What This Guide Covers
This guide explains what an orthodontist is, how they differ from a general dentist, and what kinds of problems they treat. It is written for anyone considering braces or aligners for themselves or their child.
You will learn about the training orthodontists complete, the types of treatments they offer, what a typical appointment looks like, and how much treatment may cost. You will also find clear guidelines on when to see an orthodontist rather than relying on a general dentist alone.
For a broader look at the specialty, visit the orthodontics page.
What Is an Orthodontist?
An orthodontist is a dental specialist who diagnoses, prevents, and treats problems with tooth alignment and jaw position. All orthodontists are dentists first, but not all dentists are orthodontists.
After finishing dental school, an orthodontist completes an additional 2 to 3 years of full-time residency training in an accredited orthodontic program. [1] During this residency, they study biomechanics (how forces move teeth through bone), craniofacial growth and development (how the face and jaws grow over time), and advanced treatment planning. This specialized education goes well beyond what general dentists receive.
According to the American Association of Orthodontists, only about 6% of all dentists are orthodontists. [1] That small percentage reflects the competitive, additional training required to earn the specialty credential.
Education and Training Path
Becoming an orthodontist requires roughly 10 to 11 years of education after high school. The path starts with a 4-year undergraduate degree, followed by 4 years of dental school to earn a DDS (Doctor of Dental Surgery) or DMD (Doctor of Medicine in Dentistry) degree. [2]
After dental school, future orthodontists apply to a residency program accredited by the Commission on Dental Accreditation (CODA). These programs last 2 to 3 years and focus entirely on orthodontics and dentofacial orthopedics (the guidance of facial bone growth). [1] Residents treat hundreds of patients under faculty supervision, learning to manage everything from simple crowding to complex skeletal problems.
Many orthodontists also choose to become board-certified by the American Board of Orthodontics. Board certification involves a written exam and a clinical case review. It is voluntary but signals a commitment to meeting high practice standards.
Orthodontist vs. General Dentist
A general dentist provides a wide range of dental care, including cleanings, fillings, crowns, and extractions. Some general dentists offer basic orthodontic services like clear aligners for mild cases. [2]
An orthodontist, by contrast, focuses entirely on tooth movement and jaw alignment. Their residency training gives them deep knowledge of how teeth respond to different forces, how bone remodels during treatment, and how to plan for facial growth in children. For moderate to complex alignment or bite problems, an orthodontist's specialized training typically results in more predictable treatment outcomes.
Think of it like the difference between a family doctor and a cardiologist. Both are real doctors, but one has extra years of training focused on a specific area of the body.
Conditions Orthodontists Treat
Orthodontists treat a wide range of dental and skeletal problems. The most common issues include crooked or crowded teeth, gaps between teeth, and various types of malocclusion (a bad bite). [1]
Specific bite problems include overbite (upper front teeth overlap the lower teeth too much), underbite (lower teeth sit in front of the upper teeth), crossbite (some upper teeth close inside the lower teeth instead of outside), and open bite (front teeth do not touch when the back teeth are closed). Orthodontists also treat jaw asymmetry and problems related to abnormal facial growth in children.
- Crowding: teeth overlap because the jaw is too small or teeth are too large
- Spacing: gaps between teeth caused by missing teeth, small teeth, or jaw size
- Overbite: upper front teeth extend too far over the lower front teeth
- Underbite: lower front teeth sit ahead of the upper front teeth
- Crossbite: one or more upper teeth bite inside the lower teeth
- Open bite: upper and lower front teeth do not overlap when biting down
When Should You or Your Child See an Orthodontist?
The American Association of Orthodontists recommends that every child have an orthodontic evaluation by age 7. [1] This does not mean treatment starts at 7. It means an orthodontist can check for developing problems while baby teeth and permanent teeth are both present.
By age 7, the first adult molars and incisors have usually come in. An orthodontist can spot early signs of crowding, crossbites, and jaw growth problems at this stage. In some cases, early intervention (called Phase I treatment) can guide jaw growth or create space for permanent teeth, potentially reducing the need for more complex treatment later.
Many children will not need treatment until most or all permanent teeth have come in, typically between ages 11 and 14. The orthodontist may simply monitor the child's growth over time and recommend the right moment to start.
Orthodontic Treatment for Adults
Orthodontic treatment is not just for teenagers. Adults of almost any age can benefit from braces or aligners. According to the American Association of Orthodontists, roughly 1 in 3 orthodontic patients today is an adult. [1]
Adult treatment may take slightly longer than treatment for teens because adult bone is denser and no longer growing. However, the biological process of tooth movement works at any age. Adults often choose clear aligners or ceramic braces for a less noticeable look.
Some adults seek treatment for cosmetic reasons. Others need orthodontic care before getting dental implants, crowns, or bridges because teeth must be in the right position for those restorations to fit properly.
How to Prepare for Your First Visit
Preparing for an orthodontic evaluation is simple. Bring your dental insurance card if you have coverage, and bring any recent dental X-rays your general dentist can provide. These help the orthodontist assess your case without repeating imaging.
Write down any questions you have about treatment options, timelines, and costs. If the appointment is for your child, let them know the visit is just a checkup. No braces go on during the first visit.
What Happens During an Orthodontic Visit?
A first orthodontic visit typically involves a clinical exam, diagnostic imaging, and a discussion of treatment options. Most initial consultations last 30 to 60 minutes.
The Initial Consultation
The orthodontist will examine your teeth, jaws, and face. They will check how your teeth fit together when you bite down and look for signs of crowding, spacing, or bite misalignment. [1]
Diagnostic records are usually taken during or shortly after this visit. These may include digital X-rays (such as a panoramic X-ray and a cephalometric X-ray, which shows the side profile of your skull), photographs of your face and teeth, and digital impressions or molds of your teeth. The orthodontist uses these records to create a treatment plan.
At the end of the consultation, the orthodontist will explain what they found, whether treatment is recommended, and which treatment options suit your case. They will also discuss estimated treatment time and cost.
Common Treatment Options
Orthodontists use several types of appliances to move teeth. The best option depends on the complexity of the problem, patient age, and personal preference.
Traditional metal braces use stainless steel brackets bonded to each tooth and connected by a wire. The orthodontist adjusts the wire at regular appointments to gradually shift teeth into position. Metal braces can treat virtually all types of orthodontic problems. [2]
Ceramic braces work the same way as metal braces but use tooth-colored or clear brackets. They are less visible but may stain if not cared for properly.
Lingual braces are placed on the back surfaces of the teeth, making them invisible from the front. They are less commonly used because they can be harder to clean and may take time to get used to.
Clear aligners (such as Invisalign) are removable plastic trays that are swapped out every 1 to 2 weeks. They work well for mild to moderate crowding and spacing. Complex bite corrections may still require braces.
What Happens During Active Treatment
Once braces are placed or aligners are started, you will return to the orthodontist's office for adjustment appointments every 4 to 8 weeks. During these visits, the orthodontist checks progress, replaces wires or provides new aligner trays, and makes any needed changes to the treatment plan.
Treatment length varies. Simple cases may take 6 to 12 months. Moderate cases commonly take 12 to 24 months. Complex cases involving significant bite correction can take 24 to 36 months or more. [1]
After active treatment ends, you will wear a retainer. Retainers hold teeth in their new positions while the surrounding bone stabilizes. Most orthodontists recommend wearing a retainer long-term, often at night, to prevent teeth from shifting back.
How Much Does Orthodontic Treatment Cost?
Orthodontic treatment typically costs between $3,000 and $8,000. [2] Costs vary by location, provider, and case complexity. Several factors influence the final price.
Type of appliance: Traditional metal braces are generally the least expensive option. Ceramic braces cost slightly more. Lingual braces and clear aligners often fall at the higher end of the range.
Complexity and length of treatment: A mild spacing case requiring 6 months of aligners will cost less than a severe bite correction requiring 2 or more years of braces. The number of office visits also affects the total.
Geographic location: Orthodontic fees tend to be higher in large cities and coastal areas compared to smaller towns and rural regions.
Insurance and Payment Options
Many dental insurance plans include an orthodontic benefit, often with a lifetime maximum of $1,000 to $2,000 per patient. [2] Some plans cover only patients under 18. Check your specific policy for details on coverage limits and age restrictions.
Most orthodontic offices offer monthly payment plans that spread the cost over the length of treatment, often with little or no interest. Flexible spending accounts (FSAs) and health savings accounts (HSAs) can also be used to pay for orthodontic care with pre-tax dollars.
Ask about the full cost breakdown during your consultation. The quoted fee should include all adjustment visits, the retainer, and a set number of post-treatment follow-up appointments. Some offices charge separately for certain items, so get the details in writing.
When Should You Choose an Orthodontist Over a General Dentist?
You should see an orthodontist whenever you have a bite problem or moderate to severe tooth misalignment. General dentists can handle some mild alignment cases, but orthodontists are better equipped for anything beyond basic crowding or spacing.
Here are clear situations where an orthodontist's expertise matters most.
- Bite problems: overbites, underbites, crossbites, or open bites require an orthodontist's training in jaw mechanics and skeletal growth. [1]
- Children with early signs of jaw problems: an orthodontist can evaluate whether early intervention might reduce the need for surgery or more complex treatment later.
- Moderate to severe crowding or spacing: cases involving extractions, impacted teeth (teeth trapped in the bone), or significant tooth movement benefit from specialist-level treatment planning.
- Surgical orthodontic cases: adults with severe skeletal discrepancies may need jaw surgery combined with braces. An orthodontist coordinates this care with an oral surgeon.
- Complex cases involving other dental work: if you need implants, bridges, or other restorations, an orthodontist can position teeth precisely to allow the best result from your restorative dentist.
- Treatment that has not gone as planned: if you started clear aligner treatment through a general dentist or a direct-to-consumer company and results are not meeting expectations, an orthodontist can evaluate and recommend next steps.
Find an Orthodontist Near You
If you or your child has crooked teeth, a bite problem, or jaw alignment concerns, an orthodontic evaluation is a good first step. You can search for a qualified orthodontist in your area by visiting the orthodontics page on My Specialty Dentist. Look for a provider who is a member of the American Association of Orthodontists and ask whether they are board-certified during your consultation.
Search Orthodontists in Your Area