What is an orthodontist?
An orthodontist is a dentist who specializes in the diagnosis, prevention, and treatment of malocclusion (improper bite) and jaw and facial irregularities. Orthodontists use various appliances—braces, headgears, rubber bands, and retainers—to gently move teeth and jaws into alignment. The overall goal of orthodontists is to improve the health and appearance of their patient's mouth and smile.
An orthodontist typically:
Evaluates the patient's dental and medical history and performs an oral and dental exam
Orders and interprets imaging tests and takes dental impressions
Diagnoses malocclusions, underlying tooth irregularities, and injuries or defects
Educates patients about their orthodontic needs and options and how to care for orthodontic appliances
Educates patients about good oral hygiene and prevention of cavities and gum disease
Treats various orthodontic conditions using oral appliances
Works closely with other dental specialists to ensure optimal patient care
Refers patients to other specialists, such as an oral and maxillofacial surgeon, as needed
An orthodontist may also be known as a braces dentist. Orthodontics is also known as orthodontia and dentofacial orthopedics.
Who should see an orthodontist?
The American Association of Orthodontists and the American Dental Association recommend that children see an orthodontist no later than age 7, when their permanent teeth start to come in. Orthodontic treatment usually begins between the ages of 8 and 14. During this time, it is easier to correct orthodontic problems because the jaws are still growing. Adults may also seek care from an orthodontist, but treatment may take longer than it does in children because growth in the jaw has stopped.
A general or specialty dentist often refers patients to an orthodontist to diagnose an improper bite or other jaw or facial irregularity. Abnormal or misaligned jaw and facial structures affect mouth and jaw function and the ability to eat and speak normally.
Some people seek care from an orthodontist only for cosmetic reasons. Anyone who wants to improve the appearance of their smile or is having problems biting, chewing or speaking should seek care from an orthodontist.
When should you see an orthodontist?
Consider consulting an experienced orthodontist as recommended by your general dentist, or if you or your child has any of the following symptoms or conditions:
Biting the cheek or biting into the roof of the mouth
Crowded, misplaced or protruding teeth or gaps between your teeth
Early or late loss of baby teeth
Facial imbalance or asymmetry or deformities of the teeth, lips or jaw
Inability to close your lips comfortably
Jaw pain or difficulty chewing or biting
Speech difficulty
Teeth grinding or clenching
Teeth that meet abnormally or don't meet at all
Thumb or finger sucking
What conditions and diseases does an orthodontist treat?
Orthodontists treat a variety of diseases and conditions including:
Bruxism, also known as teeth grinding
Malocclusion including overbite, underbite and crossbite
Oral trauma including injuries to the teeth and jaw
Teeth conditions including crooked, missing, crowded, or extra teeth (supernumerary teeth)
Orthodontists also work with other specialists to treat complex health problems associated with oral abnormalities including:
Congenital conditions including cleft lip and cleft palate
Sleep apnea due to misaligned jaws
Temporomandibular joint (TMJ) disorders including TMJ disorder due to arthritis, trauma, or a displaced disc in the joint
What tests does an orthodontist perform or order?
An orthodontist can order or perform diagnostic tests including:
Imaging studies including bitewing, periapical and panoramic (full view) X-rays of the teeth and jaws
Oral exam including your dental history, the overall condition of your teeth and gums, and taking photographs of your teeth and face
What procedures and treatments does an orthodontist perform or order?
Orthodontists use a variety of dental appliances to correct malocclusion:
Aligners are custom-made, clear, removable trays that straighten teeth and correct misaligned bites by putting pressure on the teeth and moving them gradually into their desired position.
Braces are bonded directly to each tooth's surface or placed behind the teeth in some cases. Braces consist of brackets and wires. Wires attach to the brackets and gently move the teeth and jaws to the desired position.
Dental impressions create a plaster model of the teeth.
Headgears are removable appliances attached to the braces. Headgears are used when extra force is needed to move the teeth and jaws.
Palatal expanders widen the upper jaw so that the bottom and upper teeth will fit together better.
Retainers are appliances used to prevent teeth from shifting once braces have been removed.
Rubber bands, also called elastics, attach to the braces and are used when extra force is needed to move the teeth and jaws into the desired position.
Temporary anchorage devices (TADs) are mini screws that are temporarily fixed to bone in the mouth and provide a set point from which to apply force to move teeth.
Orthodontist training and certification
All dentists have some basic training in orthodontics, but additional education, training and experience are key elements in establishing an orthodontist's level of competence. An orthodontist has:
Completed three or more years of undergraduate education
Graduated with a degree of Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) from a four-year dental school accredited by the American Dental Association. DDS and DMD are equivalent degrees and involve the same level of education.
Completed two to three years of additional specialized training in an accredited residency training program in orthodontics and dentofacial orthopedics
Passed the requirements for state licensure
Orthodontists can choose to earn board certification from the American Board of Orthodontics. Board certification verifies that a doctor has completed residency training in the specialty and has passed competency examinations.
A board-certified orthodontist has completed all the educational and training requirements listed above as well as passed written and clinical examinations administered by the American Board of Orthodontics.
To maintain certification in orthodontics, orthodontists must be revaluated by clinical examination every 10 years.