With the right training and support, you can provide good orthodontic care as a

general dentist or as an orthodontic specialist. So what s the difference and whic

h is the better option? They can both be rewarding and have different benefits.
This guide can help you determine the best fit based on the most common consider
ations.
Orthodontic Residency vs. Orthodontic Continuing Education - Overview
If you decide to specialize in orthodontics in the USA, you would first apply to
one of the 67 accredited orthodontic residency programs1. After 2 or 3 years of
full time training, you would specialize in orthodontics, treating patients onl
y within this realm of care. This can be a great option if you know that you are
passionate about orthodontics and only want to treat patients with orthodontic
needs. You must be willing and able to dedicate 2 or 3 years to get this special
ized orthodontic training as well as beat out 93% of the other applicants4.
If you are considering helping patients with braces but don t want to limit your s
ervices, there are several orthodontic continuing education programs that can he
lp you. While attending one of these programs, you can continue to provide gener
al dentistry work, but would expand your services to include orthodontic care. W
hile there are many orthodontic CE courses out there, this blog will focus on co
mprehensive orthodontic courses (18 to 24 months in duration), since this is mor
e comparable to orthodontic residencies. Getting reputable GP orthodontic traini
ng can be the best option if you want to provide great care in a variety of area
s and want (or need) to start making money already.
Time Investment
Orthodontic residencies have a more extensive time commitment with residents ded
icating 2 to 3 years full time for schooling. In this time, residents focus on t
heir training in class and apply their knowledge during patient rotations at uni
versities or hospitals.
Comprehensive orthodontic continuing education programs are typically 18 to 24 m
onth part time commitments. There are also a few extensive multi-level programs
that add on additional advanced or Master s curriculums for a total of 3 or 4 year
s of part time education6. Classes usually run a few days each month or a few da
ys every few months. Since these are part time, you can continue to work and app
ly the training on patients in your office between sessions.
classroom.jpg
Orthodontic Knowledge
Orthodontists are trained to understand and treat all types of orthodontic cases
. In residency, you get to try out many different types of products, systems and
appliances and can listen to guest speakers that universities have access to. Y
ou ll try several appliances, read the literature, and learn about the different s
ystems to determine your favorites. You ll also get a good understanding of the hi
storic figures and discussions that have happened in orthodontics.
Dentists taking orthodontic CE programs typically don t have the time and finances
to learn the ins and outs of each orthodontic system like in a full time reside
ncy. Usually dentists will learn 1 or 2 systems that work well for them. Most GP
orthodontic courses focus on the practical aspect of providing a high level of
orthodontic care, and since there is less time, students may not get as much bac
kground with literature review, orthodontic history, and various systems. While
there is some loss in this academic knowledge, most dentists that choose this op
tion like how they can efficiently focus their efforts on getting a high level o
f diagnostic understanding and treatment ability.
Practicality & Clinical Ability
practical-ability.jpgOrthodontics is known to be a very intellectual specialty,
and clinical ability is greatly correlated with diagnosis experience. Thus, the
best orthodontic work often comes from dentists and specialists that have seen a
nd treated more patients.
Since accredited orthodontic residency programs have guidelines and more trainin
g hours, there is more control over the ability graduates can expect to have. Re
sidents rotate among hospitals or clinics to get their clinical and surgical exp
erience. They usually diagnose, treatment plan, and follow several of their own
cases throughout the program, and can have treated 10-50 cases by graduation. Th
ere is typically a requirement for residents to diagnose and analyze at least 6
cases since this is the requirement to be board certified by the American Board
of Orthodontics after graduation4.
Graduates of comprehensive orthodontic programs can also have a high level of cl
inical skill, but it varies on the individual and the program. Like with residen
ts, diagnosing cases and seeing their results is invaluable to gaining clinical
orthodontic skills, but general dentists typically have the advanage of a greate
r breadth of experience in dentistry which can improve their diagnostic ability
and retention.
Some CE programs have students diagnose and treatment plan 50+ instructional cas
es in class to give them confidence and ability. To ensure students can treat pa
tients effectively, some programs have minimum completed case requirements of 1
or 2 patients. Since this requirement is lower than in residency, there is a gre
ater variation of ability. However, some ambitious GPs successfully treat 50, 10
0 or 200+ cases by the time they graduate their CE program.
Patient Source
In many communities there is more orthodontic demand than there are professional
s to help. While there is a large source of those that need orthodontic care, sp
ecialists and dentists get their orthodontic patients in different ways.
Orthodontists get their patients from other dentists, usually with referrals fro
m multiple practices. To increase their patient source, they often build good re
lationships with dentists in the area or market to patients directly.
GPs typically start orthodontic cases by discussing the dental needs and goals f
or their existing patients during routine exams. Although they can promote their
orthodontic services, dentists usually get their orthodontic patients internall
y as their patients typically trust the dentist s recommendations.
Financial Investment
Orthodontic specialization is a large financial investment. According to the Ame
rican Association of Orthodontists data, tuition can cost up to a quarter of a mi
llion dollars.1 There are a few opportunities to get stipends to cover living or
personal expenses. However, the majority (84.5%) of orthodontic residents do no
t get enough stipends to cover the amount for their tuition. There are a few pro
grams (like Mayo College or Virginia Commonwealth) that have minimal tuition whi
ch can make learning financially feasible. However, the average total tuition a
U.S. orthodontic resident will pay is $102,5891 (this is for public in-state and
private school tuition rates; out-of-state public tuition would make this avera
ge higher).
In addition to direct costs, prospective residents should also understand the op
portunity costs of a full time residency. You would not be building your practic
e or working for 2 to 3 years. This can be difficult if you already have student
s loans that you need to start paying off. Luckily, if you get into a residency
program and are able to afford or finance it, you can typically see higher annua
l salaries than a general practitioner by a median national difference of $28,89
0 per year.2, 3
Although orthodontists typically have higher salaries, many successful general d
entists who have honed their skills and efficiency can see high profitability. U
sually dentists that do quality orthodontic work see greater demand for all thei
r care.
If you choose the GP Orthodontic route, you luckily don t have to take a few years
off from working because you can earn while you learn your new skill. And, what s
a nice bonus, your tuition can be a lot less with reputable programs such as Pr
ogressive Orthodontic Seminars and the United States Dental Institute having tui
tions between $10,000-$20,000.
Summary
The rewards of helping your community with orthodontic care can be a satisfying
addition to your practice. There are several ways that you can accomplish that g
oal as a dentist or as a specialist that can be both lucrative and professionall
y enriching. Your research will help you to decide what the best fit is for you
and situation.
Orthodontic Residency vs Comprehensive Orthodontic CE
Category
Orthodontic Residency1
Comprehensive Orthodontic CE
Time commitment
Full time, 2-3 years
Part time, 18 to 24 months (plus optional 1-2 year advanced or Master's programs
)
Treatment & clinical ability at graduation
Moderate to advanced and grows with on-the-job experience
Typically moderate (but dependent on case starts), and grows with on-the-job exp
erience
Academic understanding
High, with some programs having higher focus on research
Low to Moderate
Cases you can work on
Orthodontics (and Dentofacial Orthopedics)
All types meeting the standard of care: Orthodontics (and Dentofacial Orthopedic
s), Periodontics, Prosthodontics, Surgical, Endodontics, Implantology
Application Acceptance
Very Competitive: 1 to 15 accepted each year per school with acceptance rates av
eraging 6.7%4
Registration is typically open to all dentists until class is full
Financial Investment
Tuition: $0-$250,000
Loss of working income unless residency offers a stipend
Orthodontist median salary: $187,2002
Tuition: $10,000-$20,000 (additional fees for advanced or Masters programs)
Students can continue to work full time, earning income.
GP median salary: $158,3103
Break Even Point
Usually after graduation (~15% during residency)
During training or after graduation
*This summarizes a typical U.S. graduate based on the data sourced below
References
1: Accredited Orthodontic Programs . American Association of Orthodontists. Retriev
ed May 25, 2016.
2: Occupational Employment and Wages, May 2016. 29-1023 Orthodontists . U.S. Bureau
of Labor Statistics. Retrieved May 25, 2016.
3: Occupational Outlook Handbook: Dentists . U.S. Bureau of Labor Statistics. Retri
eved May 25, 2016.
4. What is an Orthodontist? . American Association of Orthodontists. Retrieved May
25, 2016.
5. Jorgensen, Greg. What s the Difference between an Orthodontist and Dentist that
Does Orthodontics? March 16, 2015.
6. MSc Specialized Orthodontics Study Structure . McGann Postgraduate School of Den
tistry. Retrieved May 25, 2016.