So you want to be an orthodontist. You love teeth and want a specialty where you can have a great lifestyle, avoid back pain, and delegate most of your tasks to your assistants. Let’s debunk the public perception myths and give it to you straight. This is the reality of orthodontics.
Orthodontics is the specialty of dentistry that deals with the diagnosis, prevention, and correction of malpositioned teeth and jaws. Although orthodontists are best known for straightening teeth, a more accurate description of what they do is ensure their patients have a healthy “occlusion,” which includes proper alignment of teeth, jaws, and the bite. This means that the teeth are not only straight in the upper and lower jaws but also fit well when the jaws close together.
Improper alignment can lead to a variety of problems including asymmetric growth of the jaws, irregular wear, impaction, and early loss of teeth. In addition, issues such as crowding may inhibit your ability to adequately clean your teeth and gums which can lead to other issues down the road such as tooth decay, inflammation of the gums, and loss of bone around the tooth.
Other problems include difficulty with speech, chewing, and swallowing in addition to aesthetic concerns if the jaws and bite are not fitting together properly. Therefore orthodontists are critical in developing proper form and function in the oral cavity, which can ultimately help patients maintain their teeth for longer.
Every patient is different, so it’s the orthodontist’s job to use a combination of in-person exams and x-ray imaging to develop a personalized treatment plan. Although most patients immediately think of braces when they hear orthodontics, these are not the only tools in the orthodontist’s arsenal.
There are a variety of appliances such as aligners, palatal expanders, micro-implants, headgear, and facemasks, also known as reverse pull headgear, that an orthodontist may use to improve a patient’s bite. The tools used will depend on the patient’s complexity and individual needs.
An important method of differentiating an orthodontist’s practice is private practice vs academic vs community clinics.
An orthodontist is a dental specialist who diagnoses, prevents, and treats dental and facial irregularities. They help improve the function and aesthetics of their patients’ bites by applying braces, clear aligners, retainers, headgear, and other appliances. Becoming an orthodontist is an extensive process that requires many years of education and training. If you’re interested in embarking on this rewarding career path, here is a step-by-step guide on how to become an orthodontist:
Step 1: Earn a Bachelor’s Degree
The first step to becoming an orthodontist is completing a bachelor’s degree at an accredited 4-year university While the specific major is not important, orthodontic schools recommend focusing on science courses to help prepare for the dental education curriculum Common majors for aspiring orthodontists include
- Biology
- Chemistry
- Biochemistry
- Physics
- Mathematics
Some students choose to major in a non-science field and take the required science prerequisites separately. Along with sciences like biology, anatomy and physiology, students should also aim to take courses in subjects like psychology, communications and business, which provide a well-rounded background.
Step 2: Take the Dental Admission Test (DAT)
Most dental schools require applicants to take the Dental Admission Test, or DAT This standardized exam is designed to assess knowledge and scientific comprehension in the following areas
- Survey of the Natural Sciences (biology, general chemistry, organic chemistry)
- Perceptual Ability
- Reading Comprehension
- Quantitative Reasoning
The DAT takes around 5 hours to complete and is offered multiple times throughout the year by the American Dental Association. It’s advisable to spend several months preparing through practice tests and review courses. High DAT scores increase the chances of acceptance into orthodontics programs.
Step 3. Earn a DMD or DDS Degree
The next requirement is completing a 4-year Doctor of Dental Medicine (DMD) or Doctor of Dental Surgery (DDS) program at an accredited dental school. The first 2 years focus on classroom instruction and lab work in subjects like:
- Anatomy
- Physiology
- Biochemistry
- Pharmacology
- Dental materials
- Restorative techniques
The last 2 years shift to clinical experience treating patients under supervision of licensed dentists. Students learn skills like:
- Exams and diagnosis
- Oral surgery
- Restorations
- Endodontics
- Periodontics
- Pediatric dentistry
They gain experience in all dental specialty areas, including orthodontics.
Step 4. Get Licensure in General Dentistry
After earning a DMD or DDS, prospective orthodontists must get licensed as a general dentist before they can specialize. The licensure requirements include:
- Passing national written dental boards
- Passing a state or regional clinical exam
- Completing continuing education courses
- Passing an ethics and jurisprudence exam
Licensure must be obtained in each state you want to practice. Once licensed, many dentists choose to gain professional experience in general dentistry for 1-2 years before pursuing specialization. However, it’s not strictly required.
Step 5. Complete an Orthodontic Residency
The next step is admission into an accredited orthodontic residency program, which takes 2-3 years. These highly competitive programs accept around 100-150 students nationally each year. They provide intensive education in topics like:
- Facial growth and dental development
- Diagnosis and treatment planning
- Application of orthodontic appliances
- Orthognathic surgery
- Clef lip/palate treatment
- TMJ disorders
Extensive clinical experience is also gained treating orthodontic patients under supervision of experienced orthodontists. A research project is usually required to complete the program.
Step 6. Get Licensed in Orthodontics
After completing residency, orthodontists must obtain an orthodontic specialty license in their state. This involves:
- Passing a written exam on orthodontics
- Completing a clinical exam or having sufficient experience
- Finishing continuing education courses
- Maintaining CPR certification
Orthodontists must renew their specialty license periodically by completing continuing education. Requirements vary by state but range from 10-50 credit hours annually.
Step 7. Get Board Certified (Optional)
Board certification by the American Board of Orthodontics is optional but demonstrates an orthodontist’s exceptional expertise. Certification requirements are:
- Graduation from an accredited orthodontic program
- A minimum of 2 years clinical experience
- Passing a comprehensive written exam
- Passing a clinical exam with case record reviews
- Maintenance through recertification every 10 years
While not required, board certification provides peer and patient recognition of an orthodontist’s knowledge and proficiency.
Step 8: Set Up a Practice
Once licensed, orthodontists have a few options in establishing a practice:
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Open a solo private practice – This involves finding office space, hiring staff, obtaining equipment, establishing billing systems and acquiring patients independently. It offers autonomy but also more financial risk.
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Purchase an existing practice – Buying a practice from a retiring orthodontist allows taking over an established patient base and reputation. However, it also involves more upfront costs.
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Join a group practice – Associating with a multi-orthodontist practice provides benefits like sharing expenses, staff and resources. However, there may be less flexibility.
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Work for a corporate practice – Orthodontic chains like SmileDirectClub hire orthodontists as employees. While they handle operations, compensation is lower.
The path involves many years of rigorous education and training, but orthodontics offers the reward of helping patients of all ages achieve healthy, confident smiles. With proper preparation and persistence, you can successfully embark on this in-demand dental specialty career.
FAQs About Becoming an Orthodontist
How long does it take to become an orthodontist?
The total time commitment is generally 8-10 years, including 4 years undergraduate study, 4 years dental school, 2-3 years orthodontic residency, and 1-2 years practicing general dentistry (though this last part is optional).
What undergraduate major is best to become an orthodontist?
While any major is acceptable, orthodontic schools encourage science majors like biology, biochemistry, anatomy, chemistry and physics to gain a strong science background.
What GPA is required for orthodontics programs?
The average GPA for entering dental students is around 3.5. For orthodontics residencies, which are highly competitive, the average GPA is even higher at 3.7 or above.
How competitive is admission to orthodontics residencies?
Orthodontic residency programs are very competitive, accepting around 10-15% of applicants. Excellent DAT scores, GPA, research experience and recommendations are needed to stand out.
Can I become an orthodontist without going to dental school?
No, completing dental school and obtaining general dentistry licensure are mandatory steps to becoming a licensed orthodontist. There are no shortcuts or alternate paths.
Is it better to specialize in pediatrics or orthodontics?
Both allow you to work extensively with children and teens. Pediatric dentistry provides broader initial training, while orthodontics offers the reward of seeing major transformations as bites are corrected over time.
How much student loan debt do orthodontists have?
The average dental school debt is around $285,000. Additional costs for orthodontic residency can add $100,000-200,000. However, orthodontists earn salaries high enough to comfortably pay back debts.
Is becoming an orthodontist worth it financially?
Yes, orthodontics is one of the most lucrative dental specialties. The median pay is above $200,000 annually. Top orthodontists can earn $500,000 or more, making the extensive education a wise investment.
Becoming an orthodontist requires dedicated time and effort, but brings excellent rewards in terms of pay, satisfaction, and the ability to improve patients’ lives. For those willing to undertake the journey, a bright future helping people smile awaits.
How to Become an Orthodontist
To become an orthodontist, you must first become a dentist, which requires completing college and four years of dental school. If you know you want to be a dentist or orthodontist from high school, there are combined dental programs that reduce the number of years required for college and dental school as well.
After dental school, you need two or three years of orthodontics residency to become an orthodontist. There are two types of orthodontics residency programs: academic and hospital-based.
Academic orthodontics residency programs are often affiliated with a dental school and include both a didactic component and a clinical component as part of their curriculum. This means that residents will split their time between the classroom and the clinic. These programs can either be two years or three years in duration.
One of the benefits of completing a three-year program is that they generally include a Master’s degree upon completion whereas many two-year programs do not. Additionally, a full orthodontic treatment generally takes 2-3 years to complete, so residents in three-year programs will have the opportunity to see more complex cases from beginning to end whereas students of two-year programs may not be able to see these cases to completion.
That being said, there are definite downsides to three-year academic programs, the big one being tuition. Unlike medical residencies where you are paid to be there, the majority of academic orthodontic residencies charge tuition. These residencies are not cheap either, with some schools charging upwards of $110,000 per year.
Hospital-based orthodontic residencies are, as the name suggests, affiliated with hospitals instead of academic institutions. They are generally two years long and, unlike academic programs, are mostly clinical with fewer didactic and research components. In addition, many hospital residency programs offer stipends as opposed to charging tuition.
In terms of competitiveness, orthodontics is known for being one of the most competitive dental specialties, with only around 55% of applicants matching into orthodontics each year.
Dental students best suited for orthodontics are often well-rounded and highly motivated. They tend to be social and enjoy a low-stress environment with a healthy work-life balance.
For orthodontists that want to subspecialize further, there is only one main fellowship option available.
Craniofacial orthodontics is a 1-year fellowship program that provides orthodontists with additional training and skills in the management of complex craniofacial anomalies. This includes issues such as cleft lips and palate and other dentofacial deformities.
Craniofacial orthodontists will often work as a part of a craniofacial team, which includes plastic surgeons, oral surgeons, pediatricians, pediatric dentists, prosthodontists, speech pathologists, otolaryngologists, geneticists, and neurosurgeons among others.
It should be noted that many orthodontists receive training in craniofacial orthodontics during residency and will still treat craniofacial patients in their respective practices. As such, those that pursue fellowships in craniofacial orthodontics are generally passionate about treating patients with craniofacial abnormalities and want the extra experience, or they are interested in working in academic or hospital settings.
In terms of compensation, craniofacial orthodontists typically make less than general orthodontists as they will most likely be focusing on craniofacial syndromes instead of the more bread-and-butter orthodontic treatments which are often paid out-of-pocket.
What You’ll Love About Orthodontics
There’s a lot to love about orthodontics.
To start, the lifestyle of an orthodontist is desirable relative to most medical and dental specialties. Most orthodontists work regular 9-5 business hours. The number of days you work depends on the lifestyle you want – some will work only a few days per month while others work 5-6 days a week.
Although there is generally a tradeoff between lifestyle and compensation, orthodontists are also at the higher end of compensation relative to other dental specialties. According to the U.S. Bureau of Labor Statistics, the average orthodontist takes home around $267,000 per year.
Orthodontics is also less physically demanding than many other dental specialties. Whereas most dental specialties struggle with strain on the back and hands from lengthy procedures, much of an orthodontist’s work can be delegated to assistants. As a result, the orthodontist’s main job is to direct the treatment rather than directly perform the procedures, leading to more downtime during patient care.
Another benefit of being able to delegate work is that orthodontists can see many more patients per day. The average orthodontist will see around 30-60 patients per day with some seeing greater than 100 patients per day. Patient volumes will vary, however, depending on the size of the practice as well as the systems that are in place to delegate work to assistants.
Orthodontics is also known for being a relatively low-stress occupation. There are no life-threatening emergencies and most mistakes are often reversible.
Lastly, the fulfillment of building relationships with patients over years of treatment can be rewarding as you transform the smile and lower face of the patient.
