Understanding orthodontic second opinions

Understanding Second Opinions About Orthodontic Treatment

It is common and worthwhile to have initial consults with more than one orthodontic office before deciding where to start you or your child’s treatment.  Starting braces, Invisalign, or other treatment with an orthodontist often means you will be seeing them every five to six weeks for one or two years. Because of this long-term relationship, the first item to consider is if the office and team members fit your personality. You want to feel comfortable enough to speak up with your questions or concerns, and you also want to have a good feeling when you visit each month.

You may find as you visit different orthodontists they have different treatment plans or ways to correct you or your child’s teeth. This often alarms and confuses potential patients and their parents as they just want to do what’s best for their oral health and don’t know who to listen to. The following are some common areas of confusion patients encounter when getting multiple opinions on orthodontic treatment.

Multiple Types of Appliances

There are different devices available to correct bite problems. You may hear about a Herbst appliance, elastics, springs, carrier or motion appliance, etc. All of these devices essentially provide similar tooth movements, with the difference being some involve more or less patient cooperation to be successful. It often comes down to what works best for each orthodontist. If you come to see us for a consultation, be sure to ask us about these mechanics if you have questions and we will provide a more in-depth explanation.

Orthodontic Expander Use

Another area of confusion is expanders. Certainly expanders provide an excellent service to patients with a constricted upper jaw and/or posterior cross-bite. Expanders widen the arch in the roof of the mouth as opposed to braces that only provide dental expansion. The decision to use an expander or braces will be made by your orthodontist based on your unique situation.

However, some orthodontists seem to use an expander on nearly every patient. This may be due to recent interest in “airway” friendly treatment, in which an expander is used in an attempt to treat sleep apnea or sleep disordered breathing. Fortunately, extensive, credible research has been published recently on orthodontics and its ability to help with sleep apnea. This current research shows expanders should not be used purely for airway issues in the absence of a narrow upper arch or cross-bite because expanders do not alleviate sleep apnea, it is mainly a muscular issue, not an upper-jaw size issue.

Length of Treatment

Total treatment time may be another area of discrepancy between orthodontists. At Milnor Orthodontics, we tend to give a best and worst case scenario for total treatment time. Studies show speed of tooth movement varies widely between individuals and is independent of the force level applied. Certainly, we have averages for different degrees of crowding, spacing, or bite issues, and this is what we base our treatment time ranges on.

We encourage everyone to get multiple opinions before they start treatment, and to ask questions if they get conflicting information or do not fully understand the treatment plan. In our experience, a knowledgeable patient is a happy patient.