Thursday, March 12, 2009

three orthodontists walk into a bar...

My kid has some jacked up teeth, which is the result of almost continuous finger sucking (left hand, ring and middle fingers together) since 6 months of age. She's now almost 8 1/2.
(Long boring story ahead for referance purposes mostly.)

We made appointments with two of the orthodontists in town. There are probably six in town, if I had to guesstimate; I chose to meet with one who we saw a few years ago for Brittani, who ended up *not* getting braces, and the other one I just pulled off of the Goooogle.

Our first appointment was with a Downtown Orthodontist (Dr. Sutherland); my first impression upon entering the office was how chaotic it was. The staff were very friendly, though. I sat down and noticed a wall of pamphlets, the titles of which escape me now, but the topics were Christian based. There were a few on Crisis Pregnancy (which is code for anti-abortion literature). Lots of godly literature. Marriage is meant for 1 man + 1 Woman kind of stuff; some Pray the Gay Away pamphlets, too, IIRC. That kind of disturbed me, but I am aware that he runs his own business and can display whatever literature he chooses. My dentist always has LDS magazines out, though he has finally added some good stuff--Us Weekly, People-- to his magazine library. My dentist is awesome, and he could have all that same literature out, and I would still see him. Good care is hard to find, you know.

So I gave this guy the benefit of the doubt. His treatment coordinator, Maritza, was awesome. Super nice and welcoming. The Dr came in, and what I loved about him was how he addressed Maya directly. *She* is the patient; I just pay the bill. He sat and talked with us about life in general: school, work, hobbies, etc. He didn't rush through the consultation exam; he gave us plenty of time for questions. He gave Maya a water bottle (the bad kind, though...BPA and all that).

The care plan at this point was to simply break the habit of sucking her fingers (thumbguard), and then he would see how her teeth fell into place, at which time, we would look into the next phase (braces, headgear, whatever else it will entail). The estimate was $880 with a 3% discount for full payment up-front (our insurance doesn't cover orthodontia).

The next appointment was several weeks later (mid January) with the Sunrise Orthodontist (Dr. Almond). We had seen this Dr before with Brittani. That was the Dr who gave us a $30,000+ estimate for her orthodontics and oral surgery. Wayne gets a bad vibe from the guy; he seemed nice enough to me in our prior visit, but his estimate was just so high and his treatment plan was so aggressive with Brittani (cut her lower jaw to shorten it, wire the jaw shut for a couple of months) that it was scary. Our dentist recommended that we not pursue that treatment with Brittani. He said, "If she was my kid, I wouldn't do it."

So that's our history with the Sunrise Orthodontist.
The office staff, of course, are super nice. They always are. Like the previous office, they do computerized check-ins that the patients initiate themselves. It's pretty cool.
We get back to see the Dr, and everything he says to Maya has to do with what he needs her to do ("open your mouth; bite down..."); there was no conversation between her and the Dr or between us and the Dr. He kept bringing up Brittani's bite, which was annoying. He was obsessed with Brittani's lower jaw, which caused him to really focus on that during Maya's visit.

His treatment plan was far more aggressive (of course): thumbguard (to prevent finger sucking) with expanders, braces on the front four teeth and headgear. $3700 for Phase 1. Wow.

I was *stunned* when we left his office.

How could two orthodontists have two totally different approaches to Maya's finger-sucking, and how do I make sense of it all? I may spend more at the Sunrise Ortho up front, but at least that cost is there, and I'm aware of it. On the other hand, I really just want her to stop sucking her fingers; I'm not worried about her bite or her jaw growth right now. She's 8!

I was concerned that all of that stuff together could be overwhelming for her. It's hard enough to stop a soothing habit, but to throw braces and headgear into the mix at the same time? I know my kid, and I know that would stress her out.

When we left that appointment, I knew we were in for another appointment with yet another orthodontist. I was getting really sick of orthodontist consults, and they work such wacky days that we ended up having to wait a few weeks for an appointment.

The final orthodontist we saw was a South Hill Orthodontist (Dr. Sutherland).
Again--office staff is great. The treatment coordinator was fabulous, as they all are; let me digress for a sec: The office staff are the salespeople; the Dr is the delivery guy. That seems to be the case for the offices we visited anyway. I think one would be hard-pressed to find an orthodontist office that has a really rude staff.

Okay, so we're chatting with the treatment coordinator while waiting for the Dr. Like the Downtown Orthodontist, the Dr and treatment coordinator really took time to talk with Maya and make her feel comfortable before they started poking and prodding around her mouth and face.

This orthodontist presented a similar treatment plan to what the Downtown Orthodontist presented. I asked about the headgear and braces, and he said that maybe in a few years but not now. He said his opinion is that she is still too young, and he wants to see how her teeth will come in without the fingers getting in the way. He said the headgear will change her jaw by just a few millimeters and that he doesn't see the benefit right now in her case.

The treatment plan he presented was a thumbguard for now with future orthodontia needs to be determined in the future. $800 with a 5% discount for full payment up-front.

Then we had to make a decision: which orthodontist do we go with?

The Downtown and South Hill orthodontists were our options. There was no way in hell we were going to the Sunrise Orthodontist; he is very aggressive (from our experience with both the girls we've taken to him for consultations), and when it comes to orthodontia, aggressive = expensive = his next family vacation. Also, I really didn't appreciate his lack of communication with Maya, especially when the other two were so warm and welcoming when they spoke to her and to me.

We ended up choosing the South Hill Orthodontist, but that was largely because of location. I would highly recommend either the Downtown Orthodontist or the South Hill Orthodontist, and I let the Downtown Orthodontist know that I loved their office, staff and Dr; it just saves us about 40 minutes per appointment to use the South Hill Orthodontist.

Maya had her first appointment with SHO yesterday to place the spacers; she did great. She has one more appointment next week, and then the week before spring break is when the thumbguard will be placed.

Wish me luck. That is not going to be an easy habit to break...

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