Pedo vs ortho

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Jordwin

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Hey all,

I am a D3 and have been having a hard time deciding if I want to do ortho or Pedo. I've been told ortho is "dying and won't be able to make as good of a living" as peds. Also that it's hard to find ortho jobs. Is this true?


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Both are very successful careers. Ortho = more treatment planning and less using your hands; Pedo = more patient management and using your hands. Ortho tends to be an older population of kids.

If you enjoy dentistry but like working with kids, pedo. If you don't like dentistry and don't know what to do, ortho.
 
Hey all,

I am a D3 and have been having a hard time deciding if I want to do ortho or Pedo. I've been told ortho is "dying and won't be able to make as good of a living" as peds. Also that it's hard to find ortho jobs. Is this true?


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I'm doing ortho not because of the money but it's the only thing I like in dentistry. I'm sure I'll make less than as a GP or even pedo but what are ya gonna do. No dentist or specialist is gonna be super wealthy anyway.
 
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Thanks, but is the job market coming out as depleted as I hear for ortho?


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If you're doing ortho for the lifestyle, not the money, you will be ok. If you happen to make good money as an ortho, the better. You CANNOT do pedo for the money. You will snap. Only do pedo if you have a wick that's like 10 miles long or committed to being faculty where you will have constant access to the OR. Maybe you should do some more shadowing.
 
If you're doing ortho for the lifestyle, not the money, you will be ok. If you happen to make good money as an ortho, the better. You CANNOT do pedo for the money. You will snap. Only do pedo if you have a wick that's like 10 miles long or committed to being faculty where you will have constant access to the OR. Maybe you should do some more shadowing.

Thanks! I know I like them both (and general for that matter), but all else being equal I would like to have the most ideal job opportunities in the future.


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Thanks! I know I like them both (and general for that matter), but all else being equal I would like to have the most ideal job opportunities in the future.


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most ideal job opportunities = 100% pedo
 
I believe there are fewer opportunities as an Orthodontist, because of Invisalign and the Smile Direct Club options. I don't frequently see many people getting metal braces anymore. Just my 2 cents, I would like to hear what others think about Invisalign and Smile Direct Club.
 
Doc, you may not be seeing metal braces because you're not hanging out with a bunch of 12 year olds.

Invisalign is still not a panacea for adult malocclusion, but will probably one day come very close. SDC is depressing, not in that it's going to take aligner cases from dentists and orthos, but because people are being sold something that, at the moment, can only tip teeth. There are no attachments, no IPR. The best it can do is flare someone's dentition. So, they'll eventually be in the orthos office, just having already spent their insurance benefits.
 
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Doc, you may not be seeing metal braces because you're not hanging out with a bunch of 12 year olds.

Invisalign is still not a panacea for adult malocclusion, but will probably one day come very close. SDC is depressing, not in that it's going to take aligner cases from dentists and orthos, but because people are being sold something that, at the moment, can only tip teeth. There are no attachments, no IPR. The best it can do is flare someone's dentition. So, they'll eventually be in the orthos office, just having already spent their insurance benefits.

SDC scared me a little because it would decrease # of jobs, but now your post made me feel better.

Also what do people think about new products such as that charcoal whitening product?

http://www.foxnews.com/health/2016/...rcoal-as-teeth-whitener-reaches-millions.html
 
It's basically the same as using baking soda. It's abrasive, so it removes surface stains. I don't recommend anyone use whitening toothpaste (or charcoal for that matter). There is no reason to mechanically abrade your teeth twice a day, you're just wearing away enamel.

Use a non-abrasive toothpaste and bleaching trays occasionally if you are concerned with staining.

It's people like this woman advocating the use of charcoal that will help assure dentists never go without work. She can "whiten" her teeth all the way down to the yellow dentin, then some dentist can give her whatever shade veneers and crowns she wants.
 
It's basically the same as using baking soda. It's abrasive, so it removes surface stains. I don't recommend anyone use whitening toothpaste (or charcoal for that matter). There is no reason to mechanically abrade your teeth twice a day, you're just wearing away enamel.

Use a non-abrasive toothpaste and bleaching trays occasionally if you are concerned with staining.

It's people like this woman advocating the use of charcoal that will help assure dentists never go without work. She can "whiten" her teeth all the way down to the yellow dentin, then some dentist can give her whatever shade veneers and crowns she wants.


PHEW, another one bites the dust =p
 
how about dual specialize in both? anyone have any opinions on this?
 
how about dual specialize in both? anyone have any opinions on this?

Why not just do pedo and have an ortho component to your practice. You will receive ortho training in pedo residency. You can get more ortho training via CE after pedo training as well.
 
Just follow your head. Follow what you can see yourself doing for the next 40 years. Go and shadow ortho's and pedo's as much as you can . Talk to them all,,, as many as you can,,,, see what fit's your percieved life and personality. You can do good in both area's as long as you are smart enough to find the right area and be the right person .

Soooooo many new grads insist they have to live in a big city ,or in an over saturated area ( they do not realize it though ). They all follow the obvious and easy.
Don't do that!

. Go and find the un filled area's and do whatever kind of dentistry you want and things will be great ( do your homework on where to practice ,,,,, don't be so resigned to live where you are from or where the weather is always warm, or,where it easiest to get a license). Following the road less travelled, often offers the best views and best destinations. Or,,,, do whatever the hell you want and pound sand for the next 40 years.

Ortho is great if you can find the right area to work. Pedo is great in most all area's ( except most big city's/ or other over saturated places ( California, NYC )).

You have to do what works for you. If you don't have a love for pedo, you will go crazy ( despite , whatever your income is),,,,, , ,And income can be very good in Pedo if you have what it takes.
Personally, I love Pedo ( I could have seen myself doing ortho,,,,,,,,maybe,,,,,,,. , but you have to do soooooo much as///// kissing to get referals ( more than all other specialties,,,,,,that I don't think I could have dealt with that so easily ).

In Pedo,,,you do not rely on referrals so much. Maybe in the beginning I guess,,,,a little,,,... But,,,as you develop in practice,,,and , If you are really good,,, word spreads fast (mothers groups ,,and social media crap ). At this point in my career, I get 80 % of new patients from existing patients. I get a ton of referrals,,,from GP's. , but seriously, if I had zero referrals,,,,,from GP's. I would still be fine! No other Specialty can say that.

A warning to all thinking about specializing! Any specialty ( except Pedo) If you want to be sucessful as a specialist, ( especially starting out ). you are going to have to be an incredibly good at as/ kissing mto be busy. You are going to have to call all your,local GP's regulary , take them out to lunch, dinner, professional sporting events,, and throw Big CE courses ( fully paid and sponsored ) and othe shi/ too. At liest in the begining ,,,;,,;, Ortho ,,,, especially , it seems that atliest in my less competitive than normal area. Yeah most of the ortho's are very busy,,,, but oh my gosh do they do sooooo much as/ kissing , I feel sorry for them.

As a Pedo,,,,,, I do absolutely zero solicitation for referals. I did some when I first started out. I was and am always helpfull and friendly with all local GP's when I see them at meetings, or other gatherings. If they give me a phone call, I am cool and helpfull at all times,, I am myself ,,, cool, and happy to help,,, but I do not have to kiss any ones as/.

I get 80 % percent of my new patients and referals from word of mouth and existing patients. Do good and you will do good.
Ortho , and other specialties,,,,,, are a different . They are always out competing with each other, it seems. Always sending crap,to our office ( food, snacks , cakes and deserts,,,,,,, tickets to sporting events, and other sh/. The list goes on)
I feel so sorry for them having to try to do all this crap. Seriously though,,,, just treat my patients right, Make them happy as much as you can and do good work, and I will refer you more. But still, ,the efforts to solicit do not end.

I don't have to do this crap,,,, I do all I can to make the best experience for kids and parents,,,,,, and things explode in good ways! No need to kiss any GP as/ 's
So , yeah for me Pedo is easy to be big if you are a nice ,friendly, sociable, down to earth , humble,yet confident and are great/ awesome ,,,,, with kids . It's easy with all that. With all that,,,,,, income can be amazing.,,,,GP's have no clue.

Any way,,,,, just some things to think about.
My 3 cents.
Good luck and best to you!
 
If you've treated kids and don't mind the screaming pedo has much better prospects.


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Pedo is really not about screaming kids. In my office there is very very little screaming going on. It's actually all pretty cool and controlled if ,,,, you do,things the right way. Occasionally a kid gets up set,no matter what you do,,, ( not often though ). , little 2 year old usually cry for a 1 minute exam, but 98% of the time, things are pretty happy and cool. Not every PEDO office is the same though. It depends on your skill and style of practice.
 
Pedo is really not about screaming kids. In my office there is very very little screaming going on. It's actually all pretty cool and controlled if ,,,, you do,things the right way. Occasionally a kid gets up set,no matter what you do,,, ( not often though ). , little 2 year old usually cry for a 1 minute exam, but 98% of the time, things are pretty happy and cool. Not every PEDO office is the same though. It depends on your skill and style of practice.

Would you attribute the atmosphere of your practice to be due to the patient population you serve? The kids are just generally calmer? Or practice style (more sedation heavy)? Do you utilize the papoose board at all?
 
Would you attribute the atmosphere of your practice to be due to the patient population you serve? The kids are just generally calmer? Or practice style (more sedation heavy)? Do you utilize the papoose board at all?

The attomosphere of my practice is really due to the way I work with kids ( my behavior management and treatment mentality ).

My patient population is a mix of medicaid (30% , and fee for service 70%).
I do zero sedation, but for restorative treatment everyone gets nitrous. I do go to the OR about 3-4 days a month.
I do not do any papoose treament, but do rarely do some limited treatment via lap exam / tx with the parents helping hold the child (eg..... quick exams on kids 3 and under, and rare trauma type emergency treatment on young pre- cooperative patients).

I very rarly work on resistant or crying children. If I am doing operative or surgical treatment and kid completely looses it, we usually stop and figure out another way to approach things.

I do use Silver Diamine Fluoride in a lot of situations to buy time and delay treatment ( avoid the OR if possible). We do have some crying but 95% of it is from 2 -3 year old that are only getting an examination ( short , short appointments). All in all ,,,,,, days are pretty happy in the office. Most good Pedo practices are very similar to mine.
 
Hey all,

I am a D3 and have been having a hard time deciding if I want to do ortho or Pedo. I've been told ortho is "dying and won't be able to make as good of a living" as peds. Also that it's hard to find ortho jobs. Is this true?


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Apply to a pedo program that offers extensive ortho 😉
 
Great advice to the OP on this thread. I agree with comments by Tooth, CanaDMD, Doc Yankem, and Wax n' Relax. Choosing a specialty can be difficult during school because it is hard to know what it is really like until you are actually doing it. Just do some shadowing and talk to a lot of different people at different stages of their career (residents, just graduated, mid career, etc.) Opinions will vary a lot.

I would say that ortho is getting harder and harder with respect to job and practice opportunities. Perhaps some of the other pedo's here could chime in, but it seems to me that pedo start ups break even much quicker than ortho. In my area, ortho jobs are very hard to find, and pedo jobs are fairly hard to find as well, but not quite as bad.

I think going to a pedo program with some heavy ortho, or perhaps a dual trained program, sounds fantastic. If I could reverse time I might have done that.
 
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