The Challenges of Military Families: Moving in Braces
Imagine you are twelve years old, entering sixth grade, shy, and often don’t smile because you don’t like your teeth. Your mom notices how you slump over when you walk and asks what would make you feel better. You tell her, “I want to feel comfortable smiling.” She takes you down the street, and you meet Dr. Johnson, an orthodontist near where you live. She tells you what she sees and how braces can make your smile so beautiful!
When Plans Change
The excitement of getting braces put on your teeth grows. You can’t wait to tell your friends and show your grandma back in Virginia over Facetime. However, the following month at family dinner, your parents tell you they just received unexpected military orders to move from California to Japan in six months. Your dad is a Marine aviator with the Air Wing on Miramar and is being reassigned to Okinawa. Also, your mom is a Navy physician and will be working at the hospital there.
Your parents begin to discuss the overwhelming logistics of getting everything ready to move from selling their cars to setting up household goods to deciding what will stay in storage. You raise your hand and ask, “Who is going to be my orthodontist and take care of my braces?”
In the military, moving, transitioning, and adapting is a way of life. When it comes to orthodontic treatment that can span from interceptive to comprehensive care, often it does not align with moving in the military. As an orthodontist in the Navy, I see many children and adults who transfer overseas that are unsure what their benefits are in this area.
Tour Lengths Vary
Military tours (the length of time a military member is in one place) are typically 2-3 years, depending on the assigned unit. Some areas with larger military populations offer more leeway for families to stay longer, but this is never guaranteed. So, where are the military orthodontists located? It depends on the branch and the other duties the orthodontist is assigned in the area. Often many are stationed at major medical centers such as San Diego, Bethesda, and San Antonio.
In addition, some military orthodontists are called upon to serve in administrative positions. This can be as Executive Officers, Squadron Commanders, and leadership positions that have them practicing a few days a month, limiting the capacity of cases in their practice and the number of patients they can see.
Orthodontic Care Overseas
Military orthodontists are in the Navy, Army, Air Force, and Public Health Service. They primarily take care of active duty when stateside and dependents when overseas. Not every base overseas has a military orthodontist, so families often rely on the dentists in the local economy to see what’s available. There is no guarantee that a civilian orthodontist in their area speaks English or will continue the prescribed treatment that the previous orthodontist set in place. This may include replacing all of the existing brackets and charging additional fees. Translators are often essential and may need to be hired at one’s own expense. In addition, costs may vary significantly from what is charged in the states.
Insurance Coverage for Braces May Vary
What about insurance coverage for orthodontics? The Tricare orthodontic benefit has a lifetime maximum dollar amount per dependent that can be used up to age 21 or until they turn 23 for a full-time student or spouse.
The Tricare Area Office issues authorization for off-base orthodontics for your region. Contact the Tricare Area Office before beginning orthodontic treatment to gather information about the approval process. You should not start treatment before obtaining this approval.
If applying for on-base orthodontics, you’ll want to keep that maximum age in mind. Approval for on-base orthodontics is not immediate and typically takes up to three months. If accepted for orthodontic care delivered by the military dental clinic, your Tricare orthodontic benefit will not be debited.
Working Within the System
In places with military orthodontists, their practice size and capacity vary. They may have 2-6 chairs and 1-4 assistants. No two practices are alike, and you can’t automatically assume continued care into a military orthodontic practice.
The initial requirements that must be met are the following for a military practice:
AAO Transfer form and any records from the existing orthodontist.
Family Entry Approval-showing that the patient is on the military orders to be in the country assigned.
Updated dental exam to confirm there is no other existing treatment, such as cavities, that would interfere with orthodontics is needed.
A common mistake is that patients will have orthodontic treatment started after they find out they are leaving the US. When this occurs, they move to the bottom of the list and put in an orthodontic board. The preferred scenario is that orthodontic treatment was started before orders being cut. The intent is to help military families who originally thought they would be in an area for three years, long enough to complete orthodontic care to leaving sooner than expected. It is not uncommon for the military to send out orders moving personnel much sooner than planned due to the needs of the Navy/Army/Marines/Air Force/Space Force.
Remember the 12-year-old who just received her braces? Do not worry, keep smiling! The military supports you and your family. But just like everything with the military, please be patient while we do our best to help as many families as possible. I know because I served in the military my whole life before raising my hand to join.
Author’s note
The views expressed here do not reflect the Department of Defense or the Department of the Navy. As a reminder, Military personnel and their families need to go through their chain of command and utilize their sponsor when relocating.
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