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In our most recent survey, we asked dentists what percentage of orthodontic cases they refer to an orthodontist. One in four dentists reports that they treat most braces patients themselves. On the other hand, one in three refers out all orthodontic patients.
"It's a win for everyone!" said an Illinois dentist who refers out all orthodontics. "Patients are well served, we are looked upon as caring, and orthodontists are geared specifically to do this." A Georgia general dentist disagreed, stating, "I don't need to refer for 95% of cases or more."
Read the dentists’ comments for more insight into their thoughts on referring patients out to orthodontists.
Click the graphs below for more data. Roll over to see exact percentages.
The most remarkable differences were related to geographic location. The trend in the data is clear: rural dentists are more likely to treat orthodontic patients themselves. Over half of rural dentists (54%) report treating braces patients themselves, while only 9% or urban dentists and 26% of suburban dentists do.
The reason for this is that rural areas have fewer local specialists. Even today, there's a kernel of truth in the "country doc" stereotype: in rural places, a general dentist may be the only dental practitioner for many miles.
Gender differences were dramatic. Male dentists were more than twice as likely to treat orthodontic patients. Female dentists were more likely than their male colleagues to refer these patients out to a specialist.
A number of general dentists treat some but not all orthodontic patients, keeping half and referring half out to an orthodontic specialist. Specialists,
on the other hand, appear more decisive. In addition, specialists are slightly more likely to refer patients than general dentists are, and less likely to treat these patients themselves.
Simple cases are fine for general dentists, but complicated ones demand specialists
- "Minor tooth movement is within the purview of dentist and pedodontist. Treatment planning for major malocclusions is better done by an orthodontist and an oral surgeon." (Minnesota oral surgeon referring 60-80%)
- "Since I do ortho, I only refer the surgical cases." (Florida dentist referring less than 20%)
- "Only the tough cases and tough patients." (New Jersey pediatric dentist referring less than 20%)
- "Difficult cases should be in the hands of specialists." (Minnesota dentist referring less than 20%)
Why take chances? Send them to an orthodontist.
- "I believe that only a good orthodontist can get really good, long-lasting results." (Texas dentist referring out all orthodontics)
- "I feel the best treatment for my patients is for a specialist to do things for which they are better trained than I am. This goes for ortho, oral surgery, perio, and endo. Weekend courses do not compare to the rigorous training that specialists receive in their residencies. Our profession is awash in undertrained dentists putting their bottom line ahead of their patients' best interest, and I feel this will marginalize our profession in the medical community." (North Carolina dentist referring more than 80%)
- "I refer all orthodontics to the specialist. The relationship I have with my orthodontist is one of the most valuable in my practice." (Florida dentist referring out all orthodontics)
- "Win for everyone! Patients are well served, we are looked upon as caring, and orthodontists are geared specifically to do this." (Illinois dentist referring out all orthodontics)
Aren't general dentists qualified for ortho?
- "I do all my own orthodontics and I believe the average GP is just as capable. It is just that at Dental School it is instilled in us to refer and not touch it." (Australia dentist referring less than 20%)
- "I do all but class 3. It is my understanding that GP's do 80% of all ortho in the USA, so that means that orthodontists make a living on 20% of ortho cases. If we (GP's) as a whole just knew how easy ortho is, the vast majority could increase monthly income by 15 to 25%. I took my classes from USDI, love doing it, and now me and my stay at home wife are both driving Mercedes." (Michigan dentist referring less than 20%)
- "Don't need to refer for 95% of cases or more." (Georgia dentist referring less than 20%)
Some dentists are happy to avoid orthodontic work
- "I am rusty, and classes are very expensive to catch up." (Texas dentist referring more than 80%)
- "I am untrained in Ortho. It is best to stay within your comfort zone." (Illinois dentist referring more than 80%)
- "They can do it more efficiently and have all the associated stuff that would increase my overhead. I would however have a young associate/partner do ortho to build his practice." (Michigan dentist referring more than 80%)
It just depends on if the dentists enjoys ortho
- "I have no interest in doing ortho." (California dentist referring out all orthodontics)
- "I pick and chose what I want to do and refer out the rest. Invisalign for adults and young kids are great!" (Louisiana dentist referring more than 80%)
- "I am happy to refer out those cases which I don't feel competent to treat or which I just don't want to treat for whatever reason. Having been actively treating orthodontic cases in my general practice for over twenty years now there are not a lot of cases which I refer out. Ortho provides me with a change of pace from the daily drill and fill routine." (California dentist referring less than 20%)
Orthodontic work often involves kids
- "I do not see patients under 10 years old, therefore do not refer many young ortho patients. I have several adult patients having ortho treatment." (Arkansas dentist referring out all orthodontics)
- "Not interested in the multi-visit, child-intensive nature of orthodontics. Happy to send those patients to the specialist." (Georgia dentist referring more than 80%)
- "I refer all difficult cases and children." (General dentist referring 40-60%)
What about Invisalign?
- "We offer Invisalign braces in our office, but all wire and brackets are referred to a traditional orthodontist. We have some great doctors we refer to! " (Oregon dentist referring more than 80%)
- "The vast majority of GPs have no formal training so they should refer out. Most of the GPs who do Invisalign have no clue about ortho and are doing a disservice to their patients. They have no way out of the case if it goes south because the only tool they have are plastic aligners that are limited in their scope/action!" (Michigan dentist referring less than 20%)
Are orthodontists really all that great?
- "Very few orthodontists pay attention to condylar position and parafunction. The cases I treat are much more stable, have better facial esthetics, have better skeletal symmetry, and the patients end up with condyles correctly positioned within the TMJ. I have found very few specialist orthodontists who even consider those factors." (Illinois dentist referring less than 20%)
Referrals are a great way to get rid of patients you don't want
- "Send out the 'turkeys' and problem patients." (West Virginia dentist referring less than 20%)