Anywhere between 50% and 80% of kids in the US are flashing metal-filled, rite-of-passage-to-teenagerdom smiles. But how many of those kids absolutely needed braces for medical reasons?

It’s hard to say.  A thought-provoking article by Marc Ackerman, the Director of Orthodontics at the Boston Children’s Hospital, explained, “In simple terms, we orthodontists are able to straighten your teeth, but we really have little idea how or why they went crooked in the first place.  In fact, many of the dental traits that have been labeled orthodontic problems are merely examples of normal human variation.”

Human variation? Like how some people have bright red hair and some have blonde? Or how some people hit the gym for two hours a day to no avail and others just seem to shed pounds in their sleep?

Turns out, some people’s teeth are overcrowded simply because it’s written in their genetics. What’s more? Orthodontists haven’t been able to determine exactly what makes a “healthy bite” and who has, unfortunately, been handed down genes that require a little stainless steel intervention.

Ackerman goes on to explain that an imperfect bite cannot actually determine whether a person needs braces.  Instead, it’s the symptoms, or what results from that imperfect bite, that ultimately plays the deciding factor.

Are your child’s teeth so crowded that they can’t brush them thoroughly, and end up dealing with cavity after cavity?  Did their teeth erupt in such a way that they’re causing a speech impediment?  That’s when it’s time to step in with braces.

But what about the other kids who are walking around with a mouth full of metal?  The ones who could eat, breathe, and talk normally without braces?

Our society has become more image-centric than ever before.  Many times, parents opt for braces for their kids solely for cosmetic improvements – although this might be as good a reason as any.  A good smile goes much further than we think.  Children who grow up with crooked or buck teeth often face ridicule that leads to insecurities.

Unfortunately, the bias doesn’t seem to disappear with adolescence.  A top social scientist claims that our standing in society “is becoming increasingly dependent not on our education or our upbringing – but on the state of our gnashers.”  Malcolm Gladwell, famed author, agrees that “teeth are becoming the new benchmark of inequality.”

According to these two, people with bad teeth have less of a chance at success because they are denied certain entry-level jobs. Interestingly, a survey showed that people with whiter teeth were thought to earn over $16,000 more than they actually do. Hence, nicer smiles imply greater success.

Bottom line – it’s more difficult than you think to classify who needs braces and who doesn’t. Instead, parents have to consider a multitude of factors: their preference, their child’s preference, their child’s medical history, the long-term effects of NOT fixing their smile, timing, and cost.  Either way – whether braces are medically necessary or cosmetically necessary – both are good reasons to give your child braces.

Ackerman offers his decision-making guidelines: “When a parent thinks their kid needs braces then they probably do, and when a parent doesn’t think their kid needs braces then they probably don’t, it’s as simple as that.”

So where do you stand? Are you willing to shell out a few thousand dollars for your child’s perfect smile? Or are braces an unnecessary expense that’s become a quick and easy way for orthodontist’s to keep their practice up and running?