What to Look for When Choosing an Orthodontist

In today’s America, we consumers have more choices than ever when it comes to not only choosing the products we buy, but also the people from whom we receive services. This includes the choice in our healthcare providers, such as orthodontists. Oftentimes, patients will seek out multiple consultations from several different orthodontists before making a choice, often shopping around to compare prices. It is important to make the distinction that unlike trying to find the best deal on a new TV from multiple different stores, orthodontic treatment is a service and not an interchangeable commodity. Here are a few considerations and questions worth asking when making this very important decision on who will be caring for you and/or your child.

What days are available for appointments and what are the hours?

This may seem like an obvious one, but it is often forgotten about. Orthodontic treatment often lasts up to 2-3 years with appointments being required every 4-8 weeks. You want to make sure that the office is not only located in a place that is convenient for you, but also has appointment availability during times that work with your schedule. In some practices, the doctor is only in the office for a limited number of days each month. Missed appointments are one of the largest contributing factors to delayed treatment times, so you want to make sure you and/or your child is able to make it to all of the appointments.

Is this a private, group or corporate practice? Will there be more than one doctor involved in your treatment and how long will that doctor be there?

In a corporate and/or group practice, oftentimes the orthodontist treating you is an employee of the practice and has signed a contract to be there for a certain amount of time. When that contract ends, a new doctor will come in and take over your treatment. Or sometimes, there is more than one doctor in the practice at the same time. Every doctor has a different treatment philosophy and when you see more than one doctor, your treatment often ends up taking longer as each doctor practices differently. Make sure that if you go to a multi-doctor practice or a corporate practice, that you are okay with not having the same doctor for your entire treatment. In a private practice, the orthodontist is usually the owner and does not plan on leaving anytime soon, so you will have the same doctor for your entire treatment. They also are personally invested in making sure you have a good experience.

What level of training does your orthodontist have? Are they an actual orthodontist or a general dentist practicing orthodontics? Is the orthodontist board certified?

Every orthodontist is a dentist, but only 6% of dentists are orthodontists. All orthodontists and dentists first complete the same training initially, but orthodontists complete an additional two- or three-year residency and more than 4,800 hours of orthodontic training. Some general dentists will take a few weekend continuing education courses to dabble in orthodontics, but it is not equivalent to an orthodontic residency.

Beyond orthodontic residency is optional board certification. Only 1 in 3 orthodontists in the US is Board Certified. “ABO Board Certification is a voluntary credential that represents an orthodontist’s personal and public commitment to the standards of specialty practice and lifelong learning. The ABO Certification process requires the completion of peer-developed, externally validated written and clinical examinations. A Board Certified Orthodontist has reached this level of achievement by pursuing additional voluntary education and ongoing self- assessment. “

You will also want to take into consideration how long the orthodontist has been practicing. Is your orthodontist a lifelong learner, taking many CE (continuing education) courses throughout the year to better themselves, and grow as a practitioner? Are they open to evolving with the times, or very traditional in the way that they practice?

Is the practice up to date with the latest technology?

There are constantly updates to the technology used in the healthcare fields, and many of these advances equate to better or more comfortable care for the patient. Do you have to waste time in the office filling out lengthy paperwork or can you do it digitally before your appointment to save time? Can you easily communicate with the office both during and after office hours via email, text, Facebook/IG messenger, etc? There’s also advanced dental equipment like digital X-Rays (which have less radiation than analog), impressionless intra-oral scanners (to avoid those uncomfortable, messy, goopy impressions, and more accurate than traditional impressions). These things make the patient experience more enjoyable. Using cloud based software also guarantees an additional level of safety for your PHI (protected health information). The latest improvement in orthodontics has been the introduction of in-office 3D printers, which allow the orthodontist and their team to manufacture aligners, and retainers, in the office, in less time than sending them to outside labs (such as Invisalign). Digital photography is something that some doctors are now using to their advantage. How often does your orthodontist take photos? Is it at every visit, to easily see the changes from one visit to the next, or is it only at the beginning and end of treatment? Does your orthodontist offer any additional photography during/after treatment, such as headshots or portraits?

What is your orthodontist’s treatment philosophy and what do they focus on?

Depending on where your orthodontist was trained, what additional continuing education they pursued, as well as who their mentors have been, their treatment philosophy will be completely different from the orthodontist down the street. Some orthodontists favor the extraction of teeth while others favor non-extraction treatment. Some orthodontists are more comfortable than others doing more complex, multi-discisplinary treatment using adjunct devices such as temporary anchorage devices (TADs), or miniscrews, in order to perform traditionally more complex tooth movements. The use of TADs has allowed orthodontists to not only avoid extractions in some cases, but also jaw surgery. They can also be used to help correct gummy smiles and close spaces from previously extracted teeth, saving the patient the potential cost of having to get a dental implant after orthodontic treatment.

Traditional orthodontists are focused mainly on creating a functional bite but ignore the aesthetics of the smile. Did your orthodontist mention smile aesthetics during your consultation and what they would do to improve it? Some orthodontists also focus on making sure your final smile will look age appropriate, and age well with your face. Smile Arc Protection (SAP) is the latest method for creating wide, toothy beautiful smiles that follow the curve of the lip (rather than flattening out the smile curve like traditional bracket placement).

What is the patient experience like? What is your perceived value of the treatment and service you will be getting?

Choosing an orthodontist is like choosing to be in a long-term relationship. You will be going there every 4-8 weeks for up to 3 years, so you want to make sure this is a relationship you wish to cultivate. Ultimately, you want to choose the place in which you feel the most comfortable and feel that you will have the best experience. Did the doctor make you feel comfortable during the consultation and allow you to ask any questions? Did the treatment coordinator work with you to make financial arrangements that are manageable for you? Are there any additional costs that you need to be aware of? What all is and is not included in your treatment? How many sets of retainers are included? Are there any fees for broken brackets? What creature comforts are available to you (or your family/friends) while you wait? Comfortable seating, refreshments, charging stations, homework benches, televisions, art, brushing stations…These are all things you may want to consider and see if they are important to you when making your decision.