Orthodontist or General Dentist? What to Check Before Starting Braces or Aligners
How orthodontists' specialty training and board certification differ from a general dentist's, and how to verify a provider before starting treatment.
Who can straighten teeth?
In the United States, any licensed dentist may legally offer orthodontic treatment, including braces and clear aligners. That is why you will see aligners advertised by general dentists, cosmetic dental practices and orthodontic specialists alike. The treatment may look similar from the outside, but the training behind it can be very different, and knowing that difference helps you ask better questions before you commit to months or years of care.
What makes an orthodontist a specialist
Orthodontics is formally called Orthodontics and Dentofacial Orthopedics, and it is one of the dental specialties recognized through the American Dental Association's National Commission on Recognition of Dental Specialties and Certifying Boards. The commission defines it as the specialty that covers "the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures." In plain terms, orthodontists focus on how teeth line up, how the upper and lower teeth meet, and how the jaws grow and relate to each other.
According to the American Association of Orthodontists (AAO), an orthodontist first completes dental school and then a two- to three-year orthodontic residency program that combines advanced coursework with supervised clinical treatment of patients. General dentists complete dental school too, but they are not required to complete an orthodontic residency. Some take shorter continuing-education courses in aligners or braces, which can vary widely in depth.
This does not mean a general dentist can never do good orthodontic work, especially for simple cases. It does mean that for bite problems, jaw growth concerns in children, impacted teeth or complex crowding, a specialist has spent years training specifically for that kind of diagnosis.
What board certification adds
Finishing a residency makes a dentist an orthodontist. Board certification is a further, voluntary step. The American Board of Orthodontics (ABO), founded in 1929 as the first specialty board in dentistry, certifies orthodontists who pass its written and clinical examinations. The ABO describes certification as "a voluntary achievement," and certified orthodontists go through a renewal process every 10 years.
Many excellent orthodontists are not board certified, so the absence of certification is not a red flag by itself. But if certification matters to you, it is easy to check: the ABO offers a public orthodontist locator where you can search by name or location.
How to check a provider's background
- Ask where they trained. A specialist can tell you which university or hospital program they completed their orthodontic residency in. This is a normal question and should get a direct answer.
- Check the state dental board. Every state licenses dentists, and most boards offer an online license lookup that shows whether the license is active and whether any public disciplinary actions are on record.
- Look up board certification with the ABO locator linked above if that credential is important to you.
- Understand what directory listings mean. Our directory lists orthodontists from the federal NPPES registry, where each provider's primary taxonomy is Orthodontics and Dentofacial Orthopedics. That taxonomy code is chosen by the provider when applying for a National Provider Identifier; CMS explains that providers select the code that best describes them and mark one as primary. It is self-reported, so it is a useful starting point but not a verified credential. Always confirm training and licensure directly.
Questions to ask at a consultation
- What exactly is my problem: crowding, spacing, an overbite, an underbite, a crossbite, or a jaw-size difference?
- Which options would work for my case, and why do you recommend this one? Would braces give a better result than aligners, or the reverse?
- What records will you take (X-rays, photos, scans) before treatment begins?
- How often will I be seen in person, and who will I see at those visits?
- What happens if the teeth do not move as planned? Are refinements or extra aligners included?
- What retainers will I need afterward, and are they part of the fee?
A careful provider will explain the diagnosis before talking about products. If a consultation feels like a sales pitch for one brand of aligner with little discussion of your bite, it is reasonable to get a second opinion.
A note on aligners without an office visit
Some companies sell aligners mostly by mail, using impressions or scans with limited or no in-person examination. The U.S. Food and Drug Administration's clear aligner information page states that clear aligners are prescription devices meant to be used under the supervision of a licensed practitioner, and it warns that using them without appropriate professional supervision may increase the risk of complications such as an uneven bite, unintended tooth movement, pain and tooth loss. The AAO has also published a consumer alert urging people to make sure an in-person exam, including X-rays, is part of any orthodontic treatment. X-rays can reveal gum disease, bone loss or other problems that are not visible in a photo.
The bottom line
A general dentist may be a reasonable choice for a simple, mainly cosmetic alignment case, particularly one you trust and who examines you in person. For children, for bite and jaw problems, or whenever you are unsure how complex your case is, consulting a specialist orthodontist is a sensible first step. Many orthodontists offer an initial consultation, and you do not need to commit to anything to get a clear diagnosis and a list of options.