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Why Are Braces So Expensive? [11 Reasons 2023]

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When a dentist suggests you or your child need braces, the shock of the overall cost can prevent you from getting them.

Braces are expensive for many reasons. These include the lack of insurance coverage, materials and supplies needed to make and install braces, patient age, and orthodontic needs. Additionally, an orthodontist’s experience and business operations that include required regulations contribute to high costs.

1. Dental Insurance Coverage: Lack Of, Partial

In many cases, braces are not covered or are covered minimally by health or dental insurances. This is because most people get braces for aesthetical factors rather than health reasons.

When braces are more than a cosmetic fix, orthodontists can provide a medically necessary treatment that insurance may cover.

Some workplaces do not offer dental insurance to their employees. If they do, the dental insurance may only cover routine cleanings and not orthodontic work. 

If a workplace does not offer their employees dental insurance at all, then you can consider purchasing your own. 

Dental policies will vary across each state. However, you have to do some research to find insurance that covers orthodontic work. At this point, monthly premiums could be costly, and you’ll need to determine if it’s worth the monthly investment.

In many dental insurance plans, the coverage may differ between adults and children as well. Patients must be prepared to pay any co-pays, deductibles, or co-insurance fees. It is important to know the fine details so that you can plan accordingly. 

Many orthodontists offer payment financing plans for those without insurance coverage. These often have interest rates, but allow the patient to afford braces over time.

2. Components Of Braces

Braces are made of connecting parts and mechanisms to align teeth. These components must be moved at the right pace with the right amount of pressure. 

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Braces are available in different kinds of materials. Without any insurance coverage, braces cost anywhere from $2000 to $13,000. The orthodontist’s treatment plan for the issues with a particular patient’s set of teeth will also determine which type of braces will work best.  

Type of BracesCost (Without Insurance Coverage)Characteristics
Ceramic$2,000 to $8,500

  • Clear plastic or porcelain brackets to camouflage with the teeth

  • More fragile than metal

  • Stain easily

Metal$3,000 to $7,500

  • Traditional method

  • Faster alignment

  • Highly visible

Lingual$5,000 to $13,000

  • Metal braces installed behind teeth out of sight

  • Higher difficulty to install and adjust

Invisalign$3,000 to $7,000

  • No brackets

  • New, clear thermoplastic molds every 1-2 weeks to move teeth into alignment

  • Slower process than bracket option

  • Best for patients without severe misalignment

There are at-home aligners much like Invisalign without the visits to the orthodontist. These are for patients that do not need monitoring and do not have major misalignment or jaw issues. Patients that go this route, can still spend a couple of thousand dollars.

Often after braces, patients will wear a retainer to fine-tune the work and keep teeth from shifting back to their old positions. This costs money to produce for each individual’s mouth.

All of these components cost money to produce and “install” onto a patient’s teeth.

3. Number Of Appointments

When a patient gets braces, they will be visiting the orthodontist for several years. Braces move teeth to align them, and teeth move slowly with the pressure that braces put on them.

Each visit to the orthodontist is going to involve adjusting the braces and making sure the plan to align teeth is going well. 

Depending on your care plan, you may have up to thirty routine visits, for at least an hour each time, occurring every few weeks. 

The more alignment that your teeth need, the longer you will wear braces, and the more appointments you will have.

Part of each visit’s bill pays for the orthodontist’s time and expertise, as well as their office staff, supplies, and other business costs such as utilities.

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4. Patient Care Of Braces

Additional appointments may be necessary for repairing broken components. This can happen if foods become lodged in the braces or break a component when eating.

Those with braces may also have rubber bands to help pull the jaw into alignment, and this band needs adjustment. 

Patients that use Invisalign braces, must wear each mold for the majority of the day, including when they are sleeping. 

If they do not use them as intended, it slows down the process considerably. This results in more molds and more appointments to get the teeth aligned.

If a patient does not carefully follow all care instructions, the process can move along more slowly and as a result, the whole process costs more.

5. Supplies To Care For The Patient

In addition to the initial appointment to put on the braces, every visit incurs fees related to the supplies used to care for you.  

These may include:

  • Equipment sterilization
  • Lab work
  • Supplies or products used on the patient during a visit (such as rubber gloves, masks, drool bibs, etc.)

Some of these supplies may be minimal in cost, but they add up over time.

6. Age Of Patient

Adult teeth do not move as readily as children’s, since their jaws are fully formed. So, adult braces take longer to work than those in children. 

This means they will need more supplies, more orthodontic time, and so on, which costs more.

7. Orthodontic Practice Location

Costs of living, population density, and urban, suburban, or rural locations can all affect the costs associated with getting braces. 

Various states will have different pricing, which is affected by the costs of transportation, taxes, and proximity to resources.

 Generally, higher populations raise the cost of land and cost of living in urban areas. Therefore, prices reflect that.

8. Orthodontic Specialty

Orthodontists are specially trained dentists. To obtain an orthodontic certification and license to practice it will take them 10 to 11 years for their upper education, as well as residency work. 

This means orthodontists do not start earning income for their work until they are in their 30s.

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Aligning teeth is a scientific and careful process. Orthodontic work involves not only the teeth but the jaw bone and connecting muscles. The functioning of the jaw would be impaired or a patient could lose teeth if they make an error.

The orthodontist’s time costs money to diagnose the problem and then form a treatment plan. Then, there is the time to implement the plan and put the braces on, with adjustments in upcoming visits.

Specially trained professionals with more years of training cost more.

9. Building A Practice

Orthodontists may open a private practice or team up in groups. An established group of orthodontists will share the bills of operating the business.

If an orthodontist builds their practice, this requires obtaining a building, ensuring it is up to code, and managing all of the related utility and business costs and taxes.

Costs for maintaining a practice are absorbed into the overall cost for the patient’s bill.

10. Practitioner Insurances And Regulations

Orthodontists must have malpractice insurance and possibly a retaining lawyer to cover themselves in the case of patient injury. 

Employees are offered medical insurance plans as well as workman’s compensation plans. 

There are regulations and fees for using radiation, as well as making sure they are compliant according to regulations for the:

  • American Disabilities Act (ADA) to ensure they can meet the needs of all patients
  • American Association of Orthodontists (AAO) to support patient care, research, and obtain affordable practitioner insurance
  • Drug Enforcement Administration (DEA) because they prescribe controlled substances for pain relief

11. Other Support Staff

In addition to the cost of expertise of the orthodontist, the support staff must also be paid. 

Support staff maintains the reception area, makes phone calls, and submits billing or insurance claims.   

Assistants work with the orthodontist during routine visits in whatever they need to get the job done.

Other personnel will sanitize rooms and equipment after each patient. There may be a cleaning company that does a deeper clean after hours.

Conclusion

The cost of braces is high when you factor in the time, materials, and the orthodontists’ expertise needed in helping their patients get a great smile. Adding in the costs related to dental regulations and running a practice, the final bill can be expensive.  

In many cases, due to poor or no insurance coverage, patients will pay out of pocket to get braces if they are not deemed medically necessary.

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