First consultation with ortho -- questions

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#1 Post by **Banana1214** » Thu Dec 08, 2005 12:04 pm

So I saw an ortho today who seemed top notch -- great staff, beautiful, clean office and nice technology. He told me my problems were much worse than I thought. All I wanted was braces on top because I have a bicuspid that never came down. But he says my whole bottom jaw is out of whack and needs to be fixed (it's true, in the pics they took I could definately see that my chin leaned to the left and one side of my face looked "caved in" a little because the bottom teeth on that side were pushed in so far toward my mouth).

So he wants me to wear an expander on top for 3 months to make room for the tooth to come down (doesn't believe in extractions) and then ceramics on top and bottom for probably 18 months to realign my jaw and other teeth.

Sounds great -- thing is, it's going to cost $7,500. That seems like a lot to me, but his nurse said that's because he's one of the best in South Florida and my problem is a little more extreme than most.

I'm going to see another ortho for a second opinion, but I really like this first guy and want to go for it -- and the nurse says every other ortho in the area may charge less but will just extract my teeth, leaving my jaw looking even more caved in instead of brought out the way this ortho wants to do it with the expander.

So what do you guys think? Spend a lot of money to get it done "right" or spend less and do it the easy way?

#2 Post by **nvcarissa** » Thu Dec 08, 2005 12:10 pm

I hate feeling like someone is giving me the bums rush. So I would say, go ahead and do the second consult. Don't necessarily believe what the first office is telling you without checking it out. For instance, if doc #2 wants to do extractions, ask if it will make your face look more "sunken." Don't take the nurse's word for it.

#3 Post by **KJM** » Thu Dec 08, 2005 12:44 pm

I agree with nvcarissa. I would get atleast one more opinion, maybe two. Ask questions.
Sometimes its worth paying more (ie a top notch doc, specialist etc), sometimes your only helping pay for that posh office.
If you have a couple more opinions you should be able to choose which option works better for you.

Good Luck!

#4 Post by **Banana1214** » Thu Dec 08, 2005 3:12 pm

Thanks for your advice. I'm going next week to the guy my dentist referred me to, so we'll see what he says. Here are the photos they took today. You can see how my jaw is offset and the lower cheek is a little more pulled in on one side. The ortho drew on the pic to show where my top and bottom teeth are supposed to line up. I'm a whole tooth off on the bottom.

#5 Post by **gunter8888** » Thu Dec 08, 2005 5:00 pm

Get the 2nd opinion - definitely! I had 3 consults and everyone had a different take; surgery, 2 extractions, no extractions w/ expander (the one I chose).

I liked the ortho that suggested surgery and he shared something interesting with me. In his practice they keep their office simple. Its clean and comfortable, but there are no XBoxes for the kids to play on or TVs on the ceiling. He said they keep the decor simple as part of their effort to keep fees down.

As it turns out, the ortho I chose has a very similar approach. I'd rather have my $ go toward the technology in my mouth rather than on the ceiling.

#6 Post by **dena** » Fri Dec 09, 2005 12:16 am

just to agree with others, get another opinion. I went to my first consult 4 years ago and was scared away by the price and his take on how bad my situation was. this year, i've been to three different orthos and they all had different treatment plans. i havent started treatment yet really so i cant back up my choice, but i definitely found that i was more comfortable with one orthodontist and one price than with the others. also, within one geographic region (like 1/2 hr apart) i had two price quotes that were $2000 difference. now, i am going with the less expensive one which means extractions. but i liked him better and the guy who had a much much higher price quote said extractions were still likely...having all that info gave me a better idea of who i wanted to go with. just for price alone get the second opinion.

#7 Post by **Banana1214** » Tue Dec 13, 2005 9:21 am

Ok, I saw the second guy today, the one my dentist recommended. Very different experience. The office is tiny and straightforward, just a few dentist chairs. The ortho comes in, doesn't even introduce himself or shake my hand, just sticks this dirty looking mirror in my mouth. Then he says what I already know about my teeth, and that it may be possible to expand my uppers but that I may need surgery (which the first guy never mentioned). I showed him the picture from my first ortho so he could see my teeth better, but he didn't say much. He just said he'd have to do the whole x-ray and mold process before he could tell me what he'd do or how long it would take or how much it would cost. I said, can you give me any kind of price estimate, and he says probably between 4,000-5,000. Then he starts moving away and says "do you have any other questions." And I'm like, that's it? I was in and out of the chair within five minutes and didn't learn a thing, except now I know I won't be going back there.

It was even worse because I had to drive half an hour to my mom's office so she could watch my six-month-old, then 20 minutes back to the ortho office, then 20 minutes back to my mom's work, then half an hour back home. All for a five minute "consultation." What a rip-off. I guess I was spoiled by the first guy I went to, who spent almost an hour with me, took full pictures and gave me a price on the spot. Maybe you get what you pay for. The first guy will charge more, but he has a nicer place, better-looking equipment and much better bedside manner, while the second guy will charge less but isn't friendly or helpful. Which would you choose?

I still have one more guy to see, and I'm pinning a lot of my hopes on him, since he's the "board-certified" one and the guy my mother-in-law says is so great. I hope so!

#8 Post by **weird_wired** » Tue Dec 13, 2005 10:20 am

The same kind of happened to me - I planned just for an upper brace, for cosmetic reasons. I mentioned this to the hygienist, and she said: "yes, your bottom teeth are really crowded, a brace would really help."

So I'm now getting both treated.

#9 Post by **gunter8888** » Tue Dec 13, 2005 4:43 pm

My 3rd ortho was very similar. I wasn't expecting champagne and caviar, but his office was messy and the equipment looked old and dirty. After spending 25 minutes in his crowded and messy waiting room, he spent less than 5 minutes examining me. He stuck a mirror in my mouth, looked around and said, "Oh, you'll need surgery. We don't handle surgery cases." I got the impression that he just looks for the easy, straight-forward, children's cases. He doesn't seem to want any patients that may require a little extra time, effort or knowledge.

On the other hand, the ortho I chose to go with has been amazing. His staff spent 30 minutes doing the x-rays, photos, questionnaires, etc. Once they were done he laid it all out in front of me, told me what he recomended and answered every silly question I could think of. In all, I spent over an hour just for my first consult.

A few days later I had thought of a few new questions and called his office. At first, the office manager was going to have him call me back later in the day; which would have been fine with me. Instead, she said, "Why don't you stop by on your way home from work today. We'll put you in the chair and you and Dr. ___ can talk." I was blown away. Never has any kind of doctor given me that kind of attention. It certainly made me VERY comfortable with my choice in orthodontists!

#10 Post by **dena** » Tue Dec 13, 2005 10:41 pm

i think what you are describing is common and even a little lucky. now, the first ortho, who looked good to begin with, seems like a great fit with you. sometimes seeing someone worse has its benefits. I know you were initially concerned about cost, but if you still are, seriously try another orthodontist. If you still end up only liking the first office, it will help put the cost into better perspective. I think you will find what you are looking for. Good luck.

#11 Post by **ssfw** » Tue Dec 13, 2005 11:40 pm

Hi Banana1214,

If possible, try to get 3-4 orthodontic evaluations (alot of orthos don't charge for evaluations). I feel you learn alot about the orthodontist and orthodontics during each evaluation.

I feel you should choose the orthodontist based on the treatment plan that you prefer and the orthodontist you feel most comfortable with because you will be spending quite a bit of time in their office. You want to feel comfortable asking questions and sharing your concerns about your ortho treatment throught the entire time. If you don't completely agree about the treatment your ortho is suggesting, inform him/her about what you prefer and why and ask if it would be possible. If not, ask them what the pros and cons would be regarding the various ortho treatments.

Good Luck.

ssfw

#12 Post by **Mahder123** » Thu Dec 15, 2005 1:03 pm

check them out @ doctoroogle. it gives you doctors with ratings, or Kudzu.com. I found my current ortho on Dr oogle, he's owesome.

it is worth the search. I ended up loosing my pre-paid money of $1500 to this crook dentist who misrepresented himself.

It was two years ago and I found him on line advertising invislign. Invislign was fairly new technology in 2003. He said I won't be a good candidate for invislign. But he didn't want to let me go so he recommended something else because I mentioned my Flex Spending money account. He got so excited and recomended I get implants first for a missing lower tooth (totaly different) He lied to me by saying that implants should come first and so on. He was a former sales rep for a clothing company and very articulate.
He then sent me back and forth with my family dentist refusing to do the implants unless i got every little minute cavitis taken care of.

A year after the process, I cancelled the plan and requested for a refund..I had him charge my credit card for the amount I had on my flex spending inorder to get reimbursed from the plan. He first asked for the Bank info to report it to my human resources Dep which was not his business.
Then few months later, he denies and even says I owed him $600 more for a job he hasn't done. I am suing him right now; he has been served Dec 2nd.
So shop around, it is worth your time.

#13 Post by **Banana1214** » Thu Dec 22, 2005 8:21 am

Well, I saw my last two orthos this week. The first was a woman whom I liked very much and was very interested in my entire oral history, even asking questions about a scar on my cheek, thinking it might be somehow related to my teeth (it's not). She was very in-depth and took pictures and x-rays at no charge. Her plan was to use Damon 3's to fix my teeth and said a lot of the time they can fix crowding and widen the upper arch with no expanders needed. She also thought a lot of my dental problems were due to my being "tongue-tied," that is, my tongue doesn't have all the range of movement it should because my frenulum is too close to my tip and it's keeping my tongue at the bottom of my mouth. She says your tongue is supposed to hit the roof of your mouth 2000 times a day, every time you swallow, and that the muscle helps maintain your upper arch. Therefore, if my tongue is not getting up there, my teeth will start to crowd because my arch isn't being widened correctly by the tongue. Does that make sense? Anyway, she also says that if I get it fixed, I'll speak more clearly as well (I've always had problems enunciating certain words, but thought that was just the way I spoke). That definitely intrigued me. Her estimate was 18-24 months and $6,000, plus seeing a surgeon to get my frenulum clipped.

The second ortho was a guy, also board-certified like the woman, who sort of laughed at the tongue tie idea and said that my upper arch could not be widened unless I had surgery. So he would take just one tooth from the back of my upper jaw and push that misplaced canine down. This means I might have a crooked smile, right? He uses braces similar to Damons, but a different brand. He said they had problems with Damons popping off and getting the doors to open. He also said my crooked jaw, which the other doctors said they could fix with rubber bands or just by straightening my teeth, would never be fixed unless I had jaw surgery. Basically, his take was "you'll have a straight smile, and no one's going to notice your midline's off and your jaw is crooked." I didn't really get the greatest vibe from this guy. And he also said that if I used Damon's to widen my arch and get that tooth down without extractions like the woman suggested, all I'd be doing is "tipping" my teeth out and they would dislodge from my jaw bone and cause more problems. His estimate for treatment was 27-30 months (b/c of the extraction) and $5400.

So now I've seen 4 orthos with completely different plans and ideas of what's wrong with me. I'm more confused than ever and I don't know who to believe. It's like one guy says, I'm right and they're all wrong, while every other guy says, no I'm right and they're all wrong. My husband, who had braces as a teen, says that these are just initial consultations and once they take full records and molds and whatever, they may completely change their mind about treatment. He says the most important thing is to pick someone I'm comfortable with and I trust. I guess that's good advice; I'm just terrified of picking the wrong one!

Anyone else have this many contradicting consultations?

#14 Post by **KJM** » Thu Dec 22, 2005 8:40 am

Wow Banana1214, it all sounds like its "clear as mud"
I really think you did the right thing by getting a few different opinions but I am sorry that it is still so very unclear.

It sounded like there are only two that are in the running, the first office you went to and one is the lady that suggested the tounge tied explanation. Is this right? Maybe you can call your dentist and ask him what he thinks about the tounge tied explanation and see what he says? It might help you to decide.

Good Luck with your decision!!

#15 Post by **Attagirl2** » Thu Dec 22, 2005 1:44 pm

Hi Banana and WOW is right. Let me shed a little light on my progress in Damon 3's:

1. I love them. The only problem I had with them popping off were the ones that were glued onto my gold crowns - I have all four first molars as gold crowns. Three of them managed to popp off twice due to my eating things that were to hard, so I had them banded. No problems since.
2. I have had tremendous trouble with the doors not opening - I manage to make a lot of tartar and it gets into the brackets and keeps the doors from opening. They always tried to open them with a "pick" like instrument. This last time, the orthodontist himself opened them with a new tool that I had never seen before. It was like a pair of wide, but thin sissors. He just went along each bracket and popped each one open without any effort! (Just the visit before last I had to have the lowers replaced with Smart Clips because of the doors). Had he had this tool, I may not have had to have them replaced.
3. My arch has widened and my teeth are not just "tilted" out. Granted, my molars and premolars tilted in slightly to begin with, but the whole area that the teeth are attach too has wideden too - or at least that is what appears to have happened.
4. My bite was crooked - the left side of my lower teeth drop away on and angle. It has levelled out some and the doctor is going to finish bringing them up with elastics starting at my next visit.
5. I think the doctor made since about your speech problem. My mother was telling me that when my older brother was born, the doctors clipped something in his mouth because the doctor said he would have trouble talking later if he didn't have more range of motion... Sorry, I don't know what it was. BTW, I am 52...
6. My Orthodontist just started his own orthodontic journey and it is in DAMON 3's!

I just wanted to you get some positive and negative on the Damon situation from a wearer - not just what the Doctor said.

Good luck in whatever decision you make.