An orthodontist must earn a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree, complete a 24-month accredited orthodontic residency program, and pass state and national board exams to practice. This path requires at least 10 years of post-secondary education beyond high school.
Orthodontists specialize in diagnosing, preventing, and correcting dental and facial irregularities-primarily misaligned teeth and jaws. They use braces, aligners, and other appliances to improve bite function and facial aesthetics. Unlike general dentists, who treat many oral health issues, orthodontists focus exclusively on tooth alignment and jaw development.
The process begins with a bachelor's degree in a science-related field such as biology, chemistry, or biochemistry. Most applicants to dental school have completed at least 3 years of undergraduate study with strong grades in math and science courses. The American Dental Association (ADA) reports that the average dental school applicant has a GPA of 3.5 or higher and scores above 180 on the Dental Admission Test (DAT).
After completing a bachelor's degree, aspiring orthodontists must enroll in an accredited dental school. These programs last four years and lead to either a DDS or DMD degree. Both degrees are equivalent in clinical training and eligibility for licensure. Students take courses in anatomy, pharmacology, oral pathology, and restorative dentistry, and participate in hands-on clinical rotations.
Upon graduation, candidates must pass the National Board Dental Examination (NBDE) Part I and Part II. State boards also administer jurisprudence exams covering local dental laws. Only after passing these exams can a graduate apply for a dental license to practice in their state.
Even with a dental license, a dentist cannot call themselves an orthodontist without additional training. After earning a DDS or DMD, individuals must complete a residency in orthodontics, which typically lasts two to three years. These programs are accredited by the Commission on Dental Accreditation (CODA), ensuring standardized instruction in biomechanics, craniofacial growth, and advanced orthodontic techniques.
| Step | Duration | Outcome |
|---|---|---|
| Bachelor's degree (science major) | 4 years | Prerequisite for dental school |
| Dental school (DDS/DMD) | 4 years | Graduate with dental license eligibility |
| Orthodontic residency | 2-3 years | Specialty certification in orthodontics |
| National board exams (NBDE) | Pass required | State licensure eligibility |
Orthodontic residencies are highly competitive. According to the American Association of Orthodontists (AAO), only about 60% of applicants secure a spot in an accredited program each year. Programs accept candidates based on DAT scores, GPA, letters of recommendation, personal statements, and interview performance.
During residency, trainees manage complex cases involving malocclusions, skeletal discrepancies, and pediatric orthodontics. They learn to use cephalometric analysis, 3D imaging, and digital treatment planning tools. Residents also conduct research and publish findings in peer-reviewed journals.
Upon completion, graduates must pass the American Board of Orthodontics (ABO) certification exam to become board-certified. While not legally required, board certification demonstrates expertise and is preferred by many patients and referral networks. As of 2023, over 7,000 orthodontists were certified by the ABO, representing about 60% of licensed practitioners in the U.S.
Many assume orthodontists are "just" dentists who fix braces. This is incorrect. Orthodontists undergo more specialized training than general dentists. While both hold doctoral degrees, orthodontists spend an extra 2-3 years in focused clinical and research training.
Another misconception is that orthodontists can perform general dental procedures like fillings or extractions. They are trained to assess and treat orthodontic conditions but typically refer patients for restorative work. Some orthodontists may offer limited preventive care, but they do not replace general dentists in routine services.
A lesser-known fact: orthodontic residency programs are often funded through federal grants and institutional scholarships. The Health Resources and Services Administration (HRSA) allocates funding to programs that serve underserved populations, especially those in rural areas. This support helps reduce student debt and increases access to orthodontic care in low-income communities.
Dr. Elena Ramirez earned her B.S. in Molecular Biology from the University of California, San Diego, with a 3.8 GPA. She scored 208 on the DAT and was accepted into UCLA School of Dentistry. After graduating with her DMD in 2018, she passed the NBDE and obtained her California dental license.
She then entered a two-year orthodontic residency at the University of Michigan, where she treated over 200 patients, including cases involving cleft palate and severe underbite. During her residency, she published a study on early intervention in adolescent Class III malocclusion in the *American Journal of Orthodontics and Dentofacial Orthopedics*.
After finishing her residency, Dr. Ramirez passed the ABO written and clinical exams. She now practices in a private clinic in Ann Arbor, MI, where she specializes in clear aligner therapy and surgical orthodontics. Her patients include children as young as 7 and adults over 60.
When asked about the most challenging part of her training, Dr. Ramirez said, "The hardest thing wasn't the academics-it was learning how to explain complex treatment plans to anxious parents and teenagers. You need technical skill, but empathy matters just as much."
Despite these differences, all three professions require rigorous postgraduate training, state licensure, and ongoing continuing education. But only orthodontists combine dental expertise with specialized orthopedic training in craniofacial development.
Understanding what degree does an orthodontist need clarifies the depth of preparation involved. The path is demanding, but it ensures precision, safety, and long-term outcomes in patient care. For anyone considering this career, the timeline and academic rigor are not barriers-they are the foundation of excellence.