Of all the innovations in orthodontics, one thing has remained steady — there are families who cannot afford braces for their children.
Some of those families might qualify for treatment under Medicaid, but for those who do not, there are orthodontists like Randall Markarian and the Smiles Change Lives program.
Smiles Change Lives recently honored Markarian with its Distinguished Service award for his work over the last 10 years with dozens of children needing orthodontic work.
He said he had tried to help children in need before, but there was a problem.
“It was hard because how do you screen for actual financial need?”
Markarian is one of three orthodontists in the metro-east and about a dozen in the greater St. Louis area who work with the Smiles Change Lives program. One of his missions is to change that. He is trying to get the program endorsed by the American Association of Orthodontists, which he hopes will enable more children to get treatment nationwide.
The program isn’t quite free to qualifying patients. There is a $30 application fee, and if accepted, the family pays Smiles Change Lives $600 in administrative fees. It’s still significantly less than most orthodontic treatments, said office manager Julie Stewart, who has worked with Markarian for about 20 years. Typically, a full treatment of top and bottom braces over two years costs between $5,000 and $6,000, Stewart said.
Markarian’s practice, with offices in Swansea and O’Fallon, has about 1,200 patients in active treatment at any one time. “Active treatment” means the patients are regularly seen by the doctor for adjustments to their orthodontic gear. About 25 to 30 are getting treatment through Smiles Change Lives.
The long-term treatment is part of what drove Markarian to orthodontics instead of other roles in dentistry. He completed an externship in oral surgery in New Orleans, which he called “an awesome specialty,” but one that did not fit his gregarious personality.
“I get to know patients over two years (of orthodontic treatment),” he said. “They grow up, get married. In oral surgery, it’s all very serious” and that relationship does not develop.
Paula Farley has had plenty of time to get to know Markarian and his staff, as four of her children needed braces.
Kim, 13, the youngest of her five daughters, has a top set of braces now to space out her teeth before getting lower braces later. The cost is about $2,500 after insurance. Kim is also the youngest of three daughters the Farleys adopted in Bogota, Colombia. Paula said Markarian’s work was incredibly helpful after the adoption.
“They had a lot of health and dental (concerns at first), and he was able to check them out,” she said. “He was very good with getting us all organized with that.”
The family fully approves of Markarian’s work with Smiles Change Lives.
“Of course, I’m for any kind of pro bono work people can do,” she said.
Kim doesn’t mind her time in the orthodontist’s chair.
“It’s fun, actually I enjoy coming here and talk to people here — there’s a rodent that lives here,” she said, referring to a groundhog outside that Markarian’s staff have pointed out to patients.
The doctor is “very laid-back,” office manager Julie said.
“The whole place is 90 percent of the time nothing but fun. It makes it very easy to work here.”
Parent Sally Rudolf, of Belleville, said her 13-year-old daughter Gretchen looks forward to her orthodontist visits.
“She’s excited to get colored rubber bands and free Chapsticks,” Sally said.
Markarian, 49, who grew up in Granite City and now lives in St. Louis, has been in practice 22 years.
Hobbies that keep the rest of Markarian’s life fun include taking his Porsche, a 911 Turbo, to the race track.
“It’s way faster than any car needs to be,” he said, but it was his dream car when he was a teenager. He doesn’t have time to go to Gateway Motorsports Park every time the Porsche club races, citing other commitments with his family: his wife, Annette, and their three daughters, Grace, 24, Gabrielle, 20, and Gillian, 8.
Grace works part-time in her dad’s office, and is considering a future in the dental arts. He said his other daughters come closer to his musical side. Until recently, he played guitar in a band that had gigs around St. Louis. Gabrielle is studying at Loyola University to be in the music business, and Gillian recently went to her first concert, Maroon 5.
He downplays his role in both the organization and in the difference he makes to children’s smiles, saying he doesn’t deserve the award because previous Distinguished Service Award winners served even more patients.
“It’s what every orthodontist should be doing — which is treating some kids for free,” he said.
Changes in orthodontics
Treatment has changed during Randall Markarian’s 22-year career as an orthodontist, he said. One change was helped along by the space program.
- 1. “The wires are much more gentle now,” he said. “The mouth responds better to gentle forces; the old way was a lot of force.” He said the wires that orthodontists use now were developed for the space program in the 1960s; but it wasn’t until fairly recently that the technology “trickled down” to orthodontics.
- 2. Another huge innovation in his practice is the 3D imaging machine, which replaces the “gooey disgusting impressions” to make retainers. “No patient ever liked getting an impression done, but (the machine) is also much more accurate,” he said. Using 3D imaging also reduces costs in a way, because the orthodontist doesn’t have to adjust retainers as he did when using molds, and appliances don’t need to be sent back. “It always fits,” he said.
Smiles Change Lives
- What it is: An international nonprofit that connects caring orthodontic providers with qualified and motivated children in need of braces whose parents cannot afford the full cost of braces. Dentists or orthodontists can refer patients between the ages of 10 and 18 who show need.
- How it works: Families provide financial information to qualify, and be willing to pay the non-refundable $30 application fee and the non-refundable $600 required financial investment (per child).
- Information: http://www.smileschangelives.org/