Most people are familiar with the “standard” equipment and materials for orthodontic treatment. Things like wires, brackets, aligners, and colored rubber bands are often the first things that come to mind. As the average person starts to elaborate on that list, orthodontic appliances come up, but the knowledge and familiarity around how these instruments are often limited. In this post we will touch on some of the most commonly used appliances in orthodontics.

Rapid Palatal Expander (RPE)

This appliance is usually the most commonly known orthodontic device. These appliances are often placed in younger patients that are still growing and are used to slowly widen a narrow upper arch to create more space for teeth where there is crowding or to help correct bite issues such as a crossbite. The tool is placed in the roof of the mouth and has connecting “rods” which are cemented to the patient’s molars. At the center of the device is a small screw with a hole that when turned, extends the “rods” outward and pushes them against the teeth. The screw is turned with a special “key” once a day. This is a very gradual expansion process which lasts over a period of 4-5 months. The RPE only moves .25 mm with each turn which allows the two bones in the palette to grow back together as they are slowly spread apart.

Herbst

This functional device is used to help correct overjet issues. An overjet is where the upper jaw extends out past the lower jaw further than it should. An overjet often causes issues with how a person closes their mouth, chews food, speaks, and their overall facial appearance. The appliance has a hinge mechanism connected by screws that causes the lower jaw to move forward and repositions it into an ideal bite with the upper maxilla (jaw) which is held in place. By repositioning the jaw, it corrects the bite and makes it more stable.

Carriere (CMA)

This fixed appliance is used to correct a molar malalignment. The device can be placed on either the upper and lower arches and uses a metal rod that attaches from the back molar to the canine. A bracket with a hook is then attached to a tooth on the opposing arch and serves as an anchor tooth. Then an elastic band is used to connect the anchor tooth to the canine. Lastly the patient wears a clear retainer to hold the opposing arch in place. The CMA device uses light uniform backward force with controlled rotation of the molars while moving the whole canines to the molars segment as a unit. With proper patient compliance, the device moves the teeth into the proper position. A great indicator that the device (and the patient) has done the needed work is a small space forming between the canine tooth and the lateral incisor.

Distal Jet

A distal jet appliance is a device that is anchored against the roof of the mouth and consists of coiled springs that are attached to premolars and molars. The anchored springs apply constant backwards force to the molars, which slowly moves them back and creates the needed space to correct crowded teeth or for emerging teeth. It can also correct misalignments. Once proper alignment has been reached, a nance appliance replaces this device to hold the molars in place.

Nance

Like with anything new, there is a period of adjustment and getting used to having one of these in one’s mouth. It is not unusual to have some mild discomfort, but with a little time each of these devices will feel normal and you will be well on your way to reaching your ideal smile!

Insurance can be a confusing topic. Let’s go over some frequently asked questions to better understand your insurance.

“Does your office accept my insurance?” This is the most asked question during a new patient phone call. Here at Davis Orthodontics, we accept almost all insurance carriers. The amount insurance is expected to cover is dependent on your plan. We strive to help all our patients utilize their insurance policies if available. Think of your insurance as a coupon for treatment, it might have rules and restrictions, but it is there to help cover some portion of the cost.

“Can I change my insurance to the lower plan since I am already in orthodontic treatment?” Insurance companies cover your orthodontic treatment throughout your full treatment time. For example, if Dr. Davis recommends treatment for 15 months, then your insurance provider will set up a fee schedule to cover payments for 15 months. We highly suggest maintaining the insurance throughout treatment to receive the maximum benefit and to prevent having to cover the remaining balance from the insurance company. If you change employers and/or must cancel your coverage, we can file a treatment in progress claim to the new carrier. Keep in mind, some carriers do not accept treatment in progress which means since you started treatment with a different carrier, the new carrier will not cover the remaining balance.

“Why doesn’t my insurance cover more of the treatment fee?” An average orthodontic maximum is $1000 to $2500 depending on your employer’s plan that they are enrolled in. The expected coverage amount is also based on treatment time and the treatment fee. As previously mentioned, your insurance pays throughout the course of treatment.

“I have the same insurance, and I used my full orthodontic treatment a few years ago. Why doesn’t my orthodontic insurance benefit renew every year?” Orthodontic insurance benefits have a lifetime maximum, which means if you utilize the full benefits for a previous orthodontic treatment then no benefit will be available for an additional treatment. Lifetime maximum is per insurance patient. So, if you used all your benefits for your own orthodontic needs but have a child who needs treatment, they will have their own separate lifetime maximum.

“I have two different active insurance policies; can I file both?” Absolutely, we are more than happy to assist you with both policies. This is called having primary and secondary insurance coverage. Usually, the way insurance works is you are required to file primary first then you can file secondary. As long as both policies have something called coordination of benefits (COB), we will file claims and could possibly collect benefits from both. The estimated amount of benefit is determined based on the COB within each of the policies. This means they will coordinate with each other to reach the lifetime maximum on the primary first and then the secondary will pay any remaining benefit if available. For example, if you have $1500 lifetime maximum coverage with your primary and only $1000 with secondary coverage. You will only be estimated to receive a lifetime maximum benefit of $1500 from primary. Secondary will not cover any benefit. Another example is if your primary benefit is $1000 and your secondary benefit is $2000 then it is estimated that you will receive $2000 benefit, $1000 from primary and $1000 from secondary. Again, these are only estimated examples. In all cases, the responsibility for payment of the entire orthodontic fee rests directly from the patient.