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Orthodontic Budgeting (or Why I Have Crooked Teeth)

May 21st, 2008 . by economistmom

tooth holding dollarThe other day I took my two younger kids for their regular dental checkup, and our long-time dental hygenist, Sue, said to me, in disbelief, that kid #3’s teeth actually looked pretty straight, compared with kids #1 and #2, who have already been through two palate expansions and three sets of braces between them, and compared with kid #4’s dental situation, which Sue always refers to as something like a “major excavation and reconstruction project” ahead…  

Let me pause here to say that having already paid for three sets of braces on just two kids, I often wonder if orthodontics are a way of giving families “practice” in paying outrageous bills–i.e., practice for (or prevention of?) paying for college.  It was at the time kid #2 was about to get her second set of braces, that  I first realized that this “double braces” treatment that I had agreed to before she got her first set of braces, was going to be double the cost.  Of course, I had to swallow hard and pay the bill, but as an economist and not just a mom, I was left wondering if early orthodontic treatment makes economic sense for anyone but the orthodontist.  Does one end up spending double the money for the same ultimate result?  Or is the result that much better that it’s worth paying for the early treatment?  Anyone out there know?

…Well, back to kid #3’s story:  Sue the hygenist asked what the orthodontist had said about kid #3, because although kid #3 looked pretty good, it wasn’t completely perfect, and I happily reported that the orthodontist said this kid would NOT need braces, and if the orthodontist himself is saying that, you know it would be totally frivolous to spend all that money to correct very minor imperfections in kid #3’s teeth.  I went on to say, with a laugh, ”well, I’d get braces for myself before I’d get braces for her–you know how messed up my teeth are.”

But afterwards I realized that no, I wouldn’t really get braces for myself before I’d get braces for my almost-orally-perfect kid #3.  I wouldn’t do that, because that would seem even more frivolous–not because my teeth couldn’t objectively use some fixing, but because I’m too old and far along in my life to make straightening my teeth a wise investment.  Heck, my teeth are awful in more ways than how far from straight they are; I’ve had so many root canals and crowns since age 40 that I’m convinced I’m not that far away from having all my teeth fall out.  And how would I ”use” straight teeth?… I know I’m not going into a career in show business, despite the unusual movie stardom of my boss, Bob Bixby.

(My own parents had already done the cost-benefit analysis on my orthodontic situation when I was a kid, and when my younger sister was so obviously in greater need of braces than I–so she got them, and I did not.  My parents were not economists, but they’ve always been better at family/home economics than I am.  They knew how to budget as if there were constraints, because they had them (they were working in academia as underpaid scientists)…) 

But kid #3, well, she could very well become a movie star someday….she’s danced at the Kennedy Center twice after all (I’m sneaking in the brag book)… or even if she doesn’t, she’s young and has her whole, pretty life ahead of her!  The marginal lifetime benefit to perfecting her teeth is way higher than the marginal lifetime benefit to fixing mine, if only because she has a lot more lifetime left.

All parents know that spending money on one’s children never feels quite as frivolous as spending money on oneself.  I know that pretty much anything that my kids don’t immediately consume–and I mean literally consume, as in EAT–I think of as worthwhile investments.  (Come to think of it, I justify buying that more expensive, organic food for them at Whole Foods, as an investment, too.)  The thousands of dollars spent on my kids’ music lessons, ballet school, sports, all sorts of camps, their hobbies (kid #2 is a great photographer), etc.–all wise spending that gives my kids a “richer experience” with life that will make them better, more productive, happier adults.  (That is why the term “enrichment” is such a great way to get parents to spend money.)

There might be a little bit of irrationality in how parents do the cost-benefit analysis when it comes to their kids (more on this in many future posts), but I think parents do the intergenerational math much better than the government does.  Becoming a parent makes one a lot more far-sighted and forward-looking (even with the occasional banana-peel slip ups), while the politicians and policymakers seem to only see as far as the current electorate and immediate distractions (banana peels all around).  As a public finance economist and a mom, for years I’ve felt that the government invests too little in the human capital of the young (i.e., in their education and health care), while government spends too much on the pure consumption of the old, whether that be subsidies for old industries that don’t need them, or tax cuts for really rich, old people who have just transitioned to being really rich, dead people.  As a society, it’s not a wise investment strategy and doesn’t maximize social, lifetime net benefits.  It makes as much sense as my getting braces.

7 Responses to “Orthodontic Budgeting (or Why I Have Crooked Teeth)”

  1. comment number 1 by: Dr. T

    My regular dentist, who I trust, told me that early orthodontia has been an expensive failure for most kids. Early orthodontia should be undertaken only for very bad bite problems that cause difficulties with chewing or talking. My dentist had seen many cases where kids with moderate bite problems got braces before age 12 and then needed braces again as teenagers. The rapid jaw and skull growth during puberty and the arrivals of 3rd molars and wisdom teeth caused new misalignments.

    Both of my girls got their braces just before they turned 14, and both had good results.

  2. comment number 2 by: Carolyn Rader

    I enjoyed your presentation in Atlanta today. I have three children, ages 13, 11, and 7 and have just started back to work full time, and have spent a lot of money on “camps” to get them through summer. Your topic of first improving the economic situation in our own homes was something I can relate too! As a city planner my interest is in how we provide nurturing, socialization, and enrichment right in our own neighborhoods, without all of this running around to a myriad of activities. Older neighbors, family members, and others would be our children’s mentors. In my childhood, no one charged anything to teach a child a skill. A neighbor taught us to swim, my friend’s mom let us watch her paint her oil paintings and give us some paints to try out, and the kids would just figure out how to play a game of baseball all on their own (imagine that!).

    I am off topic for this comment page: I wanted to share that my 13 year old daughter is starting all over with braces (add $5,000 to the previous $2,500 plus cost of teeth extraction). We are obviously now seeing a different orthodontist. She began the process when she was in 5th grade, and had four adult teeth pulled at such a young age. I truly regret this. I would advise anyone to get several very good opinions before moving forward with this kind of dramatic work. Thanks and all the best.

  3. comment number 3 by: directdad

    My oldest started to see the orthodontist almost three years before braces. I set the expectations in our first meeting. He said we could have braces right away, but there was a possibility that he may need additional treatment as he grew. I told him that, as an engineer, I was comfortable with making decisions after a good cost/ benefit analysis. Like most real decisions, we do not know all the information when we need to act, and we need to access the situation periodically. After some fact finding, the Orthodontist, my son, and I decided to wait. He began braces just before his 14th birthday, and things seem to be going well.

    That is the same discussion that we need to have with our representatives, and the candidates that want to represent us.

    When opt for services and insist that we pay less than the cost we go into debt. It works the same in government as in a family.

    We need to demonstrate that we understand basic budgeting and hold candidates and representatives to the task of managing limited resources. Only then we will get more fiscally responsible government.

    As I often say, we get the government that we deserve.

  4. comment number 4 by: jessica

    um how dos that help me
    !!!

  5. comment number 5 by: Children's Dentist GA

    Braces are a necessity to a healthy smile. And teeth are a gauge on how healthy we truly are internally. If you keep the teeth healthy, then the body is healthy. The two go hand in hand. So it is an important investment to provide your children with the essential tools to live a healthy lifestyle, including braces and/or corrections to their smile.

  6. comment number 6 by: topdog

    regarding the dentist’s comment, how ridiculous is that? Orthodontia has no health claims - it’s mainly cosmetic for most people. Potentially I will spend $7500, with more to come after that - and my son is in 3rd grade. I want to wait. I’m told I should not wait. Either way, I’m not sure I want to do it at all. But as you point out very well, how will my son *use* straight teeth? This factor is hard to measure. In addition, how will it affect his experience in his future life? He will fit in better in the US, but in other places, it will mark him as an American the minute he smiles… I have not spent money on orthodontia yet, I am on the fence. Orthdontists need to back up their claims about early intervention, and they need to be more honest about the necessity and benefits. I have had difficulty finding anything helpful about this online. nice blog

  7. comment number 7 by: Angie

    I think orthodontia is over rated. For most kids, it is purely cosmetic. My oldest son will not get braces. He is 13 years old and many denstists have commented on how nice and straight his teeth are. He might not have a PERFECT smile, but there is no way I am spending 3-6K on his teeth when it is not necessary for him.

    My daughter(who is 10), will need braces. In her case, she has some sideways teeth and also have a pretty signifigant underbite. She is the child I will spend money on for braces and whatever else she may need to correct the problem. In her case, it is not purely cosmetic.

    My youngest son however, is an open book. I may or may not need to get him braces. He is nearly 8 and it’s hard to say just yet if he will need them or not. We will decide that as time goes on.

    I don’t think all kids NEED braces. I think it has become a “right of passage” and one that not every child needs to go through. I think it is very important to have a healthy mouth and I agree that dental health is important to overall body health. However, aligning teeth that aren’t severely out of line, is not necessary.