i started ortho treatment at the age of 37 with Dr. Karotkin, and i was very selective with choosing an Orthodontist. I met many doctors before i came to Dr.Karotkin office, and upon the initial meeting i was very impressed. They have a fantastic staff of experienced, warm people. You find out everything you need to know on your initial visit. All x rays, exams, are done in house and Dr. Karotkin spent almost an hour with me on the initial meet. You can get a good sense that he is dedicated to his profession, and it his goal to perfect your teeth. He took measurements of profile, face, pictures after pictures, and discussed possible treatment plans. I have some crowding and was concerned of the appearance during the treatment. He understood completely and we discussed in depth all the options we could take. i went with a combined clear bracket and invisalign approach. Happy with the decision and glad i met the guy. if your considering ortho treatment, i would encourage you to set an appointment with their office, and discuss your goals before you jump in. Best of luck!!