By Dr. Nishant Patel, DDS, MS, Orthodontist and Founder, Tooth By Tooth Orthodontics
Last updated: July 9, 2026
If your family dentist just said it is time to see an orthodontist, or you have finally decided to fix your own smile, the next question is the hard one: who do you actually trust with it? Apex families have good options within a short drive, and from the outside a lot of orthodontic offices start to look alike. This guide walks through what really separates a strong orthodontist from a nice waiting room, so you can choose with your eyes open.
Orthodontist or general dentist: the difference that matters
An orthodontist is a dentist who finished extra specialty training in moving teeth and guiding jaw growth. According to the American Association of Orthodontists, that means two to three years of full-time residency after dental school, roughly 3,700 hours spent on orthodontics alone.
Plenty of general dentists now offer clear aligners, and for very minor cosmetic movement that can be fine. But bite problems, crowding, spacing, and anything involving how the upper and lower teeth meet are a different job. For those, the specialty residency earns its keep. Our take: if your case is anything beyond small front-tooth touch-ups, see someone who trained specifically for this. It is the single easiest way to lower your risk of a result that looks straight but bites wrong.
Why the same doctor, every visit, beats a flashy office
Orthodontic treatment is not one big appointment. It is a long series of small adjustments over 18 to 24 months, and each one builds on the last. The person who read your first scan and set the plan is the person who should be making those adjustments, because they carry the whole picture in their head.
This is where a lot of families get surprised. At a larger multi-doctor or corporate-owned practice, you might meet a different provider each visit, and no one of them owns your case start to finish. A wall of screens and a slick lobby do not fix that. Continuity does. Dr. Patel built Tooth By Tooth as a single-doctor practice on purpose, after years inside a larger corporate-owned group, precisely so he could see every patient himself at every appointment.
When you tour a practice, the question that cuts through everything is simple: “Will I see the same doctor at every visit, or whoever is available that day?” The answer tells you most of what you need to know.
What to look for at a consultation, and what to ask
A good consultation should feel like a conversation, not a sales pitch. Here is a short checklist you can bring with you to any office near Apex.
| What to look for | What to ask |
|---|---|
| Specialty training (a real orthodontic residency, not a weekend course) | “Where did you complete your orthodontic residency, and how long have you practiced?” |
| Continuity of care | “Will I see you at every visit, or a rotating group of providers?” |
| Modern diagnostics like 3D digital scanning instead of goopy molds | “Do you use a digital scanner, and can I see my scan and plan explained?” |
| Real options for your age and case (kids, teens, and adults; braces and clear aligners) | “What are my treatment choices, and which do you actually recommend for me, and why?” |
| Honest reviews from local families | “Can I read recent patient reviews or see finished before-and-after cases?” |
| Transparent financing | “Is my quote a firm estimate, and what are the down payment and monthly options?” |
No two cases are the same, so treat this as a starting point for the conversation, not a scorecard. A confident orthodontist will welcome every one of these questions, because the honest answers are what set a strong practice apart.
Good options flex to the patient, not the other way around
The right treatment depends on the person in the chair. The AAO recommends a first orthodontic check by around age 7, not because most kids need braces that early, but because it is when an orthodontist can spot a developing problem while the jaw is still growing. Many young kids just get monitored. Teens are the classic braces years. Adults often lean toward clear aligners for how discreet they are at work.
Here is the honest part a good orthodontist will tell you: not every case is an aligner case. Some bites move faster and finish better with braces, and a practice that offers only one option, or pushes the same one on everyone, is solving for its workflow, not your smile. Ask which the doctor recommends for your specific case, and make sure the reasoning makes sense to you.
A short, easy drive from Apex
Location matters more than people expect, because you will make this drive many times over a couple of years. Tooth By Tooth sits in West Cary at 7250 O’Kelly Chapel Road, near Parkside Town Commons, which is a quick and simple trip for most Apex families. Late and Saturday appointment times help when you are working around school and practices.
Where Tooth By Tooth fits
To be straight with you, Dr. Patel is not the only good orthodontist within reach of Apex, and this guide is meant to help you choose well no matter where you land. If continuity is what you care about, though, Tooth By Tooth is built around it. Dr. Patel earned his DDS at the University of Illinois at Chicago, where he graduated at the top of his class, completed his MS and orthodontic certificate at the University of Minnesota, and had his research published in the American Journal of Orthodontics and Dentofacial Orthopedics. With more than a decade of hands-on experience, he sees every patient himself and uses digital scanning and 3D printing in daily treatment. One doctor, one location, every visit. That is the whole idea.
Ready to talk it through?
Starting orthodontic treatment can feel like a big decision. We make the first step easy: come in, ask questions, no pressure. You will meet Dr. Patel, get a straight look at your options, and leave with a clear picture.
Frequently Asked Questions
Do I need a referral to see an orthodontist?
No. You can book an orthodontic consultation directly, whether or not your dentist suggested it.
What age should my child first see an orthodontist?
The American Association of Orthodontists recommends a first check by around age 7. Most young children are simply monitored, but an early look lets the orthodontist catch a developing bite or spacing issue while the jaw is still growing, which can make later treatment shorter and simpler.
Are clear aligners as good as braces?
For many cases, yes, and they are far less noticeable. But it depends on the specific bite. Some corrections move more predictably with braces, and aligners only work if you wear them the recommended number of hours a day, which asks more of the patient. The better question is not which is better in general, but which is better for your case. A good orthodontist will look at your teeth and tell you honestly, rather than steering everyone toward the same product.
How much does orthodontic treatment cost near Apex?
Cost varies with the complexity of the case and the treatment chosen, so any honest answer comes after an exam, not before. What you should expect from any practice is a firm estimate with no surprises later, plus clear down payment and monthly options. At your consultation you will get a real number for your situation.
Is it too late to get braces as an adult?
Not at all. Healthy teeth can be moved at almost any age, and a large share of orthodontic patients today are adults.
About the author
Dr. Nishant Patel is the founder and sole orthodontist at Tooth By Tooth Orthodontics in Cary, NC. He earned his DDS at the University of Illinois at Chicago (top of his class) and his MS and orthodontic certificate at the University of Minnesota, where his research was published in the American Journal of Orthodontics and Dentofacial Orthopedics. After years practicing in the Chicago suburbs, he opened Tooth By Tooth to do orthodontics his way: one doctor, one location, every visit. Meet Dr. Patel.
