Move teeth and jaws into place with braces and aligners. A dentist first, then two or three more years of training.
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What you earn and what it costs to get there.
Median
$289,140
Bottom tenth
$99,850
Top tenth
$416,000
The national median is $289,140 a year, and the bottom tenth sit near $99,850. One warning about these numbers: the federal survey counts people who are paid a wage. Plenty of orthodontists own their practice and take the profits instead, so they are missing from the count.
About $150,000 to $250,000
Associate in someone else's practice
New graduates usually work as an associate first, often paid a percentage of what they produce with a daily minimum while they build up speed and a patient list.
$416,000 a year
Practice owners and partners in busy group practices
The jump comes from owning rather than working for someone. Buying into a practice costs hundreds of thousands of dollars, and banks lend to dentists readily because so few of those loans go bad.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a community college start into a public university in your own state for the bachelor's degree, a dental school in your own state at about 40,000 dollars a year, and an orthodontic residency that pays a small stipend instead of charging tuition. The high end is four full years of undergraduate study plus a private dental school near 90,000 dollars a year once fees and instrument kits are counted, and a residency that charges tuition on top. Residency cost is the wild card here and varies enormously between programs, so check each one before you apply rather than assuming. This is one of the most expensive training paths in the country and several hundred thousand dollars of debt is normal, so in state public dental schools are worth looking at hard before anything else.
This is one of the most expensive training paths in the country and graduating with several hundred thousand dollars of debt is normal. File the FAFSA (Free Application for Federal Student Aid) every year and look hard at in-state public dental schools before anything else.
Associate percentage
A share of what you produce or collect, usually with a guaranteed daily minimum at the start.
Practice profits
As an owner you keep what is left after staff, rent, lab bills and supplies. You are running a small business.
Payment plans
Most families pay for treatment over 18 to 30 months, so the practice collects steadily rather than in one lump.
Public Service Loan Forgiveness
Ten years of full-time work at a nonprofit clinic, public hospital or university can cancel what is left of your federal loans.
The exact path from high school to qualified.
You qualify as a dentist first, then specialize. Ten years after high school at the fastest.
High school
Grades 11 and 12
Strong grades in biology, chemistry and math. Anything that builds steady hands helps too.
Bachelor's degree
4 years
Any major is allowed, but you must finish the science prerequisites and keep a high GPA. Sit the dental admission test in your third year.
Dental school
4 years
Four years for a DDS (doctor of dental surgery) or DMD (doctor of dental medicine). The two degrees are equivalent. Schools must be accredited by the Commission on Dental Accreditation.
Licensing exams
Final year of dental school
Pass the written national board exam plus a clinical exam accepted by the state dental board where you want to work.
Orthodontic residency
2 to 3 years
An accredited advanced program in orthodontics and dentofacial orthopedics. Two to three years, often ending with a master's degree.
Biology
Growth and development of the face and jaw is the core science of this specialty.
Chemistry and physics
Required for pre-dental science courses, and physics explains how a wire moves a tooth.
Math
You will read measurements and angles off scans every single day.
Art, shop or anything hands-on
Dental school admissions look for manual dexterity. Sculpting, model building and musical instruments all count.
There is no national license. Each state has a dental board that issues your license to practice, and most states also have a separate specialty permit or announcement rule before you may advertise yourself as an orthodontist. Boards set continuing education hours, investigate complaints and can suspend a license. Moving states usually means an application, fees and sometimes another exam.
Orthodontics is one of the hardest dental specialties to get into. Programs take only a handful of residents a year, so class rank, national board scores, research and letters from faculty all matter. Many applicants do not match on the first try and spend a year working as a general dentist before applying again. That year is paid, so it is not wasted.
Things you don't need, but that help.
Board certification
The American Board of Orthodontics runs a voluntary certification with a written exam and a review of cases you actually treated. It is a mark of quality, not a license.
Clear aligner systems
Digital scanning and aligner planning are now a large share of the work. Learn them in residency if you can.
Surgical orthodontics
Preparing patients for jaw surgery alongside an oral surgeon. Complex cases, higher fees.
Cleft and craniofacial teams
Hospital-based work with children born with cleft lip and palate. Usually a university or teaching hospital job.
Research during dental school
Residency programs are academic. A published paper stands out.
Spanish or another second language
You are explaining a two-year treatment plan to worried parents. Doing it in their language matters.
Business classes
Most orthodontists end up owning a practice. Nobody teaches payroll and leases in dental school.
Time in a practice
Work as a dental assistant or front desk helper in high school or college. It shows you what the days are really like.
Day to day, pros and cons, where you'd work.
Short appointments, one after another. A full day can be 40 to 70 patients, most of them in the chair for 10 or 15 minutes to have wires changed, brackets rebonded or aligner progress checked. Between those you see new patients, take scans and photographs, and lay out treatment plans with parents. Assistants do a lot of the hands-on work while you diagnose, adjust and decide. The clinic is loud, young and social, which some people love and some people find exhausting.
The good
The hard parts
Things people don't tell you.
The American Board of Orthodontics was founded in 1929 and was the first specialty board in dentistry anywhere. Certification is still voluntary, and the board says about 69% of orthodontists in the national association hold it.
The American Association of Orthodontists represents a little over 18,000 members across the United States, Canada and abroad. For comparison there are well over a hundred thousand general dentists in the United States alone.
There is no route into orthodontics that skips dental school. You finish the full dental degree, get licensed, and only then specialize. That means if the specialty does not work out you still have a profession to fall back on.
The national association describes orthodontists as having roughly 3,700 hours of extra training beyond dental school in how to move teeth and guide jaw growth. That is what separates the specialty from a general dentist offering aligners.
Last checked September 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise.