Our Blog

What are Clear Ceramic Braces and Will They Work for Me?

July 7th, 2020

You know braces. You’re familiar with images of teenagers with metal braces in their mouth as a way to help straighten out teeth. But braces have come a long way and it’s not just the classic metal look anymore. There are ways to have braces that are less noticeable, more comfortable, and more versatile for the wide variety of people who may end up needing braces at different stages of their lives.

If you’ve been told by a dentist or orthodontist that braces are going to be a benefit to you, then you might want to consider your options beyond just the classic metal wire braces. Ceramic braces are a lesser known but no less effective option you can spring for if you don’t want to deal with the discomfort and aesthetic issues that come from metal wire braces.

What Are Ceramic Braces?

Ceramic braces use clear or tooth colored brackets as opposed to the metallic wiring of normal braces. Despite this aesthetic and material difference, they perform the same job and do so rather effectively. They’re an ideal option for anyone concerned that they will feel self conscious while wearing braces and can make the process more comfortable and appealing. But that doesn’t mean they’re right for everybody. As with everything, ceramic braces have their pros and cons.

Why Ceramic Braces May Be Right For You

The biggest benefit of ceramic braces is that they are less visible and obvious than normal braces that use metal wiring. The coloring is more subdued and matches the natural color of teeth. On top of that you do have some options when it comes to picking your colors. While Invisalign is the ideal for those who want teeth alignment without braces, ceramic braces move teeth into alignment much quicker. Another great benefit of ceramic braces is that their lack of metal means they won’t interfere with any imaging tests you need to get during the course you wear them.

Why Ceramic Braces May Not Be Right for You

The first thing to know is ceramic braces are more expensive than traditional wire braces. The ceramic brackets are also a little larger and can be more irritating on sensitive gums than traditional braces. They’re slightly less durable than metal wiring and have a higher chance of breaking off or fracturing. They work slower than metal braces as aligning teeth and when you do get them removed they may leave some permanent damage to your tooth’s enamel surface. They also may stain during the course of wearing them.

Ultimately, Colorado Orthodontics want to help you get the best possible option for your braces needs. A consultation is going to be the best way you can understand what ceramic and traditional braces can offer you. If you’re in the market for clear ceramic braces in Aurora, give us a call to schedule a consultation or appointment so we can best understand your needs and get you the perfect solution to your dental problems.

What is an ABO Certification?

May 27th, 2020

The American Board of Orthodontics is nationally recognized as the highest standard of excellence in orthodontics through competency assessments. There are different aspects and levels to how one is deemed board certified. Certification to the board requires multiple boxes to be checked off: completion of a graduate program in orthodontia or Doctor of Dental Surgery or Doctor of Dental Medicine, but also completion of a CODA accredited residency in orthodontics.

What an ABO certification suggests is not just a necessary level of competency and training for an orthodontist but also a commitment to excellence in the field. And in an industry that takes the health of others into their hands, it’s incredibly important to have a drive to be the best and most professional at what you do. That’s why at Colorado Orthodontics, we strive to boast the most comprehensive staff of board certified orthodontists.

What is the ABO?

The American Board of Orthodontics is the  oldest and most respected governing body in the field of orthodontics. It was founded nearly 100 years ago in 1929 and has spent every year since then making sure all professional orthodontists meet their standards and promote progress in the field. A series of tests and evaluation goes into certifying qualifying orthodontists and it can take as long as 10 years to achieve this feat. So a team of board certified orthodontists is nothing to blink at.

What is the Certification Process?

As mentioned above, an orthodontist seeking a certification from the board must first have a graduate level degree in dentistry or orthodontics and have completed a multi-year residency in an accompanying position to qualify. The next step is to complete a written examination, administered by the board, to further explore and evaluate the skills of the orthodontist. After this is completed, a certificate is awarded to the doctor but they must go through the proper renewal process each year to ensure continued competency.

Membership Upkeep

To remain members in good standing and maintain a certificate, an orthodontist must follow the renewal procedures for each period that their certificate expires. Because the board is required to remain financially independent, their budgets each year are boosted by the fees of members and examination fees. In this way, the board can continue to ensure that only the best and most competent dentists are working in the field while maintaining their own function and financial freedom. This also prevents any biases from the board or monetary favors.

How Do I Find a Board Certified Orthodontist?

At Colorado Orthodontics we’re proud to say every orthodontist on staff is an ABO certified dental professional or is in the process of completing their certification. This ensures safety and security during your orthodontics procedures. Make sure any dental professional you see is certified and competent in their area and make sure you’re getting the best possible care for your oral health.

Does CHP Pay for Braces in Colorado?

May 21st, 2020

We see a lot of folks with CHP and CHP+ in our offices. Many have been bounced back and forth between Medicaid and CHP. With many of these folks, there is some confusion on the subject of CHP and how that works with braces.  So let us try to clarify.

The answer to the question, “does CHP pay for braces in Colorado?” is maybe and kind of. We know, not much of an answer, so here are the details. The state of Colorado outsourced the processing of CHP to a third party called Dentaquest. This was a relationship that is structured in such a way that Dentaquest acts much like a private insurance company.  There are rules and guidelines set by the state which they much follow, but within those rules and guidelines, they get to determine if a claim is approved or denied and it is in their financial best interest to pay out as few claims as they can as long as they remain within the parameters set by the state. The result is, very few claims are approved for CHP.

But what are those guidelines and how do they apply?  Well, first, to get coverage, any CHP or CHP+ member must have had CHP for a full year, without a break, at the time of their orthodontic evaluation.  Even if you have had CHP for say 18 months, if it was dropped in the middle of those 18 months you are not eligible as it would not have been 1 continuous year.  If you meet this criteria, CHP will still not pay for phase 1 orthodontic treatment (for an explanation of phase 1 vs. phase 2 treatment, see our blog “Does Medicaid Pay For Braces?”). If you are looking for phase 2 coverage under CHP AND have had coverage for an entire year, you then would come in for a free consultation and evaluation.  During the evaluation, we will score your kiddo against the criteria the state established for medical necessity.  This criterion is actually far more limited than the criteria for Medicaid and as such far few kids get approval. In the end, we find that about 10% of kids with CHP get coverage.

What does coverage mean with CHP? Well, sadly, unlike Medicaid, it does not mean that CHP covers the cost for braces.  What it means is that the doctor should apply a contracted rate for treatment (at this moment, in early 2020, that’s about $5200) and then CHP will pay $1500 of these charges to the doctor over time.  The “over time” piece is important here because if you lose coverage before treatment has continued for at least a year, you will only receive half of this benefit. But, assuming you get the entire benefit, you will still be looking at about $3700 out of pocket.  Many providers will do what we do which is to let you finance this interest-free over 2 years, so your payments are likely around $130 per month, but it will still cost you money. In our practice, since we know how unreasonable all of this seems for struggling families with CHP, we offer a substantially discounted rate for care to any of our CHP patients who are denied.

So what does this all mean for you?  Well, first of all, if you are one of those families that bounce back and forth between Medicaid and CHP, wait until you are back on Medicaid and then run, don’t walk, to an orthodontist and see if you can get the process all completed before the insurance switches back.  Even if you lose Medicaid the day after we started braces, while there will still be out of pocket expenses, in our practice for example, the MOST we would charge you would be $1800 over the next two years.  So far, far less than what you would have paid with CHP—and that is a WORST case scenario (it is true that other major practices will charge more than the $1800 noted—this is just our policy for patients who we start with Medicaid and lose coverage.  Again, for more on that, see our blog: “Does Medicaid Pay For Braces?”). If you are stuck with CHP and can not get other private insurance and are struggling to pay for braces, look into using an FSA or HAS account to save a ton of money on taxes. Not familiar with these acronyms?  Don’t worry, we’ll post another blog about these very soon.

Lastly, if you are here in the metro Denver area, we’d LOVE to see you! We openly take all CHP and CHP+ patients (and to our knowledge are the only 5280 Top Orthodontist (and have been for 10 years!) and winner of the #1 practice in the state by Colorado Parent magazine that does so), and, while still a family-owned and operated practice, have 9 locations throughout the city to see patients. Just give one of our offices a call and schedule for a consultation.

We hope this all helps!

Does Medicaid Pay For Braces?

May 21st, 2020

This is a question we get nearly every day.  Not only from folks here in Colorado but from around the country.

The short answer: maybe ….

Let us explain.  First, Medicaid coverage for orthodontics varies by state policy.  In some states Medicaid does provide coverage for some cases to be treated, while in others it does not.  Here in Colorado, for example, there is Medicaid coverage for orthodontics. In all states, however, coverage is only for people under the age of 21. If you are 21 or over, have Medicaid, and want braces, we are sad to say that your insurance will not help you with the costs.  You can still get braces, you will just have to pay for them yourself. 

We should note that our practice has a somewhat unique understanding of this topic. A few years ago, in working with our state here in Colorado to design the state criteria, we performed a nation-wide analysis of state-by-state coverage.  Later, as Dr. Baskin, one of our doctors, had been asked to help determine policy for the AAO on medical necessity, we updated this analysis for the AAO. Between these efforts, we came to realize that we might have a stronger grasp on this topic than almost any other practice in the nation.

So let’s say you live in a state that DOES offer orthodontic care and you have a child who you think could benefit from care.  You may ask, how does it work?  Well, to start, we need to provide a bit of “orthodontics 101” education. Orthodontics often has two different phases of treatment. Phase 1 (also called interceptive treatment) is for early care and is done often between the ages of 7-10 while the child’s jaw is still developing and they still have multiple “baby” (also called primary) teeth. This phase typically addresses more structural issues of the jaw such as a narrow palate, impacted teeth or an underbite.  It is done early because a child’s jaw is far more malleable (for example at the top of the mouth, the palate has not yet formed) and so treatment can be done far more easily and quickly than it could in later years, sometime avoiding what would have been surgical solutions later down the road. Phase 2, or comprehensive treatment, is done for people for 10-99.  It’s orthodontic care once most or all of the adult teeth have erupted in the mouth.  It is important to note here that because some children would significantly benefit from early Phase 1 care, our national organization (called the AAO for American Association of Orthodontics) strongly recommends that all children see their orthodontist at age 7.  Not every kid at 7 needs care, in fact most do not, but much like a checkup to the pediatrician, it’s important that children be “checked-out” by an orthodontist when they are 7 or 8.

So, back to Medicaid coverage.  Most, but not all states that provide orthodontic benefits cover both Phase 1 and Phase 2 treatment.  While rules change all the time, to the best of our knowledge there are still some states that do not cover phase 1 care.  For either phase of care, before they will pay for anything, all states require that the need for the child to get braces is “medically necessary”.  How do they determine medical necessity?  Well again this varies by state.  Each has developed its own set of criteria.  Some use one of a few commonly accepted scoring mechanisms.  With these, you get a certain number of points for exhibiting various conditions, and only if your point total meets or exceeds the required amount will the case be considered medically necessary. In other states, like here in Colorado, there is a checklist of criteria.  In theory, if you meet any of the criteria on the checklist, you qualify for coverage.  We say “in theory” because there is still a bit of a subjective element here.  We have submitted cases that we think show 1 or more the criteria and have still had these cases denied for coverage.  Why?  Well, put simply, while our doctors may say that the x-rays and photos of a patient clearly show a condition, the folks who review the cases for the state may disagree.  And in the end, the state reviewers have the final say.

“How often do kids get approved then?” you may ask. As you might imagine, again this varies greatly by state and phase of treatment. Politics and state budgets also sadly come into play. Here in Colorado, for example, as recently as 3 years again, we would often see about half of all kids get approved.  More for Phase 2 than Phase 1, but just over 50% when taken together.  Now, in the past year, that number has dropped to about a third.  As the criteria for Phase 1 is more limited, this splits, roughly, to about 25% of Phase 1 cases being approved and about 40% of Phase 2. If you live outside of Colorado, these numbers could be drastically different.

Medicaid Braces

The last piece to explain here is HOW Medicaid pays. Yet again, it varies by state.  Here in Colorado, they will pay in full for a Phase 1 case.  So, if you had Medicaid coverage on the day your evaluation consultation occurred and continue to have it on the day the braces or appliances are put on, you are all good.  Even if you lose care the next day, the treatment has been paid for.  Years ago, this also was true for Phase 2. But starting in 2017, Colorado changed these rules and now pays the doctor in installments. This can create some financial issues.  If you lose coverage during treatment (Phase 2 often lasts about 2 years), you will most likely be responsible for paying the provider for the remaining care.  What they charge you is completely up to them as, now that Medicaid is out of the picture, the practice can charge whatever they want.  We know many of our competitors, for example, will charge $130-$150 a month for as many months as you still need treatment.  Our practice, knowing the hardship on these families, decided to set a policy of charging $100/month and only charge for the number of months that we did not get Medicaid coverage (so no more than 18 months maximum, depending at what point the patient lost coverage).  If you regain Medicaid coverage at a later date while still in treatment, the practice can attempt to re-apply for benefits and adjust your financials accordingly (you may still owe money for the period where there was no coverage).  And yes, if you get private insurance during this time, this can sometimes be billed as well (depending on the policy).

So what do you do now armed with this knowledge?  Well first, if you have a child over the age of 7 who has not seen an orthodontist (and yes, even if they have seen a dentist, they should be seeing an orthodontist who has 2-3 more years of training specifically on jaw and tooth development and correction), schedule to see one.  It is painless for your child, free to you, and will assure they are getting the proper medical care they need. Secondly, as it relates to Medicaid coverage and approval, work with your orthodontist.  They are on your side and want to get you covered as much as you do.  They can advise if you get denied what the best next step may be (e.g., wait a year and try again, start with mild treatments that do not require approval but are covered by your insurance, etc.). 

Lastly, if you are here in the metro Denver area, we’d LOVE to see you! We openly take all Medicaid patients (and to our knowledge are the only 5280 Top Orthodontist (and have been for 10 years!) and winner of the #1 practice in the state by Colorado Parent magazine that does so), and, while still a family-owned and operated practice, have 9 locations throughout the city to see patients. Just give one of our offices a call and schedule for a consultation.

We hope this all helps!

Need a location closer to home?
Visit our sister sites:

all about orthodontics lodo orthodontics
arvada orthodontic office south aurora orthodontic office thornton orthodontic office highlands-ranch orthodontic office
Arvada
S. Aurora
Thornton
Highlands Ranch
Click here to Request your Free Consultation
Coronavirus Update ×