How to Get Braces
Written by: Dr. Laura Edwards, Orthodontist
Medically reviewed by: Dr. Oleg Drut, Orthodontist and Diamond Braces CCO
Date: October 8, 2020
The Complete Step-by-Step Guide
The process of getting braces can be confusing at first – but this guide will help you understand everything that happens on the way to your healthy smile.
Step 1: Choosing on Orthodontist
Patients generally find an orthodontist from one of two ways: either they are referred by their general dentist, or they seek out an orthodontist on their own. Your general dentist may have a referral at hand for a great, trusted orthodontist, but you can also do your own research to find an excellent orthodontist for you or a family member.
Great ways to find an expert orthodontist:
- Get a recommendation from family or friends that have had braces
- Ask your dentist, periodontist, or general doctor
- Do a google search for local orthodontists and compare reviews and ratings
- Use the locator tool from the American Board of Orthodontics
- Visit several practices to ask questions and compare prices
For more experienced orthodontists and lower prices, seek an orthodontist in a free-standing orthodontic facility rather than a general dentist’s office. While general dentists can straighten teeth, only licensed orthodontists receive extra specialized training to master the art of orthodontia. And since orthodontic practices are only straightening teeth and not performing a wide variety of dental treatments, costs tend to be lower.
The photo below shows a free-standing orthodontic facility:
A note on mail-order orthodontics: in recent years, several companies have cropped up offering braces-by-mail, with clear aligner treatment mailed to you at home without visiting an orthodontist. While this sounds convenient, treatment without direct doctor supervision presents serious risks to your health. In-person treatment is critical to achieving safe, effective results. Many consumer complaints have been filed against mail-order orthodontic companies; be sure to research these treatments thoroughly to understand the risks.
Step 2: Braces Consultation with Orthodontist
Once you've chosen an orthodontist, you will schedule a visit for your consultation. These consultations are generally complimentary and don’t require a commitment to seek treatment, so you can schedule several consultations to get different quotes and treatment recommendations and decide which is right for you.
At your consultation, the orthodontist and assistants will gather preliminary information about your smile: If necessary, they will take x-rays and pictures of your teeth, get your health and dental history, and ask for your complaints with your teeth and any side effects of the issues. The orthodontist will establish a comprehensive diagnosis of your condition, which is sometimes comprised of multiple issues.
Step 3: Select a Treatment Plan
Once your diagnosis is established, you and your orthodontist will discuss treatment plans. Some treatment styles are less effective for certain conditions, so your doctor will offer recommendations for the best treatment for your condition and an estimate for length of treatment.
If you have a preference for your treatment appliance - such as clear braces or clear aligners – this is the time to tell your doctor, so they can determine whether your case can be corrected using that appliance.
Step 4: Make a Payment Plan
Cost matters when selecting a treatment plan as well: at your consultation, you’ll get a quote for the cost of your preferred treatment to correct your condition. You’ll discuss with your orthodontic team and administrative staff about how you will pay for your care, and develop a payment plan.
The orthodontist office can also help you negotiate your insurance coverage: many offices take care of all billing directly, so you can just provide your insurance details and pay the balance, either up-front or through a monthly payment plan. Ask your orthodontic office about who takes care of the billing: offices that handle billing directly will save you a great deal of time and effort.
Step 5: Consent Forms & Contracts
Before your braces can be put on and treatment begun, there will be some paperwork to fill out. If you are a minor, your parent or guardian will have to sign on your behalf, as braces are considered a medical procedure and subject to all the same legal requirements as medical care. You or your guardian will sign an Informed Consent to Treat, which means you understand the risks associated with treatment and authorize the orthodontist to treat you. You will sign medical release and privacy forms as well, in compliance with HIPAA, and you also may be given a photo release, which you can choose to sign or opt out from.
Contracts are legally binding agreements to pay the amount of money agreed upon for your braces, in return for the care you have agreed upon. There may be multiple financial contracts to sign depending on how you are paying for your treatment.
Be sure to sign and read all pages of the consent forms and contracts, and if you have any questions about what you’re signing, ask your orthodontist or their staff: it’s important to know what you’re signing up for. If you or your parent/guardian needs an interpreter to understand the forms, your orthodontist is legally obligated to find one for you before you sign.
Step 6: Doctor Designs a Case Plan & Begins Your Orthodontic Treatment
Once you've established a treatment plan with your orthodontist, and the forms are signed, it's time to begin! Your orthodontist will design a unique treatment plan for your specific condition and case.
How soon you can begin treatment depends on which type of treatment you select: traditional metal braces and clear braces can often be put on the same day as your consultation, because the treatments all begin with bracket bonding and installation of the archwire.
Other treatments require your orthodontist to design a plan and then receive the materials from an outside production facility. For instance, Invisalign clear aligners are produced in specialized Invisalign facilities, and are mailed to your orthodontist to be fitted for your mouth. Lingual braces are also produced in an outside facility and mailed to your doctor. These specialized treatments require a detailed treatment plan crafted by your expert orthodontists, which is one reason they tend to cost more than traditional metal braces. For these types of treatment, you can begin 3 to 6 weeks after your consultation.
Step 7: Adjustments and Routine Care
Once your braces or aligners are on, you'll have time to get used to them and adjust to the new appliance. Some pain or discomfort is normal as your teeth and mouth adjust to the new orthodontia. There are many tips to address discomfort or pain at home.
An important part of any orthodontic treatment is your at-home oral health routine. Be sure to follow all dietary restrictions provided by your orthodontist, as well as instructions for cleaning your teeth and appliance.
Brushing and flossing every day is critical to keep your treatment working, and to keep your teeth, mouth, and appliance fresh and clean throughout your care. There are specialized instruments that can help you brush and floss and clean your braces, to prevent plaque build-up, gingivitis, staining or discoloration, and more.
You'll also visit the dentist throughout your orthodontic treatment for cleanings and check-ups: it is still possible to get a cavity during braces care.
Throughout treatment, you'll visit your orthodontist regularly so they can check your progress and make adjustments. If you have a fixed appliance like metal braces, they’ll tighten the archwire and change out the elastics ties to continue your progress. For removable clear aligner braces, they will provide you with a package containing the next few sets of aligners. Fixed appliance patients – those with metal, ceramic, or lingual braces – will come to the orthodontist every 4 to 12 weeks, while Invisalign clear aligner patients can come in less frequently, generally every 8-12 weeks or even longer intervals.
Though rare, you may also need to come in for an emergency visit during treatment, if something happens to your appliance or you need a replacement. Many orthodontic emergencies can be treated from home and addressed at the next visit.
Your treatment length depends on your specific case and the treatment type: most braces wearers will achieve straight teeth between 12 and 36 months. When you reach the end of your treatment time, it will be time to celebrate the end of treatment and your beautiful new smile.
Step 8: De-Bonding & Retention Phase
After your treatment is complete, your malocclusion corrected, and your teeth have been straightened, it's time for everyone’s favorite day: braces de-bonding!
You’ll visit your orthodontist for a final progress check, and if the orthodontist approves your case as complete, their assistants will remove the braces appliance using specialized instruments, and remove any excess residue left by the bonding glue. You'll get to see your beautiful new smile, and photos will be taken to mark your results.
You're not completely done, however: retainers are important to keep the teeth from moving back. You'll be provided with a retainer, either a bonded retainer, attached to the back of the teeth where it's not visible, or a removable retainer. There are several types of retainers: learn about them all with this retainer guide.
You'll generally go back to the orthodontist for at least a few follow-up visits after de-bonding and retainer insertion, generally twice a year for 1-2 years. If you lose or break your retainer, you'll need to go back to replace it, but as long as you continue to wear your retainer and take good care of your teeth, you may never need to go back to the orthodontist!
Signs an Adult or Child Need Braces
Do you or someone in your family need braces? Sometimes, it can be obvious that braces are required – but you may be surprised at the signs that actually point to a need for orthodontic care.
Below are some tell-tale signs that someone needs braces:
Signs a Child Needs Braces
Severely crowded teeth
Gaps between permanent teeth
Trouble closing mouth fully
Complaints of jaw pain, dental pain, or severe headaches
Snoring or trouble sleeping
Premature or delayed loss of primary (baby) teeth
Too many teeth or not enough teeth
Mouth trauma causing disruption to teeth or dental growth
Signs an Adults Need Braces
Difficulty flossing or brushing
Speech impediments such as a lisp
Difficulty closing the mouth so that all teeth touch
Severe crowding or overlapping teeth
Clicking jaw when chewing or biting
Aching jaw or headaches
Large gaps between teeth
Pain or discomfort when chewing or biting
Trouble sleeping due to jaw pain
The positioning of baby teeth is not a perfect indicator of a future need for braces: for instance, some children have large gaps between their primary teeth that will be filled when the permanent teeth grow in.
However, the earlier children see an orthodontist, the greater the potential for fully effective orthodontic care. The American Association of Orthodontists recommends children see an orthodontist by age 7, for an examination and to determine the potential need for braces, as well as any early interventions that can be taken to minimize the need for further treatment later.
Questions to Ask the Orthodontist Doctor at Your Visit
When getting braces, your initial consultation is an excellent time to ask the orthodontist any question you may have about your treatment, their diagnosis, and what their office can offer you.
Remember, the initial consultation may be complimentary and no-commitment necessary, so you can easily go to several orthodontists and compare prices and treatment options.
Questions to ask your doctor at your consultation:
How long will my treatment take?
Do you have examples of similar patient treatments you can show me?
What is your experience treating my specific kind of condition?
What is the cost of the various treatments you offer?
Does your office accept insurance?
Does your office offer monthly payment plans, and is there an interest fee?
Are you offering any savings or promotions on certain treatments?
Are you licensed in this state to provide orthodontic services?
How long have you been practicing orthodontics?
Where did you train for your orthodontic license?
Are you practicing out of a freestanding orthodontic facility or a general dental office?
Are you always available in case of emergency?
What is your Invisalign experience and rank?
Are all your assistants state certified?
Are you using Invisalign aligners or other types of aligners?
Alternatives to Braces
If you’re not certain about getting braces treatment, there are alternatives you can consider.
Invisalign clear aligners
If you don’t want the visible appearance of orthodontic appliance, Invisalign clear aligners are an excellent alternative. Removable, discreet, and easy to clean, Invisalign are a popular option for teens and adult of all ages. Learn more about Invisalign.
Depending on your specific condition, the issue may be corrected using oral surgery. This is the case for issues such as impacted teeth and crowded teeth, where an extraction is the only treatment necessary.
If your issues with your teeth are only cosmetic, you can get veneers to cover the surfaces of your teeth and improve the appearance of your smile. Veneers do not correct any underlying issues, however, so this is not a good option for patients with more complex orthodontic issues that impact their bite, speaking, oral health, or overall health. For those patients, it may be necessary to ger orthodontic care before getting veneers.