How to become an orthodontist

1. 1Earn a bachelor's degree with dental school prerequisites

   Time: 4 yearsCost: College tuitionSources 1

   Dental schools do not require a specific major, but they expect science prerequisites such as biology and chemistry, and many prefer a science major. High grades matter even more than for general dentistry, because the residency application comes later and draws on the same record. Shadow both a general dentist and an orthodontist, and get hands-on experience, for example as a dental assistant.

2. 2Take the DAT and apply to dental school

   Time: During junior or senior yearCost: $580 DAT fee (2026)Sources 2, 1

   The Dental Admission Test is accepted by all U.S. dental schools. It runs 5 hours and 15 minutes at Prometric test centers and is offered year round. Schools weigh the DAT with grades, interviews and recommendations. A partial fee waiver covering half the fee is available in limited numbers for applicants with financial hardship.

3. 3Complete a 4-year DDS or DMD program

   Time: 4 yearsCost: $39,130-$72,240/yr tuition at one public school (2026-27)Sources 4, 1

   Dental school combines basic sciences with supervised patient care. Future orthodontists should aim for top grades, seek out orthodontics electives and research, and build relationships with orthodontic faculty for recommendation letters. Class rank and faculty letters weigh heavily in residency selection. At the University at Buffalo, 2026-27 tuition is $39,130 a year for New York residents and $72,240 for non-residents.

4. 4Pass the INBDE and a clinical licensure exam

   Time: During dental schoolCost: $890 INBDE; $2,995 ADEX plus facility and typodont fees (2026)Sources 3, 6, 1

   The INBDE is a two-day exam accepted in all U.S. states and territories for the written part of licensure. Most states also require a clinical exam, such as the ADEX Dental Examination, which combines clinical procedures on manikins with the computer-based DLOSCE; from August 1, 2026, the periodontal exam is a required part. Check whether your residency or state expects you to hold a general dental license before or during training.

5. 5Finish an accredited orthodontic residency

   Time: At least 24 monthsCost: Tuition varies widely by programSources 5, 1

   CODA requires orthodontic residencies to run at least 24 months and 3,700 scheduled hours. Residents treat their own caseload of patients under faculty supervision and study growth and development, biomechanics, cephalometrics and treatment planning. Many programs award a master's degree along with the specialty certificate and require a research thesis. Tuition differs widely between programs, so compare costs before applying.

6. 6Start practice and consider board certification

   Time: After residency; certification is optionalCost: $1,140 ABO written exam; $1,875 clinical examSources 7, 10

   New orthodontists usually join a practice as associates or buy into or open a practice. Board certification by the American Board of Orthodontics is voluntary. Residents can take the ABO Written Examination after 18 months of an accredited program, and graduates who pass it can take the Scenario-based Clinical Examination. Certified orthodontists must renew every 10 years.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Three-dimensional thinking

Moving one tooth changes the bite and the spaces around it, so orthodontists must picture how the whole arch shifts over months.

Fine hand control

Bending archwires and placing brackets by fractions of a millimeter decides whether teeth end up where planned.

Working with children and teens

Most patients are young, and getting them to wear elastics and keep braces clean depends on earning their trust.

Explaining cost and timelines

Families commit to treatment that can last years and cost thousands, so plans and payment terms must be clear from the start.

Business management

Most orthodontists eventually run or co-own a practice and must handle staff, scheduling, equipment and finances.

O*NET 31.0 rates these skills as most important for the occupation: active listening, speaking, critical thinking, monitoring, reading comprehension.

Training cost

$161K–$489K

Before financial aid

Time

10-11 years after high school

Typical path

Median pay

$289,140

All US jobs: $50,980

Payback once qualified

0.7–2.1 yrs

Pay above the all-jobs median vs. cost

Low: 4 years of 2026-27 resident DDS tuition at the University at Buffalo, $156,520, plus the 2026 DAT ($580), INBDE ($890) and ADEX Dental ($2,995) exam fees. High: the same school's non-resident DDS tuition, $288,960, plus those exam fees and the $195,729 median federal loan debt of advanced dentistry graduates, used as a rough measure of residency costs. Undergraduate tuition, university fees, instruments, living costs and ABO fees are not included. Many dental schools and orthodontic programs cost more.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Practice owner or partner

  Associates often buy into an existing practice or open their own after a few years, which requires business loans and management skills.

• Multi-office practice owner

  Successful owners add satellite offices and associate orthodontists, shifting time toward management.

• Orthodontic faculty or program director

  A master's degree and research experience help orthodontists move into teaching, and program directors often hold ABO certification.

• Dentist$170,950 median

  Every orthodontist is already a licensed dentist; some keep a general dental license active and do general work part time.