I do think the orthodontic specialty is on the decline like many have pointed out but there is no other better alternative out there. The GPs also experience oversaturation problem due to openings of new dental schools. The same thing happens for Pedo. OS and perio compete for patients. Implants hurt endo. They open more pharmacy, optometry, and medical schools as well. To survive, you just have to be smart at controlling your overhead so you can bring home more of your hard earned money.
So you think that with all the new technology coming out, the tasks of straightening teeth become easier and more GPs can do ortho in their practices? This is a big misconception. In ortho, what makes the job easy is not the technology but it is the doctor’s ability to make the right diagnoses and to come up with the right tx plans to correct the ortho problems. And this ability can only be acquired from attending a formal residency program and from treating a lot of cases for many years. Nothing can replace the human brain. Poor tx plannings in ortho often create more work, more headache, and more time for the doctor to fix the mistakes. This is why some GPs, who do some ortho tx in their offices, know their limitations and still have to refer certain cases out.
IMO, technology has done more harm than good for ortho. For example, an intraoral scanner can only scan one mouth at a time. With the traditional impression technique, we can take impressions on several patients at the same time. And you also have to pay a fee for each scan. Technology is the main culprit for causing rising cost in starting and running an ortho office. Higher overhead forces many orthodontists to raise the tx fee. Higher tx fee makes it less likely for patients to accept treatments. Lack of case acceptances from patients forces the orthodontists to close or sell their offices. And then they come to this forum and whine.
I think it’s a mistake for many ortho programs to introduce to their residents the latest technology and make them become the slaves of these new toys. I am glad I went to a program that made me do everything by myself such as making all ortho appliances instead of using an outside lab, hand-tracing the ceph films, treating patients without an assistant, calling patients, presenting and selling cases to the patients etc. I think learning to do things the hard way during residency training better prepares a person for the real world practice when he/she gets out.
