What Does an Orthodontist Do?
An orthodontist specializes in diagnosing and correcting malocclusion, the clinical term for teeth that do not fit together properly. This includes crooked teeth, crowded teeth, gaps between teeth, and misaligned jaws. Orthodontists use braces, clear aligners, retainers, and other appliances to move teeth into their proper positions over time.
Beyond straightening teeth for appearance, orthodontists treat functional problems. A misaligned bite can cause difficulty chewing, uneven wear on teeth, jaw pain, and speech issues. By correcting the alignment of teeth and jaws, orthodontic treatment can improve both oral health and daily comfort.
Orthodontists treat patients of all ages. While many people associate braces with teenagers, a growing number of adults seek orthodontic care. Treatment planning for adults may differ because the jaw has stopped growing, but the teeth can still be moved effectively at any age.
Orthodontist Training and Education
Every orthodontist begins as a dentist. After earning a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree, which takes four years, an orthodontist completes an additional 2 to 3 years of full-time residency training in an orthodontic program accredited by the Commission on Dental Accreditation (CODA).
During residency, orthodontists study biomechanics (how forces move teeth through bone), craniofacial growth and development, advanced treatment planning, and the use of specialized appliances. They treat hundreds of cases under faculty supervision, gaining experience with a wide range of complexity levels.
After residency, many orthodontists pursue board certification through the American Board of Orthodontics (ABO). Board certification requires passing written and clinical examinations and presenting treated cases for peer review. While not required to practice, board certification signals an additional level of demonstrated expertise.
Orthodontist vs. Dentist: What Is the Difference?
All orthodontists are dentists, but not all dentists are orthodontists. A general dentist provides a broad range of services including cleanings, fillings, crowns, and extractions. An orthodontist focuses exclusively on tooth movement and jaw alignment.
Some general dentists offer clear aligner treatment, such as Invisalign, in their offices. For straightforward cases involving mild crowding or spacing, a general dentist with aligner training may produce good results. However, complex cases involving significant bite problems, jaw discrepancies, or the need for precise tooth root positioning benefit from an orthodontist's specialized training.
The key differences come down to training volume and case complexity. An orthodontist has spent 2 to 3 additional years studying nothing but how teeth move and how jaws grow. They see alignment cases all day, every day, and have experience managing complications that general dentists encounter less frequently.
Conditions an Orthodontist Treats
Orthodontists evaluate and treat a range of alignment and bite conditions. During your initial consultation, the orthodontist will examine your teeth, take X-rays and photographs, and may create digital or physical models of your bite to develop a treatment plan.
Crowding and Spacing
Crowding occurs when there is not enough room in the jaw for all the teeth to fit properly. Teeth may overlap, rotate, or get pushed forward or backward. Crowded teeth are harder to clean, which increases the risk of decay and gum disease. Spacing is the opposite problem: gaps between teeth caused by missing teeth, small teeth, or a jaw that is larger than the teeth it holds.
Bite Problems (Malocclusion)
An orthodontist treats several types of bite problems.
- Overbite: The upper front teeth overlap the lower front teeth excessively. A moderate overbite is normal, but a deep overbite can cause the lower teeth to bite into the roof of the mouth.
- Underbite: The lower front teeth sit in front of the upper front teeth. This is often related to a jaw size discrepancy and may require combined orthodontic and surgical treatment in severe cases.
- Crossbite: Some upper teeth sit inside the lower teeth when biting down. This can affect front teeth, back teeth, or both, and may cause uneven jaw growth if left untreated in children.
- Open bite: The upper and lower front teeth do not touch when the back teeth are together. This can make it difficult to bite into food and may affect speech.
- Overjet: The upper front teeth protrude significantly forward of the lower teeth. This is sometimes called "buck teeth" and increases the risk of dental trauma.
Jaw Alignment Issues
Some orthodontic problems involve the position or growth of the jaws themselves, not just the teeth. In children and adolescents whose jaws are still developing, orthodontists can use functional appliances, palatal expanders, or headgear to guide jaw growth. In adults with significant jaw discrepancies, orthodontic treatment may be combined with corrective jaw surgery performed by an oral and maxillofacial surgeon.
Types of Orthodontic Treatment
Orthodontists have several tools for moving teeth. The right option depends on the complexity of your case, your lifestyle preferences, and your budget.
Traditional Metal Braces
Metal braces use stainless steel brackets bonded to each tooth, connected by a wire that applies gentle, continuous pressure to move teeth into position. They remain the most versatile and effective option for complex cases. Modern metal braces are smaller and more comfortable than older designs. Treatment time varies but typically ranges from 12 to 36 months.
Ceramic (Clear) Braces
Ceramic braces work the same way as metal braces but use tooth-colored or clear brackets that blend in with your teeth. They are a popular choice for adults and older teens who want a less visible option. Ceramic brackets are slightly more fragile than metal and may cost $500 to $1,500 more than metal braces.
Lingual Braces
Lingual braces are attached to the back (tongue side) of the teeth, making them invisible from the front. They are fully customized for each patient and can treat many of the same conditions as traditional braces. Lingual braces are the most expensive bracket option and require an orthodontist with specialized training in this technique.
Clear Aligners
Clear aligners, such as Invisalign, are removable plastic trays that gradually shift teeth into position. You wear each set of aligners for one to two weeks before switching to the next set. Aligners are popular with adults because they are nearly invisible and can be removed for eating and cleaning. They work well for mild to moderate crowding, spacing, and some bite issues. Complex cases may still require braces for the best results.
How Much Does Orthodontic Treatment Cost?
Orthodontic treatment typically costs $3,000 to $8,000, though prices vary based on the type of appliance, the length of treatment, the complexity of the case, and geographic location. Metal braces tend to fall on the lower end of this range, while lingual braces and clear aligners may cost more.
Many orthodontists offer in-house payment plans that spread the cost over the length of treatment with no interest. Dental insurance plans often include an orthodontic benefit, typically covering $1,000 to $2,000 of the total cost. Some plans limit coverage to patients under age 19. Flexible spending accounts (FSA) and health savings accounts (HSA) can also be used for orthodontic treatment.
During your initial consultation, the orthodontist will provide a cost estimate based on your specific treatment plan. Ask for a written breakdown that includes diagnostic records, appliance fees, adjustment visits, retainers, and any additional costs. Costs vary by location, provider, and case complexity.
When Should You See an Orthodontist?
The American Association of Orthodontists recommends that every child have their first orthodontic evaluation by age 7. At this age, the orthodontist can identify developing problems with jaw growth and tooth eruption while there is still time to intervene. Early treatment does not mean early braces in every case. Many children are simply monitored until the right time for treatment.
For older children and teens, common signs that an orthodontic evaluation is needed include crowded or overlapping teeth, difficulty biting or chewing, mouth breathing, a protruding jaw, and teeth that do not meet properly when biting down.
Adults can benefit from orthodontic treatment at any age, as long as the teeth and supporting structures are healthy. If you have crooked teeth, a bite problem, or jaw pain related to alignment, an orthodontist can evaluate whether treatment would help.
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