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How to Become an Orthodontist: Education, Skills, Programs & More

Orthodontist and Orthodontic Assistant Team

Written by: Laura Edwards, DDS and Diamond Braces Orthodontist

Date: November 17, 2020

All orthodontists are dentists, but not all dentists are orthodontists.

In fact, orthodontists receive specialized training that makes them uniquely suited to the art of straightening teeth. To become an orthodontist requires 2-3 more years of education before acquiring a certification in orthodontic care.Once licensed and certified, orthodontists treat a wide variety of dental alignment issues, also known as “malocclusions”.

They use precise clinical methods to safely and effectively align teeth and create healthier dental structures for patients of all ages. If you had orthodontic treatment at some point in your life, you likely saw the impressive results achieved by these expert professionals.While the path to becoming an orthodontist is challenging, competitive, and expensive, orthodontists enjoy high salaries, great work-life balance, and a friendly, sociable teamwork environment.

Read on to find out how to join the ranks of an important medical field.

Orthodontic Education & Training Requirements

Complete Dental School and Become a Licensed Dentist

To become an orthodontist, you must first complete dental school to achieve a doctorate in dentistry and become a certified dentist. Admission to a dental school requires completion of a bachelor’s degree (although some universities offer a combined degree program) and a passing grade on the Dental Admission Test (DAT).

Dental schools are competitive and very demanding, much like medical schools. They’re also pricey: the average dental school degree costs $150,000-$300,000, depending on the program. Luckily, dentist and orthodontist salaries are high (according to U.S. News, dentists made a median salary of $151,850 in 2018, while an orthodontist’s median salary in 2018 was $208,000), so most dental professionals find that the cost of school pays off eventually.

There are two types of doctorates, a Doctor of Dental Surgery (DDS) or a Doctor of Dental Medicine (DMD). The difference depends on your program, but both certifications allow you to practice dentistry.

Most dental schools are 4-year programs. The first two years will generally be classroom learning, taking subjects such as anatomy, biochemistry, microbiology, radiology, and oral pathology. The next two years will be clinical training, where students study under trained dentists to learn how to treat patients.

Orthodontic Residency

Aspiring orthodontists apply to an orthodontic residency in their final year of dental school; after completing your DDS or DMD, you’ll be a certified dentist and ready to begin an orthodontic residency.

Dentists not going on to specialized training will take and pass the National Board Dental Examination, and also complete their licensure requirements in their state, upon which they can begin practicing. Dentists can still perform orthodontic treatment, but they lack specialized training in the field; for that reason, most dental professionals practicing today are registered orthodontists who completed a residency. Only those dentists can call themselves orthodontists.

For those interested in practicing orthodontics full-time, an orthodontic residency is the next step towards becoming a licensed orthodontist. An orthodontic residency is completed at a teaching hospital, often attached to a university.

How to Get Into an Orthodontic Residency Program

Getting accepted to an orthodontic residency is competitive: according to the American Association of Orthodontists, there is 1 residency spot open for every 15 applicants. Graduating in the top percentage of your dental school class is the best way to win a spot in an orthodontic residency. Some aspiring orthodontists may apply several times before getting accepted to a program.

Most residency programs require applicants to have already passed the National Board Dental Examination, which is the national licensing exam that allows dentists to practice. Because this exam is taking during dental school, you won’t have to take time between dental school and your orthodontic residency, unless you failed the exam and need to retake it before applying to schools.

You can find a list of CODA-accredited orthodontic residencies on the American Association of Orthodontist’s database. This list contains programs in the U.S. and Canada: nearly all states accept Canadian orthodontic training, but those with orthodontic training from other countries will likely have to complete their education again in the U.S. before practicing dentistry or orthodontics in America.

The residency program is 3-5 years, depending on the institution. In the residency, orthodontists receive intensive instruction in the art and science of orthodontia: their learn how to safely and effectively move teeth (orthodontics), and the proper guidance of dental, jaw, and facial development (dentofacial orthopedics). By the end of a residency program, orthodontists will have participated in hundreds of orthodontic treatments, giving them a comprehensive knowledge of this specialty.

Some orthodontic residencies pay their residents, while others require payment. If there is pay, it is generally in the form of a stipend, which is a relatively small annual fund to cover some basic living costs and/or travel to conferences. Hospital residencies are more likely to pay a stipend than university residencies.

Top Orthodontic Residency Programs

According to the Commission on Dental Accreditation, there are currently 68 orthodontic residency programs in the U.S. Below are some of the top programs in the country, ranked for the quality of training, post-residency placements, research, and more.

  • University of Michigan. The orthodontics program at University of Michigan is the oldest in the country. It incorporates a wide array of clinical trainings, producing expertly-trained, comprehensive orthodontists.

  • University of North Carolina. This competitive program is attached the University of North Carolina’s top-ranked dental school in Chapel Hill.

  • University of Maryland. This university boasts the country’s first dental school, and its award-winning orthodontic program produces some of the country’s finest orthodontists.

  • Maimonides Medical Center: This large teaching hospital is located in Brooklyn, New York. This program is competitive, for its ideal location and its unusually generous stipend: first-year residents make more than $51,000.

  • Montefiore Medical Center: This program is located in the Bronx, New York, and offers top-of-the-line instruction and a $60,000 stipend throughout the residency.

Getting Licensed to Practice Orthodontics

After you have successfully completed an orthodontic residency, you’ll be ready to start practicing orthodontics. To do so, you must have passed the national dental board exam, as well as the state licensing requirements in the state where you intend to practice. The licensing requirements for orthodontists are the same as for dentists.

Orthodontists can also choose to become board-certified by the American Board of Orthodontics (ABO), but in the U.S. board certification isn’t necessary to practice (it is required in Canada). The orthodontic board certification consists of written and clinical examinations. You can learn more about getting board certified on the website of the American Board of Orthodontics.

Most orthodontists have already taken the National Board Dental Examination before beginning their residency: all practicing medical professionals must periodically recertify and complete continuing education courses throughout their career.

State licensing requirements vary, but nearly all states require passage of a “jurisprudence exam”, which tests your knowledge of that state’s dental laws. There may be other clinical exams or licensing requirements: you can find your state’s dental licensing requirements on the American Dental Association’s state-by-state licensure database.

Staying Licensed

Like all medical professionals, orthodontists are required to keep their licensure up to date with continuing education and regular recertification.

In the majority of states, orthodontists and dentists must complete 40 hours of professional education a year. This ensures dental professionals are caught up on the latest research and clinical developments in their respective fields, to provide the highest-quality, up-to-date treatment for their patients. State re-licensing varies: consult your state's dental board for more information on how to stay up-to-date with your dental license.

What to Do After Graduating an Orthodontic Residency

Once you’ve completed your training and licensure as an orthodontist, it’s time to look for a job.

There a variety of resources to help you find work as an orthodontist:

  1. Professional association job boards. The American Dental Association and the American Association of Orthodontists both host job boards where practices and medical facilities can share hiring notices. Joining a professional association is also an excellent networking opportunity, and a way to connect with your colleagues across the country. Both the ADA and the AAO sponsor conferences each year, where dentists and orthodontists can connect and learn about the newest developments in dental medicine.

  2. Online job sites like Indeed, ZipRecruiter, and CareerBuilder. These online sites are national clearinghouses for jobs in countless fields, and more and more companies and medical practices rely on them for staffing great employees. You can filter for preferences like full-time or part-time, distance from your home, and minimum salary, in order to find the right position for you.

  3. Your school or program’s job resources. Orthodontic residency programs, like all higher education institutions, are invested in helping their students find jobs after graduating: program ratings are closely tied to the employment rates of their alumni. For that reason, most CODA-accredited orthodontic residencies have resources to help their students find jobs. There may be an online job board, an email listserve, or dedicated career counselors that can help connect you to opportunities. Ask your professors or school administrators for help applying to jobs post-residency.