Considerations on Orthodontic Treatment for Military Families

  • Published
  • By Lt Col Duy Nguyen
  • 86th Dental Squadron

February is Children’s Dental Health Month, and one important topic to discuss when highlighting children’s oral health is the topic of orthodontic treatment, or braces. Orthodontic treatment can significantly improve the alignment and function of the bite as well as the esthetics of a person’s smile. It can also improve self-confidence and quality of life. There is no doubt that orthodontic treatment is beneficial, but when is the right time to start orthodontic treatment in children? This article discusses the factors to consider when deciding to seek orthodontic treatment for your child as well as your orthodontic benefits under the Tricare Dental Plan.

The American Association of Orthodontists (AAO) recommends that children get their first orthodontic check-up by the age of 7 or upon recognition of orthodontic problems. At this age, children will have a mixture of primary (or baby) teeth with some permanent teeth, and potential signs of skeletal and dental discrepancies may be recognizable. Your dental professional should advise you on treatment options and recommendations. Frequently, many families are eager to correct early childhood crowding or alignment, however; it should be noted that most orthodontic treatment should wait until adolescence or when the patient’s adult dentition is present. Except for limited scenarios that require early intervention such as: traumatic bites, psychosocial concerns, or growth disharmonies; there is sound research and several reasons why you should delay orthodontic treatment until all the primary teeth are gone. The first is that you can’t align the adult teeth until they are in the mouth. Starting too early will result in extensive time spent in orthodontic appliances waiting for the eruption of permanent teeth. Often, this extended treatment time results in increased risk for cavities, demineralization (white spots), gingivitis (gum disease), and orthodontic fatigue. Waiting for the patient to mature and become more proficient at taking care of their own dentition will greatly improve their oral hygiene during treatment and overall orthodontic experience.

Military families, especially those stationed OCONUS (outside the contiguous United States) should also consider their DEROS (date of estimated return from overseas) in the timing of treatment. Apart from patients who experience skeletal discrepancies that require growth modification (or treatment that needs to take place during peak adolescent growth), you must consider if the treatment can be completed prior to your PCS date. If treatment is not completed, you will need to transfer and continue care with another orthodontist. While this is not ideal, it can be done. However, it’s best to begin and end treatment with the same provider for several reasons including communication issues, differences in treatment philosophies or the use of difference appliance systems. This can lead to increased treatment time and increased cost.

Families need to be aware that under the TRICARE Dental Program administered by United Concordia, there is a lifetime maximum benefit of $1,750 per enrollee for orthodontic treatment that is at play. So, if you utilize your benefit with one doctor and don’t finish treatment prior to your PCS, your paid benefit does not transfer to the gaining provider. For OCONUS situations, the base orthodontic department must sign the OCONUS Non-availability and Referral Form (or NARF) for you to utilize your TRICARE benefit via civilian providers. The process of attaining this form can vary by clinic, so please contact your base dental clinic for inquiries. For more information regarding your TRICARE dental benefits, please visit

In conclusion, the decision to initiate orthodontic treatment for your child is an important one that can be profoundly beneficial. You, your child, and the orthodontic team should carefully evaluate the treatment options, and consider your child’s age, growth, and remaining time on station to determine the plan that works best for your child.