I was at a restaurant, when the waitress stopped by and asked me about my braces. How much did they cost? Who was my orthodontist?

These are both great questions, and begs the larger question, how do you choose an orthodontist? I’ll share my process, so it can be helpful to others, and invite others to share their experiences, too.

First, let me say that so far, 6 months into my treatment, I am happy with my orthodontist. OK, here’s how I chose my orthodontist.

  • Find orthodontists to interview:
    • I first asked my dentist for a recommendation. I think most dentists have relationships with orthodontists, so this is a great place to start. You can even ask orthodontists for recommendations of other orthodontists; this is easier to ask when you’re looking for one in another area.
    • Then I sent an email to my friends and acquaintances asking for recommendations for orthodontists. I got a lot of great responses, including people I didn’t even know — friends of friends — who went out of their way to investigate. I asked these folks to tell me about their experience with the doctor; what was good or bad about working with that doc. Also asked them how much they paid.
    • I even searched for “orthodontists” on yelp.com. This only works in cities where there are enough entries; since I’m in San Francisco, it actually yielded some info. There might be other online sources in your community that are helpful. And there are always the yellow pages, offline and online.
    • You can even go up to someone wearing braces and ask them about their orthodontist.
  • Identify a few to get a consultation from and set up appointments. Some criteria to consider are:
    • If you have insurance, do they take yours?
    • Location: Are they convenient to you? Is parking a pain? I’ve found that it’s been helpful to be relatively close to my orthodontist, because I’ve gone back many times to have wires clipped, etc.
    • Hours: Are their office hours convenient to you? Can your work schedule be accommodated? Remember, kids tend to come in after school. I’ve found my appointments on weekday mornings –which works with my schedule–are more relaxed and usually less crowded.
    • Options: If you definitely want to consider a specific kind of treatment–Invisalign, for example–do they offer that? Do they have enough experience with it that you are comfortable?
  • Decide what’s important for you. In some cases, this is obvious, but I’d guess for most adults this requires some prioritizing.
    • In my case, my ultimate goal was to get my bite fixed so that I could have healthy teeth for the long-term. So I’m more concerned about functional improvement versus cosmetic.
    • My list also included quality of care, cost, length of treatment, and service. Also, convenient location.
  • Go meet the orthodontists. Usually there will be a “business” person who guides you through the process, including giving you an estimate of the cost and time for the treatment. The orthodontist will take a look at your mouth, and will give you an assessment and recommendation.
    • I met with 4 orthodontists. The first was too far away from my home, so was out of the running early on. However, I learned about what kind of treatment she recommended. In my case, she said braces over Invisalign. Because my bite needed correction, Invisalign would only get there 80%. This was great information. Plus I got data on the fee. I felt comfortable with the amount of data I got with the 4 consultations; I encourage you to get at least a 2nd opinion.
    • Ask lots of questions. Don’t be shy. After all, this is about spending 1-2 or more years in treatment, and spending $5,000+. It’s not a small decision. Some things you want to know:
      • What is their assessment of your situation? (Ask this even if you know what your situation is; good to confirm that this potential doctor is seeing the same things as the others.)
      • Why do they recommend the particular kind of treatment over another? For example, braces over Invisalign; 2 years over 1 year; one kind of brackets over another.
      • Have they worked with other patients who’ve had similar issues? If they only work on kids, you might want to find a doc who works with adults.
      • Cost. Get the details on the cost to you, including the insurance portion. Do they have a payment plan? Extra for X-rays?
      • Who will be doing the work? The doctor? Or his or her staff? I didn’t like the feel of one of the places I checked out; it felt like a “factory”. Lots of seats with orthodontic assistants doing the work, and an office with 6 or so orthodontists. I wondered, who would actually be overseeing my progress? Would anyone really care?
  • Gather your data and make a decision. Don’t forget to include your “gut reaction” to doctors and their offices.
    • I decided to go with my current orthodontist, who was the fourth and last consultation. By that time, I had decided that braces were the way to go, versus Invisalign.
      • (I was not happy with the recommendation of Invisalign that I got from the 3rd consultation, since I thought they were being “lazy” and weren’t willing to serve me. I don’t think I’m incorrect in believing that Invisalign is less work — and a cash cow — for orthodontists.)
    • Mine was the first doctor who was specific about the kind of brackets he would use. Damon, self-ligating. He told me that he recommends them because they would do the job, and would work faster and with less pain than traditional brackets. I was happy to hear this, including the description of how they worked and why this meant greater speed and less pain. Granted, I had to ask the questions to get this information, but he was willing to answer me.
    • I asked about clear brackets versus metal brackets–which would reduce the metal-mouth look a bit. He said that because of the material, the clear brackets would require more time than the metal, so he recommended the metal. I liked that straight answer. (It turns out that the brackets on my top teeth are half clear anyway.)
    • I saw that the office was small and that I’d get the attention of this doctor. He does share with another, but I could continue to schedule times when he is there. (And this had been the case, though usually it is an assistant who does the work on me.)
    • Finally, the price was the best (and they worked with my insurance). Almost $2000 less than the highest consultation!

Well, this has become quite long. I invite others who have gone through this decision-making process to share it, too.