Orthodontist Consultation: What to Expect

What is an orthodontist and how do they differ from a dentist?

An orthodontist is a dental specialist who has completed dental school plus an additional two to three years of an accredited orthodontic residency, focusing exclusively on diagnosing and correcting misaligned teeth (malocclusion) and jaw relationships.

A general dentist manages overall oral health — cavities, cleanings, fillings, extractions — and can identify when a patient might benefit from orthodontic care. Many dentists also offer clear aligner treatment for straightforward cases. Orthodontists, however, manage the full range of tooth and jaw alignment problems, including complex bite issues, jaw discrepancies, and cases requiring coordination with oral surgeons 1Ref 1Batista KBSL, Thiruvenkatachari B, Harrison JE, O'Brien KD (2018).Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents.Cochrane systematic review on orthodontic treatment for malocclusion in children, supporting discussion of orthodontic treatment approaches and the role of specialist evaluation.

When should you or your child see an orthodontist?

The American Association of Orthodontists recommends that all children receive an orthodontic screening no later than age 7 2Ref 2American Association of Orthodontists (2024).When Should Your Child See an Orthodontist? The Age 7 Visit.AAO recommendation that all children have an initial orthodontic screening by age 7, with rationale based on mixed dentition allowing early detection of bite and spacing problems. At this age, the first permanent molars and front teeth have usually erupted, allowing an orthodontist to detect emerging bite and spacing problems early enough to take advantage of jaw growth.

For adults, there is no upper age limit for orthodontic treatment — malocclusion can be addressed at any age as long as the teeth and supporting bone are healthy. Common reasons adults seek an evaluation include:

• Crowded or overlapping teeth that are difficult to clean, raising cavity and gum disease risk
• A bite that does not feel right (overbite, underbite, crossbite, open bite)
• Gaps between teeth
• Jaw pain or TMJ symptoms that may have a bite component
• Cosmetic concerns about tooth alignment

What happens during the consultation?

A comprehensive first orthodontic visit typically includes:

1. Medical and dental history The orthodontist will ask about any dental work already done, jaw pain, past injuries, medications, and concerns you have brought to the appointment.

2. Clinical examination The orthodontist examines the teeth, gums, and jaw relationship — checking how the upper and lower teeth come together (the bite), any crowding or spacing, and individual tooth positions. They may also assess jaw movement and listen for clicking or popping.

3. Diagnostic records Most consultations include: - Panoramic X-ray — a single image showing all teeth, roots, and bone - Cephalometric X-ray — a side-profile head X-ray used to measure jaw relationships and tooth angulations - Photographs — of the teeth and face from multiple angles - Digital scan or impressions — a 3D scan or traditional impressions of the teeth

4. Diagnosis and treatment discussion Based on the records, the orthodontist explains the diagnosis in plain language and reviews treatment options, expected duration, and estimated cost. You are not expected to commit to treatment at this visit.

What treatment options might be discussed?

The orthodontist will recommend the option best suited to your alignment issues, age, and preferences. Common options include:

• Traditional metal braces — brackets bonded to the teeth connected by wires, adjusted periodically. Effective for the full range of problems, including complex bite corrections 1Ref 1Batista KBSL, Thiruvenkatachari B, Harrison JE, O'Brien KD (2018).Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents.Cochrane systematic review on orthodontic treatment for malocclusion in children, supporting discussion of orthodontic treatment approaches and the role of specialist evaluation.
• Ceramic (tooth-colored) braces — similar mechanics but less visible; more common in adults.
• Clear aligners (e.g., Invisalign) — removable plastic trays changed on a schedule. Well-suited for mild to moderate crowding and spacing; orthodontist-supervised therapy can address more complex cases than over-the-counter aligner products.
• Functional appliances — used primarily in growing children to influence jaw growth and bite development.
• Retainers — used after active treatment to hold teeth in their new position; considered a permanent commitment.

For adults with severe jaw discrepancies (skeletal malocclusion), orthodontic treatment may be combined with orthognathic (jaw) surgery.

What questions are worth asking at the consultation?

Coming prepared with questions helps you understand the full picture:

• What specifically is wrong with my bite or alignment, and why does it matter beyond appearance?
• What are all the treatment options for my situation, and which do you recommend and why?
• How long will treatment take, and what does that estimate depend on?
• What happens if I choose not to treat — is this likely to worsen?
• What does the total cost include — are retainers, X-rays, and follow-up visits covered?
• How do I manage oral hygiene during treatment?
• What happens if a bracket breaks or an aligner is lost?
• Will I need any teeth removed before treatment begins?

Gale can help you prepare a personalized list of questions and find an orthodontist in your area.