When Are Braces Medically Necessary?
Braces may be medically necessary when problems with tooth or jaw alignment affect your ability to chew, speak or maintain good oral health. At Dhingra Orthodontics, we can evaluate these concerns and determine whether braces are needed to improve function and protect long-term dental health.
- Braces are sometimes medically necessary to improve oral health
- Severe bite problems can affect chewing, speech and cause jaw discomfort
- Crowded teeth increase the risk of cavities, gum disease and impacted teeth
- Misalignment may contribute to TMJ symptoms like jaw pain, headaches and difficulty chewing
- Some insurance plans provide coverage when orthodontic treatment is considered medically necessary
When most people think about braces, they think about straighter teeth and a more pleasing smile. While aesthetics are a big benefit of braces, orthodontic treatment is about much more than appearance.
Braces are sometimes medically necessary to protect your long-term oral health, improve function and prevent future complications. Your orthodontist evaluates far more than just how teeth look — they focus on how they work and come together!
What Does “Medically Necessary” Mean?
“Medically necessary” treatment is more often covered by insurance plans than treatment that is purely cosmetic. Braces are often considered medically necessary when tooth or jaw alignment issues:
- Interfere with proper chewing or speaking
- Cause pain or jaw strain
- Increase risk of tooth decay or gum disease
- Lead to abnormal wear or damage
- Contribute to long-term dental instability
Orthodontic problems can worsen over time if left untreated. An early evaluation of your smile allows an orthodontist to determine whether treatment is recommended for health reasons.
Problems That Typically Require Braces
Certain orthodontic issues can create real health concerns beyond just aesthetics. The good news is that braces are an excellent tool for fixing and resolving these problems.
Bite Misalignments
Severe overbites can create problems such as:
- Lower teeth biting into the roof of the mouth
- Premature enamel wear
- Jaw discomfort
Similarly, a severe underbite can:
- Make chewing inefficient
- Create uneven tooth wear
- Contribute to jaw strain
Crossbites can also be problematic. They can:
- Cause gum recession
- Lead to bone loss around teeth
- Shift the jaw out of proper alignment
An open bite, or when the upper and lower teeth don’t touch, can:
- Interfere with chewing
- Affect speech
- Increase stress on certain teeth
Crowding and Impaction
Crowded teeth are not just a cosmetic concern. When your teeth overlap or twist significantly:
- They are harder to clean
- Plaque buildup increases
- Risk of cavities and gum disease rises
In some cases, severe crowding can also affect how teeth erupt or cause permanent teeth to become impacted. An impacted tooth is one that cannot properly erupt through the gums.
If left untreated, impacted teeth may:
- Damage neighboring teeth
- Cause cysts
- Lead to infection
- Require more complex surgical intervention later on
Jaw Pain and Functional Issues
Improper bite alignment can place strain on the jaw joints, also known as the temporomandibular (TMJ) joints.
Symptoms of a TMJ disorder (or TMD) may include:
- Jaw clicking or popping
- Facial soreness
- Headaches
- Difficulty chewing
Additionally, your teeth play an important role in speech development and function. Kids are especially prone to speech impediments due to orthodontic concerns. Significant misalignment may contribute to:
- Lisping
- Difficulty pronouncing certain sounds
- Improper tongue positioning
Insurance Considerations for Medically Necessary Braces
Some insurance plans only provide coverage when orthodontic issues meet specific severity guidelines. Other plans cover more of your treatment’s cost when it is considered medically necessary. If you are experiencing one or more of the problems listed above, schedule a free consultation at Dhingra Orthodontics!
Our team can help review your benefits and determine what your plan may cover. We also offer flexible payment options to make treatment accessible to those without insurance.
A Healthier Smile Is More Than Cosmetic
If you want to know if braces are medically necessary for you or your child, schedule a free consultation at one of our locations in Beavercreek, Bellefontaine, or Springfield. We’re happy to help you figure out your insurance benefits, determine the orthodontic treatment that works best for you and your family, and get you started on a happier and healthier smile!