7 min read · By Dr. Kevin Baharvand, Diplomate, American Board of Orthodontics · Practice & Industry News

What an orthodontist does

An orthodontist is a dental specialist trained to diagnose and correct misaligned teeth and jaws. Day to day, that means evaluating bite and alignment problems, then designing and managing treatment with tools like braces, clear aligners, and retainers.

A quick note on terminology, since it comes up constantly: people say Invisalign to mean clear aligners, but Invisalign is one brand. Orthodontists work with several, including Invisalign and Angel Aligners. Beyond fitting appliances, the job includes monitoring progress over months of treatment and coaching patients on how to care for their teeth along the way. If you want the patient-side view of how a specialist differs from a general dentist, our post on orthodontist versus dentist covers it.

How to become an orthodontist in Texas

The path is a real commitment. Here is the step-by-step:

• Earn a bachelor’s degree. Focus on pre-dental coursework such as biology, chemistry, and physics.
• Take the Dental Admission Test (DAT). This exam gauges your readiness for dental school.
• Complete dental school. Four years for a DDS or DMD at a program accredited by the American Dental Association. Texas has several strong options, including the Texas A&M School of Dentistry in Dallas and the University of Texas School of Dentistry at Houston.
• Finish an orthodontic residency. Two to three additional years focused entirely on tooth movement, jaw growth, and bite mechanics. This is what turns a dentist into an orthodontist.

Licensing and board certification

To practice in Texas, you need a state dental license, which requires graduating from an accredited program and passing the required national and state examinations. Orthodontic training on top of that lets you present yourself as a specialist.

Board certification is a separate, voluntary step. Becoming a Diplomate of the American Board of Orthodontics means submitting real cases for peer review and passing rigorous exams beyond the minimum needed to practice. Not every orthodontist pursues it, which is exactly why patients treat it as a mark of extra rigor. You can read more through the American Dental Association and the American Association of Orthodontists.

What orthodontists earn in Texas

Pay varies a lot, and honest ranges are more useful than a single headline number. The big factors are location, patient volume, practice efficiency, and whether you own the practice.

• Metro versus rural. Larger markets like Dallas, Austin, and Houston tend to offer higher earning potential, though smaller communities often have strong demand and less competition.
• Hourly range. Estimates commonly land somewhere around $100 to $200 per hour, influenced by the factors above.
• Entry level. Newer orthodontists in rural or underserved areas may start closer to $100,000 to $150,000 a year, with income rising meaningfully as the patient base grows.

Treat these as rough guideposts, not guarantees. Compensation figures shift over time, so anyone seriously weighing the career should check current data from a source like the U.S. Bureau of Labor Statistics.

The day-to-day and work settings

One appealing part of the field is flexibility in how you practice. Many orthodontists in Texas own and run private practices, solo or in a group. Others work in hospitals, corporate group practices, or academic and teaching roles.

At Elate, we chose the private, patient-centered route across three locations, which shapes everything from how we schedule to how we plan treatment. The setting you pick influences your hours, your autonomy, and how you spend your day, so it is worth thinking about early. And yes, to answer a common question, the daily uniform is usually scrubs and a lab coat, not a suit.

Frequently asked questions