case:
Note: Fees quoted almost always are all inclusive i.e.,: 1. All visits from beginning to end; 2. all emergency visits, and 3. retainers to hold the teeth in place.
Additional fees are are rarely sometimes added when "special" retainers/laboratory devices are required or when special diagnostic records are required to understand the nature of the problem and how the expected outcome of treatment will "look." Almost always I will quote a fee to treat your problem at your first visit to my office unless special diagnostic records are essential to make an accurate diagnosis and treatment plan.
Fees rise depending on whether you need treatment for the upper teeth , the lower teeth or both the upper and lower teeth.
Fee rise depending on whether your jaws are normal in relation to on another, or if the upper jaw is over-grown (overbite) in relation to the lower jaw, or the lower jaw is over grown (underbite) in relation to the upper jaw (problems related to excess length or shortness of the jaws). Other problems include those related to the length of the face from from bridge of the nose to chin as well as problems related to how "steep" your jaw angle is.
Fees rise depending on whether you will need to have no teeth removed, or one tooth or two teeth or four teeth.
Fees rise depending on whether you opt to have (if you are given a choice) a removable mouth piece device (like a retainer) which is very rare, or typical/traditional metal braces, or "Cosmetic" braces such as Clear braces with tooth-colored-wire, Invisible Lingual (behind-the-teeth) braces (iBraces, SBt or Ormco 7th generation linguals), or both Invisible and removable (like Invisalign). Fees may vary as well if you choose some combination of the above such as Invisalign on the top teeth and Clear on the bottom teeth. Another example is the choice of clear on the top teeth and metal on the bottom teeth. You should realize that certain of the braces are clearly a better choice for some types of problems and I will advise you when such is the case.
The fee tends to increase if the treatment requires an "orthopedic" intervention (for growing children) such as non surgical widening of the upper jaw with a palatal widening device, or requires moving an under-grown upper jaw forward non surgically with an orthopedic device to help "grow" the jaw forward. Or, finally devices that can be worn within the mouth the can help an under grown jaw to grow forward.
You may have noticed that I have a PhD. What you probably do not realize is just how few orthodontists have a PhD. What is significant about my PhD is that it is directly related to my daily work as an orthodontist in that its subject matter is Growth and Development of head, face and jaws-- normal and abnormal. I am particularly proud of my Doctorate since it was published in the most significant journal in our field the "American Journal of Orthodontics and DentoFacial Orthopedics".*Part I **Part II (see below).
The fee rises if you need both braces and jaw ("Orthognathic") surgery. If surgery is part of the solution the fee tends to increase if the surgery is required for the upper jaw, or the lower jaw or for both jaws in that order. If such intervention is a consideration I will refer you to an Oral surgeon for a consultation.
Fee tends to increase with the number of "phases" of treatment. For example, some problems require immediate attention as soon as possible, such as a "X-bite" in the front teeth at age seven (phase 1). Moreover, a second stage of treatment (phase 2) is required, as evidenced by the X-ray, but cannot be treated until the baby teeth are lost and replaced by most of the permanent teeth at age 10.5 -12-.5.
The fee ("the out-of-your pocket") part of the orthodontic fee when you do have dental insurance that covers some part of the orthodontic treatment varies greatly depending on the insurance company: Orthodontic benefits tend to range between $1300 and $1800, and sometimes, but rarely, as much as $2500.
Payment of Fees
Discounts for fees paid in advance for example are frequently offered and may vary between 5%and 10%.
In my office payment arrangements are as follows:
You may pay the fee in total at the start of treatment
By installments starting with an initial payment between 20-40% of the total fee
By monthly fee without a large monthly down payment
By CITI Health Card and CareCredit
By Master, Visa, Discover and AMEX credit cards
By certified check only at the start of treatment and as final payment when braces are removed
The fee for Orthodontic Jaw Wiring is payable as an Initial payment of $685 before the OJW appointment, and the balance due when the OJW appliance is placed.
Monthly payment arrangements tend to be between 14 and 18 months sometimes as long as 22 months.
Aetna, Caerington, Cigna, DC37, Delta Dental, GHI, Guardian, Healthplex,
Oxford, Metlife, UFT, United Healthcare
May 16, 2010
* Dr. Ted's Doctoral dissertation written in 1971 was published in his professional journal in November 2001. It is a great honor. Want to know what his contribution is? Click here.
**November issue of AJODO, 2001: Part II: Growth from 10-14: an original scientific article by Dr. Ted Rothstein :-)