What Happens at Your First Orthodontic Appointment?

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It is normal to be nervous anytime you are doing something for the first time. If you’ve never been to see an orthodontist before, it is not surprising that you may be wondering what is going to happen at that visit. Here’s what your first visit will be like in my office…

Your dental and medical history is important
As with all visits to any healthcare provider, there will always be some preliminary “paperwork” that will need to be taken care of before we get started. This can take place on our website, by filling out the paperwork that we’ve mailed to your home, or by filling out forms in our reception area when you arrive. The paperwork asks for standard things like your name, address, and phone number, insurance information (so we can verify your benefits for you), your health history, your dental history, and a brief explanation of what you’d like to accomplish during treatment. If you are under 18 years old, you’ll need to come with a legal guardian.

Pictures and x-rays help determine what needs to be fixed
Once the paperwork is taken care of, a member of our staff will obtain a set of diagnostic records to help us decide the most appropriate treatment for you. These records usually include pictures and an x-ray. Some problems don’t require x-rays and a few patients bring copies from their dentist. If there is any question about the need for additional x-rays, I’m the one who will let my staff know what is required. X-rays help me to see the health and position of your teeth, bone, roots, and jaws. (Direct-to-consumer aligner companies skip this step.) There are some decisions that I just can’t make without them. The purpose of the pictures is not only so we have a record of where your teeth are at the beginning of treatment, but also to help me evaluate your profile, lip posture, and facial symmetry.

Orthodontists check jaw function, health of gums, bite, and teeth
With your diagnostic records completed, you and I will take a minute to get to know each other and discuss your concerns. I’ll then examine your face, lips, gums, teeth, and bite to help me determine what’s good, what could be better, and the best way to get from here to there. This initial examination is perhaps the most important step in getting the right treatment. Ironically, this is the step skipped by "direct to consumer" aligner companies. During your exam, my treatment coordinator will take notes so that I can communicate with your primary care dentist about the problems I see and how to fix them. Finally, I’ll explain all of your possible treatment options and then recommend the one I feel is the most appropriate for you. There are generally four outcomes after your exam.

Treatment options and timing are then be presented
First, if I don’t think you need braces, I’ll let you know. There might be other options that are quicker, easier, or that better address your chief complaint. Additionally, there are times when I just don’t believe that you would benefit by orthodontic treatment. This typically happens when a problem is so minor that the cost and risks associated with braces outweigh the benefits.

If you're not yet ready for treatment, a follow up exam will be scheduled
Second, you might need braces but are not ready for them yet. This most commonly happens when you still have baby teeth to lose, your 12-year-molars are not yet in, or your treatment is dependent upon your jaw growth and we need to observe it for a while. In any of these situations, we’ll schedule you to come back a few months down the road so that we can check on your development. This is called a recall or observation appointment. The length of time until your next visit is usually six months, but that can vary depending upon the reason we’re waiting.

You may need to return to your dentist or see another specialist
Third, although you may need braces, you might need to see another dentist first. This can happen if you need to have some routine dental work finished, have some gum or bone issues that need to be addressed, or your treatment will require the help of another dental specialist. If you have unfinished work or just need your teeth cleaned before we can start, I’ll refer you back to your primary care dentist. If your jaw sizes don’t match or if you have impacted teeth, you may need to see an oral surgeon. If you have gum problems, you will be referred to a periodontist. If you need a root canal for any reason, I’ll recommend that you see an endodontist. Orthodontic treatment sometimes requires a team approach and this is best coordinated before your braces go on.

If you are ready, treatment can usually begin that day!
Finally, the most common result of your initial exam is that you are ready for braces and can get them on right away. My treatment coordinators will work with your family to make the best possible financial arrangements and get the necessary informed consent. Once that is done, you are ready to get started! Believe it or not, the majority of patients today actually choose to get their braces on the same day as their exam since they have already taken time off from work or school. My staff and I have streamlined the initial exam process to make it as convenient as possible for everyone involved. See you at your first appointment!

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and nearly 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 35,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.