Frequently Asked Questions
We hear a lot of the same questions from families in Cary, Apex, Morrisville, and across the Triangle. And they’re good questions. Below, Dr. Patel answers the ones that come up most, from treatment timing to cost to what makes a solo practice different from a corporate office.
If you don’t see your question here, we’re happy to answer it in person.
Kids, Teens & Timing
When should my child first see an orthodontist?
The American Association of Orthodontists recommends an orthodontic evaluation by age 7. That doesn’t mean treatment starts at 7. It means Dr. Patel can spot crowding, crossbites, or jaw growth issues early, when they’re easier to address. Most kids who come in at 7 leave with a “let’s watch and wait” plan, and that’s perfectly fine.
What are signs my child might need to see an orthodontist sooner?
If your child has trouble biting or chewing, breathes through their mouth most of the time, has crowded or overlapping teeth, or if their jaw shifts or clicks, those are worth checking early. A dentist referral helps, but you don’t need one. You can bring your child in directly.
Does my child really need Phase I (early) treatment, or can we wait?
Not every child needs Phase I. Dr. Patel won’t recommend it unless there’s a clear clinical reason. Early orthodontic treatment is typically for issues like crossbites, severe crowding, or jaw alignment problems that are easier to correct while a child is still growing. In Dr. Patel’s experience, many kids who come in at age 7 can wait for a single phase of full treatment later. When Phase I is recommended, it usually lasts 6 to 12 months, followed by a monitoring period until the remaining permanent teeth come in.
The goal is always fewer interventions, not more.
How long do braces take for kids and teens?
Most kids and teens are in braces for 12 to 24 months. The range depends on what’s being corrected. Mild crowding resolves faster than a complex bite issue. Dr. Patel gives every family a personalized timeline at the consultation and adjusts the plan as your smile progresses. Checkups are typically every 6 to 8 weeks.
Can my child play sports or instruments with braces?
Yes to both. Dr. Patel recommends a mouthguard for contact sports, and we can help you find one that fits over brackets. For instruments, there’s usually a short adjustment period of a week or two, and then most kids are back to normal. Orthodontic wax helps with any irritation in the early days.
What happens if a bracket breaks or a wire pokes?
Call us. Most issues like a loose bracket or a poking wire aren’t true emergencies, but we’ll get you in quickly to fix it. There’s no extra charge for these visits at our office. In the meantime, orthodontic wax (we send you home with some) covers any sharp spots until we can see you.
Have questions about your child's bite?
Dr. Patel is happy to take a look. No commitment, no runaround
Treatment Options
What types of braces and aligners do you offer?
We offer metal braces, clear (ceramic) braces, and clear aligners for kids, teens, and adults. Dr. Patel recommends the option that fits your case best, not the one with the biggest margin. At your consultation, he’ll walk you through the options and explain why one might work better for your specific bite and goals.
Are clear aligners as effective as braces?
For many cases, including mild to moderate crowding, spacing, and some bite corrections, clear aligners work just as well as braces. For more complex issues like significant bite problems or cases that need precise tooth rotation, braces often give Dr. Patel more control. The honest answer is that it depends on your case. That’s why we don’t recommend one over the other until we’ve actually looked at your teeth.
When do you recommend braces instead of clear aligners?
Dr. Patel typically recommends braces when the case involves complex bite correction, significant rotation, or when a younger patient may not consistently wear removable aligners 20 to 22 hours a day. Braces work around the clock without relying on compliance. For adults and teens with good discipline and a case that fits, aligners are a comfortable, effective option.
Are clear aligners more expensive than braces?
At our office, pricing depends on case complexity, not which appliance you choose. In many cases, braces and clear aligners are priced similarly. We’ll give you a clear cost breakdown at your consultation so you can choose based on what works best for your smile and your life, not just your budget.
Do clear aligners work for teens?
They can, and they do, for the right cases. Teens who can commit to wearing aligners 20 to 22 hours a day and keeping track of their trays are good candidates. Some aligner systems have compliance indicators built in so parents and Dr. Patel can see if wear time is on track. If we have any concerns about compliance, we’ll be upfront about that.
Starting orthodontic treatment can feel like a big decision.
We make the first step easy. Come in, ask questions, no pressure.
Cost, Insurance & Payment
How much do braces cost in Cary, NC?
Braces in the Cary and Triangle area typically range from $3,000 to $7,000+, depending on the complexity of the case. At Tooth By Tooth, most braces plans run $600 to $800 down with monthly payments of $225 to $250, and we offer 0% interest financing. Your fee includes records, adjustments, and retainers after treatment. We don’t nickel-and-dime you with add-ons. Dr. Patel will walk you through the full cost picture at your free consultation.
How much do braces cost per month?
Most braces plans at our office run $225 to $250 per month with $600 to $800 down. Aligner plans typically start around $225 to $275 per month with $750 to $950 down. We offer 0% interest financing options, and we’ll map out monthly payments that work for your family at the consultation. No surprises after you start.
How much do braces cost without insurance?
Without insurance, you can expect to pay the full treatment fee, typically $3,000 to $7,000+ in our area. That’s why we offer 0% interest financing, so cost doesn’t become a barrier. With down payments starting around $600 for braces, many families without orthodontic coverage find that monthly payments of $225 to $250 make treatment very manageable.
Does dental insurance cover braces?
Many dental insurance plans include an orthodontic benefit, typically a lifetime maximum of $1,000 to $3,000 toward braces or aligners. Coverage varies by plan, and some plans cover kids but not adults. We verify your benefits before treatment begins and file claims on your behalf so you get every dollar your plan allows.
Can I use my FSA or HSA for braces?
Yes. FSA and HSA funds can be used for braces, clear aligners, retainers, and most orthodontic expenses. We can help you plan the timing of treatment and payments around your contribution cycles, especially if you have a “use-it-or-lose-it” FSA deadline coming up.
Does Medicaid cover braces for kids in North Carolina?
NC Medicaid and NC Health Choice may cover orthodontic treatment for children when it’s deemed medically necessary, typically for significant bite problems, jaw discrepancies, or functional issues. Coverage is case-by-case and based on clinical criteria. If you think your child might qualify, we’re happy to discuss it at your consultation.
Do you offer payment plans?
Yes. We offer 0% interest financing for every family. Down payments typically range from $600 to $950 depending on treatment type, with monthly payments of $225 to $275. We also build custom plans based on your budget and timeline. No third-party financing companies, no hidden fees. We keep it simple because we think that’s how it should be.
What's included in the treatment fee?
Your fee at Tooth By Tooth covers the full course of treatment: diagnostic records, all adjustment visits, the appliances themselves, and retainers when you’re done. Emergency visits for things like broken brackets or poking wires are included too. We give you the complete number upfront. Your estimate is your estimate.
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Book a free consultation and get a straight answer from the doctor who’ll actually do the work.
Adult Orthodontics
Am I too old for braces or clear aligners?
No. Healthy teeth can be moved at any age. Dr. Patel treats adults regularly, many of whom put off treatment for years and wish they’d started sooner. The process is the same: we evaluate your bite, talk through your options, and build a plan that fits your life. Adults often choose clear aligners or ceramic braces for a more discreet look, but metal braces work great too.
How will orthodontic treatment fit around my work schedule?
We offer late afternoon and Saturday appointments specifically because we know adults and busy families can’t always take time off during the week. Most checkups take 15 to 30 minutes every 6 to 8 weeks. Dr. Patel’s goal is to keep your visits efficient. You shouldn’t have to rearrange your life to straighten your teeth.
How long does adult orthodontic treatment take?
Most adult cases take 12 to 24 months, depending on complexity. Some mild cases with aligners can wrap up in under a year. Dr. Patel maps out your timeline at the first visit so you know what to expect. Treatment plans are adjusted along the way, not locked in and forgotten.
Starting orthodontic treatment can feel like a big decision.
We make the first step easy. Come in, ask questions, no pressure.
Retainers & Aftercare
Why do I need a retainer after braces or aligners?
Teeth have a natural tendency to shift back toward their original positions, especially in the first year after treatment. A retainer holds them in place while the bone and tissue stabilize around your new smile. Skipping retainer wear is the number one reason people end up needing re-treatment later. That’s something we want to help you avoid.
What does a retainer look like?
There are a few types. A clear retainer looks like a thin, transparent aligner that fits snugly over your teeth, barely visible. A Hawley retainer has a metal wire across the front with an acrylic plate that sits against the roof of your mouth. A bonded (fixed) retainer is a thin wire glued behind your front teeth that you can’t see at all. Dr. Patel recommends the type that fits your case and your lifestyle.
How long do I need to wear my retainer?
Plan on full-time wear (20+ hours per day) for the first few months after treatment, then transitioning to nighttime wear. Most orthodontists, Dr. Patel included, recommend wearing your retainer at night indefinitely. It takes 30 seconds to put in and keeps your results stable for life. The commitment is small compared to the investment you just made in your smile.
What if I lose or break my retainer?
Call us right away. The sooner you get a replacement, the less chance your teeth have to shift. We keep your records on file, so making a new retainer is straightforward. Replacement retainers typically cost $150 to $300 depending on the type, which is a fraction of the cost of re-treatment.
Should I get a removable retainer or a fixed (bonded) retainer?
Both work well. A removable retainer gives you flexibility. You take it out to eat and brush, but it only works if you wear it. A bonded retainer stays in place 24/7 with no compliance needed, but requires careful flossing around the wire. Some patients use both: bonded on the bottom teeth, removable on top. Dr. Patel will recommend what makes sense for your teeth and your habits.
Curious whether it's the right time?
A quick visit with Dr. Patel will give you a clear picture.
Your First Visit & Logistics
What should I expect at my first visit?
Your first visit is free and takes about 45 to 60 minutes. Dr. Patel will do a digital scan of your teeth using our intraoral scanner (no goopy molds), examine your bite, and then sit down with you to talk through what he sees and what your options are. You’ll leave with a clear treatment plan and pricing, whether you’re ready to start or just want to think it over. Bring your insurance info if you have it. We’ll check your benefits for you.
Do I need a referral from my dentist to see an orthodontist?
No. You can schedule a consultation directly, no referral needed. Many families come to us after a dentist recommendation, but plenty also come on their own after noticing crowding, a bite issue, or just wanting a professional opinion. Either way, you’re welcome.
Is the consultation really free?
Yes. Your first visit with Dr. Patel, including the exam, digital scans, and a full consultation with a personalized treatment plan, is completely free. No deposit, no obligation. We believe you should be able to get an honest assessment and clear pricing without opening your wallet first.
Do you offer evening or Saturday appointments?
Yes. We offer late afternoon and Saturday hours because we know families and working adults can’t always take time off during the week. Dr. Patel built this practice around real life, not around a 9-to-5 schedule.
What if I need to reschedule an appointment?
Just give us a call or text. We understand that schedules change. Kids get sick, work runs late, things come up. We’ll find another time that works. We only ask for as much notice as you can give so we can offer the slot to another family.
Starting orthodontic treatment can feel like a big decision.
We make the first step easy. Come in, ask questions, no pressure.
Why Tooth By Tooth
Will I see the same doctor at every visit?
Yes. Dr. Patel is the only orthodontist at Tooth By Tooth. He sees every patient at every visit. No rotations, no hand-offs, no surprises. He knows your smile, your history, and your plan because he’s the one who built it and the one adjusting it every time you come in.
What's the difference between a solo practice and a corporate orthodontic office?
Dr. Patel worked in a private equity-backed practice before opening Tooth By Tooth, so he’s seen both sides. In a corporate setting, doctors may rotate between locations, treatment plans can be influenced by production targets, and the orthodontist you consult with may not be the one who treats you. At a solo, doctor-owned practice like ours, one person is responsible for your care from start to finish. And that person answers to you, not a corporate board.
Are treatment recommendations at a solo practice different from a corporate office?
At Tooth By Tooth, Dr. Patel recommends what your teeth need. Nothing more. There are no production quotas, no upsell targets, and no corporate pressure to start treatment before it’s necessary. If the best recommendation is “let’s wait and watch,” that’s exactly what he’ll tell you.
Is a solo-practice orthodontist more expensive than a chain?
Not necessarily. Pricing in our area is competitive across practice types. The difference often comes down to what’s included in the fee and the level of personal attention. At Tooth By Tooth, your fee covers everything: records, adjustments, retainers, emergency visits. Some larger offices charge separately for those.
What makes Tooth By Tooth different from other orthodontists in Cary?
One doctor. One location. Every visit. Dr. Patel earned his DDS at the University of Illinois at Chicago, where he graduated top of his class, and his MS and orthodontic certificate from the University of Minnesota. His research has been published in the American Journal of Orthodontics and Dentofacial Orthopedics, the field’s top peer-reviewed journal. After eight years practicing in the Chicago suburbs, he moved to Cary and built Tooth By Tooth to do orthodontics the way he believes it should be done: personal, meticulous, and without corporate shortcuts. He’s also a dad of two, so he gets what it’s like to juggle schedules, budgets, and big decisions.
Curious whether it's the right time?
A quick visit with Dr. Patel will give you a clear picture.
Still have a question?
We’re a phone call, text, or visit away. Dr. Patel and our team are happy to answer anything we didn’t cover here, before, during, or after treatment.
Or call (919) 466-9959 — we’re happy to talk!