American Board of Orthodontics (ABO) certification is voluntary — it isn't a license, and an orthodontist can practice without ever earning it.
It's a two-exam process: a Written Examination you become eligible for after at least 18 months of a CODA-accredited orthodontics residency, then a scenario-based Clinical Examination you can start whenever you're ready, with no deadline in between.
Once you start the Clinical, though, a 10-year clock begins.
Is ABO certification required to practice orthodontics?
No. Certification from the American Board of Orthodontics is voluntary — the license to practice orthodontics comes from the state dental board where you practice, not from the ABO.
An orthodontist who never sits for either exam can still practice, market a practice, and treat patients under their state license alone.
What it adds is a credential on top of that license: board certification is what many patients, referring dentists, and employers recognize as a mark of expertise beyond the required training.
It's also a separate step from finishing your orthodontics residency — completing residency is what qualifies you to sit for the exams, not what certifies you.
Exam one: the Written Examination
You become eligible for the ABO Written Examination after completing at least 18 months of a CODA-accredited orthodontics residency — you don't have to finish the full 24-month, 3,700-hour program before you can sit for it.
The exam runs 5 hours (300 minutes) and is administered at Pearson VUE testing centers each April.
Passing it is what makes you eligible to move on to the Clinical Examination — it's the entry point into certification, not the finish line.
Exam two: the Clinical Examination
The Clinical Examination is scenario-based: candidates work through a set of case scenarios rather than one continuous practical test.
It runs 4 hours (240 minutes) and covers at least 6 and no more than 10 scenario cases, also administered at Pearson VUE.
Passing both examinations — Written, then Clinical — is what the ABO recognizes with certification.
The board doesn't publish comparative pass rates or a difficulty ranking against other dental specialty boards, and none is estimated here.
No deadline to start the Clinical — then a 10-year window
This is where ABO certification departs from a straightforward step-by-step timeline.
After you pass the Written Examination, there is no expiration on that pass and no time limit for when you have to start the Clinical Examination.
You could pass the Written the year you finish residency and not attempt the Clinical for years afterward — the pass doesn't expire while you wait.
The clock starts once you actually initiate the Clinical Examination: from that point, you have a 10-year window to complete all of its components.
And the certificate the ABO ultimately awards is itself time-limited — it isn't a credential you earn once and hold indefinitely without any further action.
Why pursue it, given it isn't required
If certification doesn't change what you're legally allowed to do, the case for it is professional rather than legal.
ABO certification is one of the more visible signals of specialty expertise a patient, referring dentist, or employer can look for — many orthodontists pursue it specifically because it distinguishes a board-certified specialist from one who completed residency but never sat for the exams.
It's also entirely separate from finishing your training: residency makes you eligible, certification is optional afterward.
Earlier in the path?
See how to become an orthodontist for the full sequence, or the 3,700-hour residency requirement for what the training step itself involves.
Where certification fits in the bigger picture
Board certification isn't unique to orthodontics — most dental specialties run a similar voluntary certification step after residency, through their own certifying board.
See dental residency & board certification for how the mechanics compare across specialties generally.
Orthodontists remain among the highest-paid dental professionals — BLS reports a national median of $289,140 a year (OEWS, SOC 29-1023, May 2025).
Neither the ABO nor CODA publishes data tying certification status to pay, so none is implied here.
See the orthodontist salary guide for the percentile breakdown, or browse current orthodontist openings.
This article is general career information, not legal or clinical advice. Certification requirements and timelines can change — verify current details directly with the American Board of Orthodontics.