Is the Profession of Orthodontics Going Extinct? Should You Specialize?

I. Introduction
Dr. Amanda from StraightSmile Solutions delivers a candid take: orthodontics as a specialty is facing extinction within her lifetime, not fully, but significantly.
More orthodontists are being produced than needed, while GPs and pediatric dentists are increasingly doing ortho.
If given the choice again, she would not specialize in orthodontics, and she advises others against it.

II. Why the Shift?
Traditional orthodontics addresses symptoms (crooked teeth) rather than root causes (poor facial development, airway, posture).
Waiting until age 10–12 means missing the growth window – 60% of facial growth is complete by age 6, 80% by age 8.
Insurance‑driven models and corporate DSOs profit from waiting until development fails, then selling mechanical solutions (braces/aligners).
Residency programs do not prioritize interceptive growth, airway, or early pediatric intervention because the business model is built on backend treatment.

III. The Preventive Alternative
If we focus on early intervention – nasal breathing, posture, diet, myofunctional therapy – the vast majority of children would never need braces (cosmetics aside).
True craniofacial orthopedics is about preventing structural failures, not hiding them behind a straight smile.
Functional issues should be addressed early (age 2–5), not at age 10 when growth is nearly complete.

IV. The Current Landscape
Orthodontists are unhappy; the system is not working.
Pediatric dentists and GPs who adopt early interceptive models are thriving (cash‑pay, fee‑for‑service).
However, the current insurance model does not pay adequately for the pre‑work (Phase 1) – it pays for Phase 2.
The solution: shift to fee‑for‑service and medicalize early airway/orthopedic care.

V. What This Means for You
If you are considering specializing in orthodontics, think twice.
The future belongs to primary care dentists who learn early interceptive growth guidance.
Dr. Amanda is building a West Coast team (ENT, OMT, pediatric dentists) focused on airway and growth – not traditional tooth straightening.
She recommends courses by Dr. Simon Long (removables) and her own (Invisalign/fixed) – and is open to collaboration with like‑minded clinicians.

VI. The Bottom Line
Traditional orthodontics is becoming obsolete. The old model of waiting, extracting, and mechanically aligning teeth is being replaced by early, preventive, growth‑guided care.
The money and satisfaction are in Phase 1 interceptive treatment and airway management, not in routine braces.
Specializing in orthodontics is no longer a safe bet. Instead, learn to grow faces, not just straighten teeth.