Examinations Before Getting Braces: What to Expect

Before we plan braces, we gather all the findings needed for safe planning at our practice in Cologne-Rodenkirchen. In this article, you will learn which examinations are required, what each one is for, what the path to the treatment plan looks like, and which costs statutory health insurance covers.

Determining treatment need: the initial examination before braces

Whether braces are necessary is determined by an orthodontic examination; often the referring dentist provides the initial indication. The first step is therefore an initial examination: We assess tooth position and bite and check how the jaws, temporomandibular joints, and masticatory muscles work together.

The examination shows not only whether treatment is necessary, but also which type of correction is advisable and what the teeth need so that misaligned teeth can be corrected. That is why we examine the upper and lower jaws carefully before every treatment plan.

How it works with us: from initial appointment to treatment plan

After you book your initial consultation appointment, you will receive a link via text message or email to our digital medical history form “Nelly”. There you can enter pre-existing conditions, medications, and your questions conveniently from home, so that we can use the time at the practice for the examination.

At the beginning is the initial examination, in which we determine the treatment need. For the records, we then take a digital scan, photos, and a functional analysis, plus usually two x-rays—the panoramic radiograph (OPG) and the lateral cephalogram (FRS)—if the planning requires them. On this basis, we prepare the treatment plan and discuss it with you or the parents, including the costs. For children and adolescents, the parents are present at all discussions.

Dental models: scan instead of impression

The basis of planning are models of the upper and lower jaws. From them we identify misalignments and adapt the braces individually to the dentition. In our practice, we capture the teeth using an intraoral scanner, a small camera that records the dentition three-dimensionally. The impression material with the typical gag reflex is eliminated. Traditional impressions are the exception with us—we avoid them whenever possible. On the digital models, we measure the4 and plan the tooth movements on the screen;5.1

Photographs

We photograph the teeth from the front, from both sides, and from the biting surfaces, plus the face from the front and in profile. The photos record the initial findings, show the gums and smile line, and later make visible how teeth and facial profile have changed during treatment.

X-rays

Planning records usually include two X-rays. However, we only take X-rays if the image answers a question relevant to treatment planning that cannot be clarified otherwise; we assess this individually for each patient. The two images are:

• the panoramic X-ray (panoramic radiograph or OPG)

• the lateral cephalometric X-ray (FRS or Ceph)

X-rays allow the orthodontist to see in detail where problems occur. The panoramic image shows, for example, whether all permanent teeth are present and how far their roots have developed. The lateral cephalometric X-ray shows how the upper and lower jaws relate to each other and to the skull. We only need a three-dimensional X-ray (CBCT) for specific questions, such as determining the exact position of an impacted canine. A CBCT taken with standard settings involves a higher radiation dose than a panoramic X-ray and lateral cephalogram.3

Functional analysis

At JUST KFO, we specialize in orthodontic therapy that takes the temporomandibular joint into account and place great emphasis on performing a functional analysis before treatment.

During functional analysis, we palpate the masticatory muscles and temporomandibular joints, check how far and how straight the mouth opens, and listen for popping sounds or pain. This allows us to determine whether the upper and lower jaws close together in a relaxed position or whether the teeth push the lower jaw into a forced position. This can occur even in teeth that look straight. Such findings are incorporated into treatment planning, because every type of braces changes the bite. Functional analysis is part of every treatment plan at our practice. If the findings require digital measurement of jaw joint movement, we record jaw movement three-dimensionally using the DMD system in a separate appointment. Clinical and instrumental functional analysis as well as DMD measurement are private services billed according to the German fee schedule for dentists (GOZ).

What Happens After the Examinations?

Once these important examinations have been conducted at the orthodontist to determine treatment needs, a treatment plan is developed. This plan includes the measures that will be taken to correct the misaligned teeth.

This plan is discussed with the patient or parents. In many cases there are alternatives, which are also presented at this stage. We explain the advantages and disadvantages of each approach, for example fixed braces or aligners, and decide together with you.

This consultation also serves to clarify all pricing matters. This way, you know what costs to expect and the application to your health insurance can be submitted soon.

What the examination clarifies for insurance

For children and adolescents under 18 covered by statutory health insurance, we classify the findings according to orthodontic indication groups (KIG). This classification from 1 to 5 determines whether the insurance covers the treatment. If KIG 3, 4, or 5 applies: the statutory health insurance pays 80 percent of the costs directly; the 20 percent copayment is reimbursed after successful completion of treatment. For KIG 1 and 2, treatment is a private service. Adults receive coverage only in exceptional cases, for severe jaw anomalies requiring combined oral surgery and orthodontic treatment.

Whether you have statutory or private health insurance: diagnostics, consultation, and care are the same for all patients at our practice. We submit the application to the insurance company after the treatment plan discussion; we assist you with copayment documentation. Costs you bear yourself can be paid in installments of up to 18 months, interest-free, directly through our practice.

Preparation for Fixed Braces

When the patient arrives for their bonding appointment for fixed braces, another examination is conducted before placement. In addition, the teeth are thoroughly cleaned again and specially prepared by applying a diluted acid. This ensures that the bonded brackets adhere properly.

The brackets are bonded according to the treatment plan and the archwires are engaged.

Which Examinations Are Important Before Braces

To make a correct and complete diagnosis, it is important to perform several examinations before placing braces. These are also essential for treatment success — after all, orthodontists can only develop a meaningful treatment plan this way. Only with these records can a treatment plan be developed that fits your teeth, bite, and temporomandibular joints. You can schedule an appointment for the initial consultation online or by phone at 0221 93 53 020.

FAQ – Frequently Asked Questions About Examinations Before Braces