The Cost Of Things: Returning To Orthodontia As An Adult

by Alexandra MacRae

When I returned to an orthodontist’s waiting room, I was older than everyone around me by at least a decade. For the previous thirteen years, almost from the moment I got my braces off, I had barely given my orthodontic work a thought. I may have made a good faith effort to wear my plastic and wire retainer for a few days, but it didn’t really fit and no one ever enforced a solution, so I let it go. My permanent bottom-teeth retainer fell out soon after while I was eating an eclair, and that was the end of that.

Once the braces were off, I enjoyed fairly perfect teeth for the next decade. Not perfect in the objective sense, but like the army, my teeth were being all they could be. Other than using an obsessive number of Crest Whitestrips, I hardly gave them a thought.

Then they started to slide. It was subtle at first, the normal movement that anyone who has had braces will experience over time. My right lateral incisor became the worst offender, shifting back between its two neighbors to the pre-braces position. For the next few years I vacillated between focusing on it all the time and ignoring it completely. Soon I couldn’t help but worry the moved tooth with my tongue while watching TV, working, talking to friends, or pretty much doing anything.

I wondered if I should even bother correcting my teeth. They were closer to good than bad on the spectrum. But having had braces in the past to get there made the difference. I couldn’t live with teeth I wasn’t happy with when I had gone through three years of pain and discomfort on their behalf. I owed it to my past self to fix them — even though that self was an ungrateful brat who couldn’t be bothered to do the bare minimum in upkeep.

Like any dental or medical problem, trying to find possible solutions online was an exercise in obfuscation. Information on dental and orthodontic issues hasn’t flourished online like medical content has. I guess people aren’t frantically rushing to Google when they have a roaming lateral incisor quite like when they have a mysterious rash. I knew Invisalign was a possible option, and there was a decent amount of information about this, but I was dismayed to learn the estimated costs for this procedure, and the impact it would have on my social life. The general consensus: Thousands of dollars and a year to eighteen months of constant retainer-wearing.

In the lead-up to my semi-annual visit with the dentist, I fantasized about an easy solution to fix my teeth. Common sense told me that retainers are only ever meant to preserve current tooth positions and not correct, and that I’d be looking at Invisalign to correct my wayward incisor. Still I prayed for a solution between these two extremes.

When I broached the topic with my dentist, he referred me to an orthodontist. “Don’t call them, they’ll call you,” he said. For anyone who has spent literally years dissatisfied with their teeth, you will be dismayed to learn that you often need to wait up to another month for a consultation once you’ve decided to take your first brave steps.

At my consultation, which cost a $100 flat fee, I was delighted to learn that the medium-solution plan that I didn’t even really believe was possible did in fact exist! For $1,000 I could get an ersatz version of Invisalign. It was a series of plastic retainers that would progressively correct my problem tooth over the course of a few months, and more importantly, preserve the current state of my still-decent teeth. I am a classic medium-priced buyer so when presented with a solution that cost $2500 (Invisalign Express), or a low-ball at $400 (a retainer that might correct the tooth), the middle choice was easy.

When I made the decision to pay $1,000 plus other miscellaneous costs, I was okay with shelling out that amount. I didn’t feel comfortable per se, like I had the appropriate amount of disposable income, but I wanted to be proactive. I knew there was a small chance that some of the fees — consultation and lab — would be covered by my insurance, but not the orthodontic costs, as my coverage didn’t extend that far.

In the interim between my consultation and the six weeks or so when I would receive my retainers, it occurred to me that I might be eligible for coverage under my partner’s insurance as a dependent. This changed my whole perception of paying out of pocket. When the possibility of having half the expenses covered came up, I became frantic trying to get listed as a dependent before the day of my appointment arrived and I received the bill, after which point it would be too late. I convinced myself that I couldn’t possibly afford to pay for this without coverage and was conveniently ignoring that I had originally planned to do just that.

On the day of my appointment, all my stress dissipated. As I was handed my new retainers I reverted to the state that was okay with paying for them if the insurance didn’t work out. Now that that was settled, I was going to do this thing right.

The dentist gave me a run-down of my new hardware and reiterated that I would have to wear it 24/7. I immediately began tallying the instances in the near future when I’d need to break that rule. I have a meeting this afternoon, I thought, and a brewery tour tomorrow night. Definitely not wearing them for that. This was my teenage, embarrassed-to-be-alive self piping up, which was an odd phenomenon that would occur anytime I had to manoeuvre socially with my new lisp-inducing retainers. I was able to quickly overrule these insecure thoughts, which I identified as a relic of the self-preservation instinct that is particularly strong in junior high school. The desire not to have any obvious differences that can be seized on by sadistic peers.

Now, as an at-ease adult, I thought, Go ahead, ask me about my retainer. I’ll keep you here for the next five minutes to discuss my insurance saga. Which, by the way, looks hopeful, but I don’t trust it until the cheque is in hand (although 80% of my consultation fee was covered through my own dental).

I approached caring for my retainers and wearing them faithfully in a similarly grown-up manner. Mostly because I was the one paying for them this time. As a teen, I’d been personally offended by the burden of braces and all their accoutrements. Now I proudly wrote my name and phone number on my retainer case and consulted the sheet I’d been given by my orthodontist for care instructions. Written in Comic Sans and clearly geared towards teens, it began “Now that you’ve gotten your braces off…”. Still applicable for me, I thought, only a little later than expected.

Alexandra MacRae is a writer living in Halifax, Nova Scotia. Follow her on Twitter @alliejandra_m

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