Every year, millions of Americans undergo orthodontic care to straighten their teeth. Whether they’re seeking a cosmetic enhancement or improving oral health, one thing is certain: Treatment is expensive.

There is not one standard price for braces. “People in the United States should expect to spend anywhere between $3,000 and $6,000 or even slightly higher depending on the type of treatment needed, length of time and age of the patient,” says Dr. Tamara Kroboth, an orthodontist with Valley Pediatric Dentistry in New York.

According to a 2018 survey of dental fees by the American Dental Association, the average cost for comprehensive orthodontic treatment can range from $5,000 to $6,000 although pricing varies by region. For instance, an adult in Manhattan may pay an average price upwards of $11,500 for braces.

Just as there is no standard price, there is no standard time frame for how long someone needs to wear braces. Treatment can last from one to three years on average, with adults often needing to wear braces longer than children. Each additional year can increase costs significantly, and a person who wears braces for two years may have double the expense of someone whose treatment can be completed in 12 months.

Managing the high cost of orthodontic treatment can be done in a number of different ways, from shopping for the best price to maximizing tax-exempt savings accounts. Try these strategies to keep finances in check when trying to achieve better oral health.

It’s smart to get quotes from several orthodontists. That’s something Jean Chatzky, CEO of the digital media company HerMoney.com, discovered when her children needed braces. “Different orthodontists recommended different treatments at different price points,” she says. Many orthodontists provide free consultations which means there shouldn’t be a cost to getting a second opinion.

Some dental insurance plans cover orthodontic treatment and may pay up to a specific amount for braces. Most policies only cover patients who are 18 or younger, and plans usually contain a yearly or lifetime maximum that only covers a portion of the total cost. It’s important to review your plan’s terms to understand if there is a waiting period before benefits begin and whether your orthodontist is a covered provider.

Orthodontists may offer a discount if payment is made in full at the start of service, or they may have reduced rates for multiple children in the same family. “Don’t be shy to ask for help with financial arrangements and making payments ahead of time on children who will be going into treatment now or even down the road,” Kroboth says.

If you have a qualified high-deductible health insurance plan, you can open a health savings account and deposit up to $7,100 in tax-deductible contributions in 2020 if you have family coverage. That money can then be used tax-free on qualified medical and dental expenses including braces. Contributions to a health savings account never expire and can be invested, making this a good way to save in advance for future orthodontic costs. However, even if you don’t plan in advance, you could save as much as 25% by avoiding taxes on the money you use to pay for braces, Chatzky says.

Those who aren’t eligible for a health savings account may be able to open a flexible spending account through their workplace. These accounts also allow people to make medical and dental payments using tax-free dollars, but money in a flexible spending account typically must be used within a year or it is forfeited to your employer. “You have to be careful that you don’t overfund it and put more in than you can use in the course of a year,” Chatzky explains.

Many orthodontists offer flexible payment plans and are willing to work around their patient’s budget. These provide parents the opportunity to spread out payments over several months to a couple of years with no interest.

Anyone living near a dental school that offers an orthodontic program may benefit from discounted services performed by students in training. The fees may be almost half the amount charged by private practices, says J. Martin Palomo, professor and orthodontic residency director at the School of Dental Medicine at Case Western Reserve University.

Treatment is typically provided by dentists who are orthodontic residents and, in many cases, students have had years of experience in private practice. However, patient openings at dental schools may be limited, depending on the size of the program. For instance, Palomo notes Case Western Reserve University only accepts five students per year in its orthodontic program.

Families suffering financial hardship may be eligible for deeply discounted or free treatment. Programs such as Donated Orthodontic Services, sponsored by the American Association of Orthodontists, offer pro bono care to children of low-income families who lack insurance coverage or who do not qualify for other assistance in their states of residence. Other nonprofit programs like Smiles Change Lives and Smile for a Lifetime Foundation also offer discounted or free braces to kids in need.

Your orthodontist may know of other organizations or programs to help cover the cost of braces. “Always discuss any concerns with fees,” Palomo says. “There’s no need to be embarrassed.”

You’ll pay less if you can shorten the amount of time you wear braces. While there is no way to move your teeth into place faster, you can take steps to avoid delays. “Patients can help their treatment … go quickly and smoothly by following the instructions given to them by their orthodontist, such as wearing their rubber bands as directed, not eating foods that will cause their braces to break and maintaining excellent brushing and oral hygiene,” Kroboth says.

However, before you put into practice these cost-cutting strategies, it’s important to understand the different types of braces available for both children and adults.

Teeth are typically straightened using one of two methods: braces that use brackets and wire and aligners made of clear plastic. Braces can be further broken down into the following categories: metal, clear/ceramic and lingual.

Traditional braces are made with metal brackets and wires. They may be adjusted every four to six weeks to move teeth into proper alignment. The price of metal braces can run from $3,000 to $7,000, according to Oral-B.

Using clear plastic or ceramic brackets can make braces less noticeable. However, they can be more expensive than metal braces, with the typical ceramic braces cost ranging from $4,000 to $8,000, according to Oral-B. Damon Clear, a system using plastic braces, has pricing that is comparable to conventional braces and may run between $5,100 and $7,000.

These braces are placed behind teeth so they aren’t visible to others and cost as much as $10,000, per Oral-B estimates.

Aligners are also an option, and these use a series of plastic molds to move teeth into place. “Patients of all ages report feeling less self-conscious with aligners than braces,” says Dr. David Galler, senior vice president of orthodontic support for Aspen Dental.

Aligners can
be obtained through an orthodontist at a price of $4,000 to $7,000. “Clear aligner treatment is becoming increasingly popular with dental professionals, who use a comprehensive 3D scan to develop a highly customized, accurate treatment plan for each patient,” Galler says. He adds that aligners at Aspen Dental cost $3,999 regardless of how complex the treatment may be.

Companies such as Smile Direct Club and Candid also offer aligners and may charge as little as $2,000. While these mail order services offer a significant discount, many dental professionals warn against them.

“You get what you pay for,” says Dr. John Luther, chief dental officer for Western Dental & Orthodontics, a leading dental provider with locations in California, Nevada and Arizona. He notes it’s important to see an orthodontist to address underlying issues prior to straightening teeth. For instance, a person with periodontal disease who begins using aligners without strengthening gums may be at risk for losing teeth.

What’s more, not everyone’s teeth can be moved effectively with aligners. Someone requiring complex tooth movement to straighten teeth and address jaw alignment may need more intensive treatment.

“Very often, we see people who are having braces for the second or third time because they were trying to save money,” Palomo says. He recommends people look for board-certified orthodontists to ensure that whatever straightening treatment they pursue will be completed by someone committed to the highest level of professional standards.

For young patients, teeth may be moved in two stages. In the first phase, baby teeth may be removed to make room for permanent teeth, or braces may be used to straighten teeth or correct a problem such as underbite.

Early intervention is one way to save money on braces, according to Kroboth. “Common phase one treatments, such as palate expanders, create space for these erupting teeth,” she says. While early intervention may not eliminate the need for a comprehensive treatment plan later, it could make the straightening process easier, shorter and, in turn, cheaper.

It’s more difficult to move adult teeth than children’s teeth, Luther says. Older patients may have brittle bone structures that could be prone to breaking if moved too quickly. That’s one reason orthodontists say people should be careful of any treatment that claims to quickly straighten teeth. Another problem, Luther explains, is the tendency of teeth to relapse to their original position if not properly retained after treatment.

Braces are an investment that can pay off in greater confidence and self-esteem. By understanding how they are priced and using the tips above, you can make this expense more affordable.