FAQs at Westwalk Orthodontic Group


How much does orthodontic treatment cost?

Fees for treatment in orthodontics vary widely based on the diagnosis of the problem to be treated. Once an examination and diagnostic records have been obtained, a treatment plan can be outlined.

The plan of treatment defines the time requirement as well as the type of braces required to resolve the problem. This information is explained at a consultation visit, and all fees are explained in detail. This includes a number of different payment options and budget plans.

Your decision to pursue treatment will be made once all this information has been discussed. We accept all major credit cards.

Can braces be removed for a special occasion, such as a bar or bat mitzvah, wedding, school photo shoot, etc.?

Yes, braces can be removed for special occasions and then replaced.  Usually the braces on the upper front teeth are removed, since these are the most visible. This requires using new braces during replacement and requires additional time. There is an extra cost for this service as a result of these factors.

Do you offer a variety of payment options?

Yes, we offer payment options in addition to the office payment plan described above. We utilize CareCredit Financing. With CareCredit, there is no down payment. You can select a monthly payment that fits within your budget.

Your payments will never change and interest rates are competitive. The application process is fast and confidential when you use their website or toll free number, 24 hours a day, 7 days a week. Fee arrangements can be tailored for specific needs.

Is it necessary to remove permanent teeth to straighten my child’s teeth?

In cases where there is severe crowding of the front teeth or when teeth are sufficiently protruding to prevent normal lip closure and swallowing, it may be necessary to create space by extracting permanent teeth.  However, we find that in the majority of cases, removal of permanent teeth is not required for a successful result.

Isn’t it too early to straighten teeth if all the permanent teeth haven’t come in?

It is not always necessary to defer treatment until all permanent teeth have erupted. There are problems which in fact can and should be addressed before all permanent teeth have erupted.

For example, if upper front teeth in an eight-year-old child are positioned behind the lower front teeth, producing what we describe as crossbite, this can and should be addressed as early as possible. If you see a large opening between the upper and lower front teeth when the back teeth are in contact, we call this an open bite.

Frequently these open bites are the result of ongoing finger sucking and improper tongue position when swallowing. Often a simple appliance to prevent finger and tongue habits can be placed to correct such a problem.

If an upper jaw is narrower than the lower jaw, you may frequently see crowding of the upper front teeth as well as a crossbite of the back teeth. This can be corrected by expanding the upper jaw with a device called a rapid palatal expander, sometimes called an expander.

When appropriate and successful, this can create additional space for permanent teeth, which otherwise would not have room to erupt normally.

I am a professional person who deals with the public, and I’d be very self-conscious about wearing braces. Do you use braces that aren’t especially noticeable?

Yes, we have many adult patients who express the same feelings, and we have clear ceramic braces, which are very unobtrusive and work just as well as conventional metal appliances. Another option is Invisalign®, which utilizes a series of clear and barely noticeable aligners that are worn most of the day to accomplish orthodontic movement gradually.

My dentist sent me to you because I have several missing teeth. Why does he think I should wear braces? My teeth look fairly straight, so what is the reason?

Very often, people who have lost teeth and not had them replaced with fixed bridges or partial dentures have back teeth that have moved into positions that preclude the fabrication of sound replacements. This usually is a result of poorly inclined positions.

It is often necessary to upright these teeth before a proper bridge can be constructed. Occasionally, spaces created by prematurely lost teeth can be closed, which precludes the need for any bridgework at all. With the increasing practicality of bony implants, teeth adjacent to the unwanted space must have their roots separated sufficiently to allow proper implant placement.

I’ve been told that my teeth can’t be straightened with braces alone. According to my dentist, my teeth can be straightened, but I will also need some extensive surgery along with wearing braces. What does this involve?

In a small percentage of patients, teeth do not fit together properly because the supporting bone has grown unevenly. In a still smaller group, there are visible facial asymmetries that are cosmetically unacceptable to the patients and cause improper bites.

When this situation occurs, the orthodontist works with a highly trained oral-maxillofacial surgeon to formulate a treatment plan that addresses not only the fit of the teeth, but a repositioning of jaw structures that will provide a stable foundation for orthodontically repositioned teeth.

Usually, this begins with the orthodontist aligning malpositioned teeth as preparation for the eventual surgery that may involve repositioning one or both jaws to bring the correctly positioned teeth into a proper fit. This pre-surgical orthodontics can last from 12 to 18 months.

When the case is ready for surgery, the patient is hospitalized for one to two days and leaves the hospital with upper and lower teeth fixated together. In most instances, with modern rigid fixation of the moved jaw structures, this fixation lasts only about one to two weeks.

In fact, after leaving the hospital most patients can return to work or school within seven to ten days. Surgical procedures are done within the mouth so there are no visible marks upon the face. Post-operative pain and swelling are usually minimal and the procedures themselves are done under a general anesthesia.

After fixation is removed, patients return to the orthodontist’s care for small finishing movements of the teeth that usually take from three to six months. After braces are removed, the patient is given removable retainers to maintain the correction. These are usually worn full-time for three to six months and then worn at night.

The cost of the surgical procedure and hospitalization are usually covered by many insurance plans.

I’ve been having pain my face and jaws and my dentist said I probably have TMJ problems. What does this mean?

The term “TMJ” is an abbreviation used to describe the joint at which the lower jaw connects to the skull, located just in front of each ear. If there is actual damage within the joint itself, the problem is called Temporo-Mandibular Joint syndrome.

Frequently, there is pain associated with opening and closing during chewing, but this need not be present to fall into this category. Occasionally TMJ syndrome is attributable to an old injury caused by a blow to the lower jaw, perhaps sustained in a sports or automobile accident even years before pain becomes evident.

However, the majority of patients we see in our practice actually have no internal injury. Their pain often can be related to “clenching.” Constant clenching stresses the muscles to the point where they suffer a constant “spasm” which causes facial pain that can be ongoing and very annoying.

This condition is then referred to as MPD, or Myo-facial Pain Dysfunction syndrome. This condition can become pervasive and, until a diagnosis is made, patients can become very anxious about a potentially serious medical condition. The anxiety only serves to increase their stress that further aggravates muscle spasm.

Very often, the use of very simple and inexpensive measures coupled with a clear explanation to the patient are all that’s required to relieve the condition. In more recalcitrant circumstances, over-the-counter pain relievers and home self-care procedures can produce relief very rapidly. It is the identification and alleviation of stress that is key in treating myo-facial pain.

Will my dental insurance cover the cost of orthodontic treatment?

Many dental insurance plans cover a portion of orthodontic treatment. Usually there is a deductible to pay and a co-payment amount with a lifetime maximum benefit. Typically, the lifetime maximum is quite a bit lower than the full orthodontic fee.

If you have orthodontic coverage, we'll e-file the appropriate forms to your insurance carrier. Your orthodontic benefit will be applied directly to the treatment fee, lowering your out-of-pocket expense.

After the braces are removed, how long do I have to wear retainers?

Typically, we suggest that retainers be worn day and night for the six months after appliances are removed. After this period, retainers are worn after school to the next morning for an additional six months. We recommend nighttime wear after this period for an additional year.

We encourage patients to continue with some nighttime wear after this period to maintain the correction they have worked so hard to achieve. In a few cases where we believe that stability on a long-term basis may be a problem, we may continue some retention indefinitely with a fixed-type retainer.

How do I know when my child should see an orthodontist?

Because of the high quality of the majority of general dentists in this community, if you bring your child to regular dental checkups from age three, it is likely your dentist will detect orthodontic problems at a very early age and make the appropriate referral.

However, if you see and suspect the alignment of teeth looks abnormal, you should feel free to make an appointment for a clinical examination.

We have seen advertisements on TV for straightening teeth without using braces, called Invisalign. What is this and does it work?

Unquestionably, many of you have seen the spot television advertisements for the “Invisible Braces Technique.” This is a technique that utilizes a series of thermoplastic clear removable appliances to align the teeth.

These aligners, as they are called, are prepared by a computer CAD-CAM program based on special impressions taken in the orthodontic office. We have incorporated this appliance therapy into our practice philosophy. Invisalign is a patented appliance therapy of the Align Corporation.

However, other companies have recently introduced thermoplastic removable appliances for aligning teeth (after several court tests). At present we have a number of patients under treatment with these clear appliances from a number of companies, including Invisalign.

After using these appliances for several years, we have concluded that this method is appropriate for relatively simple, uncomplicated situations. Problems with severe crowding, that require tooth removal, or that include severe protrusions and deep bites do not respond to this type of therapy.

Additionally, because of the 22-hour-per-day wear demand, we find this technique lends itself primarily to adult treatment. The cost of Invisalign therapy is higher than regular orthodontic therapy, primarily because of the fees charged to the orthodontist by Invisalign.

Is the Invisalign technology without substantial problems?

According to recent reports, several of these cases have resulted in “posterior open-bites” at their conclusion. In simple terms, this means that some or all of the back teeth do not come into contact upon closure of the jaws, which is annoying to say the least.

Is this a common occurrence? Frankly, we cannot answer that question at this time, due to insufficient data. In our office, we have not found this to be the case when we finish Invisalign treatment.


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