Any person, who has a dental license, can practice orthodontics. You don't have to go to a pedo residency that has strong ortho focus. There are plenty of ortho CE classes out there that teach you to do ortho. To me, an orthodontic certificate is simply a "ticket" that allows a person to practice orthodontics. And it is an important ticket because:
1. Without it, a person cannot advertise his practice as "limited to orthodontics." The GPs don't refer patients to another GP or a Pedo, who knows how to do ortho. They'd rather refer their patients to a real ortho (with an ortho certificate), whom they know won't compete against them and whom they know will do a better job.
2. Without it, a person cannot get an associate ortho job at the dental chains and other private ortho offices. Dental chains don't hire GPs to do ortho. From treating high volume of ortho patients and from dealing with the similarly difficult cases every day, the orthodontists gain more clinical experience. A GP or pedo, who tries to learn ortho never has the same kind of clinical exposure that an orthodontist has. A person who does nothing but ortho tends to be better at doing braces than a person who does a variety of things. The GPs know that and they would rather refer patients to the orthodontists for better quality of care.
3. There are some patients, who know the different between an orthodontic specialist and non-orthodontic specialist.
4. The pedodontists or GP's, who do ortho, can only get ortho patients from their own patient pool. That's why they cannot survive by doing ortho alone. They have to do other dental procedures to support their practices. The orthodontists can get patients from multiple sources: different GP offices (this is key), advertisements, insurance referrals, word-of-mouth referrals etc. The majority of the GP offices still refer cases out to orthodontic offices. The GP offices, that do ortho or hire an in-house orthodontist, are the minority.
These are the reasons why some general dentists, who are very good at doing ortho, gave up their practices and went back to school to obtain the orthodontic certificate. My little sib at my ortho program was one of them.
