Dra. Cléo Salustiano In this article
SummaryWhat does orthodontic treatment consist of?How do you compare orthodontic proposals?FAQRead nextHow much do braces cost? What determines the price
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Quick summary of this article+
This article doesn't list prices: Brazil's Dental Code of Ethics doesn't allow prices to be advertised. Orthodontic treatment consists of records (X-rays, photographs, models or a scan), placing the appliance, periodic adjustments over months or years, any related procedures (extractions, mini-implants) and the retainer, which is part of treatment, not optional. Duration weighs the most, and it comes from the problem being corrected, age, individual response and cooperation, not from choosing a plan. When comparing proposals, ask what adjustments include, whether retainers and records are included, the estimated duration and what happens if treatment runs longer. In Mooca, with Dr. Cléo Salustiano (CRO-SP 170844).
Orthodontics is the treatment where comparing prices is most confusing, because it isn't a single procedure: it's ongoing care that spans months or years, with a start-up phase, periodic adjustments and a final stage many people forget to account for. You won't find prices here: Brazil's Dental Code of Ethics doesn't allow dental offices to advertise prices, and a number given before orthodontic records are taken would ignore what defines the case.
What can be explained is how treatment is structured and what makes one case take longer than another. Duration, more than any other factor, determines the total for orthodontic treatment, and it comes from the problem being corrected, not from choosing a plan.
In this article, Dr. Cléo Salustiano (CRO-SP 170844) explains what makes up the treatment, why retainers need to be part of the budget from the start and what to ask before comparing proposals.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the braces and clear aligners page to learn how the treatment is done here and book your assessment.
What does orthodontic treatment consist of?
It starts with orthodontic records: X-rays, photographs and models or a digital scan. That's what the diagnosis, the plan and the estimated duration are based on. Without records there's no plan, only a hunch.
Next comes placing the appliance. The type chosen changes the workflow: metal braces, clear or tooth-colored braces (ceramic or polycarbonate), self-ligating braces or clear aligners each have different materials, visit intervals and logistics. With aligners, there's also digital planning and production of the tray sequence.
From there, treatment consists of periodic adjustment visits, when the braces are adjusted. This is where duration becomes the central factor: a case that takes longer has more visits, and that weighs more on the total than choosing one type of bracket over another.
What determines duration is the problem being corrected. Mild crowding in the front teeth and a bite problem involving both arches are cases with very different timelines. Age, individual biological response and cooperation with wearing elastics or aligners also play a part.
Some cases require related procedures: extractions, space maintenance, anchorage mini-implants (temporary anchorage devices) or, in specific situations, a joint assessment for orthognathic (jaw) surgery. These are separate steps, and the records are what reveal whether they'll be needed.
There's also appliance maintenance along the way: a bracket that comes loose, a wire that needs replacing, a lost aligner tray. It's worth knowing from the start how these events are handled in the plan.
And there's the retainer, which is part of treatment, not an optional extra afterward. Finishing braces without a retainer means accepting that your teeth will shift back. A retainer involves fabrication, follow-up and possible replacement over the years, so it needs to be in the budget from day one.
Finally, there's oral health during treatment. Orthodontics on inflamed gums or with active decay won't hold up: a cleaning and any prior treatment come first, and preventive follow-up continues throughout the time you wear the appliance.
| Step | What it is and why it matters |
|---|---|
| Orthodontic records | X-rays, photographs and models or a scan; defines diagnosis, plan and estimated duration |
| Placing the appliance | The type chosen changes materials, visit intervals and logistics; aligners include digital planning |
| Periodic adjustments | The adjustment visits; this is where case duration weighs most on the total |
| Related procedures | Extractions, anchorage mini-implants and other steps the records reveal |
| Repairs along the way | Loose bracket, wire change, lost tray: worth knowing how the plan handles these |
| Retainer | Part of treatment, not optional: fabrication, follow-up and possible replacement |
| Oral health during treatment | Cleaning and prior treatment before placement, and preventive follow-up throughout |
How do you compare orthodontic proposals?
Ask what the monthly adjustment includes and what it doesn't. Wire changes, repairing a loose bracket, elastics, follow-up X-rays: proposals with the same adjustment fee can cover very different things.
Confirm whether the retainer is included and how long follow-up lasts after the braces come off. This is the most common difference between plans that look similar.
Ask for the estimated duration and what happens if treatment goes beyond it. That question reveals the most about how the plan was built.
Check whether orthodontic records are included or charged separately, and whether progress records are planned mid-treatment.
Ask who manages your case and how often you'll be seen by the responsible dentist. Continuity matters in treatment that lasts months or years.
Be wary of a fixed plan before records are taken. Promising duration and price without an X-ray is a rough guess, and it's the kind of proposal that changes along the way.
Consider your cooperation as part of the cost. Wearing elastics as instructed, wearing aligners for the recommended hours and keeping visits on schedule shorten treatment; the opposite lengthens it, and more time means more adjustment visits.
And remember that the price is only presented after the assessment and records because that's what defines treatment: the type of appliance, the estimated duration and any related procedures. Before that, there's nothing to quote.
How much do braces cost?
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Prices can't be shared here: Brazil's Dental Code of Ethics doesn't allow dental offices to advertise prices. What determines the cost is the records, the type of appliance, the estimated duration, the number of adjustment visits and the retainer at the end.
What weighs most on the total cost of orthodontic treatment?
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Duration. Since treatment consists of periodic adjustments, a case that takes longer has more visits, and that weighs more than choosing one type of bracket over another.
What determines how long treatment takes?
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Mainly the problem being corrected. Mild crowding and a bite problem involving both arches are cases with very different timelines. Age, individual response and cooperation also play a part.
Do clear or self-ligating braces change the plan much?
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Prices aren't discussed here. What can be said is that materials and visit intervals differ between types, and the difference in duration between them is usually smaller than advertising suggests. The recommendation is clinical.
Do aligners work differently in the quote?
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The workflow is different: there's digital planning and production of the tray sequence. Tray changes follow a schedule, and a lost tray is handled in its own way in the plan, so it's worth asking how that works.
Is the retainer included?
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Not always, and it's the most common difference between similar plans. The retainer is part of treatment: without it, teeth tend to shift back. It involves fabrication, follow-up and possible replacement over the years.
What does the monthly adjustment cover?
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It varies between offices. It's worth asking whether it includes wire changes, repairing a loose bracket, elastics and follow-up X-rays, since proposals with the same fee can cover different things.
Are orthodontic records part of the plan?
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It depends on the proposal. Confirm whether they're included or charged separately, and whether progress records are planned mid-treatment.
What if treatment takes longer than expected?
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That's one of the most useful questions to ask before starting, because it reveals how the plan was built. It's worth understanding what happens with the adjustment visits during that period.
Do I need to treat my gums or cavities before getting braces?
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Yes. Orthodontics on inflamed gums or with active decay won't hold up. A cleaning and any prior treatment come first, and preventive follow-up continues throughout.
Are extractions and mini-implants charged separately?
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They're usually separate steps, and the records reveal whether they'll be needed. It's worth confirming how they appear in the plan.
Can I get a fixed price before records are taken?
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Not reliably. Promising duration and price without an X-ray is a rough guess, and it's the kind of proposal that tends to change along the way.
Does my cooperation change the cost?
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Indirectly, yes. Wearing elastics as instructed, wearing aligners for the recommended hours and keeping visits on schedule shorten treatment; the opposite lengthens it, and more time means more adjustment visits.
Is there an age when treatment is simpler?
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There's no age limit for treatment, and the right time depends on the case. In children, early assessment can make use of growth in specific situations; in adults, treatment is entirely possible, with its own particularities.
Where can I get an orthodontic assessment in Mooca?
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Dr. Cléo Salustiano (CRO-SP 170844) sees patients at Rua Hipódromo, 1141, in Mooca, São Paulo, Monday to Sunday, 8 a.m. to 10 p.m., in Portuguese, English and Spanish. The assessment and records define the type of appliance and estimated duration, and the plan is presented before any decision.
