Orthodontic Care for Children and Teens

kansas city pediatric orthodontist

Moments before her turn, 11-year-old Yuliana Alvarado pulls herself upright in the reclining treatment chair. She raises her hands to eye level. They’re trembling.

“I’m so nervous,” she says. “I’m just shaking.” Thrilled with anticipation is more accurate.

Thirty feet away at the orthodontist’s office this month, Yuliana’s big sister, Rosa, 14, lies back in another chair, the first to get her dental braces. Yuliana will be next.

For so many kids, such a moment is just a bothersome part of growing up.

But for Yuliana — who for more than a year was insulted and bullied, who day after day would step off the afternoon bus at home and collapse into tears because the cruel, but popular girls in her fourth and then fifth grade class made fun of her small and crooked teeth and her gums that protrude in a pink crescent — it is everything. “Beaver teeth,” they called her. “Why are your gums so big?” they’d say, mocking and snide. Yuliana is slender, with raven-black hair to her waist. She smiled easily and often before the girls who used to be Yuliana’s friends turned nasty. “It hurt me,” Yuliana said. She vowed she wouldn’t tear up in front of them. It didn’t always work. It was not until recently, after Yuliana’s family came to know of a Kansas City nonprofit, Smiles Change Lives — started 22 years ago by a woman who, like Yuliana, had been mercilessly bullied as a child because of her teeth — did she think there was a possibility that her working-class family could afford the $5,000 to $6,000 it typically costs for braces, let alone double that for both her and Rosa. The price tag now via the nonprofit, in which some 850 orthodontists nationwide volunteer to work for free: $650 each — everything included. The organization, which in 1997 served 16 children in Kansas City, this year is expected to fit braces on close to 2,000 in all 50 states and three provinces of Canada. Its goal is to expand by convincing more orthodontists to work pro bono. In some locales, such as Boston, Seattle, Philadelphia and Las Vegas, many have signed on. But in others, including in Kansas and Missouri, children often must wait two to three years to be treated because too few orthodontists are willing to step up. “We have probably dealt with 60,000 to 70,000 applications over the years,” said Tom Brown of Kansas City, the president of the organization and whose late mother, Virginia L. Brown, began the nonprofit. “Every one of them has been bullied. Every one.”



Yuliana climbs back in the chair at Burleson Orthodontics & Pediatric Dentistry in Briarcliff.

“OK, are you ready?” asks orthodontist Don Sanchez.

Sanchez is 61 with short salt-and-pepper hair and a cheery demeanor. He’s partners with 40-year-old Dustin Burleson, a native Ohioan and 2004 University of Missouri-Kansas City dental school alumnus whose father, both brothers, uncle, cousin and ex-wife are all dentists, orthodontists or other specialists.

Burleson was a dental resident when he began working with Smiles Change Lives and, over the years, has done upwards of 500 free cases. All the materials for the braces are provided by suppliers for free. Some orthodontists take on one or two pro bono cases a year. Burleson is among the few willing to take 50, 60 or more.

“I think if you talk to any orthodontist,” he said, “the best part of their day is to see a child who was shy, or teased or bullied, or to see a kid who wouldn’t smile, begin to blossom.”

Yuliana opens wide.

She’s already had her initial X-rays. Just before their procedures started, she and Rosa handed Sanchez a gift bag of chocolates. Each scripted a personal note. Yuliana’s began, “Thank you so much for changing my life …”

Neither Burleson nor Sanchez knows much about the girls, beyond what they can see from their exams. Sanchez looks at Yuliana’s teeth. Some are turned in, others rotated out. They’re overcrowded. Her overbite is not as pronounced as Rosa’s. But Yuliana’s upper gum bulges under her lip.

“She’s more complex than her sister in that she has overgrowth here of the gums and the bone,” Sanchez explains. “What we’re going to do is we’re going to start straightening…”

She’ll need braces for at least two years.

”When we get close to the finish, when we’re not going to be moving the teeth that much, we’ll send her to a gum specialist,” he says. A periodontist they know is willing to do the work for free. “They’ll probably take down this gum a little bit.”

He holds a mirror in his left hand and clasps a whirring wand in his right.

“I’m just going to clean your teeth off here a little bit,” he says, then directs. “Open. There you go, sweetie. Just a little air. You, OK?”

“Uhmm hmm,” Yuliana says.



Although it might seem there is little to connect Yuliana to Virginia Brown — a woman who became affluent enough to begin her own foundation and ultimately a nonprofit — the link is in the pain of their childhood humiliation.

Brown, known as Gini, was 92 when she died in July last year. Born Virginia Lippert in 1926, she attended Hyde Park High School in Chicago, and then majored in English at the University of Illinois at Urbana-Champaign, where she met her husband from Kansas City. They would have three children. She’d marry again. Her second husband, Maurice L. Brown, was part of a successful oil and gas business, selling it in 1983.

As an adult, she was wealthy.

“When she was younger,” her son said, “her parents suffered the woes and throes of the Depression. They didn’t have enough money to give her braces at the time. They only had enough money to give braces to her older sister.”

Eventually, she would get braces just prior to college. Until then, Brown said, “she was subjected to a lot of name-calling: ‘snaggletooth,’ ‘You’re a vampire.’ … She was a very attractive woman, but her teeth were bad. She didn’t like to smile. To be honest with you, it scarred her for life.

“Despite all the things she did over her life, she never got over the shyness, the reticence to project herself, which all stemmed from what happened when she was a teenager.”

Her husband died in 1989. Years prior, the couple established a fund to help people with facial deformities. The cause gradually morphed into one that helped children from low-income families obtain braces and build confidence.

The organization’s focus then moved beyond helping families in poverty to one that would also provide braces to children in working-class, middle-class or other families that simply can’t afford them. The model now is based on “sustainable income.”

“You have a family that makes, say, $60,000 a year with four kids. That’s not poor,” Brown said. “But if you break that down, you can’t afford braces for all those kids.

“The idea is not to make a choice between braces or food. The idea is to give these working people for whom there are no programs an opportunity. That’s what my mother insisted.”

Everyone who seeks help from Smiles Change Lives writes an essay as part of the application.

“Last week we got an application from a woman in Parkland, Florida,” Brown said. Parkland is where on Feb. 14, 2018, a gunman with a semi-automatic rifle opened fire killing 17 people at Marjory Stoneman Douglas High School.

“She wrote that her son had been on the school grounds when the shooting began,” Brown said. “Her husband had lost his job. Her son had … post-traumatic stress disorder. It was having a deleterious effect on their daughter who needed braces.”

They weren’t rich or poor, but had a need they couldn’t meet.

“She wrote, ‘If you would help my daughter who is suffering mightily in all ways, this would be a godsend.’”

The $650 fee pays for neither the orthodontist nor for materials, all of which are donated. Brown said the money instead assures that the parents and children have buy-in to the program, feel committed to keeping appointments and comply with the orthodontist’s instructions. But the money is primarily used to support the nonprofit’s tiny staff in Kansas City in its efforts to spread the word to more orthodontists nationwide and to enlist them into agreeing to work for free to help more kids.


Sanchez rinses Yuliana’s teeth, pointing out the strength and health of her gums.

“She’s one of my bright stars already,” he says. Yuliana giggles. “Little water here, sweetie.” She closes down on the straw to draw the water away.

“All right, are you ready? Ready, set, go?” Sanchez says.

“Go for it,” Yuliana chimes.

He begins to work, drying and preparing her teeth to glue each tiny bracket.

“Proud of you,” he says.

Sanchez is unaware of how Yuliana has longed for this.

In June, Burleson held an open house to assess kids for the program to see who might be ready or need more time to fill cavities before their braces are placed. More than 100 children and their families showed, crowding this waiting room and lining up outside his office. Some drove hours to get there.

Many of the kids were similar in that they were too embarrassed to smile. If they did, their mouths were closed and tight. If they laughed, they raised their hands to hide their teeth.

In photographs from years past, Rosa’s smile is a thin, closed-lipped line. This year she entered Lincoln College Preparatory Academy as a freshman. “I just felt my teeth were messed up. I wouldn’t show them,” she says.

Parents said some of their kids’ personalities had changed out of self-consciousness. They’d turned shy.

When Yuliana was told after Burleson’s open house that she would, indeed, get braces this summer, her shoulders quivered. She wept in relief and buried herself into her mother’s side.

Yuliana at first didn’t tell her mother about the bullying, although clearly something was wrong.

“When she comes from the school, she is always crying,” Maria Rodriguez said.

Rosa began to notice, too, how nearly every night her little sister, lying in the adjacent bed, ground her teeth from mounting stress. Her mother insisted that Yuliana tell her what was happening.

“She told me, ‘Everyone is mean to me about my teeth,’” Rodriguez said.

Like most parents, Rodriguez urged her daughter to be proud of who she is and how she looks and to ignore the taunting. “I told her, ‘You’re so beautiful,’” Rodriquez said.

Yuliana tried to talk to the girls at school, asking them why they were being so mean. Her mother’s words helped.

“I looked at myself in the mirror,” Yuliana said, “and I was like, ‘You are pretty.’ … But there was a deep sadness in my heart. I’m pretty, but deep down I felt like I wasn’t, you know?”

Gradually other students in upper grades began to make fun of her teeth, Yuliana said. Rosa tried to intervene on her sister’s behalf, to talk to the girls and tell them to back off, but it did no good and even got worse. The alienation spread.

“I had a little group, like two or three friends, I would ask, ‘Don’t you want to be my friends?’” Yuliana said. “They’d stay quiet. It was really hard to deal with that.” She searched for a metaphor. “It was like I was hanging on a rope and I was climbing,” she said, “and they’ll cut it and I’ll fall down. And I’ll keep on climbing, but they’ll keep on cutting it.”

Time and again, Yuliana’s mother, 35, went to the school to complain. Time and again, she said, the principal promised action, but little changed.

“It just kept going on,” Yuliana said.

It turned her inward. “I wanted it to stop,” she said.

Their dad signed them up for boxing lessons, just to give the girls strength and confidence.

The whole drama, Yuliana said, made her feel “weak.”

When fifth grade ended, the family decided to remove Yuliana from the school and sent her to Crossroads Academy on Central Street for sixth grade. This month she began seventh at its sister school, Crossroads Preparatory Academy, where she’s found friends and is happier.

Her smile unchanged, she feared the future and being bullied again.

Rodriguez, 35, and her husband, Jose Alvarado, 46, felt compelled to at least attempt to get their girls braces. But the cost at $5,000 to $6,000 each seemed impossible. Though not poor, the family is far from wealthy.

Jose Alvarado, a concrete worker, rises each day at 4 a.m. and works past 7 p.m., even 8, to support the family — Rosa, Yuliana and their youngest, 6-year-old Jose, named for his dad. Rodriguez, for extra money, sometimes works a shift on a food truck. She considered adding another job, or more shifts, but who would watch the kids after school?

Sensitive to her sister’s misery, Rosa not only said she would forego braces, but offered to get a job to help Yuliana. Next May, Rosa will turn 15 and mark her quinceañera, a milestone often celebrated with a special dress and elaborate party. Forget it, Rosa told her parents. Use the money to help Yuliana.

“I said, ‘It’s fine. We don’t need it,’” Rosa said. “We can just have a normal day. Celebrate together — just the five of us.”

Her sacrifice wasn’t necessary. At a doctor’s appointment, they saw an ad for the Smiles Change Lives program. At first they thought it couldn’t be real, or maybe they misheard: $650? It had to be a scam, they thought, until they later heard about it again, and found out it was bona fide.

yuliana selfie


Working left to right, Sanchez glues 12 brackets, one each to the front of Yuliana’s top teeth. In about three months, he’ll do the bottom teeth.

“Now what I’m going to do is make sure they are positioned on the tooth, properly, OK?” he says.

Yuliana has dreamlike expectations of how braces will change her life. In the weeks before the appointment her face brightened as she talked about being “empowered.”

“It actually makes me feel really good,” she said. “I feel more relieved of everything. I feel like this is not going to happen no more. It’s all going to be all over with. It’s going to be gone. It’s going to be like ‘goodbye.’

“When I found out I was going to get the braces, I really wanted to cry. I felt like, oh my God, it’s time. It’s time for me to get out of my shell like I used to be when I was a little girl. … It’s going to be a whole new world. It’s going to be like Disney World or something, but probably happier than that.”

Sanchez finishes up. His technician, Brooklyn Gaddie, cures the brackets, sets the wire and elastic bands in place. Rosa chose white bands; Yuliana chooses aqua. “It just reminds me of the ocean,” she says, a place she’s always been happy.

“She’s going to go over a lot of stuff with you and your mom, OK?” Sanchez says. “How to brush, what you can eat, what you can’t eat, not allowed to have any boyfriends.”

Yuliana laughs.

“All right. We did it,” Sanchez says.

Minutes later, she is done. Gaddie, the tech, passes Yuliana a hand mirror. Later, seated on a grassy rise outside of Burleson’s office, she will hold up a cellphone and take selfies.

In this moment inside, she lies back and looks at her teeth in the mirror, turning her head left and right.

“Oh my God,” she says. “They’re so pretty.”

For more information, read this article at, The Kansas City Star