We all know kids’ baby teeth don’t last forever. Eventually, your kid loses her first tooth. And then another. And then another. After a few years, all those tiny little choppers have fallen out and been replaced by permanent teeth. (And let me just say that at $5 each, losing teeth is a pretty good gig these days. It’s a long way from the 25 cents that the Tooth Fairy shoved under my pillow in exchange for each of my baby biters.)
However, in many cases, those “Grown Up” teeth come in with a price. And it’s a price that often strikes fear in the hearts, and wallets, of millions of parents around the world. It’s a price that is spelled out in two words that you hope to never have to utter, but once you do, you never forget no matter how hard you try:
The Orthodontist.
Lyndon Johnson once described the U.S. House of Representatives and the U.S. Senate as “The difference between chicken shit and chicken salad.” You can apply that same assessment to the difference between taking your kids to the dentist, and taking them to the orthodontist.
On one level, it’s the same game: Your kids get their teeth worked on. They sit in a chair, lean back, and a doctor specializing in dental health digs around in their mouths for a while. And as this goes on, you sit back and play a game on your phone as you try to not think about how much lighter your wallet is going to be when you check out at the end of the procedure.
But the dentist, as much a pain as it can be, and sit through, is still pretty simple, all things considered. You get told how your kids need to brush more. You say you “try” to floss every day. At times, there is a cavity that needs to be filled. But that’s why the dentist has nitrous oxide and novocaine. And the kid always comes home with a travel-sized tube of toothpaste and some gadget they picked out of the dentist’s toy box.However, when that dentist finishes up a procedure, and tells you that he’s going to recommend your daughter see the local orthodontist…Well, that’s a phrase that brings little more than immediate dread. It’s like learning that the cable has gone out or finding there’s no more beer in the fridge. And the greatest feeling of dread comes from knowing that the word “ORTHODONTIST” is just another way of spelling “MONEY”.
Our adventures in orthodontia began with our oldest child, our daughter Maddo. Last year, after examining Maddo’s mouth and determining that if we didn’t do something soon her teeth might start coming out of her foot, our dentist referred us to the local pediatric orthodontist.
This is a guy whom, due to how many local parents knew his name, probably has a multi-car garage loaded with Porsches paid for by years of kids’ mouths full of braces. But, he also had a good reputation, and we never heard any complaints about his work, even as other parents winced when talking about how he had vacuumed out their wallets.
The initial examinations were nothing unexpected. We took Maddo in to the orthodontist’s office and he did a standard round of X-Rays of her mouth. He showed us how her teeth were coming in and the crazy directions they could take if we didn’t do something soon. And the first of those things was to take the kid back to her dentist so he could pull four baby teeth from her mouth (two up top and two down below) that would, in effect, create an open road for some of Maddo’s grown up teeth to drop into. And, yes, even though those teeth came out at the hands of her dentist, to Maddo, they counted as lost teeth and you bet she put them under her pillow for the Tooth Fairy to retrieve that night. And at five bucks a tooth, she literally made $20 in her sleep.
What came next was what the orthodontist labeled Phase One. And just like we have all been learning new terminologies while dealing with the coronavirus pandemic (social distancing, sheltering in place, remote learning, etc.), Phase One of our trip deep into Maddo’s mouth introduced us to a bunch of words, and equipment, that sound like they would be as much at home in a hardware store as in an orthodontist’s chair.
There were spacers, which were really just rubber bands stuck around a few teeth in order to prepare them for the next item to go into Maddo’s mouth.
And that next item was something called an expander. Now, we were really getting into the nuts and bolts of the world of orthodontia. An expander is exactly what you think it sounds like. It’s a metal gizmo that is fitted onto the roof of the kid’s mouth, with some “arms”, if you will, that connect to the girl’s teeth. In the middle of the piece, there is a hole that’s big enough to fit a sewing needle. And every night for several weeks, you have to take a tool with a metal prong that’s about the the size of a sewing needle, stick that into the hole, and give it a crank. Over the course of doing this cranking, the expander, well, expanded things in Maddo’s mouth to get it ready for the next step in the process, the headgear.

The Phase One Smile.
Only that next step didn’t come along as soon as expected. You know the saying about how if you want to make God laugh, just tell him what your plans are? God was about to start chortling more than I did the first time I saw “Animal House.”
I dutifully cranked the wrench in Maddo’s mouth once a night, every night, for about six weeks. All was going according to plan, and we were set to bring the kid in to the orthodontist’s office for a checkup, and to have her expander taken out, on March 19. But, before we could do that, everything changed.
The weekend before Maddo’s appointment, President Trump declared a national emergency because of the coronavirus pandemic. Schools here in Oakland closed temporarily, and would eventually remain shuttered for the rest of the school year. California Gov. Gavin Newsom locked down nearly all businesses across the state in an effort to get ahead of the virus’ spread. And among those businesses was Maddo’s orthodontist.
Our appointment to have the kid’s expander removed was immediately cancelled.
This presented us with a a lot of questions, but one that really stood out among all others was just what leaving this expander in would do to Maddo’s mouth. The thing was called an “expander”, after all. Would it keep expanding on its own? Would we soon be able to fit a baseball bat between each of her teeth? Would her mouth end up looking something like that of a World War I-era British coal miner?
We called the orthodontist, who told us to put a halt to our nightly wrenching, and that there was nothing to worry about by leaving the expander in place for the foreseeable future. This calmed my wife and I down a bit, but, still…There was no way of knowing when we might get the all-clear signal and be able to get this hunk of metal out of Maddo’s mouth.
That time came a good two months later, in June, when the office called to say it was OK to bring Maddo in. Of, course, by that time, the office policies had changed. We didn’t just walk right in off the street. Appointments now consisted of having to fill out a wellness form a day ahead, then calling the office from the parking lot upon arrival, and then waiting outside the office for a technician to bring Maddo inside for her procedure. I couldn’t even go inside to ask the office manager a question; I had to call her from outside the office, all the while being able to see her through the office’s glass door as she answered my call.
And with this being orthodontia, we were nowhere near done with the string of equipment to be attached in some way to Maddo’s mouth. After a short reprieve, we were back in the office getting Maddo fitted for the headgear that she now needs to wear for 12 hours a day. She’s gotten pretty adept at hooking this gear up—one strap over the top of her head, a second one across the back, and all of it connecting with this metal bar that is its somehow jammed into a couple of connectors inside her mouth—and has only had a couple occasions where I’ve had to help remove a strand of her hair, or a hand towel, from the works.
This is still all part of Phase One, and its nearly $3,000 price tag. I don’t know how long this phase will last, but there never is a Phase One for anything without a Phase Two (and, maybe, a Phase Three) on the horizon. That next phase, when we eventually get to it, will almost certainly include the inevitable braces that will be part of Maddo’s appearance for a year or more. I have no idea how much the chicken salad of Phase Two will cost, but I do know it will be enough to make Phase One look like chicken shit.