Whats the deal with general dentists and orthodontics?

[Ryanpoore]

Hey there, quick question. So I'm about to take my DAT and apply to dental schools, I have a 3.9 and I've worked pretty hard to get to where I'm at today, and I was perfectly prepared (mentally at least) for the work load ahead of me as I continue pursuing my goal of being an orthodontist. I was talking to a family friend tonight who asked me how school was going and what I wanted to do. I explained my plan, and to my surprise, she is an assistant in an ortho office. I instantly started firing off questions and we got on the topic of general dentists who could offer orthodontics. I didn't want to tell someone who's been working in the field for 20+ years that she was wrong, but I was thinking "No way can a general dentist do anything outside invisalign!" After reading how near-impossible it is it get into an ortho program, I assumed that LEGALLY it would be against the law for a general dentist to offer orthodontic treatment. Low and behold, I get home and do some searching and find out that general dentists can practice ortho after doing some weekend continuing education courses! My mind is blown right now. I have some questions for anyone who may know. Thanks everyone .

1) Legally, can a regular dentist seriously do orthodontics if they are properly trained to do so by those continuing education programs or weekend seminars or whatever they're called?

2) What are any "legal" issues associated with this? Can I graduate dental school, attend every ortho seminar known to man, and then open and orthodontic practice? Or do I have to advertise myself as a dentist who also does ortho? Are there any actual LAWS regarding how I advertise myself assuming that I'm just as competent in handling ortho cases as an actual ortho?

3) Do any of you see dentistry and ortho slowly becoming one skill in the future as technology requires less and less work on the ortho's side?

4) Does anyone know or have experience with a general dentist who sees nearly all of his patients for ortho reasons?



Thanks again guys. If this is true, it would lift a huge weight off my chest. I'm super worried that I won't be able to get into ortho. I know I'll do well in dental school, but beating out 90% of my classmates... I'm not for sure I can do that.


Thanks

-Ryan

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[KenKim]

umm general dentists can do everything in the dental field.

 

[Daurang]

YES you can do anything you're comfortable with at your own office. A lot of general dentists do braces, especially in California.

 

[AChad26]

Just get through dental school first and see if you even like it... People can't know what they want to specialize in until they learn dentistry first and are around it enough. I'm a fourth year and I still basically haven't decided.

 

[gryffindor]

Poor pre-dent with a blown mind.

The only "legal" issue would be if a GP is taken to court due to an unfortunate orthodontic outcome, the GP will be held to the standard of a specialist. I am still waiting to read about a court case like this as in I don't know of any cases where this has actually happened to a GP.

As a new dental student, I would be more worried about the outrageous tuitions the ortho programs charge, the saturation with new grads due to many new programs being opened in the last 10 years, and the older docs refusing to retire. Also in bigger cities or places like California, GPs like to "keep it in-house" and hire a traveling orthodontist come to their office once a month and see all of their ortho patients instead of referring the patients out to a specialists office. The one who suffers in this arrangement in the patient.

There are GPs who limit their practices to ortho. They can't call themselves "Orthodontists" legally, but they advertise heavily that do braces. The general public can't always tell the difference between a GP and an orthodontist much less the difference between an orthodontist and an ABO board certified orthodontist. On top of that, there are many "fake boards" out there for GPs to "board certify" themselves in orthodontics which results in even more public confusion about who exactly is an orthodontist vs an imposter.

Here is an organization for non-orthodontists who do ortho: http://www.iaortho.org/introduction.aspx

 

[Ryanpoore]

KenKim and Daurang, thanks for the info guys!

Achad, I totally agree, I don't think I will know forsure what I like doing best in dentistry until I get in there and start getting my hands dirty. However, I never got braces (buying them this summer!) and so I really understand how much they can change someones life. It can literally give someone more self esteem and confidence. I love the idea of helping people get to that point because I've been self-conscious about my smile my whole life. But you're absolutely right, thanks for the input.

Gryffindor, thanks for the detailed info. I really appreciate it. Didn't really need to sarcastic one liner, but hey it's SDN I should expect as much. Would you mind elaborating on the issues you mentioned? The issues being the rising prices of dental school/ortho programs, and the saturation of new grads?

I could questions I have for you Gryff:

1) I really have no one who's knowledgeable in density and/or its specialties. I mean I've put in my shadowing hours, but I felt socially uncomfortable asking questions like how many patients they get yearly, what their overheads are, and how much they bring in a year. I'll also add that I do live in California, southern California specifically. I know this area is highly saturated with both GP's and ortho's. Do you think in the years to come dental/ortho is still going to be a well-paid profession? Yeah yeah yeah I know don't do it for the money, but unfortunately there are few things I am head over hells in love with that will also support me. Would you mind giving your thoughts on the dental field in the upcoming years within a market like southern California? Also, about the old dudes not retiring, the baby boomers gotta go eventually, right?

2) So legally, I GP who does braces can't put himself in the orthodontics part of the yellow pages? Can he have the word "orthodontist" on his building? Even if that individual is Invisalign approved? Is there anywhere I could look for more of the legalities of this topic? Would a lawyer know?

3) Finally, this one is for anyone who has a good amount of experience with ortho programs. Lets say I finish in like the 70-75% in my classes, and don't get into a program. What are the chances in getting in to a program in the following years? Would there be anything I could do to change the minds of the ortho programs? Like I said, I want to go into an ortho program, but it is nice knowing if I don't get in I can still do braces.


Really, thank you to everyone who's contributed to this topic. I really really do appreciate it. Take it easy everyone

-Ryan


*Edit: Why did you refer to GP's doing braces as "imposters?" Don't get me wrong, I bet the majority of GP's doing braces did so to make more money and don't really give two poo's about the trade. That being said, you don't think it's possible for a GP that couldn't quite make it into an ortho program did years, yes, years of research on his/her own by going to the seminars, not only around the country but around the world, reading up on all the materials available to you, ect? I'm sure ortho may be a little different than the example I'm about to throw at you due to the fact that we are talking about a physical trade/skill, but I posted on here a while back asking if there was any "short cut" into dental school. I asked if there was any way I could learn the material on my own, and then either "test out" or take extremely accelerated pre-req courses to get into school quicker. Everyone called me lazy, gave me trouble for even asking an "outragous" question like that, and told me I should choose another path. LOL. Well, I read and studied all the pre-req books, and then found a program that allows you to take all of your pre-req's in 8 months (1 month per course). I rocked those classes so hard. I learned nothing new. I honestly feel that in this day in age, with the internet and such, people can learn almost anything they want. The ONLY downside I see from not doing to an ortho speciality, in terms being very comfortable with the trait, is that I'm sure you get a lot more hands on experience in the actual program vs learning by yourself. Please, call me insane for thinking this, but give me some concrete reasons why a GP doing because will always be an "imposer."

 

[tyang581]

KenKim and Daurang, thanks for the info guys!

Achad, I totally agree, I don't think I will know forsure what I like doing best in dentistry until I get in there and start getting my hands dirty. However, I never got braces (buying them this summer!) and so I really understand how much they can change someones life. It can literally give someone more self esteem and confidence. I love the idea of helping people get to that point because I've been self-conscious about my smile my whole life. But you're absolutely right, thanks for the input.

Gryffindor, thanks for the detailed info. I really appreciate it. Didn't really need to sarcastic one liner, but hey it's SDN I should expect as much. Would you mind elaborating on the issues you mentioned? The issues being the rising prices of dental school/ortho programs, and the saturation of new grads?

I could questions I have for you Gryff:

1) I really have no one who's knowledgeable in density and/or its specialties. I mean I've put in my shadowing hours, but I felt socially uncomfortable asking questions like how many patients they get yearly, what their overheads are, and how much they bring in a year. I'll also add that I do live in California, southern California specifically. I know this area is highly saturated with both GP's and ortho's. Do you think in the years to come dental/ortho is still going to be a well-paid profession? Yeah yeah yeah I know don't do it for the money, but unfortunately there are few things I am head over hells in love with that will also support me. Would you mind giving your thoughts on the dental field in the upcoming years within a market like southern California? Also, about the old dudes not retiring, the baby boomers gotta go eventually, right?

2) So legally, I GP who does braces can't put himself in the orthodontics part of the yellow pages? Can he have the word "orthodontist" on his building? Even if that individual is Invisalign approved? Is there anywhere I could look for more of the legalities of this topic? Would a lawyer know?

3) Finally, this one is for anyone who has a good amount of experience with ortho programs. Lets say I finish in like the 70-75% in my classes, and don't get into a program. What are the chances in getting in to a program in the following years? Would there be anything I could do to change the minds of the ortho programs? Like I said, I want to go into an ortho program, but it is nice knowing if I don't get in I can still do braces.


Really, thank you to everyone who's contributed to this topic. I really really do appreciate it. Take it easy everyone

-Ryan

Very few dentists are rich anymore. Very few orthodontists are rich anymore. Dental and orthodontist salary is going nowhere but down. Boomers are delaying retirement, many of them got their 401ks decimated.

A GP can't advertise as a orthodontist and that is plain and simple. They can advertise ortho treatment though. GPs can do anything but if they mess up and they get sued then they are in big trouble and their work will be compared to a specialist.

Getting into ortho is very difficult. You have to be at the top and even being at the top guarantees nothing.


Do a search of the forums or on google and you can find many of your questions answered.

 

[Ryanpoore]

Tyang, what reason do you attribute to dentists/orthodontists not being "rich" anymore? Is it purely the saturation factor? Thanks for your reply

 

[Screwtape]

Very few dentists are rich anymore. Very few orthodontists are rich anymore. Dental and orthodontist salary is going nowhere but down. Boomers are delaying retirement, many of them got their 401ks decimated.

A GP can't advertise as a orthodontist and that is plain and simple. They can advertise ortho treatment though. GPs can do anything but if they mess up and they get sued then they are in big trouble and their work will be compared to a specialist.

Getting into ortho is very difficult. You have to be at the top and even being at the top guarantees nothing.


Do a search of the forums or on google and you can find many of your questions answered.

What do you consider "rich"? Most established dentists today are well into the top 5% of wage earners in US, not saying this will be the same in future but that's a different arguement. I live in Midwest and most starting salaries around me are right around $100,000. That figure alone places new grads around me in the top 7% of wage earners.
So is rich to you like Kennedy money? If so, then you're right, most dentists today are not "rich".
Source: http://en.wikipedia.org/wiki/Personal_income_in_the_United_States

 

[gryffindor]

1) I really have no one who's knowledgeable in density and/or its specialties. I mean I've put in my shadowing hours, but I felt socially uncomfortable asking questions like how many patients they get yearly, what their overheads are, and how much they bring in a year. I'll also add that I do live in California, southern California specifically. I know this area is highly saturated with both GP's and ortho's. Do you think in the years to come dental/ortho is still going to be a well-paid profession? Yeah yeah yeah I know don't do it for the money, but unfortunately there are few things I am head over hells in love with that will also support me. Would you mind giving your thoughts on the dental field in the upcoming years within a market like southern California? Also, about the old dudes not retiring, the baby boomers gotta go eventually, right?"

I shadowed in what felt like a zillion offices as a pre-dent and dental student and ortho resident, and I had my mind blown once I learned about what goes into an ortho office overhead which wasn't until I was about halfway through residency and went to a course that addressed some of these things. Good luck finding a mentor to share that kind of info with you. Seems like all ortho mentors I usually met wanted to show me some great clinical trick. No one ever wanted to share numbers or ugly side of what's involved in running a business.

Dentistry is still a good field, but I don't know how to make it in Southern California. I live 3000 miles away so I don't really follow what goes on out there.

2) So legally, I GP who does braces can't put himself in the orthodontics part of the yellow pages? Can he have the word "orthodontist" on his building? Even if that individual is Invisalign approved? Is there anywhere I could look for more of the legalities of this topic? Would a lawyer know?

No one is looking in the yellow pages for an Orthodontist anymore. A GP can stuff his/her website with all sorts of orthodontic and Invisalign info to draw traffic to the website. As long as a GP doesn't actually call himself an "orthodontist" - there really isn't any further legality to pursue on this topic. There are advertising guidelines set by each state board of dentistry that you can cite if someone is advertising improperly, but that's like a slap on the wrist offense. A GP can't advertise his office with the word "ORTHODONTIST" outside but he could write "BRACES AND INVISALIGN" and there would be nothing wrong with that. A GP can choose to do any dental procedure as long as they hold a dental license. At the end of the day, moving teeth whether with plastic (Invisalign) or brackets and wires, is a dental procedure.

3) Finally, this one is for anyone who has a good amount of experience with ortho programs. Lets say I finish in like the 70-75% in my classes, and don't get into a program. What are the chances in getting in to a program in the following years? Would there be anything I could do to change the minds of the ortho programs? Like I said, I want to go into an ortho program, but it is nice knowing if I don't get in I can still do braces.

You won't know until you apply.

*Edit: Why did you refer to GP's doing braces as "imposters?" Don't get me wrong, I bet the majority of GP's doing braces did so to make more money and don't really give two poo's about the trade. That being said, you don't think it's possible for a GP that couldn't quite make it into an ortho program did years, yes, years of research on his/her own by going to the seminars, not only around the country but around the world, reading up on all the materials available to you, ect?

Please go do some reading over at Dentaltown to continue having your mind blown on this topic. There are some GPs who have done exactly what you are saying and some of them post on there on a regular basis, but the really knowledgeable ones are few. Many GPs think ortho is just brackets, wire, glue, and money in the bank. I use the word "imposter" not to say that a GP has less knowledge and shouldn't even be dabbling in ortho, but more to refer to the situation that it creates a lot of confusion in the public's mind who is an actual specialist and who isn't. They think that anyone who puts braces on your teeth is an orthodonitst. It's a turf war really, and it's not just limited to GPs doing ortho versus real orthodontists. Medicine has lots of people dabbling in "cosmetic surgery" who are not actually plastic surgeons. I'm sure they have lots of turf war issues too.

 

[ortho lurker]

Downsides of doing ortho as a GP:

1.) Referrals from other GPs would be very limited, but again if GPs aren't really sending out ortho referrals then that's really not a problem.
2.) Cannot get hired by the chains or do medicaid ortho (may be a blessing in disguise), but if you need the extra income to supplement your practice then that is not available.
3.) Harder to do marketing overall. As a specialist, I do muffin runs to GP offices, school events & sponsorships with my practice's name & logo "XYZ Orthodontics", and I do health fairs with my banner and we pass out our brochures. If you cannot state that you are an "orthodontist" with this marketing material, then you will have to find a way to advertise that you do braces as a dentist.

 

[Ryanpoore]

Wow... thanks so much Ortho Lurker and Gryff, that really did answer most of my questions. Serious, thank you.


I have but one last question:

I'm not sure when you guys (or gals) graduated, but in your honest opinion, in todays situation of dental school being so expensive and then having to pay a boat load more towards the ortho program if I'm blessed enough to get in, is ortho still worth the extra 2-3 years of lost salary and additional debt? If I was determined to be the best damn GP doing ortho that ever lived, is the price worth being able to actually advertise myself as an "orthodontist?" It seems like thats most of what current ortho grads are paying for now. If you had to do it right now, would it be worth the lost sleep to be in the top 10% and the extra cost afterwords?

Once again, you guys have been such a help, I'm sorry for bombarding you with questions and if you didn't live 3000 miles away I would gladly buy you lunch or something. Thanks


*edit...I lied, again. One more question regarding the legality of a GP offering ortho. Lets say I was okay with doing most type I and II cases, but for some of the more serious ones, I bring IN an ortho and pay him on a per-case basis. The important part is me bringing him INTO my practice as an employee. Would I then "technically" be allowed to put the word "orthodontics" on my door? How strict is the governing body (ADA or Court of Laws, not sure) when it comes to these sort of advertising loop holes? What's a typically punishment for such offense?

 

[yappy]

You forgot the part where the stock market has made up for all of its losses in the last few years and then some. This guy is too extreme to be taken seriously.

Very few dentists are rich anymore. Very few orthodontists are rich anymore. Dental and orthodontist salary is going nowhere but down. Boomers are delaying retirement, many of them got their 401ks decimated.

A GP can't advertise as a orthodontist and that is plain and simple. They can advertise ortho treatment though. GPs can do anything but if they mess up and they get sued then they are in big trouble and their work will be compared to a specialist.

Getting into ortho is very difficult. You have to be at the top and even being at the top guarantees nothing.


Do a search of the forums or on google and you can find many of your questions answered.

 

[Ryanpoore]

I hoped as much. He seemed very pessimistic about the situation lol

 

[Silent Cool]

OP,

Based on everything I have learned over the past few years, Ortho and dentistry will still be a good profession into the future, but with a few new challenges.

1) Like all fields, there are cycles. Right now, because the economy sucks and people have a lot of debt, dentists and orthos aren't doing as well. That's because dentistry, unlike medicine, is much more market-driven. In other words, when the market tanks, dentists almost always suffer because people don't usually make dental care a top priority. The market won't suck forever.

2) Older orthos are not retiring. This is, of course, making the market more difficult. But they won't work forever. Even with older orthos retiring in fewer numbers and more programs opening, consider that the population is growing (albeit slowly), and more adults these days are getting braces. An increase in orthos and dentists by some degree is inevitable, given population growth and more overall demand.

3) When you set up a practice, focus on keeping the overhead low. Also look into going a bit "rural." The SoCal market is notoriously hard. Everyone dentist I know of there has said so. You would do infinitely better in the midwest, south, and southeast.

4) The tuitions that some of these programs charge is truly outrageous and, in my book, borderline unethical. I emailed several schools about it and their response was simply, "do IBR." That's not a very good long-term solution, IMO. Anyway, if you apply, my advice is to: 1) take the GRE and, 2) apply to every program that has reasonable or no tuition. I just don't see how someone can pay for 3 years of USC ortho at 80K per year if he already has 400K of loans. That's insane. That would be over 700K at the current interest rates.

5) When you set up a practice, consider offering evening and weekend appointments. I messaged one orthodontist on dentaltown whose office hours are something like M-Th, 2-8. That's a great idea. Many people would prefer to see a dentists orthodontist in the evening or on weekends, rather than have to leave work mid-day to go back, or pick their kids up from school and then take them back. It's a pain. By offering evening and weekend hours, you have a good chance at capturing a segment of the market that other orthos may be less likely to get.

An option to consider is PSLF. This is an often-forgotten option relative to military but it is a good option especially because many dental schools these days have a hard time recruiting long-term faculty. I believe that the weekly requirement for PSLF is 30 hours. You could do that and then easily work another 25+ hours per week at your own practice. As it is, many orthodontists work only 3 days per week. Also, I believe that your years of ortho training would count towards your PSLF committment, so you would end up owing only 7-8 years after training.

good luck.

 

[Ryanpoore]

Thank you so much. This answered so many of my questions. I was just laying in bed last night after studying, and while there are a good amount of ortho's in socal, I was just doing some round numbers and it still seems amazingly profitable. I'm actually a marketing major, and I've always been the guy that thinks with more of a marketing cap on. I'm not even kind of the smarted kid in the room when it comes to science (meaning I have to try harder than most to stay at the top ~10% of my classes) but I definitely have a better business background than most my classmates, which I'm hoping will set me apart from the other guys. It also kinda sound bad saying this, but I'm a tall, good looking, sociable, stereo typical "good looking guy," and where I plan to settle down and practice 90% of the population are upper/middle class white families. It almost seems too easy to get the housewives to choose me over some of the other guys, who are mostly Asian/Indian (I'm not trying to say anything bad here, it's the same reason I would never open an office in a predominantly Asian/Indian community).

I actually got pretty lucky yesterday... my parents got a stray dog at their house and long story short it ran away and I had to go chase it down. It ran into this nice mans backyard, and after talking to him for a little bit I found out that he is an ortho and is also a teacher at USC dental's school. I'm super excited and he gave me his card and we set a meeting up at his place to talk. I don't know how valuable it is knowing someone like a teacher at a dental school to put in a nice word when it comes to applying to specialties, but I thought it couldn't hurt.

I think I'm just going to do a lot of number crunching and market research to help myself come to a conclusion on whether or not ortho is worth specializing in nowadays. The amount of time I could save by not doing ortho I could put towards setting up business models and marketing schemes for my practice so it would be ready to go the day I get out of school, and considering I would save 2-3 years of both time and tuition, I'm not sure ortho is worth it anymore just to be called an "orthodontist." I'll have to talk to some experienced orthos and dentists to get their take on this, but I have a feeling that orthodontics is more of a marketing game now, as opposed to years past where it was more "hey look I'm an ortho and I'm the only one that can straighten your teeth. Hey dentists, please send me your clients and money." I think orthodontists have to do just as much marketing as a dentist who does ortho now... so if you think about it, is it really worth it for that title?



As always, I appreciate all your help. I did not think I would get this much valuable information. I know it will be a few years down the line, but I can't wait to contribute my findings as a someone who is strongly considering being a GP who does 90% ortho cases. I wish I could help more people on here like you all have helped me but as you can obviously see I dont really know what I'm doing yet haha. Thanks again!!


-Ryan


*edit: I rethought it and I was wrong. I would still need to spend a good year or two learning everything I possibly could on orthodontics, so I wouldn't necessarily be saving "lost income" because if I want to know ortho as well as a trained specialist I imagine it would take a similar amount of time. I would however save a couple hundred thousand, which may be worth it just for that. I'll have to think about it some more

 

[NDPitch]

A little late to the game but I thought I'd reply.

I'm in dental school now, and this topic actually just came up in our ethics course. As others said, a GP cannot advertise as being an orthodontist. They can offer orthodontic tx, but are doing so as a GP.

Also, every ortho case you do is held to the level of an orthodontist that went through an ortho program. This means that if you botch up a case for whatever reason, the board holds you to the same standards of the specialty. So it's basically "treat at your own risk" in terms of liability. I think if I were a practicing GP that wanted to incorporate ortho to keep things fresh, I'd only take the most basic cases in an attempt to avoid any headaches down the road. I'm told that no specialists like fixing a GP's botched attempt at a complicated case.

 

[TSDentSurg]

A little late to the game but I thought I'd reply.

I'm in dental school now, and this topic actually just came up in our ethics course. As others said, a GP cannot advertise as being an orthodontist. They can offer orthodontic tx, but are doing so as a GP.

Also, every ortho case you do is held to the level of an orthodontist that went through an ortho program. This means that if you botch up a case for whatever reason, the board holds you to the same standards of the specialty. So it's basically "treat at your own risk" in terms of liability. I think if I were a practicing GP that wanted to incorporate ortho to keep things fresh, I'd only take the most basic cases in an attempt to avoid any headaches down the road. I'm told that no specialists like fixing a GP's botched attempt at a complicated case.

Seriously, don't attempt to treat anything other than simple dental malocclusions. Crossbites and skeletal malocclusions should be referred to orthodontists.

There's a reason we have specialists. Want to hear what my D4/5 friend on his OMS rotation at my school related to me when a GP thought he could do everything?

This GP had a patient with a endodontic infection of #2, and the MP root happened to be in the maxillary sinus. Believing he could treat this case, he did a RCT.

A few days post-op, the patient started to run a fever and complained of facial pain. So the GP referred the patient to our OMS department. A CT scan was done, and it revealed a periapical abscess of the MP root. Apparently, there was a hairline branch of the MP canal that the GP missed.

So that lead to one of our consultant OMSs and my friend having to do a Caldwell-Luc to get exposure for an apicoectomy and sinus washout.

This GP should've referred the patient to an endodontist. Or to an OMS to extract the tooth. Anything but treating it himself.

 

[Ryanpoore]

Well, I wrote a long response but my power went out and it all got deleted. So, long story short, I agree with both of you. GP's doing ortho surely mess up a lot of cases, and most of them are not specialists. What I'm wondering is do you think its possible to become a specialist without going in the program? I'm literally talking about taking two years off after graduating to learning everything available about orthodontics. I think the important question here is whether or not there is enough information available to people outside of ortho programs to adequately learn the trait of orthodontics, as well or better than someone who went though the program. I have learned everything from the science pre reqs, to music production (my job right now) all without a professor and by using the information available to me. I think music production is a lot like learning something like ortho to be honest. They're both traits where you need to know everything about the subject before you begin practicing the trait. I could "technically" know everything about music production, but it takes a while to figure out how to apply that information into real circumstances. Likewise with orthodontics, just knowing all the information doesn't mean you can slap braces on someone and be good to go. There would definitely be a few years, assuming you didn't have the hands on experience that the programs offer you, where you would need to take everything slow and refer the more serious cases out. Maybe make referral deals where you will refer someone if the ortho shares information on how he/she handles a case like that. I really find it hard to believe that if one set their mind to it, that you NEED to be in an ortho program to be an orthodontic specialist

In my personal experience, higher education is usually behind in terms of current knowledge, they're a bit outdated, and usually all the information could be learned on your own. What do you guys' think? Is there enough information out there? Or do the ortho programs really offer something that literally can't be learned any other way than being in that program? If there literally isn't enough information out there, I should get into an ortho program and publish all the knowledge because I have a feeling as time goes on more and more GP's are going to be doing ortho, and ortho will be considered a specialty less and less.

 

[dentalWorks]

Hey there, quick question. So I'm about to take my DAT and apply to dental schools, I have a 3.9 and I've worked pretty hard to get to where I'm at today, and I was perfectly prepared (mentally at least) for the work load ahead of me as I continue pursuing my goal of being an orthodontist. I was talking to a family friend tonight who asked me how school was going and what I wanted to do. I explained my plan, and to my surprise, she is an assistant in an ortho office. I instantly started firing off questions and we got on the topic of general dentists who could offer orthodontics. I didn't want to tell someone who's been working in the field for 20+ years that she was wrong, but I was thinking "No way can a general dentist do anything outside invisalign!" After reading how near-impossible it is it get into an ortho program, I assumed that LEGALLY it would be against the law for a general dentist to offer orthodontic treatment. Low and behold, I get home and do some searching and find out that general dentists can practice ortho after doing some weekend continuing education courses! My mind is blown right now. I have some questions for anyone who may know. Thanks everyone .

1) Legally, can a regular dentist seriously do orthodontics if they are properly trained to do so by those continuing education programs or weekend seminars or whatever they're called?

2) What are any "legal" issues associated with this? Can I graduate dental school, attend every ortho seminar known to man, and then open and orthodontic practice? Or do I have to advertise myself as a dentist who also does ortho? Are there any actual LAWS regarding how I advertise myself assuming that I'm just as competent in handling ortho cases as an actual ortho?

3) Do any of you see dentistry and ortho slowly becoming one skill in the future as technology requires less and less work on the ortho's side?

4) Does anyone know or have experience with a general dentist who sees nearly all of his patients for ortho reasons?



Thanks again guys. If this is true, it would lift a huge weight off my chest. I'm super worried that I won't be able to get into ortho. I know I'll do well in dental school, but beating out 90% of my classmates... I'm not for sure I can do that.


Thanks

-Ryan

Yeh, general dentists are capable of doing implants, braces, invisalign (yes even a monkey can set this up), even some are skilled (and interested) in the more complex endo cases, and most general dentists I know work on over 90% of their pedo patients. And I know one GPs in my school right now who did about 10-15 full-mouth reconstructions (very heavy prosth job) a year, I am sure there are many more like him.

Legally speaking, a general dentist is ALLOWED to do the work of most specialists(except oro-facial surgeries ~ aka oral surgeon work), however, where things get legally involved is in court cases.... when you are a GP doing more specialized work, you are held at the same standard as if you were a specialist.

 

[Moose A Moose]

Sure. GP can open a "Cosmetic Dentistry Clinic".

 

[ortho lurker]

There would definitely be a few years, assuming you didn't have the hands on experience that the programs offer you, where you would need to take everything slow and refer the more serious cases out. Maybe make referral deals where you will refer someone if the ortho shares information on how he/she handles a case like that. I really find it hard to believe that if one set their mind to it, that you NEED to be in an ortho program to be an orthodontic specialist.

I think that's the key about the education in an orthodontic residency program, the fact that you have an instructor over your shoulder overseeing the case from start to finish. Sure you could attend weekend CE courses on typodonts, but I doubt they would provide the direct patient instruction from beginning to end, and I doubt any sweetheart deals with local orthodontists would be that thorough. I also doubt any CE course would be adequate for orthognathic cases, but having experience with those type of cases would lead to better treatment planning.

GPs should also be a little careful with Invisalign cases if they don't know how to finish them by other means. I had consults come in asking me to rescue them because they were on their last aligner from a GP and were not satisfied with the results. What does the GP do at that time, refund the patient their $?

 

[Koalafied]

Sure. GP can open a "Cosmetic Dentistry Clinic".

Lol. But rarely live up to the name.

 

[gryffindor]

Well, I wrote a long response but my power went out and it all got deleted. So, long story short, I agree with both of you. GP's doing ortho surely mess up a lot of cases, and most of them are not specialists. What I'm wondering is do you think its possible to become a specialist without going in the program? I'm literally talking about taking two years off after graduating to learning everything available about orthodontics. I think the important question here is whether or not there is enough information available to people outside of ortho programs to adequately learn the trait of orthodontics, as well or better than someone who went though the program. I have learned everything from the science pre reqs, to music production (my job right now) all without a professor and by using the information available to me. I think music production is a lot like learning something like ortho to be honest. They're both traits where you need to know everything about the subject before you begin practicing the trait. I could "technically" know everything about music production, but it takes a while to figure out how to apply that information into real circumstances. Likewise with orthodontics, just knowing all the information doesn't mean you can slap braces on someone and be good to go. There would definitely be a few years, assuming you didn't have the hands on experience that the programs offer you, where you would need to take everything slow and refer the more serious cases out. Maybe make referral deals where you will refer someone if the ortho shares information on how he/she handles a case like that. I really find it hard to believe that if one set their mind to it, that you NEED to be in an ortho program to be an orthodontic specialist

In my personal experience, higher education is usually behind in terms of current knowledge, they're a bit outdated, and usually all the information could be learned on your own. What do you guys' think? Is there enough information out there? Or do the ortho programs really offer something that literally can't be learned any other way than being in that program? If there literally isn't enough information out there, I should get into an ortho program and publish all the knowledge because I have a feeling as time goes on more and more GP's are going to be doing ortho, and ortho will be considered a specialty less and less.

Maybe because you're a pre-dent, you still don't understand this concept yet. Dentistry is a very hand-on profession. The thing you will NOT learn from reading all the books in the world is the physical motions of doing dental procedures. You will never learn from a book what it physcially feels like to extract a tooth from someone's mouth, to feel the PDLs literally disconnecting as you take the tooth out. You will never learn what it feels like to put the cavitron tip up against some tenacious calculus and the actual amount of finger pressure required to bust that calculus off the tooth.

Similarly in Ortho, you can learn lots of academic orthodontics from books and journals and super advanced CE courses. The one thing Ortho residency will give you that you can not get from self-study is access to a pool of patients where you spend 2 years doing those procedures you read in the journals. Here is the important part - You have little liability at this time because you are covered under your residency's malpractice. Many residencies are "self taught" and the clinical instructors will not hold your hand as you perform your ortho procedures. But they will catch you before you do something really wrong. And they will cover you if something goes really wrong because the patient can not come after your dental license while being treated in an academic environment.

This is totally not the same as music production or whatever other non-procedure based field you are going to come up with now to compare the two. If you screw up your music production, is your client going to come after your license and take you to court, possibly preventing you from ever producing music again?

 

[Ryanpoore]

Gryff, thanks again for the information. The hands on aspect was the one thing that could present problems, and you're right I don't really know the relationship between what you learn and what you do yet, and how hard it is to piece the two together.

About the music production thing so I don't get yelled at anymore; I know it's not exactly comparable. Obviously any time you're doing something that can potentially hurt someone, that skill is in a league of its own. I was referring more the the idea that someone could read every book, go to every class, and learn as much about music production as humanly possible, but even then when you get your first client that throws you a really bad track, your results are not going to be good purely because you know technically what to do. You must also know how to apply you're knowledge. When I first started I would "refer" all the cases (tracks) out to other engineers because I simply was not 100% sure that my results were the best the my clients could get. As the years went by, I became more comfortable, and progressed that way. The whole analogy, albeit not the best example, was just to illustrate that it seems one could learn the trait of orthodontics given enough drive and patience (referring difficult cases out in the beginning years). I really do appreciate your feedback Gryff, you're very knowledgeable in this subject, and it means a lot to me that you're sharing years worth of experience with me. So thank you for that.

I think I've gotten all the questions I had answered, thank you to everyone who has contributed in this thread. I look forward to keeping you all updated and hopefully contributing useful information to people on this forum. Thanks again


-Ryan

 

[charlestweed]

Thank you so much. This answered so many of my questions. I was just laying in bed last night after studying, and while there are a good amount of ortho's in socal, I was just doing some round numbers and it still seems amazingly profitable. I'm actually a marketing major, and I've always been the guy that thinks with more of a marketing cap on. I'm not even kind of the smarted kid in the room when it comes to science (meaning I have to try harder than most to stay at the top ~10% of my classes) but I definitely have a better business background than most my classmates, which I'm hoping will set me apart from the other guys. It also kinda sound bad saying this, but I'm a tall, good looking, sociable, stereo typical "good looking guy," and where I plan to settle down and practice 90% of the population are upper/middle class white families. It almost seems too easy to get the housewives to choose me over some of the other guys, who are mostly Asian/Indian (I'm not trying to say anything bad here, it's the same reason I would never open an office in a predominantly Asian/Indian community).

Then you will have a hard time getting these upper/middle class patients to approve your treatment if you are a GP. These patients tend to be more educated than the average population. Not only do they know the difference between GP and ortho, they also know things like Damon brackets, lingual braces, RPE vs quad, Herbst vs BSSO advancement surgery etc. They usually google stuff on the internet before they come to see the dentist/orthodontist. The reason that many orthos in SoCal are struggling now is they all target the same top 25% income earners and largely ignore the other 75%. That's why dental chains continue to well because they choose to treat the other 75%. I know for the fact that most Hispanic and Asian patients would rather go see Asian doctors. They are actually afraid of the White doctors due to the perceived high fees and cultural differences.

Yes, it is worth spending more $$$ and years to do an ortho residency.

 

[Koalafied]

Then you will have a hard time getting these upper/middle class patients to approve your treatment if you are a GP. These patients tend to be more educated than the average population. Not only do they know the difference between GP and ortho, they also know things like Damon brackets, lingual braces, RPE vs quad, Herbst vs BSSO advancement surgery etc. The reason that many orthos in SoCal are struggling is they all target the same top 25% income earners and largely ignore the other 75%. That’s why dental chains continue to well because they choose to treat the other 75%. I know for the fact that most Hispanic and Asian patients would rather go see Asian doctors. They are actually afraid of the White doctors due to the perceived high fees and cultural differences.

Yes, it is worth spending more $$$ and years to do an ortho residency.

The secret is to keep the number of visits to a very minimal.

 

[Koalafied]

For what it's worth, take it from this fellow pre-dent:

1) Legally, can a regular dentist seriously do orthodontics if they are properly trained to do so by those continuing education programs or weekend seminars or whatever they're called?

Yes, legally but with jurisprudence. The keyword is orthodontics not orthodontist. And yes, many GP's hoard all possible cases that are within their skills set, sometimes even desperately out of their skill set; and thus, leaving you behind, as an orthodontist, with just/mostly complex cases. They've even told me in the past that a partnership consisting of at least 3 orthos which could not even handle the tides of a saturated market. The only rational way to start up an even-remotely-successful-sole-proprietorship, these days, in a large metropolitan area would require inheriting a large sum of money/funds or miraculously winning the lottery. So start taking some baking classes on how to bake plenty of gourmet cookies/brownies and classes on pampering, so that you can pamper the generals. Now with regards to weekend seminars, some of those teach you ways to manage your astronomical debt on top of the CE. Though most of those ways can found in a basic UG marketing textbook.

2) What are any "legal" issues associated with this? Can I graduate dental school, attend every ortho seminar known to man, and then open and orthodontic practice? Or do I have to advertise myself as a dentist who also does ortho? Are there any actual LAWS regarding how I advertise myself assuming that I'm just as competent in handling ortho cases as an actual ortho?

As long as you don't outright declare yourself as/an "orthodontist," then there should not be any legal proceedings assuming you've provided proper standard of care and careful documentation. And yes, heavy marketing tactics will be a GP's greatest tool/weapon in attracting/reeling-in patients/customers. Look at the YP, look at the back of church pamphlets/hymms, look at the flyers from school sporting events, and look at etc. Now carefully look at how the word "orthodontics" is elicited. Once again, look inside an UG marketing textbook.

3) Do any of you see dentistry and ortho slowly becoming one skill in the future as technology requires less and less work on the ortho's side?

Since I do not possess precognition nor any interest in becoming an orthodontist, I cannot predict the future nor make any thoughtful conjectures.

4) Does anyone know or have experience with a general dentist who sees nearly all of his patients for ortho reasons?

Yes. Like I've stated earlier in question 1. Also, at some practices/clinic I've observed, there are specific days specifically scheduled/assigned for just orthodontics.

Thanks again guys. If this is true, it would lift a huge weight off my chest. I'm super worried that I won't be able to get into ortho. I know I'll do well in dental school, but beating out 90% of my classmates... I'm not for sure I can do that.

A sizable population of 'people' at my alma mater wants to become an ortho because, and I quote, "it's the least dirtiest of 'em all."

My conclusion:
See how it all adds up? GP = orthodontics & orthodontist = orthodontist+orthodontics

It's just 2 letters that make a big difference.
And as I've quoted earlier in another thread, "It's the little things that make life big;" though there are others that beg to differ.

No problem. I hope that helps and your welcome. Study earnestly, effectively, and efficiently; and you will be fine even as a future orthodontist. By the way, I've always thought orthos were cool since they've helped straighten my teeth, but they're just not that funny.


Good luck.

EDIT: It's actually 2 letters not 3.

 

[Ryanpoore]

Hey Charles, thanks for the input. I'm not sure what area of SoCal you're involved in, but in the area I'm referring to, the ONLY reason why one mom chooses to send her kid to a certain ortho is because of what the other moms are doing. Like I said in the beginning of this thread, I have a family friend who has been an ortho assistant for 20+ years now in my location. She didn't know anything about becoming an orthodontist, hence my asking those questions here, but she knows what types of patients has, how they got there, and how educated they are. Mothers talk faster than any just about anything, and most of the time they just want to "fit in" with what everyone else is doing. They may know what the difference between an ortho vs a GP doing braces, but given that they would be dealing with a charming, good looking GP who would have a nice portfolio of cases and past patients to look at, I can tell you for a fact mothers don't care that GP does braces over an ortho. The ONLY problem, like many of you mentioned, is that first wave of clients that can begin "spreading the seeds" if you will. After the seeds have been spread, just cultivate them right and the moms will do a lot of the work for you.



As to the whole "targeting the other 75%" thing. You couldn't be more right. There are most definitely people who are on the border of being able to afford braces, and the number of those people is in fact larger than the upper/middle class market I spoke of. Here is the thing though, while I totally respect how you've approached business by targeting this market, most ortho's would rather go after that upper market and have to work less. While yes, not everyone can do that, ideally, for most, it's ideal. Not only that, but I prefer to work with the middle/upper class market. Not the snooty moms who I saw in a past post you mad that complain about things like hours, appointment times and such, but genuine middle class families who can afford braces, but it's not like they have endless money to throw so they still treat you with respect for the most part. I have a somewhat first have experience with these two markets because I'm very lucky in the fact that my parents have been pretty successful in buying and managing apartment complexes, and they've taught a lot about marketing, things I will be applying to my practice. For example they have two apartment complexes in our town, Brea. One is the cheapest in terms of rent competition, and the other is the most expensive. They have different names, they're on different sides of town, and not many know that same people own both of them. By giving two options, you can really grab a big share of the market. Someone who see's the less expensive option may want something more, and we are the people to give that to them. Someone likewise may want something less, we are also available to give that to them.

Long story short, that is my plan with orthodontics. I will start off by trying my luck in the saturated market targeting the high earners. Hopefully, I start slow and build up to the point where most of my marketing involves jump-starting the mom to mom communication train, at which point I WILL get referrals from the moms who will be very please with not only my service but the general atmosphere of the office. One I get those new referral's, depending on whether I went the GP doing ortho route or "orthodontist" route, I would need to base the 15-20 minute consultation meeting around either "Many schools teach outdated ortho menthods and the fact of the matter is orthodontists are trained to handle extreme cases, which obviously beautiful little Sara doesn't have," or "Orthodontists go through extensive training bla bla bla sell the fact that I spent 200k more and 2 years learning the trait." Either way, it's salesmanship and marketing.

If that DIDN'T workout for me, I would take a page out of my parents book and open a "value brand" orthodontic practice in a lower/middle class area. The office would be probably a lot like how yours are set up. What you see is what you get: Fast treatment (many patients a day) and run of the mill boring office (low overhead). While this isn't my preferred method of business, targeting the larger quantity of lower income people, it definitely works. I think a big reason dental chains do so well targeting this market is because they don't have to deal with the mass amounts of people. From what I understand, many dentists/ortho's dont like working for these chains for that specific reason, they see tons of patients a day and it's a lot of work to make roughly the same amount as a moderately successful ortho targeting the middle class.

I'm extremely lucky to have parents that and both willing and able to invest in 2 practices right upon my graduation, something I know most have to spend years working up to. Being able to have my own practice from the get go with little stress about in reguards to being able to pay off the practice right away will allow me to focus purely on marketing and getting people, specifically moms, through the door. If that doesn't work, I would surely take a page out of your book and begin catering to a different income market.


Thanks for your help, you're clearly very successful in what you've done, and I would be lucky to be able to get to your level of I think it was 3 practices? I may be thinking of another guy on this forum though. Either way, you clearly know what you're talking about.

 

[Koalafied]

Long story short, that is my plan with orthodontics. I will start off by trying my luck in the saturated market targeting the high earners. Hopefully, I start slow and build up to the point where most of my marketing involves jump-starting the mom to mom communication train, at which point I WILL get referrals from the moms who will be very please with not only my service but the general atmosphere of the office. One I get those new referral's, depending on whether I went the GP doing ortho route or "orthodontist" route, I would need to base the 15-20 minute consultation meeting around either "Many schools teach outdated ortho menthods and the fact of the matter is orthodontists are trained to handle extreme cases, which obviously beautiful little Sara doesn't have," or "Orthodontists go through extensive training bla bla bla sell the fact that I spent 200k more and 2 years learning the trait." Either way, it's salesmanship and marketing.

You clearly have too much free time on your hands at Whole Foods® from 10AM through noon.

 

[TSDentSurg]

You clearly have too much free time on your hands at Whole Foods® from 10AM through noon.

Don't be mean...

And OP, honestly, if you want to do orthodontics, do the residency and get your ABO cert. Things will be that much easier.

I want to do GB/TR, implants, gum grafts, etc. I *could* just take a bunch of perio and implantology CME, but I'd much rather do a perio/implantology residency where I can learn on actual patients while being taught by certified periodontists and implantologists.

You have no idea how much board certification is worth.

 

[Ryanpoore]

DentSurg, thanks. After hearing what you all have to say, I am definitely going to try to go that route. Thanks again man.


Koalafied, I do have some time on my hands right now as I'm just relaxing in the transition to dental school. No need to be a jerk though.

 

[TSDentSurg]

DentSurg, thanks. After hearing what you all have to say, I am definitely going to try to go that route. Thanks again man.


Koalafied, I do have some time on my hands right now as I'm just relaxing in the transition to dental school. No need to be a jerk though.

Lady, you mean. And thanks! Glad I could be of help!

 

[Koalafied]

By the way, I've always thought orthos were cool since they've helped straighten my teeth, but they're just not that funny.

Koalafied, I do have some time on my hands right now as I'm just relaxing in the transition to dental school. No need to be a jerk though.

You'll probably become an orthodontist.

 

[mike3kgt]

Hey Charles, thanks for the input. I'm not sure what area of SoCal you're involved in, but in the area I'm referring to, the ONLY reason why one mom chooses to send her kid to a certain ortho is because of what the other moms are doing.

Long story short, that is my plan with orthodontics. I will start off by trying my luck in the saturated market targeting the high earners. Hopefully, I start slow and build up to the point where most of my marketing involves jump-starting the mom to mom communication train, at which point I WILL get referrals from the moms who will be very please with not only my service but the general atmosphere of the office. One I get those new referral's, depending on whether I went the GP doing ortho route or "orthodontist" route, I would need to base the 15-20 minute consultation meeting around either "Many schools teach outdated ortho menthods and the fact of the matter is orthodontists are trained to handle extreme cases, which obviously beautiful little Sara doesn't have," or "Orthodontists go through extensive training bla bla bla sell the fact that I spent 200k more and 2 years learning the trait." Either way, it's salesmanship and marketing.

Big reason why dentistry as a profession is going in the wrong direction and SoCal is ground zero. Too much focus on "doing it all" or "super-GPs" that fail to recognize that many cases require specialized care. Yes the OP said he'd focus on "simple cases" and "refer at the beginning" but it's easy to think you know a lot and MUCH harder to recognize and ADMIT what you don't know. This is why many GPs get caught in trouble in endo, perio, prostho, ortho, OS.

Furthermore, having a strategy that is to "rely on good looks" and targeting a "value" practice is a good strategy, however, we will see if you actually go in this direction once you realize how hard it is to work in a "value" practice. Good looks only go so far until you patients have a problem and see somebody else. All of this is typical SoCal nonsense, as many of the good, classic SoCal providers are being replaced with foreigners, aggressive super GPs and people who have super-debt loads that need to be $$ focused even with IBR. All of this for good weather?

I was a GP for two years and know the game. I decided against this life even though it meant a pay decrease... life is more than hitting the biggest target at the end of the day.

Key: keep your debt load low (i.e. avoid USC, NYU etc), become good then fast, be business savy (which you are ahead of the game), and most importantly, don't treat patients like $$ signs.

Good luck.

 

[Daurang]

I know for the fact that most Hispanic and Asian patients would rather go see Asian doctors. They are actually afraid of the White doctors due to the perceived high fees and cultural differences.

It's not perceived; it's a FACT and part of culture. White doctors won't budge but Asian doctors will give huge discounts plus free pickup/dropoff. Which White dentist in SoCal will do prophy for $5, composite for $20, full mouth SRP for $200, PFM for $300, ortho for $1000? Same concept apply to discount when dealing with masseuse, plumber, electrician, builder, wedding planner, restaurant, Macy's, Tiffany's, etc.

 

[Koalafied]

I know for the fact that most Hispanic and Asian patients would rather go see Asian doctors. They are actually afraid of the White doctors due to the perceived high fees and cultural differences.

Yes, it is worth spending more $$$ and years to do an ortho residency.

It's not perceived; it's a FACT and part of culture. White doctors won't budge but Asian doctors will give huge discounts plus free pickup/dropoff. Which White dentist in SoCal will do prophy for $5, composite for $20, full mouth SRP for $200, PFM for $300, ortho for $1000? Same concept apply to discount when dealing with masseuse, plumber, electrician, builder, wedding planner, restaurant, Macy's, Tiffany's, etc.

In my observation, it's the "

" mentality which really explains this phenomenon.

My 2 cents.

 

[Timpson]

It's not perceived; it's a FACT and part of culture. White doctors won't budge but Asian doctors will give huge discounts plus free pickup/dropoff. Which White dentist in SoCal will do prophy for $5, composite for $20, full mouth SRP for $200, PFM for $300, ortho for $1000? Same concept apply to discount when dealing with masseuse, plumber, electrician, builder, wedding planner, restaurant, Macy's, Tiffany's, etc.

Then you will have a hard time getting these upper/middle class patients to approve your treatment if you are a GP. These patients tend to be more educated than the average population. Not only do they know the difference between GP and ortho, they also know things like Damon brackets, lingual braces, RPE vs quad, Herbst vs BSSO advancement surgery etc. They usually google stuff on the internet before they come to see the dentist/orthodontist. The reason that many orthos in SoCal are struggling now is they all target the same top 25% income earners and largely ignore the other 75%. That's why dental chains continue to well because they choose to treat the other 75%. I know for the fact that most Hispanic and Asian patients would rather go see Asian doctors. They are actually afraid of the White doctors due to the perceived high fees and cultural differences.

Yes, it is worth spending more $$$ and years to do an ortho residency.

Well, Western Dental and most of the corporate offices were founded by white dentists and they have probably the most competitive pricing around.

Most Hispanics would prefer to go to a dentist that speaks Spanish over an Asian or white dentist. I don't know where you guys got this idea. There are plenty of Hispanic dentists in California that advertise heavily to their own demographic group. Asians are very successful business owners in California but I don't think it has to do with the fact that they are seen as more trustworthy then others. Personally, one of the most negative stereotypes about Asians around here is that they are greedy and extremely stingy. I am not saying that this is true but the stereotype is there. Remember that in the 1992 LA riots Korean businesses were targeted heavily, particularly because of the Latasha Harlins incident.

The fact is Asians are over represented in dentistry, especially in SoCal. Not to mention a lot of the foreign dentists who come here are from Asian countries. These foreign dentists push prices down heavily because even if they are capable, most American patients (AKA, those with money) will probably choose to go to a dentist who is culturally American and understands how to communicate and advertise to Americans and not some FOB dentist from another country. Foreign dentists here generally compete for the patients who shop for dentistry on price alone, or are using government insurance.

 

[charlestweed]

Well, Western Dental and most of the corporate offices were founded by white dentists and they have probably the most competitive pricing around.

Here in CA, 90+% of the associate dentists who work for these chains are Asians. The patients choose to come to these chains not because the founders are White dentists but because of the low fees.

Most Hispanics would prefer to go to a dentist that speaks Spanish over an Asian or white dentist. I don't know where you guys got this idea. There are plenty of Hispanic dentists in California that advertise heavily to their own demographic group. Asians are very successful business owners in California but I don't think it has to do with the fact that they are seen as more trustworthy then others. Personally, one of the most negative stereotypes about Asians around here is that they are greedy and extremely stingy. I am not saying that this is true but the stereotype is there. Remember that in the 1992 LA riots Korean businesses were targeted heavily, particularly because of the Latasha Harlins incident.

That's true but there are not enough Hispanic dentists to take care of the nearly 40% Hispanic population in California. Just look at your classmates. How many people in your dental class are Hispanics? It's even more rare to see a Hispanic orthodontist. Finding a Hispanic orthodontist is like finding a needle in a haystack. The Hispanic patients, therefore, have to go see the Asian dentists/orthodontists.

The fact is Asians are over represented in dentistry, especially in SoCal. Not to mention a lot of the foreign dentists who come here are from Asian countries. These foreign dentists push prices down heavily because even if they are capable, most American patients (AKA, those with money) will probably choose to go to a dentist who is culturally American and understands how to communicate and advertise to Americans and not some FOB dentist from another country. Foreign dentists here generally compete for the patients who shop for dentistry on price alone, or are using government insurance.

I agree. If you are a White dentist and speak perfect English, you will have better chance at attracting the middle/high income patients. However, there are not enough White dentists to take care of the vast majority of the 60% White population in California either. Just go to UCLA and USC dental schools and count the number of White students at those schools. Due to the poor economy and the rise in housing cost, a lot of the White families move from OC to areas like Corona, Rancho Cucamonga, Upland, Chino Hills etc. There are not a lot of White dentists in these areas; therefore, they have no other choices but to go see the Asian dentists.

I purchased an office from a White retired orthodontist in one of these average income cities that I mentioned above. I have a lot of White patients at this office. I am pleasantly surprised at how nice these existing patients have treated me and have kept referring their friends and relatives to the office.

 

[Timpson]

Here in CA, 90+% of the associate dentists who work for these chains are Asians. The patients choose to come to these chains not because the founders are White dentists but because of the low fees.


That’s true but there are not enough Hispanic dentists to take care of the nearly 40% Hispanic population in California. Just look at your classmates. How many people in your dental class are Hispanics? It’s even more rare to see a Hispanic orthodontist. Finding a Hispanic orthodontist is like finding a needle in a haystack. The Hispanic patients, therefore, have to go see the Asian dentists/orthodontists.

I agree. If you are a White dentist and speak perfect English, you will have better chance at attracting the middle/high income patients. However, there are not enough White dentists to take care of the vast majority of the 60% White population in California either. Just go to UCLA and USC dental schools and count the number of White students at those schools. Due to the poor economy and the rise in housing cost, a lot of the White families move from OC to areas like Corona, Rancho Cucamonga, Upland, Chino Hills etc. There are not a lot of White dentists in these areas; therefore, they have no other choices but to go see the Asian dentists.

I purchased an office from a White retired orthodontist in one of these average income cities that I mentioned above. I have a lot of White patients at this office. I am pleasantly surprised at how nice these existing patients have treated me and have kept referring their friends and relatives to the office.

I agree with what you are saying here. Most people in California are very open to ethnicities of every type. My parents are white and go to an Asian dentist. However, the majority of my classmates that are Asian aren't any different then most Americans. We all kind of act the same now. That is the great thing about the culture of this country, it assimilates people well.

I think because Asians have been so successful really speaks to their abilities as businessmen and businesswomen. I don't find much difference nowadays between Asians and whites in Southern California or their mentality with regards to dentistry. I think the major difference comes when comparing immigrants from Asia to the people who have been in California for a long period of time, which includes many different groups of Asians.

 

[Contach]

good luck on your DAT

 

[Contach]

Don't be mean...

And OP, honestly, if you want to do orthodontics, do the residency and get your ABO cert. Things will be that much easier.

I want to do GB/TR, implants, gum grafts, etc. I *could* just take a bunch of perio and implantology CME, but I'd much rather do a perio/implantology residency where I can learn on actual patients while being taught by certified periodontists and implantologists.

You have no idea how much board certification is worth.

How much is board certification worth?

 

[jda02624]

How much is board certification worth?

I've practiced ortho for 9 years and never had a patient ask me about board certification. It may be a plus to have it noted on your website, but honestly I don't know if patients even care. I do think it is a good goal to have as a clinician, but it does not reflect the quality of work you do or your professionalism.
I will also say that I've only had maybe 2 patients or parents ever ask me about what school I went to. I think these things matter more to us in the field, but patients not so much.

 

[Shunwei]

It's not perceived; it's a FACT and part of culture. White doctors won't budge but Asian doctors will give huge discounts plus free pickup/dropoff. Which White dentist in SoCal will do prophy for $5, composite for $20, full mouth SRP for $200, PFM for $300, ortho for $1000? Same concept apply to discount when dealing with masseuse, plumber, electrician, builder, wedding planner, restaurant, Macy's, Tiffany's, etc.

Asians love price haggling and under the table kind of stuff, this is the part about my heritage I am not too proud of. It seems like this kind of behavior is not frowned upon like it is in the Western Society but rather accepted as a given.

 

[str8ner]

You forgot the part where the stock market has made up for all of its losses in the last few years and then some. This guy is too extreme to be taken seriously.

Not everyone invests well. Some guys took their money out of the market at the bottom and either didn't get back in or got back in only after the market had risen significantly.

 

[str8ner]

OP,

Based on everything I have learned over the past few years, Ortho and dentistry will still be a good profession into the future, but with a few new challenges.

2) Older orthos are not retiring. This is, of course, making the market more difficult. But they won't work forever. Even with older orthos retiring in fewer numbers and more programs opening, consider that the population is growing (albeit slowly), and more adults these days are getting braces. An increase in orthos and dentists by some degree is inevitable, given population growth and more overall demand.

Silent Cool, you make some solid points. Regarding point #2 I would like to just shed a little more light on the subject. Currently, the dentist to population ratio is at its highest in the history of the United States. The growth rate of dentists consistently out paces overall US population growth. The Pew Charitable Trusts recently published a report that the US needs 10,000 more dentists. Given that many people in power give credence to this report, the dentist to population ratio is likely to soar to new heights. Also, the baby boomer generation is generally considered to have been born between 1946 and 1964. Some, including the Pew Charitable Trust, feel the retirement of Baby Boomers will contribute to a critical shortage of dentists. However, they are already retiring. So far the number of dentists continues to go up. It's just my humble opinion but I don't think the baby boomer retirement equates to a shortage of dentists otherwise we would have already started to see the effects. My point is simply that while success can still be had as a dentist, it is going to get harder to achieve that success in the coming years.

 

[Silent Cool]

Silent Cool, you make some solid points. Regarding point #2 I would like to just shed a little more light on the subject. Currently, the dentist to population ratio is at its highest in the history of the United States. The growth rate of dentists consistently out paces overall US population growth. The Pew Charitable Trusts recently published a report that the US needs 10,000 more dentists. Given that many people in power give credence to this report, the dentist to population ratio is likely to soar to new heights. Also, the baby boomer generation is generally considered to have been born between 1946 and 1964. Some, including the Pew Charitable Trust, feel the retirement of Baby Boomers will contribute to a critical shortage of dentists. However, they are already retiring. So far the number of dentists continues to go up. It's just my humble opinion but I don't think the baby boomer retirement equates to a shortage of dentists otherwise we would have already started to see the effects. My point is simply that while success can still be had as a dentist, it is going to get harder to achieve that success in the coming years.

str8ner,

thanks for the heads up.
Would you recommend dentistry as a career? How much would you pay for it?
Where do you practice?

thanx

 

[str8ner]

Would I recommend Dentistry as a career? If you just have to be a dentist and the money doesn't matter and you do not mind the prospect of solo ownership slipping away to the chains then maybe dentistry is for you. Personally, I love being an orthodontist but that doesn't mean I wouldn't be happy or even happier doing something else. If someone is smart, motivated, hardworking, and especially creative, as many potential dentists are, he or she could easily make more money in another field without incurring so much debt. I personally do not like the way government and other biased parties manipulate the market for healthcare providers.There seems to be a resentment for healthcare providers that are financially successful. I don't get that. I also do not like that dentists have little voice or representation in these matters.

When I was applying to dental school, I looked at my state school and some private schools. The private school tuitions were ludicrous then and have only gotten worse. So, I only applied to my state school. Luckily I got in. I have many friends over 400K in debt. I think some have even more but are embarrassed to say.

I practice in the midwestern suburbia.

 

[Screwtape]

Silent Cool, you make some solid points. Regarding point #2 I would like to just shed a little more light on the subject. Currently, the dentist to population ratio is at its highest in the history of the United States. The growth rate of dentists consistently out paces overall US population growth. The Pew Charitable Trusts recently published a report that the US needs 10,000 more dentists. Given that many people in power give credence to this report, the dentist to population ratio is likely to soar to new heights. Also, the baby boomer generation is generally considered to have been born between 1946 and 1964. Some, including the Pew Charitable Trust, feel the retirement of Baby Boomers will contribute to a critical shortage of dentists. However, they are already retiring. So far the number of dentists continues to go up. It's just my humble opinion but I don't think the baby boomer retirement equates to a shortage of dentists otherwise we would have already started to see the effects. My point is simply that while success can still be had as a dentist, it is going to get harder to achieve that success in the coming years.

Where did you get that info? As far as I know, that is false. It was highest in the 80's, which is why many schools closed.
http://www.adea.org/deansbriefing/documents/finalreviseddeans/dentistsdemographics.pdf

 

[Silent Cool]

Where did you get that info? As far as I know, that is false. It was highest in the 80's, which is why many schools closed.
http://www.adea.org/deansbriefing/documents/finalreviseddeans/dentistsdemographics.pdf

The number of graduates peaked then, but I think the actual number practicing: population ratio is higher now.