I want straight teeth. Who should I go to?

Imagine this scenario: You go to your internal medicine doctor who you’ve been seeing for years. He’s a friend. No, he’s more than a friend. He’s taken care of all of your problems and he’s done a great job always explaining your medical needs and you feel like he’s part of your family. After your check-up he tells you that you look great, and you add:”Yeah, except for this ugly mole on my cheek. I’ve wanted to remove it for years but never got around to it.” He tells you that he’d be happy to remove it for you. He explains that while he could send you to a great plastic surgeon (who you know has done great work on a few of your friends) this is a small mole and he can easily take it off and save you a trip and a little money.  You begin to wonder if you should see the plastic surgeon or let the internist do it. After all, he is a doctor, right?

Every day, a similar conversation to the aforementioned one occurs in dental offices around the country except it revolves not around a mole, but rather crooked front teeth. You may have gone through braces as a kid, but didn’t wear your retainer, so a few lower front teeth are now a little crowded. It’s pretty common and it bothers you enough to mention it to your dentist. You mention how you’d like to straighten the teeth and the general dentist says something like: “I can help you with that. There’s no reason for you to go see a specialist. I can save you a trip and probably a bit of money.” And there lies the big question. Do you let them do it or do you go to an orthodontist?

According to the Bureau of Labor Statistics, there are just over 100,000 general dentists in the US right now.1  If you’re reading this, there’s a fair chance that you know at least a few. All general dentists have to pass the same courses in dental school and the same national board exams and it’s safe to say that all general dentists are roughly the same when they get out of school. However, as you will see advertised on many of their websites, it’s the education they take upon themselves AFTER graduating that really sets one general dentist apart from another. Some take lots of courses in implant dentistry, while others may immerse themselves in cosmetic courses or even orthodontics. But take note: Irrespective of the courses these general dentists take, they remain non-specialist dentists (NSD’s).

The average non-specialist dentist simply doesn’t “know what they don’t know” about orthodontics, so they naturally believe that they have the right answers for what appear like “simple” cases when they might be more complex. The outcomes can be disastrous.

Back to the question of who should straighten your teeth. The NSD you see for all of your “basic” work has offered to straighten your teeth. They say that it’s a really easy fix and there’s no need to have to travel to a specialist. After all, they’re a dentist. Should you let them, or should you go to the orthodontist?

Let’s say that your NSD has spent a day at an orthodontics course (8 hrs), or maybe a weekend course(16 hours) or perhaps they are remarkably well educated for a NSD and took 3 days a quarter over the course of 2 years (highly unusual) equaling 182 hours. Now, compare them to an orthodontist who also graduated dental school but went on for specialty training. The bare minimum specialty program in orthodontics is 40 hrs/week for roughly 48 weeks a year for a minimum of 2 years. equaling 3,840 hours (not including the book work and after hours lab work they need to do). Remember, that’s the bare minimum for an orthodontist. Most orthodontists have more training than that.

So, let’s re-examine the question. Given the choice between two people who could straighten your teeth, would you rather have the NSD with, say 16 hours of training who does an orthodontic case every week or two or an orthodontic specialist with over 4000 hours of training in all areas of orthodontics who only does teeth straightening all day long?  Why wouldn’t you go to the specialist?

I can respect how the NSD would believe that they can help you with that “small problem” but as someone who was an NSD for 2 decades before becoming an orthodontic specialist, I can tell you that an “easy case” can quickly take a turn in the wrong direction and that every single patient deserves a well thought out orthodontic treatment plan. I had no idea how involved the straightening of even a few teeth was until I became a specialist.

Before you let any NSD straighten your teeth, simply ask them: “How many hours of formal training do you have in straightening teeth?” and “How many cases of orthodontics have you performed?” Then, when you go to an orthodontist for a consultation, ask them the same question. Who should treat you will be a no brainer.

One more word of caution. In every specialty of medicine and dentistry there are those who simply don’t take their commitment to patients as seriously as they can. We’ve all read stories of doctors or dentists who’ve perpetrated terrible outcomes upon their unsuspecting patients. Whenever I espouse the virtues of all orthodontics being performed by orthodontic specialists, NSDs scream at me that they do orthodontics better than a lot of bad orthodontists. That argument holds no water. A good orthodontist (of which there are tons) will always be my choice over an NSD due to their knowledge of the field and specialty training.  Using the “lowest common denominator” argument is ridiculous. I could probably drive a bus far better than the drunk ones who make the news, but I’d always trust a well trained driver over someone who’s never done it. That’s why they have to take special tests and get a special license. Could you imagine how ridiculous it would be for me to say: “I can drive a bus way better than some of the incompetent bus drivers out there, so it’s silly to need a special license to do it.” Sure, if I really wanted to drive a bus I could stop what I did for a living, go get licensed and make that what I do. Similarly, like myself, any NSD can choose to quit doing general dentistry, go back to school and specialize in orthodontics.

You or your child deserve to have the straightest teeth you can get and you deserve to have a specialist do it for you. Ultimately, if you want your NSD to do it for you, that’s OK but let it be your choice after you’ve seen an orthodontist for a consultation.

If you have any questions, please feel free to contact me.

All the best,




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