STRAIGHT TALK ABOUT BRACES Buffalo News (c) 1996 Buffalo News. All rts. reserv. 07665036 STRAIGHT TALK ABOUT BRACES Buffalo News (BN) - TUESDAY, June 14, 1994 By: HARRY WESSEL - Orlando Sentinel Edition: CITY Section: YOUR HEALTH Page: C3 Word Count: 1,123 TEXT: More than 21/2 million U.S. children wear braces on their teeth, about one in every six kids between ages 11 and 14. That's a lot of parents putting their money where their kids' mouths are. Orthodontic braces are often the most expensive health decision that parents make for their children. Braces can be a wise investment, saving big bucks in the long run, but it's smart to ask lots of questions before taking the plunge. Q: What do braces do, exactly? A: Braces move teeth from where they are to where they ought to be. The movement is a slow process that takes at least a year, and more typically two to 21/2 years. Q. How do braces do that? A. The concept is simple. A strong wire, anchored to a metal anchor wrapped around the back molars, exerts steady pressure against the rest of the teeth and pushes them into place. Q. Aren't braces just for cosmetic purposes? A. They can be, but there are genuine health reasons for them. Misaligned teeth can result in jaw problems later in life, for example. Crowded teeth can be difficult or impossible to clean properly, which can lead to severe tooth and gum problems. Q. Are braces painful? A. There is tenderness and occasional discomfort in the teeth and gums when braces are tightened, but advanced nickel-titanium alloys have improved the efficiency of the wires, allowing orthodontists to exert lighter but steadier pressure on the teeth. In the stainless-steel days of old, the wires had to be made tighter with each adjustment because the pressure would slacken between adjustments. Q. Is there a best age to get started with braces? A. Most kids with braces are between ages 11 and 14, but orthodontists are seeing children far younger than that. Most orthodontists recommend an initial visit by age 7, earlier if the child's dentist thinks a visit is warranted. Q. How can orthodontics help a child who still has her baby teeth? A. Braces in young children can make corrections in the jaw that will help their adult teeth grow into proper position. Such "interceptive" treatment can save time and money later on. Children who have had interceptive treatment usually still need to wear braces in adolescence, but the treatment likely will be less complicated and of shorter duration than it would have been without the early intervention. In some cases interceptive treatment corrects jaw problems severe enough that they would otherwise later require surgery. Q. How much do braces cost? A. Between $1,800 and $4,500, according to the American Academy of Orthodontics, with the usual range falling between $3,000 and $4,000. Payment schedules vary widely, with patients often paying the cost in installments over the two or more years of treatment. Q. Will insurance pay for it? A. Many insurance policies will pay part of the orthodontist's bill, but few will pay all of it. Q. Can you be more specific? A. A 1992 survey of its members by the American Association of Orthodontists found that 52 percent of patients had orthodontic health insurance. But those insurance plans typically limited orthodontic coverage to between $1,000 and $1,200. That's only about one-third of the total bill. Q. So how do people afford braces? A. A typical billing arrangement would pay the orthodontist a lump sum at the outset and the rest in installments over the course of the treatment. If the bill were $3,500 for 21/2 years of braces, such an arrangement might work out to a $750 initial payment followed by $100 a month. Financing arrangements also are worked out that call for smaller payouts but more money in the long run because of interest on the loan. Q. How many visits does all that money cover? A. As many as are needed. An orthodontic patient typically will see the doctor every three to five weeks while the braces are on, with an additional handful of unplanned visits arising for problems such as a wire needing adjustment. Q. How about after the braces come off? A. Patients are given a "retainer" -- a removable, custom-made plastic and metal mouthpiece usually worn just at night -- to ensure that the teeth stay in place. Visits to the orthodontist continue every five weeks or so for up to a year, and then less frequently depending on how the patient's teeth respond. Some people stop wearing their retainers after a year, others continue wearing them for years -- some even for the rest of their lives. Q. Are the retainer, and the office visits that come after the braces come off, covered by the initial payments? A. The retainer usually is part of the package, but the follow-up office visits may not be. It is important to find that out when you're discussing the cost of orthodontics at the outset. Q. So how do I decide which orthodontist to send my child to? A. Ask for recommendations from your family dentist and from friends who have had children in braces. Be aware that over the course of the treatment you'll be making frequent visits to whichever specialist you choose, so the doctor's office location is important. Q. Do I have to go to an orthodontist for braces? Can't a dentist do the same thing? A. Some general dentists do orthodontics work, and they often charge less than orthodontists do. They have not been as extensively trained in orthodontics, however. Orthodontists do not do general dentistry or any dental work other than orthodontics. Q. Is there any way to know what results my child will get from braces? A. In addition to before-and-after photos of previous patients, orthodontists have access to computer programs that can accurately forecast what your child's face will look like at full maturity. A "Forecast to Maturity Facial Print" program, developed by Connecticut orthodontist Thomas Christie, was touted earlier this month at the annual convention of the American Association of Orthodontists. Christie's $125 facial print package is available through local orthodontists, who take a set of X-rays and send them to him. Christie's office address is 69 Sherman St., Fairfield, Conn. 06430. Q. Does my child really need a computer forecast before getting started with braces? A. Probably not, although such computer forecasting may become routine in the future. The computer forecasts are best suited for young children with more complicated dental problems, giving orthodontists a more precise idea of how the jaw will develop. The forecasts also may be a good investment if the orthodontist is recommending that teeth be extracted. "The only reason to take any teeth out is if, at maturity, the jaws haven't grown large enough to fit them in," Christie said. CAPTION: PETER COLOSI/Buffalo News Copyright (c) 1994, The Buffalo News