Orthodontic Questions, Answered

At what age should my child first see an orthodontist?

The American Association of Orthodontists recommends a first evaluation by age 7. That number surprises a lot of parents, because most 7-year-olds still have a mouth full of baby teeth. But that's exactly the point — at 7, we can see how the permanent teeth are coming in, and we still have room to influence what happens next.

Here's what we're actually looking at during an early exam:

• Eruption of the central and lateral incisors — are the front permanent teeth coming in, and are they coming in where they should?

• Width of the upper jaw — a narrow upper jaw is one of the most common problems we catch early, and one of the easiest to correct at this age.

• Shifting bites. When the upper jaw is too narrow, kids often shift their lower jaw to one side to make their teeth fit together. Left alone, that shift can become permanent.

• Habits like thumb sucking or tongue thrust that change how teeth and jaws develop.

• Eruption paths. Sometimes we can see a permanent tooth heading in the wrong direction and heading toward becoming impacted. Catching that early can mean the difference between guiding a tooth into place and surgically exposing it years later.

Most kids we see at this age don't start treatment. They go into observation, and we bring them back at 6-, 9-, or 12-month intervals to watch the eruption sequence and make sure we don't miss something we could have prevented. There's no charge for those visits.

Does my child need early interceptive treatment?

Usually not — but "usually not" is a decision, not a guess, and it's one worth making with an orthodontist.

Early treatment makes sense when there's a problem that gets harder or more invasive to fix if you wait: a narrow upper jaw causing the bite to shift, a habit actively changing how the jaw is developing, a permanent tooth on a collision course toward impaction, or over-retained baby teeth blocking permanent teeth from coming in.

If none of those are present, waiting is the right call. Starting braces on a child who isn't ready doesn't shorten treatment later — it just means more time in appliances. When we say "let's watch this," we mean it, and we schedule the follow-up so nothing slips.

How long does orthodontic treatment take?

Most comprehensive cases should be finished in about 18 months. A lot of practices quote "18 to 24 months," which is a safe answer but not a very useful one.

Cases that run longer than 18 months usually have a specific reason behind them:

• Impacted teeth that have to be surgically exposed and guided into position

• Missing teeth, where space has to be managed for a future implant or bridge

• Extensive bite correction — significant overbite, underbite, or crossbite correction takes time that simply straightening teeth does not

• Non-compliance — not wearing elastics, not wearing aligners the required hours, or repeatedly broken brackets

The first three are biology and case complexity, and we'll tell you about them up front. The fourth is the one within your control, and it's the most common reason a case that should have taken 18 months takes 26.

Braces or Invisalign — which is better for my teenager?

We pick the appliance that is mechanically better for that specific case. Not the one that's trending, and not the one the patient walked in asking for.

Some tooth movements are simply more predictable with brackets and wires. A deep bite with spacing that requires torque on the incisors is a good example — that case belongs in braces. Trying to force it into aligners means a longer treatment and a worse result. Other cases move beautifully in aligners, and for those, Invisalign is the better tool.

If a case can go either way, we'll talk through it honestly and the family gets a say.

On compliance: Dr. Finkelmeier coaches youth basketball and soccer, and he approaches this the same way. It's part of the job to get the player to do what it takes to reach the goal you both agreed on. Most teenagers, given a clear expectation and someone paying attention, wear their aligners. When a patient isn't responding, we switch them to braces rather than let treatment drag on for years. That's not a punishment — it's a recognition that the appliance has to match the patient.

What happens at the first orthodontic appointment?

The initial exam is complimentary, and the visit takes 45 minutes to an hour. Here's the sequence:

1. Our treatment coordinator meets you first and takes the records we need — photographs, and a radiograph if it's indicated for your case.

2. The orthodontist comes in to review the records with you, talk through the dental concerns, and lay out the treatment options.

3. The treatment coordinator closes the visit by reviewing your specific insurance benefits and breaking down the financial side — total fee, what insurance covers, and what the monthly payment looks like.

In most cases, you get the full treatment plan and the cost the same day. You're not scheduled for a second visit to find out what it costs.

One more thing that saves you a trip: if your treatment requires an appliance or anything fabricated by a lab, we take the digital scan before you leave. That way the appliance is ready and you begin treatment at your next appointment rather than coming back for a scan first.

My teeth shifted after I had braces years ago. Can that be fixed?

Yes, and it's more common than most people realize. Teeth move throughout life. If you stopped wearing your retainer at 22 — and most people did — some crowding in the lower front teeth by your late 30s is normal, not a sign that your original treatment failed.

For minor relapse in adults or kids, we offer an Invisalign touch-up. It's the same Invisalign product, but tailored to a much shorter time frame. Rather than ordering a full case, we minimize the number of aligners needed to correct the specific problem — which means a lower fee and a shorter treatment, typically three to six months.

You do not have to be a former patient of ours. If you had braces anywhere and you've had some shifting you'd like corrected — maybe before you invest in a new retainer — this is for you.

Am I too old for orthodontic treatment?

No. Teeth respond to orthodontic force at any age; the biology doesn't expire at 18. We treat adults in their 30s, 40s, 50s, and beyond.

What changes with adult treatment isn't whether it works — it's what we're planning around. Adults are more likely to have existing crowns, bridges, implants, or gum health that needs to be accounted for, and more likely to need coordination with a general dentist or periodontist. Adults also tend to be excellent patients, because they're choosing treatment for themselves.

If your concern is minor and mostly cosmetic, ask about the Invisalign touch-up above before assuming you need full treatment.

How much do braces and Invisalign cost in Carmel and Westfield?

Most families don't pay for orthodontics in a lump sum, so here's the number that actually matters:

Most patients pay around $167 to $250 per month, interest-free, with about $500 down.

The lower end reflects a typical $2,000 orthodontic insurance benefit; the upper end is what it looks like with no insurance at all. Either way it's spread over 24 months at zero interest, through us — no credit application, no financing company. Shorter plans of 12 or 18 months are available if you'd rather pay it off faster.

If more than one of your children is in treatment, a family discount brings that monthly figure down further.

The full fee, for reference: comprehensive treatment — braces or Invisalign, start to finish — runs approximately $5,500 to $8,000 depending on complexity, with most cases landing around $6,500. An Invisalign touch-up for minor relapse or shifting is $2,700 to $3,500, typically finished in three to six months.

Cases above the comprehensive range generally involve jaw surgery, impacted teeth, missing teeth, or large bite corrections. If yours falls into one of those categories, we'll tell you at the consultation and explain why — not after treatment has started.

A word on comparing quotes: when you see an advertised price well below these numbers, check what it covers. Those figures are usually limited treatment — a few teeth, a short time frame — not comprehensive correction. Compare the treatment plan, not just the headline.

We also accept HSA and FSA funds, and offer a discount if you'd prefer to pay in full. Your exact monthly number, with your specific insurance benefits applied, is confirmed at your complimentary consultation.

Does dental insurance cover braces?

Often, at least partially. A few things worth understanding:

We are in-network with Delta Dental. We also accept and file claims for Cigna, MetLife, Aetna, and all other insurance carriers — you don't have to file anything yourself.

Orthodontic benefits are a lifetime maximum, not an annual one. This is the piece most people get wrong. A typical orthodontic lifetime max is around $2,000, though it varies by plan. That's the total the plan will ever pay toward orthodontics for that person — you can't wait a year and get another $2,000.

Because plans vary so much, our treatment coordinator verifies your specific benefits and walks you through exactly what your plan pays before you commit to anything.

Do you offer payment plans?

Yes. In-house, zero-interest payment plans — no third-party financing company, no credit application, no interest.

• Typical down payment: around $500

• Balance spread over 12, 18, or 24 months

• HSA and FSA accounts accepted

• Pay-in-full discount if you'd prefer to settle the whole fee up front

• Family discount for additional children in treatment

Between insurance benefits, a family discount, and a 24-month zero-interest plan, the monthly number is usually a lot more manageable than the total fee suggests.

Do I need a referral from my dentist to see an orthodontist?

No. You can schedule a complimentary consultation directly. Many of our patients are referred by their general dentist, and we work closely with dentists across Hamilton County — but a referral is not required to be seen.

If you do have a general dentist, we'll keep them in the loop with correspondence after we see you, so your dental care stays coordinated.

When should a general dentist refer a patient to an orthodontist?

For our referring colleagues.

We'd rather see a patient early and tell you everything looks fine than see them three years late. Findings worth a referral include:

• Eruption timing that seems off for the patient's age

• Over-retained primary teeth

• Transverse problems — narrow arches, posterior crossbite, functional shifts

• Significant AP discrepancies

• Crowding

• Habits — thumb sucking, tongue thrust

• TMJ clicking

• Transpositions

• Eruption path concerns — any tooth tracking toward impaction

What you get back: we send correspondence after we see your patient, so you know what we found and what we recommended.

On restorative coordination: when a case involves restorative work to be completed after alignment, we try to communicate early rather than at the end. Getting your feedback on space distribution and final tooth position while we can still influence it produces a better final restoration for the patient. If you've got a case where the ortho and the restorative plan need to line up, call us before you start.

What makes Finkelmeier Orthodontics different?

A few things we'd actually defend:

Two orthodontists, including Dr. Anoop Sondhi. Dr. Sondhi is a nationally recognized name in orthodontics and a genuine wealth of knowledge for this practice. Having two doctors also means more appointment availability.

We don't make you wait. Appointments are scheduled to run on time, and we work hard to keep it that way. If you've spent 40 minutes in a waiting room at a previous orthodontist, you know why this matters.

Emergencies are handled promptly. A broken bracket or a poking wire the week before a game or a school picture is not something we make you live with until the next opening.

Appointment times built around school and practice. We offer early morning appointments, after-school times, and slots that minimize how much class a student misses. With most families juggling multiple kids and activities, when we can see you matters as much as how well we treat you.

Our Westfield office is about a mile south of Grand Park — five minutes from the soccer fields at most. If your evening already involves a drive to Grand Park for soccer, baseball, or lacrosse, an appointment beforehand costs you almost nothing in extra driving. Dr. Finkelmeier coaches youth basketball and soccer himself, so the calculus of getting one kid to an appointment and another to a 6:00 practice is familiar territory.

We treat patients like friends and family. Dr. Finkelmeier and Dr. Sondhi both take that seriously — it's a small practice, and you'll see the same faces every visit.

Why see an orthodontist instead of having my dentist do braces?

Orthodontists are dental specialists. After dental school, an orthodontist completes an additional two to three years of full-time residency devoted entirely to tooth movement, jaw growth, and bite correction. Only practitioners who complete that residency may call themselves orthodontists or belong to the American Association of Orthodontists.

That matters most in the cases that aren't straightforward. Aligning teeth that are already close to right is one thing. Correcting a significant bite discrepancy, managing an impacted canine, coordinating a surgical case, or deciding whether a growing child should be treated now or in three years — those are judgment calls built on years of doing nothing else.

Both Dr. Finkelmeier and Dr. Sondhi are orthodontic specialists and active AAO members.

How long will I have to wear a retainer?

Plan on it being permanent, at a reduced schedule.

Teeth are held in bone, and bone remodels throughout your life. That's why teeth continue to move at 30, 50, and 70 — with or without orthodontic treatment. Retention isn't a sign that treatment didn't work; it's the maintenance that protects what treatment accomplished.

We'll give you a specific wear schedule at the end of your treatment, typically full-time at first and then tapering to nights. Many patients wear a retainer a few nights a week indefinitely. That's a small commitment compared to redoing treatment, and it's the reason we see so many adults come back years later for a touch-up they could have avoided.

Retainers cannot be worn "too long."

Will my wisdom teeth make my teeth crooked again?

Probably not. This is one of the most persistent myths in dentistry.

Research has not established that wisdom teeth generate enough force to crowd the front teeth. Lower front crowding in your twenties and thirties happens on roughly the same timeline as wisdom tooth eruption, which is why the two get linked — but correlation isn't causation, and crowding shows up in people who never had wisdom teeth at all.

Wisdom teeth often should come out, for reasons having to do with decay risk, gum inflammation, cysts, and the fact that they're difficult to clean. That's a decision to make with your general dentist or oral surgeon on general dental health grounds. Just don't count on extraction to prevent your teeth from shifting — only a retainer does that.

Where are you located, and which office should I go to?

Carmel, Indiana — 912 S. Rangeline Rd., Carmel, IN 46032. Our established office. Westfield, Indiana — 846 E. 181st Street, opening October 2026.

Both offices are full-service. Anything we do in Carmel, we do in Westfield — same doctors, same technology, same treatment.

The two offices are only about 10 minutes apart, so you're not locked into one. Patients are welcome to be seen at either location purely for scheduling convenience. If Westfield is closer to work on a Tuesday and Carmel is closer to school on a Thursday, that's fine with us.

Carmel primarily serves Carmel, Zionsville, and north Indianapolis. Westfield primarily serves Westfield, Noblesville, and Sheridan.

The Westfield office sits about a mile south of Grand Park Sports Campus — five minutes from the soccer fields at most. For families already headed that direction several evenings a week, scheduling an appointment just before practice turns a separate trip into no trip at all.

Ready to get started? Schedule your complimentary consultation at either location — call 317-993-3789 or request an appointment online.