Frequently Asked Questions
Doesn’t the ASO just represent specialist orthodontists so will be biased in giving advice?
The ASO does represent the specialist orthodontic profession. It promotes continuing education, postgraduate education, research, ethics and the highest professional standards. We appreciate the future of the profession is completely dependent on the confidence and respect patients afford us. So, the interests of patients are pretty much the same as the ASO. Orthodontists, although being ASO members, have their first obligation to the welfare of the patient and we advise honesty, accuracy and transparency at all times.
Below are some common questions we receive. Sometimes patients are not completely happy with the answer we provide, however, sometimes member orthodontists are also not happy with the advice. We understand that breakdowns in the patient-practitioner relationship do occur and there can be misunderstandings on both sides. If your concern is not covered by that below, or you require further clarification, please contact us by email. Your concerns will be forwarded to the ASO Orthodontic Services Committee who may be able to help.
Do I need a referral to see an orthodontist?
No, your dentist may provide a referral letter but this is as a courtesy and not a legal or ethical requirement.
I have a quote for treatment with braces and it seems a lot. Is it excessive?
Each orthodontist is free to set their fees. There are no prescribed scheduled fees and the Australian Competition and Consumer Commission (ACCC) will not allow fee fixing, as it is viewed as anticompetitive. As a first measure, ask your orthodontist how the fee might compare to other specialist orthodontic practices. Most will be happy to answer. Sometimes the fee may incorporate some additional aspects that others may not. It might relate to costs associated with the geography of the practice. If still not satisfied then feel free to seek a second opinion from another specialist – Find an Orthodontist.
It is important the fees are compared to other orthodontic specialist practices and not to general dentists who may be practicing some limited orthodontics (see below). You should not commence treatment before you have agreed to the fee, which should be provided in writing with the payment plan.
My dentist is also an orthodontist so should I have treatment there?
Your family dentist would not be a specialist orthodontist. Specialist orthodontists have completed a course of full time study over two or three years in a University and passed the prescribed university examinations. All members of the ASO listed in Find an Orthodontist are specialists. Some dentists have completed shorter and much less detailed courses in orthodontics and have an interest in the subject. They would have varying levels of expertise and ability in orthodontics. The decision as to whether to have treatment with a specialist orthodontist or non-specialist is ultimately up to the individual. We would recommend to at least obtain an opinion from a specialist who is a member of the ASO before commencing any treatment. Some orthodontists will also hold a qualification from the ASO called AOB Certification. This is awarded following a prescribed course of continuing education and peer review of clinical results by other orthodontists.
Can I take my X-rays and details (orthodontic records) with me so I can get a second opinion?
Yes. Practitioners are used to transferring details between each other. If you have settled any account associated with producing the orthodontic records then they should be made available to you.
The orthodontist seems very busy and it sometimes hard to have a discussion.
Many patients prefer to come before and after school. Thus these time slots are always fully booked and the orthodontist has likely allowed time to complete the required clinical work, but not factored in additional time for discussion. The orthodontist is trying to run close to time so patients will not be late for other commitments before and after school. Make sure you are clear that you would like to have a treatment discussion. You may have to come back at another time so as to not be rushed and have time to fully address any concerns.
I don’t seem to gel with the orthodontist and the braces are on and now I want to change practices.
This is possible but often associated with several disadvantages. You should only change if you feel very uncomfortable with continuing. If it is just the personality that you don’t like so much, but the practitioner seems competent then it may be best to continue. You only have to meet once every one or two months for a short time. Different practices use different systems and they are not always compatible (a bit like trying to put Ford parts into a Toyota). Additional fees are likely with the transfer – there may be the need for further collection of progress records, changing some of the braces over to a different type etc. If any differences with the current treating practitioner cannot be resolved then you should notify the practice you will be seeking treatment elsewhere and have your details transferred.
I don’t want braces and have seen other options not using braces are advertised. Do these work?
Some of these techniques, such as that with sequential clear aligners (a fancy name for a series of clear plastic plates) will give a good result in straightforward cases. You should ensure you discuss these options with a specialist orthodontist before commencing treatment. Braces are still the most accurate method of moving teeth. Treatment with braces is generally more predictable and less expensive than the alternatives. The quality of the result is in most cases better with braces. Severe and difficult orthodontic problems are not suited to the alternative methods. Braces are available that can be placed on the inside of the teeth. This is called lingual orthodontics and you should be prepared to pay significantly more. Not all orthodontists will provide this form of treatment, but if you do want such treatment, the orthodontist you consult with would be able to provide you with the details of a colleague who uses the technique. More common and used by all practitioners are the so called aesthetic braces. These are also sometimes called invisible braces, however, they are not fully invisible. Nevertheless the appearance is subtle and many patients find they meet their cosmetic demands at a much lower fee. The aesthetic braces are placed on the outside of the teeth in the same way as metal braces, but are a transparent ceramic. There are very good reasons why braces still remain the most popular method of correcting crooked teeth around the world.
Why is the treatment taking longer than expected?
Treatment may take longer than predicted for a number of reasons. If you have been diligent in keeping appointments and maintained good dental home care then it may be due to your own individual biology. Some people just have teeth and jaw bone that is slower (and sometimes much slower) than others. There is little that can be done but to be patient and allow the teeth to move. Pulling harder with stronger elastics etc. will not quicken the tooth movement in these cases.
I was told I did not have to have any adult teeth removed, and now the braces are on I am told I need some extractions of adult teeth?
Orthodontics is a complex treatment process. Not every individual responds the same way to the orthodontic wires and forces. The treatment plan at the commencement is a not a recipe that should be followed no matter what. A little like renovating a house – as difficulties arise and circumstances change the treatment plan should also be modified. A specialist orthodontist has the training to not only devise the original treatment plan, but recognise when things are not proceeding as they should and develop alternative strategies.
I am not happy with my orthodontic result?
The first step is to have a discussion with your orthodontist. There are a number of factors. Would any additional cosmetic dentistry from your family dentist assist? Are the expectations realistic? Is there a problem where the braces will have to be refitted and further treatment undertaken (this is sometimes required for good reason). If still not satisfied, you may want to obtain a second opinion from another specialist orthodontist.
I seem to be having trouble with the teeth moving after treatment is completed?
This is a very difficult part of orthodontics and is called relapse. Some orthodontic problems will be more susceptible to relapse than others – some very much so. In high relapse potential cases then patients may have to wear retainers on a long-term basis (perhaps forever). The wear routine may involve wires placed on the backs of the teeth or removable plates worn usually at night on a long-term basis; that is, several years. For the most part, despite some relapse, there will still be significant improvement - try comparing with the pretreatment photos. It needs to be remembered that in some individuals there will be a gradual loss of some of the orthodontic correction throughout life unless retention is continued.