How to Care for Invisalign Braces

September 21st, 2020

Invisalign braces are a great teeth-straightening option that utilizes clear aligners instead of brackets and wires. These aligners are completely customizable to your teeth and can be removed during sleep or when eating. Since they're practically invisible, Invisalign aligners are a great solution for teens and adults alike when it comes to oral health. 

Invisalign in Arvada

However, Invisalign aligners are very similar to regular braces in that the amount of upkeep is similar. Learn how to properly care for your Invisalign braces with this simple guide. 

Brush Teeth and Trays

Just because you're taking care of your teeth with braces, doesn’t mean that you can cut corners on your cleaning routine. In fact, you may experience even more bacteria and buildup while your Invisalign braces are in use. To avoid excess bacteria and dental issues, be sure to thoroughly brush teeth before bed and when you wake up in the morning. It’s also essential to clean your trays at this time, as well. Unseen food particles and bacteria can easily get stuck in your aligner trays and result in cavities if not removed properly. 

Rinse After Wear

Another way to care for your Invisalign braces is to rinse them after every wear. If you don't rinse them properly, build up from saliva and plaque is bound to occur. This could also cause a buildup of unwanted bacteria growth and harm the aligner trays. If rinsing isn’t cutting it, try gently brushing your trays with a soft-bristled toothbrush. This can help remove plaque, saliva, and bacteria buildup from the trays, all while protecting the integrity of the aligners. Use clear antibacterial soap only when cleaning. Scented or colored soap could cause discoloration of the trays or a strange taste when you put them in.

Soak Thoroughly 

Regular nighttime care for your Invisalign trays includes soaking them using cleaning crystals or denture cleaner. Soaking ensures that bacteria doesn’t grow overnight. It also makes brushing excess plaque, food, and saliva from the trays a lot easier. After soaking overnight, brush gently and rinse before inserting it into your mouth for the day.

Establish a Routine

Utilizing all of the care methods above, create a cleaning routine that is easy to remember. Establishing a care routine for your Invisalign braces helps keep them in good condition so they’ll do the important job they were meant for. Proper care of Invisalign trays guarantees a quick turnaround for your perfect smile and keeps your teeth healthy.

Add these other care tips into your routine for the ultimate braces care:

  • Schedule ahead with your dentist for regular cleanings and checkups during treatment.
  • Set an alarm each morning and evening so you remember to properly clean your Invisalign trays.
  • Properly prepare for any nights you aren’t at home so you can keep up with your cleaning schedule.
  • Follow all instructions given to you by your dentist to promote a healthy, clean, and straight smile.

Your orthodontics team can get you started with Invisalign in Arvada, Thornton, Aurora, and Highlands Ranch, CO

How Do I Know When It's Time for Early Orthodontic Treatment?

August 21st, 2020

Early Orthodontic TreatmentOrthodontic treatment can help individuals of any age. But in order to prevent oral health problems later in life, it's best to seek out an orthodontist at an early age. Get to know the recommended age range for an early examination as well as signs that someone may need further orthodontic treatment.  

Age Range for First Visit 

According to the American Association of Orthodontists, a child should meet with an orthodontist no later than age 7. When a child reaches this age, an orthodontist can spot issues with tooth and jaw growth that may later pose oral health complications. Some of those issues include:

Gaps Between Teeth 

Although braces can correct all sorts of tooth misalignment issues, people often associate the orthodontic device with correcting gaps between teeth. Gaps can lead to difficulty in chewing, speech problems, and low self-esteem. An orthodontist can offer early solutions to the problem.

Crowded Teeth

When teeth grow too close together, they may overlap or displace one another. This makes it difficult to properly brush and floss, and eventually increases the risk of other dental problems, such as cavities and infections. An orthodontic device can correct the issue, giving your child a better chance at maintaining a healthy mouth.

Mouth Breathing

Breathing through your nose is more advantageous than breathing through your mouth. That's because your nasal breathing moistens and filters air as it heads to your lungs. Habitual mouthing breathing, on the other hand, can have a negative effect on everything from facial development to academic performance.

Mouth breathing may be the result of an anterior open bite. This is when the top and bottom front teeth slant outward and fail to touch when the mouth is closed. An orthodontist can spot this condition and offer ways to correct it early. 

Thumb or Finger Sucking

Thumb sucking is a natural reflex. However, if children don't drop the habit over time, it could eventually have a negative effect on oral development. Some of those effects include overbite, speech impediment, or changes to facial development. An orthodontist can assess whether late thumb sucking has altered jaw or tooth growth. 

Irregular Loss of Baby Teeth  

Children often begin to lose their baby teeth around age 6. Early or late loss may indicate developmental problems. Inform the orthodontist of your child's tooth development, so the specialist can determine whether or not further steps will be necessary to correct the issue. 

Early Orthodontic Treatment in Aurora

It's important to note that you don't have to wait until a child is 7 years old to visit an orthodontist. In some cases, developmental problems may be more obvious, and you should seek an expert's opinion as soon as possible. For early orthodontic treatment in Aurora, you can reach out to Colorado Orthodontics. We accept patients of any age, and our team of experts can offer preventative oral health treatments to ensure your child grows up with a bright and healthy smile.

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!

Using a HSA or FSA to Pay for Braces

May 21st, 2020

We know that even though we offer arguably the best value for orthodontic treatment in all of metro Denver, orthodontic care can still be very expensive for most families.  While you want great care for you and/or your child, and so you likely are not just looking for the cheapest provider (as I often note, if you needed open-heart surgery, you wouldn’t look for the cheapest surgeon, but rather a great one that may also be affordable—and we would hope this is the same mindset when looking for an orthodontist in Denver), you still would like to find a place you can afford. With these concerns in mind, we are often asked about financial issues and if we know of any ways to make braces more affordable. To that end, we thought it would be great to discuss the advantages of HSAs and FSAs and how they can save you a significant amount of money when paying for braces.

To understand FSAs and HSAs, we need to begin with a bit of finance 101.  What is an HSA, what is an FSA and how are they different? At a high level, both HSAs and FSAs are ways that the IRS has set up for you to save money on medical expenses. They are similar, but different important ways. So we will now describe each.

Let’s start with FSA. FSA stands for Flexible Savings Account. It is typically offered by large employers and is something that you would ask to have set up during open enrollment for the following year.  The way it works is that you have your employer set aside a certain portion of your paycheck BEFORE ANY TAXES ARE APPLIED to be used for medical expenses. You may then use this money for medical expenses without these funds ever being taxed.  Let’s look at an example. Let’s say you get $1000 of gross pay on your paycheck and you pay 30% in taxes. Normally you’d get a check for $700 after taxes.  Now let’s say you put $100 of what you earned into your FSA account. Your paycheck would now be $900 less $270 in taxes, so $630.  But you also have the $100 you can spend to pay medical bills (typically your employer will provide you with a credit card tied to your FSA account).  As a result, in this example, you end up with $730, or $30 more than if you did not have an FSA. And the FSA funds, as long as they are used for medical expenses, are NEVER taxed. To use these funds, you do need to present evidence to the FSA administrators that the funds were actually used to pay for a medical expense.  In most cases, a simple receipt from the doctor or store (there is a lot of flexibility in what is considered a medical expense, so often things like eyeglasses, over-the-counter medicines, and even things like massages may be acceptable depending on the rules of the plan provided) will suffice. Is there a downside or risk of using an FSA?  Yes. The IRS rules say that if you do not use your FSA funds for the year, whatever balance is remaining gets forfeited to the IRS. Typically (those this does vary by FSA plan) there is a grace period of a couple of months beyond the New Year to spend these funds, but it is important that you plan and monitor this account. The net-net is that FSAs are a great way to save a significant amount in taxes if you have a known medical expense for the coming year (like paying for braces!) but is not something that most advisors would recommend doing if you do not know if you will have any medical expenses of any significance in the year to come. For 2020, employees can contribute up to $2,750 to health FSAs (and yes, spouses can BOTH do this).

An HSA (which stands for Health Savings Account) is similar to an FSA in that it can help pay for medical expenses tax-free, but is different in some key important ways.  Unlike an FSA, you do not need your employer to offer an HSA. Setting up an HSA has two key components.  First, you need to select and HAS-eligible insurance plan.  This will be a high-deductible plan, but the tax savings from the HAS will almost certainly outweigh the added deductible expense you incur. Once you have an HSA eligible plan, you would open up an HSA account. This typically can be done at your local bank. You would then contribute to this account.  While you are obviously funding the account with after-tax money, when you file your taxes the following year you will be able to deduct whatever amount you contributed to your HAS from your taxable income. This will either reduce the amount of taxes you owe or increase your tax refund.  The tax benefit is based on the money you contribute, not on the money you use from this account. One key difference from an FSA is that the IRS will not take this money from you if you don’t use it.  In fact, it can accumulate year-over-year.  Every year, the amount you put in is the amount you will be able to deduct from your taxes when you file. The new HSA limits for 2020 are $3,550 for individuals and $7,100 for families.

Can you have both an FSA and an HSA? Generally speaking, FSAs and HSAs cannot be used at the same time, although a limited-purpose, or "HSA-compatible" FSA, will allow individuals to also receive benefits from an HSA. A limited-purpose FSA is a healthcare spending account that can only be used for eligible vision and dental (and orthodontic!) expenses. So, as it relates to paying for braces, if your employer offers a limited purpose FSA, you can indeed use both.

Another nice element in using these tax-saving tools for paying for braces is that our services are spread out over time.  This offers two main advantages.  First, depending on when during the year you start treatment, you can spread your payments across 2 or even 3 separate years and as such use FSA or HSA funds to pay for the entire cost of treatment—yielding you as much as $1500-$2000 in tax savings.  Additionally, as our services are spread over time, we can, quite legally, adjust the timing of our payment arrangements to better optimize the use of your FSA and HSA accounts. HSA and FSA

We hope that by understanding these tax-saving features it will make it far more affordable to help you and/or your child get the smile of your/their dreams! As always, if you are here in the metro Denver area, we’d LOVE to see you! We openly take nearly ALL insurances, have been named a 5280 Top Orthodontist for the past 10 years, and winner of the #1 practice in the state by Colorado Parent. As noted, we are confident we offer the absolute best value in orthodontics in Colorado, with world-class care at affordable fees. 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!

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