Why are braces expensive?

 Many people often wonder why the braces cost so much. For an elective type of treatment. Why is there a huge difference in cost between the different types of braces? Why do doctors charge so much to put them on? What controls the prices of braces? Why do the inexpensive variety work much less like the expensive variety if its the same exact thing? 

First lets consider the doctors themselves. Braces in most parts of the world require expertise to be placed. The graduate dentist could stick them on equally like the trained professional orthodontist, and maybe a monkey could stick them on even better than both of them. However, graduate dentists are very limited to understanding how it works. 

The angles and numbers involved. The science. That is why it costs alot to become a trained professional only to this treatment. To open up a dental practice costs a fortune nowadays compared to back in the day, let alone running and marketing costs. The running costs are in constant climb, which includes material costs, the staff training, the bracket material and the adhesives used, the electricity and other overhead expenditures, the time it takes to glue them on, the time it takes for them to work and produce noticeable results, the time it takes for the patient to respond to the treatment, errors that require correction and the time to correct them, the time to serve one patient, check another, and ensure material is acting like it should. 

What is even more troubling is the material itself. Braces were usually casted back in the day using a centrifuge machine, the type used to forge chain links and handcrafted accessories, or milled from blocks of stainless steel, or laser cut. Thanks to technology, the most common method which produces consistent results nowadays is injection molding. The material itself has to be compatible with human beings and therefore must incorporate a tiny percentage of Titanium. Some braces are usually made from casted gold because of its compatibilty to human tissue and the less irritation it is likely to cause, also because gold is considered a precious metal, its no wonder the material costs so much. 

Also, equally relevant to the material is the design features which must match specific, very strict criteria, so that teeth could be positioned correctly and controlled predictably. For example some brackets must have hooks that stick out because they serve specific functions during treatment, like pulling the teeth or pushing them. The slot where the wire runs also needs to be made to a specific size and shape, and angled to put what is known as angle on the teeth or torque, to make them become less crooked. These design features cost alot to a tiny, rice grain sized brace. These features are microscopic if not visible to the human eye. One fault and it takes alot of correction time and costs to correct. Therefore the quality assurance portion of production takes over. This is skilled labour and takes a very trained professional to spot errors in the design of the batch of metals that stick on to teeth. To train this individual, it costs money. To give them a salary is another matter. Imagine going through 4,000 of these per day!

Nowadays, with laser scanning, it has reduced the burden of having quality inspection check each individual piece of metal for defects. Metal is metal, if its bad, melt it and push it back into the circulation. Nothing goes to waste. That is purely material look into the material itself. Speaking of which, that is why there is generally a degradation of the quality of treatment with poorly formed braces, which are generally readily available to the general public and even sometimes, marketed as authentic braces. Its these braces that generally come in the subsidized forms of treatment to those who can not afford the much more expensive, quality controlled types of braces.

Next comes the time to install said metal into the patients mouth. First, the strict criteria for the adhesive that joins the tooth to the metal to work must be met. Try to dry your mouth. You will discover how difficult it is! Imagine having to work in a damp area. You hands get cracks after a while. The same thing happens with the metal rice sized attachments, only they just cant stay on the tooth if so much as any hint of moisture is in the mix. To dry the tooth costs time, and to keep it in the dried state takes skill. Skill is a perishable quality in human beings that needs constant training to keep at a specified level and even improve upon it.

Therefore doctors need to maintain this level of skill, by taking workshops and coursework, what is termed (continuing education). Additionally, the time of treatment is a critical factor in deciding the amount to charge to the patient. Most simple of cases where for example one tooth may be out of place, takes between 2-3 months of treatment. In our line of work, cases could stand well into four years or more, depending on the complexity of the case. This time is what raises the cost of treatment. The average adjustment appointment can take anywhere between four to 20 minutes. Sometimes, adjunctive procedures might elongate this time. For example, patients who might have not been brushing very well their teeth after meals with braces on, might have to get cleaning instruction from the orthodontist, or the dental hygienist. Or patients who broke the braces, extra time might be needed to repair the broken parts. This dynamicity in time allotment is a major factor in pricing. 

The upkeep of treatment adds also to the value of the overall price for treatment. In dentistry, there are two major types of treatment; elective and emergency. While most dental work is usually finished in the course of two to three months, orthodontics usually lingers far more into years. The doctor not only conducts treatment, but later, after treatment conducts what is termed the “maintenance” phase. Think of it as the aftersale service. If you purchased a vehicle, the dealership sends your VIN to the authorised service centre. They contact you during the warranty to advise you of times to check up on your vehicle and conduct mileage maintenance. In orthodontics, the doctor recalls you every six months to check up on the alignment of your teeth and conduct checks on the condition of your teeth, your gums, your hygiene, and everything else. 

In our relationships with our patients, and because we take time with our work to produce results, we sort of build personal relationships with our patients. It is not strange that a patient we treated many moons ago, might one day show up with their nine year old and ask us to examine the teeth and do what is necessary. It is the best thing about this job. We become part of our patients lives, and so do they become part of ours!

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