Why Does Changing Orthodontists Cost More?

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We just moved to a new city and had to find another orthodontist to finish our son’s treatment. I was surprised with how much the new office wanted to charge. Our first orthodontist told us that he was almost done with the treatment. Why does it cost so much?”

There are costs before your braces go on
Orthodontic treatment is much like having a house built. Before you ever break ground, there are intangible expenses incurred by the builder that must be rolled into the cost of your house. This includes architectural drawings, construction equipment, legal fees, insurance, marketing, etc. that go into running a construction company on top of the actual lumber used. When you negotiate the price for your home, those intangibles are included in the price of the home even though they may not appear as separate line items.

Some orthodontic services are non-refundable
When you pay an orthodontist to fix your teeth, you are also paying for a lot of intangibles. Unlike extra lumber that can be returned to the lumber yard for a refund if you find that you don’t need it, it is impossible to refund fees for diagnosis, treatment plan, and appliances that have already been provided. Unfortunately if you leave town early, it is difficult for the first office to calculate the exact percentage of your fee that has been earned. The best the staff can do is refund the cost of the retainers they didn’t give you plus an estimate of the adjustments not made.

Seeing a new orthodontist is starting over in many ways
When you go to your new orthodontist, he will in a way have to “start over” since he is now going to be responsible for the outcome and maintenance of your treatment. Taking over a transfer case usually requires a duplicate set of records (pictures and x-rays), a new diagnosis and treatment plan, and possibly switching out all the braces. In the same way we wouldn’t expect a second home builder to use tools provided by the first builder, we cannot expect a new orthodontist to just pick up where the first orthodontist left off without analyzing the case himself. It is unfortunate, but these duplications in the new orthodontic office will incur fees over and above the original fee agreed upon with the first doctor. Your first orthodontist must charge you for the work he provided in his office. He cannot be responsible for the work that is performed in the next one.

You may be due a partial refund
It is reasonable to expect that your original orthodontist should refund fees for procedures he did not provide if you have already paid off your account (i.e. retainers and retainer adjustments). Is it reasonable however to ask him to refund intangibles like diagnosis, treatment plan, and insurance he has already provided? Although it may not seem fair, there are parts of the original fee that are non-refundable by the first orthodontist and must be duplicated by the new one. For this reason, changing orthodontists always ends up costing more money. Always!


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. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. 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.