The Impression

What is an orthodontist?

An orthodontist is a specialist in tooth movement — but there's a lot more to it than that.

Ariel Harris
Contributing Writer

Orthodontists and dentists are both experts in teeth, but in their own ways. General dentists are a bit like your primary care physician, just for your mouth. They are your first-line of protection against all the maladies of the teeth, gums, and jaw: For things like cavities or root canals, they may treat those themselves. But for serious gum disease, they might refer you to a gum specialist, known as a periodontist. For occlusions and TMJ, they may refer you to an orthodontist. 

In other words, the orthodontist vs dentist match-up isn’t really a competition. One isn’t better than the other, but rather they’re each good at different things. Many people need both. Orthodontic treatment itself can be complex and varied. Ahead, we cover what you need to know to define orthodontist. 

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What makes an orthodontist different?

While all orthodontists are dentists, not all dentists are orthodontists. That’s because orthodontists also go to dental school — meaning they become dentists first — before continuing their education in orthodontics. Usually, that means another two or three years of learning in an orthodontic residency program

Orthodontic treatment seems straightforward: Apply pressure to the teeth, and they move. But this takes extensive, individualized planning, and a lot of know-how because often teeth need to be turned to get into the right position. Some people’s jaws need re-modeling to fit all their teeth. And doing all of this without surgery requires extensive knowledge of the underlying bone remodeling process. 

Although dentists learn about some of this in dental school, orthodontists go even deeper in their studies of the face and neck and the biometrics of tooth movement. They also learn about orthodontic treatment planning

Beyond that, orthodontists learn about all the different appliances, from traditional braces to clear aligners. Orthodontists use appliances like traditional or invisible braces and clear aligners to move your teeth into new positions. In the case of braces, your orthodontist learns how to bond a single metal bracket to each of your teeth, then connect those brackets with wire and those tiny rubber bands to apply pressure. Your orthodontist may seek extra training to apply lingual braces or damon braces, which are slightly different appliances. 

Many orthodontists today use clear aligners, too. These specially designed plastic trays are fitted to your teeth using an impression or 3D scan. Every few weeks, you are provided with a new, slightly different clear aligner, each one progressively shifting your teeth. It used to be that orthodontists only used clear aligners in specific circumstances, but today, clear aligner technology is more advanced than ever — and more accessible, thanks to teledentistry services that can connect you with an orthodontist over the internet. 

What do orthodontists specialize in? 

Straight teeth and beautiful smiles, of course! Orthodontists are most known for their ability to help patients achieve their dream smile. They use appliances like braces, palatal expanders, invisible braces, and clear aligners to guide your teeth into the ideal position — not only for your vanity, but also for your health. Straighter teeth can make it easier to brush and floss, and keep your teeth healthy. 

Your orthodontist is also a specialist in “occlusion,” which is the technical term for how your teeth fit together when you bite down. In this way, the orthodontist is also a jaw doctor, since bite issues often play a role in the development of temporomandibular joint disorder, or TMJ. 

Orthodontists are also specialists in “craniofacial development,” or how the head, face, mouth, and jaw develop. They can diagnose problems in children and adolescents as they are growing, and use appliances to nudge development in the right direction so the teeth and jaw line up. Many orthodontists specialize in treating kids for this reason. 

That said, orthodontists also treat adults — more than a million adults each year seek out the help of an orthodontist. The American Association of Orthodontics estimates its members were treating 1.6 million adult patients as of 2016. Many adults seek out orthodontists either because they didn’t have orthodontic treatment as a kid or because they’re dealing with teeth shifting. As you age, even though you’re done developing, it’s not uncommon for your teeth to move a little bit. This happens for a variety of reasons, from simple aging (like all your bones, your jaw bone tends to weaken with age) or inflammation caused by periodontal disease. Teeth shifting can also happen if you stop wearing your retainers too soon after orthodontic treatment.

Let’s get things straight.

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