Quality is of the utmost importance to me. I use only new (never recycled) braces from 3M Unitek.

In addition to the standard stainless steel (metal) braces, I also offer clear braces for those patients who desire a less conspicuous alternative (see the models below who are wearing the clear braces) and gold braces.

It may also be possible to move your teeth without braces at all. Certain limited problems can now be treated with the new Invisalign system. Click the "Invisalign" graphic below to learn more.

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• How much do braces cost?
• Do you recycle your braces?
• What kinds of braces do you offer?
• Do ceramic braces have any advantages or disadvantages compared to metal braces?
• What about braces behind the teeth?
• How do you put the braces on (does it hurt)?
• How long does it take to put the braces on?
• How do they work?
• How do you take the braces off (does it hurt)?
• What colors can be put on the braces?

Cost

(This answer is not meant to be evasive). I do not have one set fee for "braces." My fees are based upon the severity of the case. Having one set fee would mean that I would be overcharging you for an easy case, and that I would not be receiving a fair fee for a difficult case. After the initial examination visit, I can usually tell you what the fee will be or at least give you a fee range if I need more diagnostic information before developing a treatment plan. There is a nominal charge for the initial examination that is credited back to you if and when you proceed into active treatment.

I never have used recycled braces, and I never will. Tell me more

The brackets that I use are what I believe to be the highest quality in the industry. The are made by Unitek, a division of 3M. There are three basic kinds of brackets that I offer:

Ceramic Braces Advantages/Disadvantages

• Advantages:
  • Appearance: The ceramic braces are much less visible than other kinds of braces. (The ceramic braces do not stain, unlike plastic or composite brackets, but the clear elastic ties that are used to attach the wire to the braces do stain (from smoking, drinking coffee, tea or other dark liquids, tomato sauce, etc.). However, you can always call and come in if the ties stain to have me change them).

• Disadvantages:
  • Cost: Orthodontists charge anywhere from zero to $1,000 more for ceramic braces. Factors include the increased cost of the braces to the orthodontist and his/her experiences with them. I charge $250 more for ceramic braces based on the greater cost to me for these braces, and the slight increase in number of visits and visit length that usually occurs with them.

• Breakage: The nature of ceramic material is that it is brittle, so these braces do have the tendency to chip or break. I would recommend against these braces if you are involved in contact sports. If you do experience breakage with these braces, additional visits may be required to replace them. The plastic/composite braces do not chip, but these types of braces do wear down. I have had a patient transfer to me with plastic braces, and the opposing teeth had worn the braces down to a point where the braces were essentially unusable.

• Wear of opposing teeth: Since the ceramic material is harder than enamel, if any teeth bite against the braces these teeth will be worn where they contact the braces. Unless special precautions are taken (such as the use of a bite plate, waiting to correct the bite enough before putting the braces on), ceramic braces are not indicated in certain types of bite problems (such as deep overbites) or with certain tooth anatomy (very long cusps on opposing teeth).

• Difficulty in removal: Ceramic braces used to be extremely difficult and often painful to remove. There also was an increased risk of damage to the tooth with these braces. The latest generation ceramic braces that I use come off much easier than previous ceramic braces, but in my experience they can break in a way the manufacturer did not intend and leave a piece stuck to the tooth. In this case the brace needs to be ground off using a handpiece and diamond bur. This doesn't hurt, but it does make the removal visit longer.

• Treatment time: In cases where the teeth are to be moved by sliding the brace along a wire (most cases), it used to take longer (sometimes much longer) to treat a case with the ceramic braces. In order for the brace to slide along the wire, enough force has to be generated to overcome the frictional resistance between the ceramic brace and metal wire. With previous generations of ceramic braces, there was relatively more friction between the brace and the wire as compared with a metal brace and metal wire. The latest generation ceramic braces have a metal slot that the wire can slide through which decreases the friction to a level comparable to that of a metal bracket. In my experience, I have found a slightly higher frequency of "repair" appointments as compared with metal braces. This may also slightly increase treatment time.

Lingual Braces

Braces that are placed behind the teeth (on the surface facing your tongue) are called "Lingual Braces." I do not use these types of braces for several reasons:

I am not comfortable with using lingual braces. I have only treated one patient (during my orthodontic training) using these types of braces. In my limited experience with using these braces, I found the visits to be more uncomfortable for the patient (he needed to lean his head back very far in order for me to be able to see what I was doing), and more uncomfortable for me since I had to lean over more. In addition, the adjustment visits took much longer since I needed to be more precise with putting bends in wires (the braces are closer together since the arch form that connects the inside surfaces of the teeth is of a smaller dimension than the arch form that connects the outer surfaces of the teeth. The braces are also initially relatively more irritating to the tongue than braces that are on the outer surface of the teeth. My understanding is that since this is a more difficult technique, orthodontists who use this technique charge significantly more for this service. If my patients want a less conspicuous alternative, I offer ceramic braces (see above) or they may be a candidate for the Invisalign system.

Putting Braces On