I will tell you what I recommend, and why. I will not tell you what you need.
The distinction matters more than it sounds. Orthodontic treatment takes one to two years of your life and costs several thousand francs. The decision belongs to you, and you can only make it properly if you have the reasoning, the alternatives and the complete cost in front of you. My work is to provide those, and then to carry out what you decide.
Everything below follows from that.
Sometimes the answer is not to treat
Not every case should be treated, and not every case should be treated now.
With children this matters most. Early treatment is offered widely and indicated rarely. I propose a first phase only for specific conditions: prolonged thumb sucking, asymmetric crossbite, severe deep bite, anterior Class III. Where none of those applies, I say so and we arrange a review in a year. An unnecessary early treatment costs money, occupies a child for months and improves nothing about the final result.
I will also decline to begin treatment on an unstable periodontium. If your gums or your bone support need attention first, I will refer you to a periodontist before we discuss aligners at all. Moving teeth through diseased bone makes the problem worse.
Aligning teeth and treating a bite are different things
Many treatments address only the visible front teeth. The result photographs well and deteriorates within months, because nothing has changed in the way the jaws meet. The forces of chewing continue as before and return the teeth towards where they started.
I treat the occlusion, including in adults where growth has finished. This takes longer to plan and occasionally costs more. It is the reason results hold, and it is where I diverge from part of the profession.
The cost, stated once, in full
You receive the complete figure before treatment begins, and it does not change during treatment.
I have read too many quotes that open with an attractive number and reserve the right to revise it in the small print. Refinements charged separately, retention as an extra, follow-up not included. The patient discovers the real total halfway through, when stopping is no longer an option. I regard that as deception by omission, and I will not practise it.
Ask me what a treatment costs and you will get the whole answer, including what happens if your case turns out to be more complicated than it looked.
Retention for every patient
A result that lasts three years is not a result.
I bond fixed retention on both arches for every patient I treat. A removable retainer depends on the patient remembering it indefinitely, and it fails quietly: a few missed nights change nothing, a few missed months undo two years of work. A significant share of my adult patients come to me precisely because their teenage treatment was never stabilised.
This is included in the price. It is not an option.
Working with your dentist, not around them
Orthodontics is one part of your dental care and rarely the whole of it.
I work with your general dentist rather than in parallel with them. Where a case requires it, I coordinate with a periodontist, a restorative dentist, or a maxillofacial surgeon, and I sequence my part around theirs. This matters most in adult treatment, where teeth are often crowned, implanted or missing, and where the order of operations determines whether the outcome is good or merely acceptable.
Where my patients come from
Most of the people I treat were sent by someone I treated before.
That is the measure I pay attention to. Advertising can fill a waiting room once. Only results bring the next patient through a recommendation, and only honest advice keeps a patient willing to make one.
Orthodontie MC20 Wolfgang Johannes, orthodontist since 1998, in Geneva since 2003 Invisalign Diamond Apex Provider, more than 3,000 aligner cases Rue Micheli-du-Crest 20, 1205 Geneva