Some orthodontic patients are surprised to find out that the cost of braces commonly varies from office to office. Assuming that the treatment plan and final results would be similar (which may or may not actually be the case), what causes fees to be higher in one office than another? What factors affect orthodontic fees and how are they calculated?

Orthodontic fees pay for more than just the braces
As with any product or service, the cost of getting braces is determined by multiple factors. Among these are 1) the cost of the materials and supplies, 2) the cost of staff salaries, 3) the cost and maintenance of the facility, and 4) profit to the business. Here’s why orthodontic fees are higher in some offices and lower in others.

Orthodontists use different braces, supplies, and equipment
There are lots of supplies necessary to provide your orthodontic treatment. The most visible ones are the brackets, wires, and rubber bands that your orthodontist and his team attach to your teeth. The things you might not see are all of the supplies and tools used for sterilization, appliance placement and removal, and the lab where models and retainers are made. Additionally, not all orthodontists use the same quality of braces nor do they straighten teeth in the same way. Forsus Springs for example are faster and more reliable than rubber bands. They do however add several hundred dollars to the cost of treatment. While most orthodontists have some type of x-ray machine in their office, some do not. Diagnostic equipment costs money. Innovative orthodontic offices may use 3D x-rays (CBCT) that provide doctors with a lot more information about your teeth and jaws than conventional machines. Offices that use better materials, more innovative appliances (including clear aligners), and better technology must pass the costs of these improvements on to their patients.

Location and facilities affect fees
One of the most visible differences between orthodontic offices is the facility in which the practice is located and the amenities provided. Although you may be able to get straight teeth in a stark, institutional facility, many families prefer an office that is more comfortable, innovative, and fun. Those additional perks also come at a price. Offices that have games in the waiting room, cookies at the front desk, and patient rewards to encourage hygiene, timeliness, and cooperation will have fees slightly higher than offices that don’t.

Experienced staff members cost more
By far the biggest expense for all orthodontic practices is staff salaries, and those can be very different between offices. An office that has a larger, more experienced team will have a larger payroll. Their experience and expertise is worth the higher salaries that they receive. Newer offices or offices that experience a lot of turnover may have less experienced employees and that should be reflected in a lower fee.

Businesses must be profitable or they will fail
While politicians may demonize businesses that make a profit, the truth is that if a business doesn’t make a profit, it will fail. Profit is defined as the money that remains after all of the bills are paid. Successful businesses direct their profit to three places, 1) into consistent business improvements, 2) into cash reserves (for unforeseen future practice expenses), and 3) any left over to the business owner. Medicine and dentistry are constantly changing. It is not uncommon to visit the office of a dentist who has been in practice for over 30 years and find the same décor and color scheme he had when he graduated from dental school. If his waiting room and dental equipment are more than 30 years old, what does that tell you about the care he may be providing your family?

Calculating fees is just math. Usually once a year, the amount of money it costs to treat patients (supplies, staff, and overhead) is determined and divided by number of patients seen (with adjustments for the kinds and complexity of treatment and appliances used). Sometimes patients who shop around for an orthodontist will find the treatment, staff, and facility they want in one office but a lower fee in another. Hopefully this information helps explain why orthodontic fees are not the same everywhere.

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.