The difference between an orthodontist and a dentist is training: an orthodontist is a dentist who then completed an accredited residency of at least two years dedicated to moving teeth and correcting bites, while a general dentist is the broad-scope provider patients see for everything else.
That difference shapes the work — the complex end of tooth movement and bite correction is the specialist's end — and the pay: BLS medians of $289,140 vs. $170,950 (May 2025).
What's the difference between an orthodontist and a dentist?
Every orthodontist is a dentist; a general dentist is not an orthodontist.
Both hold the same dental degree and the same state dental license, and how a state treats specialty practice on top of that license is state-specific.
The difference that's universal is the training: an accredited orthodontics residency of at least two years on top of dental school, focused entirely on tooth movement and bite correction.
A general dentist can offer clear-aligner treatment — the ADA's ethics guidance expressly contemplates general dentists announcing orthodontic services, provided they're offered as general-dentistry services and don't express or imply specialization.
What a GP may treat is set state by state.
The orthodontist is the specialist whose training covers the complex end: bite discrepancies, jaw growth, and cases needing more than minor movement.
How patients arrive is different too: orthodontic patients book the specialist directly or come on a GP referral, where endodontic cases arrive by referral (see endodontist vs. general dentist).
What general-dentist aligner treatment adds is a second starting point: a patient can start clear-aligner treatment in the GP's chair, and where that ends and the specialist's work begins is the training line the rest of this page draws.
What each one does
A general dentist runs comprehensive primary oral care — exams, fillings, crowns, extractions, and preventive care — and clear-aligner treatment for straightforward crowding or spacing.
An orthodontist does one thing in depth: diagnosing alignment and bite problems, planning tooth movement, and placing and adjusting braces, aligners, retainers, and appliances that guide jaw growth in children.
| Comparison | General dentist | Orthodontist |
|---|---|---|
| Where the training splits the work | Clear-aligner treatment for the milder end of crowding or spacing | Bite discrepancies, jaw growth (the dentofacial orthopedics in the specialty's name), and cases needing more than minor movement |
| Training beyond dental school | No residency required to announce orthodontic services (ADA Code 5.I); what a GP may treat is state-set | CODA-accredited orthodontics residency, at least 24 months and 3,700 scheduled hours |
| Board certification | None — ABO certifies orthodontists, not general dentists | American Board of Orthodontics (ABO) — voluntary |
What the orthodontics residency adds
Both start the same way: a bachelor's degree — most dental programs require applicants to have at least one, plus science courses such as biology or chemistry — then dental school for a DDS or DMD, then a state dental license.
From there the paths fork: the general dentist goes into practice, while the orthodontist continues into an accredited residency — CODA's accreditation standard sets a minimum of 24 months and 3,700 scheduled hours (see the 3,700-hour requirement for what the standard covers) — focused entirely on the biomechanics of tooth movement, diagnosing and treating complex bite and jaw-alignment problems, and guiding jaw growth in growing children.
After residency, orthodontists can pursue certification from the American Board of Orthodontics (ABO) — voluntary, but a recognized signal of expertise.
The residency is what a general dentist's training doesn't cover: years of dedicated work on the harder end of tooth movement and bite correction.
Specialty rules are set state by state
Which cases a GP keeps — and which get referred
There's no fixed rule — scope is set state by state, and where a practice draws the line moves with the dentist's training, comfort, and the aligner system used.
None of the sources this page cites quantifies the split, so read the divide below as the training line the specialty draws, not a case-mix statistic.
The clear-aligner work a GP offers sits on the limited end: milder crowding or spacing, where the movement needed is small.
What generally belongs with the orthodontist: significant bite discrepancies (overbite, underbite, crossbite), cases needing more than minor tooth movement, anything involving jaw growth or interceptive treatment in children, and cases that stall or don't track as planned under a GP's aligner protocol.
The more of that training a GP adds, the more of that list can stay in-house.
How patients reach an orthodontist vs. a general dentist
Patients reach an orthodontist two ways: booking the specialist directly, or on a referral from a general dentist.
The GP side of that picture is clear-aligner treatment — where the GP's chair ends and the specialist's begins is the training line from the last section: bite discrepancies, jaw growth, and more-than-minor movement are the specialist's end of it.
That's a different dynamic from endodontics, where cases arrive by referral.
Orthodontic care reaches patients both ways, with the specialist's work defined by training depth rather than by where the patient came from.
Dentist vs. orthodontist salary: who earns more?
The U.S. Bureau of Labor Statistics tracks general dentists on their own occupational code: SOC 29-1021, Dentists, General, with a national median of $170,950 a year (OEWS, May 2025).
Orthodontists have their own dedicated code — SOC 29-1023 — with a national median of $289,140 a year from the same release, among the highest in dentistry.
Side by side, from the 10th percentile to the 90th:
| Annual wage (BLS OEWS, May 2025) | General dentist (SOC 29-1021) | Orthodontist (SOC 29-1023) |
|---|---|---|
| 10th percentile | $86,250 | $99,850 |
| 25th percentile | $125,710 | $146,580 |
| Median | $170,950 | $289,140 |
| 75th percentile | $224,040 | $342,300 |
| 90th percentile | $319,630 | $416,000 |
The medians aren't the whole story, because the two wage distributions overlap.
The orthodontist 25th percentile ($146,580) sits below the general-dentist 75th percentile ($224,040), so an individual general dentist can out-earn an individual orthodontist.
And BLS wage estimates don't cover the self-employed or owners and partners in unincorporated firms, so what an owner takes home from a practice isn't in either figure.
See the dentist salary guide or the orthodontist salary guide for each role's full percentile breakdown, state figures and drivers — or what an orthodontist does for how ownership shapes the specialist's earnings.
This article is general career information, not clinical, legal, or financial advice. Referral patterns, training requirements, and pay vary by dentist, region, and practice.