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Medical Forum / General / Dentistry / April 2005adult invisalign orthodontics in Honolulu
Hello, 36 year old male here. I am thinking of getting Invisalign to fix a couple of crooked teeth and an overbite. The overbite may or may not be possible with Invisalign, from what I've read. I've studied up on Invisalign, and one lecture I found on the web emphasizes that skill and experience are very important, because the orthodontist has to plan all moves ahead of time before making the aligners. Overall, my teeth are quite good and straight except for 1) 3 crooked front teeth, one highly twisted upper right lateral, putting a mild twist on two front incisors. 2) something like a (my guess) 70% overbite that was noted by my dentist, who sort of suggested treatment, but understood my reluctance at my age. I have never had orthodonty, though I never liked my overbite and the protruding tooth. Invisalign might change my mind, however. So my questions are a) how severe a course of Invisalign would this be? I know that I will get rough guesses at best with only the info I've provided. Are we talking 10 aligners, 20? 8 months, two years? No clue? b) what would be the probable going price in Honolulu? On the web, the cheapest I've seen anywhere is $3500 all-inclusive guaranteed. Usually people say $4000 to (ouch) $7000. At most, insurance will spring for $1000. Any Honolulu experiences? c) Is there usually rebound, so would this mean wearing an appliance for the rest of my life? d) any advice on particularly good (skill and cost-wise) Invisalign orthodontists in Honolulu? I don't just want to pick at random from the yellow pages, and my dentist is located elsewhere. Many thanks for any advice. -JA >Hello, > >36 year old male here. I am thinking of getting Invisalign to fix a >couple of crooked teeth and an overbite. The overbite may or may not be >possible with Invisalign, from what I've read. Go for it Dude! >I've studied up on Invisalign, and one lecture I found on the web >emphasizes that skill and experience are very important, because the >orthodontist has to plan all moves ahead of time before making the >aligners. Then make sure its an Orthodontist, not a fakir or poseur. >Overall, my teeth are quite good and straight except for > [quoted text clipped - 7 lines] >I have never had orthodonty, though I never liked my overbite and the >protruding tooth. Too bad. FIX IT! I mean have it fixed. >Invisalign might change my mind, however. > [quoted text clipped - 3 lines] >get rough guesses at best with only the info I've provided. Are we >talking 10 aligners, 20? 8 months, two years? No clue? Me either. >b) what would be the probable going price in Honolulu? On the web, the >cheapest I've seen anywhere is $3500 all-inclusive guaranteed. >Usually people say $4000 to (ouch) $7000. At most, insurance will >spring for $1000. Any Honolulu experiences? Yes once I was lying on the beach and .... NEVERMIND! >c) Is there usually rebound, so would this mean wearing an appliance >for the rest of my life? > >d) any advice on particularly good (skill and cost-wise) Invisalign >orthodontists in Honolulu? I don't just want to pick at random from the >yellow pages, and my dentist is located elsewhere. Beware of any Honalulu Lulus ......... Joel As you can tell, I have no idea, but call an orthodontist, I do know that! >Many thanks for any advice. > >-JA > Hello, > [quoted text clipped - 42 lines] > > -JA I'm not totally up to speed on lab fees, but I think they're considerably north of $2K. As such, $3500 as a fee seems awfully low. With limited goals (say, dealing with minor crowding/rotations, not dealing with inter-arch discrepencies) it might be possible to use some kind of removable device that is less expensive. Hopefully, Carabelli or Charlie will reply. Steve  SignatureCut the nonsense to reply Lab fees seem to be $1500-2000. See http://www.affordablebraces.com/Fees2004HTML.htm and look at the bottom table. This is the person who does it all for $3500: http://www.drperryjones.com/invisalignnew.asp Of course, cheapest might not be best. This is just the floor price level I found, useful as a starting point for estimating a reasonable price. > I'm not totally up to speed on lab fees, but I think they're > considerably north of $2K. As such, $3500 as a fee seems awfully low. > With limited goals (say, dealing with minor crowding/rotations, not > dealing with inter-arch discrepencies) it might be possible to use some > kind of removable device that is less expensive. > Hopefully, Carabelli or Charlie will reply. > Lab fees seem to be $1500-2000. See > http://www.affordablebraces.com/Fees2004HTML.htm [quoted text clipped - 6 lines] > the floor price level I found, useful as a starting point > for estimating a reasonable price. I would not take this fee as gospel re: the lab fee. I'm not certain what the fees are now, but for most cases they were definitely higher than $1500. Of course, if you are charging $6500, you might have more wiggle room. The thing about Invisalign is that the lab fees are high, but the amount of chair time should be considerably lower than conventional orthodontics. There is no doubt that the primary appeal is to people who want invisible braces. I don't think anyone claims they are more effective, and certainly they are less versatile. Another not insignificant advantage is how much easier it makes oral hygiene. I would find a good orthodontist who is capable of both Invisalign and conventional orthodontics and sit down for a consultation and have him/her A/B it for you, so you can make a fully informed decision--even if it is to do nothing. Good luck, Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I understand the $1500 lab fee to be some absolute minimum - small number of aligners, eg top or bottom only. I would believe $2000 maybe. I would worry that the guy who charges $3500 makes his money by cutting chair time. I've been with docs like that. An assistant sees you for a half hour, doc rushes in, prods you for five seconds, and rushes out to see the next patient in the adjacent office. As I said, cheap is not necessarily all that great. But if I'm paying $7000 and I know that $5000 goes to the doc (and office, and staff) once I take out the $2K lab fee, I can calculate how much I'm paying him per hour. So I'm really trying to be an informed consumer, and get good skill and time for a fair price. I just shared dinner last night with an orthodontist. (We were celebrating someone's birthday.) He told me that the last Invisalgin case he got back had a $3000 lab fee. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >I understand the $1500 lab fee to be some absolute minimum - small > number of aligners, eg top or bottom only. I would believe $2000 maybe. [quoted text clipped - 7 lines] > really trying to be an informed consumer, and get good skill and time > for a fair price. >I just shared dinner last night with an orthodontist. (We were celebrating >someone's birthday.) He told me that the last Invisalgin case he got back >had a $3000 lab fee. WoW! $1500 is the typical lab fee, which can go south if your orthodontist has good contacts or has sent several orders. As a good ballpark, 12 months of these removable braces cost your orthodontist about $2000-3000, depending on the complexity of the treatment. If the lab charges were $3000, either the orthodontist got ripped off, or the orthodontist is not telling you the truth. If the total cost of treatment in 12 months goes beyond $5000, you are being completely ripped off. With regular braces, the orthodontist incurs a very low cost. Check any orthodontic suppliers and add up the cost of everything. The total cost of appliances comes to well below $1000 per patient. The rest is their profit, which they will tell you goes towards equipment, paying their employees and sprucing up their offices. With Invisalign, their total costs are higher. Hence they charge you more to maintain their profits. The Invisalign technique transforms orthodontia. In fact, the patient does not really need an orthodontist. The company could send the patients the impression trays and create the braces for them. The issue that prevents direct service to the patient is legal liability. Invisalign avoids lawsuits as the orthodontist sends them the treatment plan and impressions. If anything goes wrong, the patient will sue the orthodontist, not the company. Invisalign needs the orthodontists to survive and thrive. Hence they won't tell you the real costs involved. The orthodontists will make your treatment sound very complicated when they speak to you, so they can charge you well beyond the cost of the treatment. The two websites that have been mentioned in this thread reveal some of the realities behind the cost of Invisalign. After visiting several orthodontists, I realized they were far from being truthful. While I am not qualified as an orthodontist, I can use my brains. I have researched for hours online and through texts from the dental school library. Mine was a simple bite problem and I could write my own treatment plan, perhaps execute too, if only I had the equipment. I would ask each orthodontist for a treatment plan and I realized how full of sh** they were. The first thing they did was check up my insurance and the place I worked. Once they figured out how much I could pay, they gave me huge estimates and a complicated treatment plans. After I had enough knowledge about Invisalign, I went to several orthodontists who claimed to treat with Invisalign. They were bluffing me too. I finally got my Invisalign braces through an orthodontist who owes me. My treatment is progressing well and I am glad to share this here. > >I just shared dinner last night with an orthodontist. (We were celebrating > >someone's birthday.) He told me that the last Invisalgin case he got back > >had a $3000 lab fee. > > WoW! Very impressive analysis. Thanks. I learned lots and I am a dentist! Joel M. Eichen D.D.S. >$1500 is the typical lab fee, which can go south if your orthodontist >has good contacts or has sent several orders. As a good ballpark, 12 [quoted text clipped - 47 lines] >> >> WoW! > Very impressive analysis. Thanks. > I learned lots and I am a dentist! > > Joel M. Eichen D.D.S. Then you are easily impressed. carabelli >>Very impressive analysis. Thanks. >>I learned lots and I am a dentist! [quoted text clipped - 4 lines] > > carabelli I have a (perhaps morbid) curiosity about how the orthodontist "owes" him. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Very impressive analysis. Thanks. >> I learned lots and I am a dentist! [quoted text clipped - 4 lines] > >carabelli This is correct! Joel This is just so wrong-headed on several important points I don't really know where to begin, so I'll insert my comments within the text. Please note to those who don't know me--I am a general dentist, and I do NOT provide orthodontic care for my patients. I have been an Invisalign patient. > $1500 is the typical lab fee, which can go south if your orthodontist > has good contacts or has sent several orders. As a good ballpark, 12 [quoted text clipped - 4 lines] > treatment in 12 months goes beyond $5000, you are being completely > ripped off. This is a value judgement, but one formed through a jaundiced eye. My reason for saying this has everything with the poster's implied impression (below) that the orthodontist is selling a finished product to the patient, and is basically not adding any value of service. I don't know what orthodontists charge for a typical Invisalign case. For a full case, my impression is that $5000 (the benchmark used by the poster as a "ripoff") is a bit on the low side of average. > With regular braces, the orthodontist incurs a very low cost. Check any > orthodontic suppliers and add up the cost of everything. The total cost > of appliances comes to well below $1000 per patient. The rest is their > profit, which they will tell you goes towards equipment, paying their > employees and sprucing up their offices. With Invisalign, their total > costs are higher. Hence they charge you more to maintain their profits. This shows a total lack of understanding of both the cost of RUNNING an office (much less "sprucing" it up) and of the actual service the orthodontist provides. Much more than for the Invisalign patient, the orthodontist is not "selling" an appliance from a box to the patient. > The Invisalign technique transforms orthodontia. It transforms a small segment of orthodontia--the adult patient with relatively minor orthodontic problems who otherwise wouldn't seek treatment because traditional appliances don't have "the LOOK". In fact, the patient > does not really need an orthodontist. The company could send the > patients the impression trays and create the braces for them. I defy you to take your own impressions with PVS material. My brother had to take my impressions three times to get a suitable impression. At the time he'd had maybe 29 years of experience taking impressions. Allowing that I have an oddly-shaped dental arch, do you think YOU would be able to evaluate an impression and tell that it was satisfactory? The issue > that prevents direct service to the patient is legal liability. The issue that prevents direct service to the patient is the state dental practice act. Direct service of this kind to the patient is illegal in all 50 states. Illegal as in criminal, not liability for negligence, which would doubtless apply as well. > Invisalign avoids lawsuits as the orthodontist sends them the treatment > plan and impressions. If anything goes wrong, the patient will sue the > orthodontist, not the company. Invisalign needs the orthodontists to > survive and thrive. Actually, although Invisalign fought it, general practitioners are now legally able to perform Invisalign treatment for their patients. Hence they won't tell you the real costs involved. > The orthodontists will make your treatment sound very complicated when > they speak to you, so they can charge you well beyond the cost of the [quoted text clipped - 7 lines] > write my own treatment plan, perhaps execute too, if only I had the > equipment. Luckily, we don't have correspondence schools for dentistry--at least not yet. If you think that Invisalign is idiot-proof, that nothing can go wrong, that anyone can do it, that all the planning goes on in the lab, that the orthodontist is superfluous except as a hole into which you throw your money, I'd advise you go google this newsgroup and read the several stories about how Invisalign can and has gone wrong. Steve I would ask each orthodontist for a treatment plan and I > realized how full of sh** they were. The first thing they did was check > up my insurance and the place I worked. Once they figured out how much [quoted text clipped - 16 lines] >> >>WoW! SignatureCut the nonsense to reply > For a full case, my impression is that $5000 (the benchmark used by the > poster as a "ripoff") is a bit on the low side of average. Please do tell us how much it should cost. Give us a range that is flexible to the complexity of the treatment, assuming it would take 12 months for the complete treatment. >This shows a total lack of understanding of both the cost of RUNNING an >office (much less "sprucing" it up) and of the actual service the >orthodontist provides. So you mean that multiplying the profit per patient times the number of patients isn't enough for you to run your office? What do you want to run? A clinic or a microprocessor chip fabrication plant? >I defy you to take your own impressions with PVS material. Who told you anyone was perfect? > If you think that Invisalign is idiot-proof, that nothing can go wrong, Who said so? > I'd advise you go google this newsgroup and read the several > stories about how Invisalign can and has gone wrong. Yes, I already did several times over several years. I have found numerous cases. All those treatments were conducted by reputed orthodontists educated in non-correspondence dental schools. That does not mean that a patient treating themselves would be any better or worse. And it does not mean that an orthodontist educated in a correspondence dental school would be any better or worse. Well, my guess is that it would be worse as the patient and the orthodontist in question would have had little practical experience. It's practice, talent and knowledge that counts. As a patient, I really don't care who treats me, as long as they have these three qualities, and they do not rip me off. That was the basis of my post. However, it looks like you saw my post as a challenge to your profession of dentistry as a whole. There's too much sentiment in your response. It wasn't meant as a challenge of any sort. My views were a patient's analysis of the situation, after collecting a lot of information and visiting dozens of dentists in three continents that I have lived for business reasons over five years. If you really want to find the costs of these braces, go to a country other than the US, where the dentists receive their set of braces by mail from the US company. Look at their receipts. The receipts from the US company don't lie. Those are the real costs involved. Add some more money to it, to pay for other things, including the cost of shipping. Also leave some room for the orthodontist to make profit. Then you get a ballpark figure. That's how I got my numbers. To others who have posted, If anybody has a better way to estimate, please let everyone know the numbers and how you calculated the costs. I would certainly welcome your ideas. Just don't post short sentences ridiculing other posters. Those short messages are rhetoric, not rational or logical statements. >>For a full case, my impression is that $5000 (the benchmark used by > [quoted text clipped - 5 lines] > flexible to the complexity of the treatment, assuming it would take 12 > months for the complete treatment. OK, fair question. I don't have a good answer for you though, because I am not an orthodontist, I do not do Invisalign orthodontics, and I cannot estimate the total costs attendent to treating an Invisalign patient for one year. Since you are assuming that the only significant cost is the lab fee, I can understand why you think I was stonewalling you. The smartass answer is that the appropriate fee is what the market will bear. There is no price-fixing in dentistry, and there is doubtless a wide range of fees out there. If a dentist can make a reasonable profit charging less for Invisalign than the guy down the block, eventually patients will flock to him and he'll clean up. The real question for me (I don't expect you to be that interested in this one) is that for a given case which can be treated conventionally with wires and brackets OR Invisalign, given the higher lab fees of Invisalign and the considerably greater chair time for conventional ortho, which one affords ON AVERAGE a greater hourly profit to the dentist. To me, this gives a truer measure of value. Steve SignatureCut the nonsense to reply > patient for one year. Since you are assuming that the only significant > cost is the lab fee, I can understand why you think I was stonewalling you. If you have read how I came up with the estimate, you'll understand that I have accounted for all possible costs for the orthodontist and also included a handsome profit for them. > The smartass answer is that the appropriate fee is what the market will > bear. Exactly my point! Orthodontists charge people to the extent they believe the patients can pay. > If a dentist can make a reasonable profit > charging less for Invisalign than the guy down the block, eventually > patients will flock to him and he'll clean up. Unfortunately, there aren't any orthodontists that are satisfied with "reasonable profit" and every orthodontist is waiting until the other guy reduces their charges. However, nobody reduces their charges. When there's a loot to me made, why not take as much as you can? What do you say? >>patient for one year. Since you are assuming that the only > [quoted text clipped - 26 lines] > there's a loot to me made, why not take as much as you can? What do you > say? Well, that's the American way, isn't it? If there is an undersupply of orthodontists, fees could actually go up until no one can afford the services. This may be true in some markets, but sadly there is no undersupply of dentists where I practice. Steve SignatureCut the nonsense to reply "prospectivegeek" <y9047mt1@yahoo.com> wrote .......... > If you have read how I came up with the estimate, I did ....you'll understand > that I have accounted for all possible costs for the orthodontist ......... And no, you didn't. carabelli >"prospectivegeek" <y9047mt1@yahoo.com> wrote .......... > [quoted text clipped - 9 lines] > >carabelli Noticed that he left out the Ferrari payment. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >"prospectivegeek" <y9047mt1@yahoo.com> wrote .......... > > [quoted text clipped - 14 lines] > > W_B Nah, paid for all four out of petty cash. carabelli >>On Wed, 06 Apr 2005 13:36:52 GMT, "carabelli" <redslaz3@att.net.not> > [quoted text clipped - 24 lines] > > carabelli May I touch the hem of your cloak? Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > >>On Wed, 06 Apr 2005 13:36:52 GMT, "carabelli" <redslaz3@att.net.not> > > [quoted text clipped - 28 lines] > > Steve I double checked, actually it's a Chrysler and there's only one of them. carabelli >> May I touch the hem of your cloak? >> [quoted text clipped - 3 lines] > >carabelli I double checked too. Still a Ferrari Diablo. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>May I touch the hem of your cloak? >>> [quoted text clipped - 13 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Do more endos, Dan. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > >> May I touch the hem of your cloak? > >> [quoted text clipped - 11 lines] > > W_B And still in the Revell box? carabelli >> I double checked too. >> [quoted text clipped - 7 lines] > >carabelli How did you know ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>> May I touch the hem of your cloak? >>> [quoted text clipped - 7 lines] > > Still a Ferrari Diablo. Me too! Mine is 1/24th scale, how about yours? >>>> May I touch the hem of your cloak? >>>> [quoted text clipped - 11 lines] > >Mine is 1/24th scale, how about yours? Same. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >> On Wed, 06 Apr 2005 13:36:52 GMT, "carabelli" <redslaz3@att.net.not> >wrote: [quoted text clipped - 21 lines] > >carabelli Me too. He did leave out the PITA fee however. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > I don't know what orthodontists charge for a typical Invisalign case > For a full case, my impression is that $5000 (the benchmark used by > the poster as a "ripoff") is a bit on the low side of average. For the record, in Honolulu Dentist wants $4100 for full invisalign course (any complexity?) Ortho wants $5000 for full invisalign course (any complexity, w/5% prepayment discount) Honolulu is very expensive for most things, but not dentistry. I think we have a lot of competing dentists and orthos, so the cost may be market driven. Just my guess. |
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