How to take the bite out of the cost of braces

Both my kids needed braces. One has a cross bite and the other crooked teeth. I wasn't prepared for the expense as neither my partner nor I had orthodontics.

I soon discovered that if your kids need orthodontics, expect big bills. Prices vary from $6000 to $9500, depending on a range of factors, according to Robert Schwartz, specialist orthodontist and spokesperson for Orthodontics Australia.

He estimates about 300,000 Australians have braces or aligners and about 75% of them are in the mouths of 225,000 children.

What can you do to save money on orthodontics?

Start early. Having orthodontics isn't an emergency medical procedure, but it is hard to put it off because there is strong evidence that a delay in straightening out crooked teeth will cause problems later, which could be more expensive - and perhaps more painful- to fix.

Orthodontists will tell you that straight teeth are important for self-esteem and confidence. Your dentist will typically give their view on whether your kids need orthodontics when they are around eight to 10 years old, says Schwartz. Some problems could be treated right away but others could be further down the track, allowing you to save up for them.

Private health insurance

Check with your private health insurer to see how much you get back for orthodontic work. The more you pay for health insurance extras the more likely you are able to claim money back for orthodontics. It isn't available with a basic insurance (extras) plan but it is in plans with special features.

If you haven't got coverage, work out if it is worth upgrading to the extra benefits option. Unlike specialised services such as physiotherapy, which have a set amount paid each year, orthodontics is limited to a maximum payment of a couple of thousand dollars for the fund member's lifetime.

Shop around for an orthodontist

Your dentist will recommend an orthodontist, but shop around as prices can vary.

While orthodontists are a fairly elite group of medical specialists, they are spread out in suburban areas as well as in city centres. There are about 550 orthodontists in Australia and, as well as being a fully qualified dentist, they have studied for a further three years full-time at university to remedy crooked teeth and jaw problems with an array of devices. They must have 5000 clinical hours before they can practise. You can check if your orthodontist is a registered specialist at ahpra.gov.au.

While word-of-mouth recommendations are always worth chasing up, check out social media and reviews about orthodontists.

Prices can vary depending on the suburb and the treatment, says Schwartz.

Get a treatment plan 

Health funds may need an orthodontic treatment plan to determine your benefits. Before you undergo any treatment, you should ask your orthodontist to provide you with a written treatment plan, recommends the Commonwealth Ombudsman.

The ombudsman says it should include the estimated length of treatment time, the dental item number used to identify the treatment, the total cost of the orthodontics and how you intend to pay for the treatment, such as upfront lump sum or monthly instalments over the duration of treatment.

Once you have your treatment plan, give a copy to your health fund so it can provide a benefit quote based on your treatment and level of cover.

Payment plans

Most orthodontists divide up the overall cost of the treatment into regular instalments that are timed to match your child's appointments, which are anywhere from four to six to eight weeks apart. The orthodontist I chose was happy to take an upfront fee of a couple of thousand dollars and then instalments of $200 every month for a couple of years. Direct debit is usually how you pay. Schwartz says orthodontists are happy to arrange payment periods that suit you.

Often our monthly visits only took 10 minutes as the braces were checked and often tightened. My advice is to keep an eye on repayments and query any bills that appear excessive.

My orthodontist explained that the total fee was worked out on the average cost of the treatments, rather than individual costs. This means that if kids have problems with their braces and need extra visits, the parents will pay the same amount as someone who has standard treatments. This could mean that you could be overpaying for standard work.

Buy now, pay later

Some orthodontists allow you to pay using a buy now, pay later plan. BNPL providers could carry out credit checks and may charge third-party fees, so it's worth weighing up the pros and cons of making 
a direct plan with your specialist.

Loan schemes 

There are a number of companies that lend money for medical costs. Check out the interest rates and terms carefully.

Look after those braces

Stress to your kids to be careful with removable orthodontics, such as plates and retainers. They are expensive to replace.

A friend's daughter kept her plate in her school uniform pocket. She fell over and it snapped in two.

Another boy took his out while he ate his fish and chips at the beach and ended up throwing them away with the wrapping. Luckily his parents were able to search through the bin and retrieve them.

Some braces are cheaper

There is a range of contemporary orthodontic treatments to straighten teeth and align the jaw that are designed to be less noticeable and comfortable.

They include traditional metal braces, ceramic or tooth-coloured braces, clear aligners that you change every few weeks and lingual braces on the inside of the teeth. The lingual braces can be more expensive because of lab fees and they are more time consuming to fit.

The orthodontist will choose the type of braces that best suit the position of the teeth, the bite and circumstances. Some are better suited to adult patients than children. For example, lingual braces can impact the tongue as they are on the inside of the mouth, says Schwartz. Usually, metal braces are the cheapest and come in all sorts of colours.

Mail order devices

DIY clear aligner products can be bought online.

They are cheaper than traditional devices, but Orthodontics Australia says that although the lower cost and convenience are appealing, consumers need to be aware of the risks from a lack of a full clinical examination and in-person supervision to assess how the treatment is progressing.

Schwartz warns that DIY treatment plans can lead to significant dental problems, such as permanent damage to the teeth, gums, jaw joints or jaws, resulting in costly remedial treatment.

The ACCC recently fined EZ Smile for falsely alleging that its treatments were supplied by dental professionals including orthodontists registered in Australia and were subject to Australian health regulation standards. In fact, the aligners were made in China.

Your dentist can provide orthodontic treatment 

Dentists are increasingly offering orthodontic treatments such as aligners. In most cases, a health fund will provide the same amount of benefit you are entitled to claim, regardless of whether an orthodontist or a general dentist provides the treatment, says the Commonwealth Ombudsman.

But in some instances, a health fund may pay a lower benefit for orthodontic treatment provided by a general dentist. The ombudsman says in order to ensure your health fund provides you with accurate benefit information, it is important that you tell your fund who will provide the treatment.

Close to home or school

There will be many visits to the orthodontist over the years, particularly if your child needs ongoing supervision. Consider choosing a clinic that is close to your home, the school or public transport for those times when your child will go there on their own.

Also do the reviews mention the waiting time? My niece often had to wait one or two hours at every appointment. These often fell during school time.

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