Orthodontics is the branch of dentistry that deals with malocclusion and dento-facial deformities. Through the use of oral appliances, orthodontists are able to correct crowded, irregular and protruding teeth. Most of us view orthodontists as the dentists who put braces on you when you were a teenager. Of course, there is much more to orthodontics than simply cementing on some brackets and wires. Orthodontists are experts in understanding the growth and development of our craniofacial anatomy. By taking careful measurements from a series of radiographs, orthodontists are able to diagnose the problem by identifying which areas of a persons face are deficient or are growing in excess. This knowledge is then used to develop a plan that can be used to correct these issues. Ideally, most orthodontic adjustments are performed during an individuals adolescent growth spurt as this is the time period when corrections can be made most efficiently and effectively.
While general dentists may become sufficiently skilled to place some orthodontics appliances during dental school and through additional continuing education course work, they usually stick to only basic and minor orthodontic procedures. Those who wish to specialize in orthodontics are required to do a residency program after dental school that lasts between 2 and 3 years where they learn the more advanced orthodontic procedures.
The first steps in orthodontics usually involve taking multiple radiographs. From these x-ray images, structures are outlined and lines are drawn connecting certain anatomic landmarks on the radiograph. Measurements are taken from these lines and points and are compared to standard measurements to assist in the diagnosis of the problem and to help determine the orthodontic treatment that should be used. Orthodontic appliances like braces, retainers and head gear are then applied to rotate and move teeth, expend the dental arches, and inhibit or encourage jaw growth depending on the patient's needs. Sometimes teeth will be removed to make more space for aligning the dental arches. In more difficult cases, orthognathic surgery may be required in which the orthodontist will need to work with an oral and maxillofacial surgeon to correct the patient's problems.
A cephalometric radiograph used for orthodontic analysis.
Orthodontic residency programs are usually among the toughest to gain admission to. Competitive applicants are usually in the top 10% of their class and score in the 90+ range on their NBDE board exams. According to the ADA, there are currently over 9,000 orthodontists in the United States. During 2007 nearly 700 applicants submitted over 7,000 applications to the roughly 250 spots at 40+ orthodontic residency programs participating in the ADEAs Postdoctoral Application Support Service (PASS). To find a list of orthodontic residency programs along with the length of each and how many students are accepted, go to the orthodontist career page on the American Association of Orthodontists site.