Do You Need a Referral To See an Orthodontist?

If you’ve noticed your child’s teeth looking a bit crowded or you’re feeling self-conscious about your own less-than-straight smile, you might be considering braces. But if your dentist hasn’t mentioned them yet, you may be wondering: Do you need a referral to see an orthodontist?

When Do You Need an Orthodontist Referral?

For the most part, you can go get an orthodontic check-up on your own. However, there are exceptions and reasons why your dentist might give you a referral, even if you don’t strictly need one.

Insurance

Ultimately, whether you must have a referral to see an orthodontist depends on what kind of dental insurance you have. Dental Health Maintenance Organization policies, otherwise known as DHMO plans, require a referral from your primary care dentist to see an orthodontist. In these plans, you typically select a primary dental facility for overall oral health management. If you need specialist care — and this includes orthodontics — your primary dentist must refer you.

Preferred Provider Organization policies generally give you more flexibility when it comes to your dental care. With PPOs, you can almost always see specialists, including orthodontists, without referrals. However, most PPOs will only offer maximum coverage for in-network specialists.

Always make sure you take a look at your specific policy and coverage and understand the rules about seeking specialist care. Not only will this maximize your benefits, but it will help prevent surprise out-of-pocket expenses.

Special Treatments

During a regular check-up, your dentist will usually screen for problems that require special orthodontic treatments, including:

• Craniofacial Abnormalities: Comprehensive treatments for conditions like cleft lip and palate after initial surgeries often include orthodontics.
• Temporomandibular Joint Disorders: Misaligned teeth or jaws associated with TMD can benefit from orthodontic treatment.
• Obstructive Sleep Apnea: OSA can often be resolved with orthodontics, such as mandibular advancement devices that maintain open airways during sleep.
• Impacted Teeth: Orthodontic treatments can guide impacted teeth into the correct position to prevent pain, infection, and damage to adjacent teeth.

Your dentist could refer you to an orthodontist for any of these issues.

Pediatric Concerns

The American Association of Orthodontists recommends that children begin orthodontic check-ups at 7 years old. Some concerns are obvious, such as overbites, underbites, or crowded teeth. However, some are less noticeable, and others may not even be seen as problems to the untrained eye. Your pediatric dentist might refer your child to an orthodontist for early intervention for these reasons:

• Prolonged Oral Habits: Most children stop using pacifiers or sucking thumbs between the ages of 2 and 4. Continuing this behavior after that age could cause orthodontic issues.
• Jaw Growth Discrepancies: Misaligned jaws or asymmetrical facial growth can benefit from early intervention to guide development.
• Speech Difficulties: Some speech impediments signal certain dental misalignments.

Your child’s dentist may also provide an orthodontic referral for early or late loss of primary (baby) teeth or excessive crowding.

Make an Orthodontic Appointment Without a Referral

In general, you don’t need a referral to see an orthodontist unless your insurance policy requires one. So, when you’re ready to enhance your smile or address orthodontic concerns, contact us at Peterson Family Orthodontics in San Tan Valley.