How to Choose an Orthodontist

When it comes to choosing an orthodontist, whether it’s me or some other highly skilled practitioner, it’s imperative that you ask questions and see how potential candidates respond.

Any orthodontist who struggles to answer your initial questions in a satisfactory way is almost certain to leave you feeling cold and uninformed later in your treatment. You want to go to an orthodontist who has chosen to make the investments necessary to obtain and use the latest technologies, primarily because it is those very technologies that will make your experience—as a patient—more convenient, comfortable, and efficient.

Choosing an orthodontic treatment plan

Let’s look at an example. Your twelve-year-old son has crooked teeth and an overbite. There are three orthodontists in town.

You are a smart consumer so you decide you will shop around and find the doc that will give you the best price. The first doctor has been in practice for fifty years. The office is decorated like it’s been stuck in a time warp and never evolved past 1972. He has spit sinks with rust stains.

He does an exam on Junior and says he needs braces for two years, four bicuspids removed, and he needs to wear a headgear (night brace) ten to fourteen hours per day. Your son asks about treatment with Invisalign and is told he is absolutely not a candidate.

The next orthodontist has been out of training for a year. She looks at Junior and says that he needs braces, but he doesn’t need any teeth removed. She says she will correct his overbite with a Herbst appliance that is entirely inside the mouth and that there is nothing that he has to put on or remove. He also needs an expander. Treatment time will be approximately two years. She also says that he is not a candidate for Invisalign.

At the third orthodontist, you are given the option of traditional braces or Invisalign and the removal of two upper bicuspids.

The costs of the various treatments are similar, perhaps within a few hundred dollars. Your head is spinning, you have seen three doctors and been given three very different treatment plans. Which one is right and which one is wrong?

That is one of the truisms about orthodontic treatments. There are a number of different ways to get from point A to point B, and it’s not merely that one is right and the other is wrong. In the end, you simply have to feel comfortable about both the plan and the doctor.

Let’s look at another example. This time, you are the one wanting to straighten your teeth. The first orthodontist takes a look and tells you that you indeed would benefit from orthodontic treatment. You have crowding and an “overbite.” You require full traditional braces and will need to have two permanent teeth removed.

The second one agrees with the first doctor but tells you that instead of having teeth removed, you need to have jaw surgery to move your lower jaw out. “What? Jaw surgery?” you say. “I just want my teeth straightened.”

The third orthodontist says that, yes, you have an “overbite,” but if that doesn’t bother you then we can treat you without removing teeth or doing surgery.

Which one is right? This is where having clear goals is important. We doctors have an obligation to offer the ideal treatment, and there are many of my colleagues who only want to perform what they consider to be an “ideal” treatment. Compromised treatment is where the result is not perfect from the orthodontist’s standpoint but it’s an improvement, and that improvement may be the only thing that was bothering the patient in the first place.

The important thing, from my perspective, is for you to know your options and what results you want to get out of going through orthodontic treatment.

My golden rules for treating a patient

Good communication is critical for a good result and positive experience. The doctor has an obligation to inform you of your condition, the treatment options, and how your treatment is progressing. It’s also important for the patient to be comfortable asking the doctor any questions regarding the treatment.

This kind of two-way communication ensures that there are no surprises. Doctors in the past were authority figures who dispensed orders that were to be obeyed and never questioned. They were not easy people to have conversations with. Fortunately, that paternalistic style is disappearing. Health care is more and more a collaborative effort between the doctor and the patient.