second guessing orthodontics

[kamsartipi]

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4th year student, months away from graduating. I wanted to be an orthodontist bc the field was interesting and the lifestyle was desirable! However, as I interact with more and more dentists they tell me not to do it because it's not worth it anymore.

I was fortunate to end up with a competitive class rank for ortho and had alot of extracurricular involvement throughout my studies. With that being said, What is the general consensus? Is ortho still worth it? Do I stay a GP or Do I see if I like other areas of dentistry?

thank you!

 

[yappy]

4th year student, months away from graduating. I wanted to be an orthodontist bc the field was interesting and the lifestyle was desirable! However, as I interact with more and more dentists they tell me not to do it because it's not worth it anymore.

I was fortunate to end up with a competitive class rank for ortho and had alot of extracurricular involvement throughout my studies. With that being said, What is the general consensus? Is ortho still worth it? Do I stay a GP or Do I see if I like other areas of dentistry?

thank you!

I highly recommend that you don't talk to general dentists about orthodontics. I say this as a general dentist. You should reach out to working orthodontists, young and old. My thoughts, for what they're worth, is that if you are interested in orthodontics you should go for it if you have the opportunity.

 

[Big Time Hoosier]

4th year student, months away from graduating. I wanted to be an orthodontist bc the field was interesting and the lifestyle was desirable! However, as I interact with more and more dentists they tell me not to do it because it's not worth it anymore.

I was fortunate to end up with a competitive class rank for ortho and had alot of extracurricular involvement throughout my studies. With that being said, What is the general consensus? Is ortho still worth it? Do I stay a GP or Do I see if I like other areas of dentistry?

thank you!

What will be your student loan balance when you graduate from dental school?

Big Hoss

 

[kamsartipi]

What will be your student loan balance when you graduate from dental school?

Big Hoss

About 350k Canadian (50k is interest free) - which is like 250-260k USD. Going to be working for 1 year in rural area to pay off debt. I’ve been considering ortho for a while but…. If it’s not worth it anymore I’d love periodontics as well due to its surgical aspect. Other than those 2 I wouldn’t be interested in anything else. What do you think @Big Time Hoosier

 

[Big Time Hoosier]

About 350k Canadian (50k is interest free) - which is like 250-260k USD.

That’s much lower than most.

Big Hoss

 

[OncePreDent]

About 350k Canadian (50k is interest free) - which is like 250-260k USD. Going to be working for 1 year in rural area to pay off debt. I’ve been considering ortho for a while but…. If it’s not worth it anymore I’d love periodontics as well due to its surgical aspect. Other than those 2 I wouldn’t be interested in anything else. What do you think @Big Time Hoosier

perio and ortho are significantly different, I'm kinda surprised you are in between those two because of how different they are. Would it make more sense for you to practice GD for a few years in a rural community and see if there is more of a calling for one or the other, or continue with GD?

 

[JacquesVallee]

If you pay off all your student loans I'd still do Ortho. The Ortho lifestyle can't be beat.

 

[vk223]

I wanted to chime in on this because this forum has lot of negative voices about orthodontics (either general dentists/other specialty/or ortho unhappy with their current pay and tuition). All of my orthodontists friends including me love our specialty and would not choose anything else. The lifestyle is decent but we can get busy seeing lot of patients too, but many of us really enjoy the intellectual side of it— problem solving, tx planning etc. Nothing in life should be done for money only- otherwise just look at owning business as a GP and real estate. If you do ortho I would recommend residency with reasonable tuition, not 100k a year for 3 years. And if you are okay with rural smaller places can probably find a place earning 400-500k and pay it off in 2-3 years. Income vary a lot depending on where you are at. It’s a profession that will never die. I worked at a DSO before and quality of GP ortho/invisalign work is pretty bad and patient will find out eventually too.

 

[sparklingwatergirl]

If you pay off all your student loans I'd still do Ortho. The Ortho lifestyle can't be beat.

agreed ortho is an excellent lifestyle specialty!

 

[TanMan]

Orthodontics would be worth it if you can finish your cases fast, have an efficient system where you don't do much of time consuming/hands on, and you have a good marketing/sales team.

 

[itsgonnabeok12]

I wanted to chime in on this because this forum has lot of negative voices about orthodontics (either general dentists/other specialty/or ortho unhappy with their current pay and tuition). All of my orthodontists friends including me love our specialty and would not choose anything else. The lifestyle is decent but we can get busy seeing lot of patients too, but many of us really enjoy the intellectual side of it— problem solving, tx planning etc. Nothing in life should be done for money only- otherwise just look at owning business as a GP and real estate. If you do ortho I would recommend residency with reasonable tuition, not 100k a year for 3 years. And if you are okay with rural smaller places can probably find a place earning 400-500k and pay it off in 2-3 years. Income vary a lot depending on where you are at. It’s a profession that will never die. I worked at a DSO before and quality of GP ortho/invisalign work is pretty bad and patient will find out eventually too.

any anxiety or doom/gloom about AI taking over?

 

[Hockey_Ortho]

any anxiety or doom/gloom about AI taking over?

I have talked to some orthodontists about this. Yes, they discussed how many general dentists charge $4,000 for Invisalign and how the technology is continually improving. They believe that ortho is on its way out and recommended I pursue a different specialty.

 

[Big Time Hoosier]

I have talked to some orthodontists about this. Yes, they discussed how many general dentists charge $4,000 for Invisalign and how the technology is continually improving. They believe that ortho is on its way out and recommended I pursue a different specialty.

Ortho will definitely feel the biggest impact from AI. The way I see it, everything else is too hands on.

Big Hoss

 

[D1Bound]

I have talked to some orthodontists about this. Yes, they discussed how many general dentists charge $4,000 for Invisalign and how the technology is continually improving. They believe that ortho is on its way out and recommended I pursue a different specialty.

I haven’t thought about this. Ortho really is going to be the first to fall along with oral path and rad.

 

[JacquesVallee]

I haven’t thought about this. Ortho really is going to be the first to fall along with oral path and rad.

Technology will be used as an asset to make diagnosis easier and treatment planning easier. It won't get rid of any specialties. No practicing medical radiologist is remotely worried about it taking over any time soon. With that said, it definitely will make things easier for general dentists when it comes to Ortho and even other procedures. CBCT for endo is really helpful for general dentists knowing how many canals are in a molar, for instance. However, endodontists will always be needed.

 

[Hockey_Ortho]

I haven’t thought about this. Ortho really is going to be the first to fall along with oral path and rad.

I agree. Many orthodontists already struggle to stay busy as it is. Having to open multiple offices and commuting +1 hour for work.

The AI for detecting caries has also become very advanced, as it can detect caries faster and more accurately than humans.

 

[D1Bound]

I agree. Many orthodontists already struggle to stay busy as it is. Having to open multiple offices and commuting +1 hour for work.

The AI for detecting caries has also become very advanced, as it can detect caries faster and more accurately than humans.

I still think AI detection for caries is bull. Unless you’re just going to slice every E2 or D1 lesion in the mouth, it requires analysis and clinical inspection to make the call even with the software

 

[Pablo Sanchez]

Technology will be used as an asset to make diagnosis easier and treatment planning easier. It won't get rid of any specialties. No practicing medical radiologist is remotely worried about it taking over any time soon. With that said, it definitely will make things easier for general dentists when it comes to Ortho and even other procedures. CBCT for endo is really helpful for general dentists knowing how many canals are in a molar, for instance. However, endodontists will always be needed.

It won’t completely get rid of any specialties, as there will always be difficult cases or general dentists unable or uninterested in treating specific cases, but it will significantly reduce the demand for the specialty. It will make things easier for a general dentist to treat. You’ll have Dr. General Dentist offering ortho for $3999 on one corner and Dr. Other General Dentist offering it for $3998 up the street. Increased ability to plan and treat cases will reduce costs in a competitive market, and reduce referrals to the specialist. With reduced referrals and reduced profits from the procedure the patient supply for the orthodontist will become less and less. If you’re pumping out more and more orthodontists with schools like GSO opening up, the field won’t be viable anymore. This is already happening and we haven’t really seen the effects of AI yet. New grad orthodontists are graduating in a competitive market with tons of debt. They’re unable to get a full time job so they have three part time jobs to make ends meet.

 

[2TH MVR]

I agree. Many orthodontists already struggle to stay busy as it is. Having to open multiple offices and commuting +1 hour for work.

The AI for detecting caries has also become very advanced, as it can detect caries faster and more accurately than humans.

I disagree with AI taking over ortho. The perception that alot of ortho is delegation with simple procedures is just not true. Sure. There are simple procedures that can be delegated, but the vast majority of the procedures require "custom" procedures/adjustments with a thorough understanding of the diagnosis to treat with quality. You can't just slap on a bunch of braces and niti arch wires and sit back and relax. There are so many variables to take into account and make the necessary adjustments. Again ..... the quality of the end result will be different depending on the orthodontist and/or braces or aligners.

Aligners have so many issues. The biggest is that the patient has to "cooperate" with the treatment. With braces .... predictability is a given. Every aligner case I have done ..... the outcome could have been better with braces. I've had to re-treat many aligner cases that failed.

The issues ortho has is the result of over saturation of the field, non-orthodontists doing ortho, and the Corp take-over.

The need for ortho remains very high.

 

[Big Time Hoosier]

The AI for detecting caries has also become very advanced, as it can detect caries faster and more accurately than humans.

Even if it can detect the caries, it can’t fix them.

Big Hoss

 

[itsgonnabeok12]

i feel like endo is the safest going forward

 

[Big Time Hoosier]

i feel like endo is the safest going forward

I don’t know. I’m 100% invested in companies that make sugar sweetened beverages. Dentistry is gonna lose that fight.

Big Hoss

 

[itsgonnabeok12]

currently debating between endo and ortho but overall feels like ortho has the best lifestyle, just don't wanna open up my own office.

 

[JacquesVallee]

The AI for detecting caries has also become very advanced, as it can detect caries faster and more accurately than humans.

This just isn't true. I was at a CE where they talked about this. There are so many false positive and so many lesions missed. It's a useful tool for getting you to look at areas but that's it. Now, when it comes to 3 dimensional CBCT, we aren't even remotely close to anything. People have said radiology would be taken over by AI 15 years ago and it still hasn't come close to happening. In fact, there's a thread in the radiology forum on here making fun of it.

Eventually, almost every job will be taken over by AI if technology keeps progressing.

 

[Hockey_Ortho]

New grad orthodontists are graduating in a competitive market with tons of debt. They’re unable to get a full time job so they have three part time jobs to make ends meet.

Sadly, I know too many orthodontists who are already in this position. 2-3 part-time jobs. Two different part-time jobs is very normal for orthodontists. They are finding it difficult to stay busy.

 

[itsgonnabeok12]

Sadly, I know too many orthodontists who are already in this position. 2-3 part-time jobs. Two different part-time jobs is very normal for orthodontists. They are finding it difficult to stay busy.

so would it still be wise to pursue an ortho specialty over endo?

 

[itsgonnabeok12]

This just isn't true. I was at a CE where they talked about this. There are so many false positive and so many lesions missed. It's a useful tool for getting you to look at areas but that's it. Now, when it comes to 3 dimensional CBCT, we aren't even remotely close to anything. People have said radiology would be taken over by AI 15 years ago and it still hasn't come close to happening. In fact, there's a thread in the radiology forum on here making fun of it.

Eventually, almost every job will be taken over by AI if technology keeps progressing.

even endo?

 

[yappy]

even endo?

In the limit, yes. Once AGI and robotics advance sufficiently, there will be no job that a robot cannot perform better than a human. But at that point, I wouldn't be surprised if AI cures most diseases, including caries.

 

[charlestweed]

Sadly, I know too many orthodontists who are already in this position. 2-3 part-time jobs. Two different part-time jobs is very normal for orthodontists. They are finding it difficult to stay busy.

It has always been like this for as long as I’ve practiced as an ortho. Since an ortho can see high patient volume in a day, he/she only needs to work a few days a month. Most private practice ortho owners don’t need to hire associate orthos because they can just hire the chairside assistants to perform the most of clinical procedures for them. So the viable option for many young ortho grads is to work at GP offices or corp offices as in-house orthodontists.

A typical GP office refers 4-5 cases to ortho every month. A busier corp office like the one, where I am at now, refers about 10-20 patients to ortho every month. If all 4-5 of these patients from one particular GP office accept and start ortho tx, the orthodontist will only have around 120-130 active patients over the 2 year period. And with 120-130 active patients, an orthodontist only needs to work 2-3 days/month (and sees 40-60 patients per day) for that particular office.

It’s the same for other specialties (endo, pedo, os, perio etc) as well. When the specialists travel to work at multiple offices, it doesn’t mean that they are struggling. Each office should save enough patients to keep them busy for the day that they are there. The daily production is usually very good. For a typical 50-60 patient ortho day, the production should be around $8-10k (if each patient pays $200 per office visit….$200 x 24 months = $4800, which is a very low fee for a 2 yr case). For a perio day with 2-3 implant placements + a few consults, the production should be at least $5-6k. For an OS day with 5-6 3rd molar cases, the production should be at least $10k.

 

[Big Time Hoosier]

I wouldn't be surprised if AI cures most diseases, including caries.

We already have a cure for that…

Big Hoss

 

[2TH MVR]

We already have a cure for that…

View attachment 404820

Big Hoss

So analog. 🙄 AI not impressed.

 

[yappy]

We already have a cure for that…

View attachment 404820

Big Hoss

Touche! But in the context of modern diet, tooth anatomy and depending on the strain of bacteria, it is hardly a cure.

 

[D1Bound]

Touche! But in the context of modern diet, tooth anatomy and depending on the strain of bacteria, it is hardly a cure.

I personally think the whole bacteria thing is complete hogwash. Rinse with water. Eat less cariogenic food. Brush your teeth. Simple. Don’t feee whatever bacteria

 

[2TH MVR]

so would it still be wise to pursue an ortho specialty over endo?

Two different specialties. Endo has one advantage in that overhead is usually lower (less staff). You will spend more time with less patients earning potentially more revenue. Ortho is about numbers. Seeing alot of patients with typically short appt times. Orthodontists needs to be a little more outgoing, extroverted, multi-tasker. Endo probably less requirement to be a people pleaser.

I personally find orthodontics to be highly intellectual. I've said it many times. Diagnosis is so important to understand how the case is to be treated.

Yes. Ortho nowadays means travelling to multiple offices. I personally do not mind it. I like variety. I work for a DSO now and travel to 5 different locations. Not an issue.

Choose a profession that you will enjoy. Everything else is just a job.

 

[TanMan]

I personally think the whole bacteria thing is complete hogwash. Rinse with water. Eat less cariogenic food. Brush your teeth. Simple. Don’t feee whatever bacteria

Lol you give too much credit to people. People will eat whatever they want, brush when they want, and they will come when they are in pain.

 

[Hockey_Ortho]

Yes. Ortho nowadays means travelling to multiple offices. I personally do not mind it. I like variety. I work for a DSO now and travel to 5 different locations. Not an issue.

I think for most people, including myself, I would prefer one office, 1 location. Typically for ortho, it cannot happen unless you are only working 1-2 days per week, but it would be nice. Lower overhead, having 1 location instead of multiple, and easier for the staff too.

 

[2TH MVR]

You’ll have Dr. General Dentist offering ortho for $3999 on one corner and Dr. Other General Dentist offering it for $3998 up the street.

There will always be a need for specialized orthodontic treatment. Discerning patients will always choose a specialist (orthodontist) rather than a General Dentist offering cut rate prices for mediocre treatment.

Increased ability to plan and treat cases will reduce costs in a competitive market, and reduce referrals to the specialist.

It's one thing for AI to properly diagnose and treatment plan a case. It's another thing to actually TREAT the case making on the fly adjustments for the infinite number of variables involved in treating the case properly.

New grad orthodontists are graduating in a competitive market with tons of debt. They’re unable to get a full time job so they have three part time jobs to make ends meet.

Agreed. I've always posted that if I were graduating in this environment .... I would work at a Corp part time and also have a small private practice shared with another specialist (Pedo). Having a single full time ortho practice is not the norm. When I graduated back in 1993 .... I bought into a part time private practice and opened another PT practice. It was the norm back then to have multiple satellite offices. I even opened a 3rd location in a small town 3 hours from my home.

 

[Pablo Sanchez]

There will always be a need for specialized orthodontic treatment. Discerning patients will always choose a specialist (orthodontist) rather than a General Dentist offering cut rate prices for mediocre treatment.

It's one thing for AI to properly diagnose and treatment plan a case. It's another thing to actually TREAT the case making on the fly adjustments for the infinite number of variables involved in treating the case properly.

Agreed. I've always posted that if I were graduating in this environment .... I would work at a Corp part time and also have a small private practice shared with another specialist (Pedo). Having a single full time ortho practice is not the norm. When I graduated back in 1993 .... I bought into a part time private practice and opened another PT practice. It was the norm back then to have multiple satellite offices. I even opened a 3rd location in a small town 3 hours from my home.

There will always be difficult cases that need an orthodontist. Discerning patients may always choose to go to an orthodontist. But you can’t deny the fact that AI only makes it easier for the general dentist to feel confident in treatment planning and providing care. AI only makes it easier for general dentists which only takes away from the orthodontist. I just don’t see any scenario where AI is going to create a barrier for general dentists and help the orthodontist. It won’t destroy the specialty entirely, but it won’t help it.