Health & Wellness

From Shy to Shine: How Orthodontic Treatment Can Bring out the Best in Anyone

Dr. Cosentino, what inspired you to enter orthodontics?
I have always been a visually-driven person. I love art and sculpture, but I also love science and I wanted to find a career that integrated both passions. Art is all about form, function and esthetics and, in a roundabout way, so is orthodontics. When you look at a patient’s before and after pictures, the transformation is usually visually striking. A beautiful smile radiates so much confidence; it’s like a work of art!

What are the most common reasons people need orthodontic treatment?
Patients will usually self-refer with crooked teeth or an over or under bite. Other indications you might need orthodontic treatment are pronounced mouth breathing, clenching or grinding your teeth, the inability to comfortably close your lips, a “clicking” jaw, and unintentional inner cheek biting.

Do you encourage people to have orthodontic treatment for esthetic reasons?
Crooked teeth or “bad bites” are rarely just an esthetic issue. There is usually an underlying cause that if not treated orthodontically can lead to more severe issues, including jaw pain and loss of teeth. This is something that is crucial for both adults and children. A parent should never dismiss their child’s crooked tooth or overbite as “cute” or something “they’ll grow out of”. Early intervention is vital to avoid bigger problems.

What interventions do you offer?

We offer all types of braces, from the conventional metal brackets and wires to the newer “clear” braces like Invisalign, and permanent retainers post-treatment. We also offer orthopedic appliances and gear to correct bite issues. These are used to reposition the jaws for better dental health and to give a more balanced facial esthetic. We aim to stay up to date with trends so we can offer the best products on the market.
Can you tell us more about Invisalign and how they differ from conventional braces?
Invisalign is one of the best advancements in the field of orthodontic appliances in recent years. The Invisalign system is clear and smooth, easier to fit, more comfortable to wear, and more esthetically pleasing. The aligners are removable and aren’t worn at mealtimes. Invisalign is more effective than conventional braces for treating open bite problems in adults, certain types of expansion issues, and for treating patients with narrow mouths.

In general, how long does treatment take to straighten teeth?
The average time is 12 to 18 months, but there are several factors that determine the exact treatment duration: the patient’s age, the severity of the problem, and the patient’s ability to maintain their appliances and comply with wearing a retainer post-treatment for as long as necessary.

Can crooked teeth correct themselves over time?
It is extremely rare that crooked teeth can correct themselves without orthodontic intervention because crooked teeth usually indicate a more severe, underlying issue that won’t “fix” itself.

When do you recommend children start with treatment?

We recommend that a child have an orthodontic evaluation at age six or seven, although, depending on the problem, active treatment won’t start until somewhere between eight and twelve. If your child experiences early or late baby teeth loss, thumb sucking, tongue thrusting and mouth breathing, it’s definitely time for a visit to the orthodontist.

Can someone ever be too old for orthodontic treatment?
Absolutely not. I have a patient right now who is 83! If someone practices excellent dental care and hygiene, there is no reason they can’t keep their own teeth well into their 80s and beyond.

How do you go about creating a comprehensive treatment plan?
First, we talk to the patient to assess their concerns. We do a thorough investigation that includes photos, x-rays and digital scans. The digital model allows us to evaluate issues in fine detail and then formulate the best course of action.

What questions should a patient ask an orthodontist before treatment?

First, they should ask for a clear explanation of their orthodontic issues and why they need to be corrected: What are the options for treatment, including all pros and cons of each one? What is the duration of treatment? What is the maintenance protocol for appliances? What are the expected results? What is the cost?

What is required to maintain dental hygiene with braces?

Brush and floss three times a day. If you have brackets, brush a little longer to make sure no food particles are left behind. Clean any removable hardware every single day. Stick to your appointment schedule for bracket tightening, elastic changes and hardware refitting.

What is the cost of orthodontic treatment?
It depends on what’s needed but usually between $4,000 and $10,000. The fee includes everything: imaging, hardware, and office visits for the full length of the treatment. We also offer interest-free payment plans, and we facilitate patients’ reimbursement if they have insurance coverage.

What do you find most rewarding and most challenging about orthodontics?

The most rewarding thing is watching patients who pre-treatment lacked confidence, blossom afterwards! Seeing huge, happy, healthy smiles is amazing! The most challenging aspect involves non-compliant patients who expect results regardless and parents who are not supportive of their child’s treatment.

Joseph Cosentino, D.D.S, received his degree in Dental Surgery and his Certificate in Orthodontics from Columbia University where he is an active member of the Orthodontic Alumni Association.
Dr. Cosentino can be reached at BWAY Smiles, 1995 Broadway, Suite 205 212-877-5577,

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