An orthodontist is a dental specialist who diagnoses, prevents, and treats dental and facial irregularities. Orthodontics is one of nine recognized dental specialties and focuses specifically on the alignment of teeth and jaws, technically known as dentofacial orthopedics.
The specialty of orthodontics has existed as a distinct discipline since the early 20th century, when Edward Angle established it as a separate branch of dentistry requiring additional training beyond general dental education. Modern orthodontists manage conditions affecting occlusion (how teeth fit together), jaw relationships, and facial growth patterns.
Unlike general dentistry, which addresses a broad range of oral health concerns including preventive care, restorative procedures, and periodontal health, orthodontics concentrates exclusively on the correction of malocclusions and dentofacial discrepancies. This specialized focus requires distinct diagnostic skills, treatment planning expertise, and biomechanical knowledge.
While both orthodontists and general dentists complete dental school and hold dental degrees, their training pathways diverge significantly after this initial education.
A general dentist completes a Bachelor of Dental Surgery (BDS) or equivalent dental degree, typically requiring four to five years of university study. This education covers all aspects of oral health, including diagnosis and treatment of tooth decay, gum disease, oral surgery, prosthodontics, and preventive care. Upon graduation and registration, general dentists can practice independently and provide comprehensive dental care to patients.
An orthodontist completes this same dental degree but then undertakes an additional three years of full-time specialist training in an accredited orthodontic program. This postgraduate education focuses exclusively on growth and development of the face and jaws, biomechanics of tooth movement, diagnosis of malocclusions, and the design and management of orthodontic treatment. In New Zealand, these programs lead to qualifications such as a Doctorate of Clinical Dentistry (DClinDent) in orthodontics or Master of Orthodontics (MOrth).
General dentists provide primary oral healthcare, including examinations, cleanings, fillings, crowns, extractions, and treatment of oral diseases. Some general dentists develop additional interests or complete short courses in certain areas, but this does not constitute specialist training.
Orthodontists limit their practice exclusively to orthodontics and dentofacial orthopedics. Their scope includes diagnosis of complex malocclusions, treatment planning for growth modification, management of impacted teeth, coordination of interdisciplinary cases (such as orthodontics combined with orthognathic surgery), and biomechanical application of various appliance systems.
In standard dental care models, general dentists typically identify patients who would benefit from orthodontic assessment and refer them to specialist orthodontists. This referral relationship ensures patients receive appropriate specialist care when needed while maintaining their regular dental home for general oral health needs. Patients continue seeing their general dentist for routine cleanings, examinations, and any restorative work while undergoing orthodontic treatment.
The pathway to becoming a specialist orthodontist in New Zealand follows a regulated, structured progression designed to ensure clinical competency and patient safety.
Prospective orthodontists must first complete an undergraduate dental degree (BDS, BChD, or equivalent) from an accredited institution, which requires five years of full-time study at the University of Otago, New Zealand’s sole dental school. Following dental school, graduates must complete at least two years of general dental practice to gain broad clinical experience.
Entry into specialist orthodontic training is highly competitive. Candidates apply to accredited three-year full-time postgraduate programs, either domestically or internationally. The University of Otago offers the Doctorate of Clinical Dentistry (DClinDent) in orthodontics, which involves intensive clinical training, research, and coursework in:
Upon completing specialist training, orthodontists must register with the Dental Council of New Zealand within the “Specialist” scope of practice. This registration is legally required to use the title “Specialist Orthodontist” or “Orthodontist” in New Zealand.
The title “Specialist Orthodontist” is protected under the Health Practitioners Competence Assurance Act 2003. This legislation means only practitioners who have completed approved specialist training and maintain registration within the specialist scope can legally use this title. Patients can verify a practitioner’s registration status and qualifications through the public register maintained by the Dental Council of New Zealand.
Registered specialist orthodontists maintain their competence through mandatory continuing professional development (CPD). Many orthodontists also maintain membership in professional organizations such as the New Zealand Association of Orthodontists (NZAO) and international bodies like the World Federation of Orthodontists (WFO), which provide ongoing education, research updates, and professional standards guidance.
Orthodontists diagnose and treat a range of dentofacial conditions, classified using standardized systems that describe the relationship between upper and lower jaws and teeth.
Malocclusion refers to misalignment of teeth or incorrect relation between the dental arches. Clinical classification systems categorize these conditions:
Class I Malocclusion: The molars have a normal relationship, but other teeth show crowding, spacing, or rotations. This is the most common type of malocclusion.
Class II Malocclusion: The lower jaw sits too far back relative to the upper jaw (retrognathic), creating an increased overjet where upper front teeth protrude significantly beyond lower teeth. This condition may have skeletal (jaw position) or dental (tooth position) origins, or both.
Class III Malocclusion: The lower jaw sits too far forward relative to the upper jaw (prognathic), causing the lower front teeth to sit in front of the upper front teeth. This creates an anterior crossbite or underbite.
Crowding: Insufficient space in the dental arch for all teeth to align properly, resulting in overlapping, rotated, or displaced teeth. Severe crowding can compromise oral hygiene and increase risk of dental decay and periodontal disease.
Spacing: Excessive space between teeth, which may result from missing teeth, small teeth relative to jaw size, or habits such as thumb sucking. Spacing can affect aesthetics and function.
Crossbite: One or more upper teeth bite inside the lower teeth, which can occur in the front (anterior) or back (posterior) of the mouth. Crossbites may cause asymmetric jaw growth if left untreated during development.
Open Bite: The upper and lower front teeth do not overlap when the back teeth are closed, leaving a vertical gap. This condition can result from thumb sucking, tongue thrust, or skeletal growth patterns, and may affect speech and chewing function.
Deep Bite: Excessive vertical overlap where upper front teeth cover too much of the lower front teeth, which can cause trauma to the palate or gum tissue.
Beyond tooth alignment, orthodontists address functional problems affecting the temporomandibular joint (TMJ), breathing, chewing efficiency, and speech. Some patients present with skeletal discrepancies severe enough to require combined orthodontic and surgical treatment (orthognathic surgery) to achieve optimal functional and aesthetic outcomes.
Orthodontists utilize various appliance systems depending on the diagnosis:
Fixed Appliances: Metal or ceramic brackets bonded to teeth with archwires that apply controlled forces to move teeth. These remain in place throughout active treatment.
Removable Appliances: Plates, functional appliances, or retainers that patients can remove, typically used for specific movements or growth modification in younger patients.
Clear Aligners: Sequential series of clear plastic trays that incrementally move teeth, suitable for certain malocclusions, primarily in adult patients or those with less complex requirements.
Functional Appliances: Removable or fixed devices that modify jaw growth in growing patients, addressing skeletal discrepancies through growth redirection.
Temporary Anchorage Devices (TADs): Small titanium screws temporarily placed in bone to provide fixed anchorage for specific tooth movements.
Treatment selection depends on multiple factors including the specific diagnosis, patient age, growth status, skeletal pattern, and treatment objectives.
The New Zealand Association of Orthodontists, consistent with international orthodontic associations, recommends that all children have an orthodontic evaluation by age seven. This timing allows assessment during the mixed dentition phase (when both primary and permanent teeth are present) and enables early detection of developing problems.
Early evaluation does not necessarily mean early treatment. Most children will not require intervention at age seven, but assessment at this age allows orthodontists to:
Parents and patients should seek orthodontic consultation if they observe:
In Children:
In Adolescents and Adults:
Orthodontic treatment is not limited to children and adolescents. Approximately 25-30% of orthodontic patients in developed countries are adults. Adult orthodontics addresses functional concerns, periodontal health optimization, preparation for restorative or implant dentistry, and aesthetic concerns.
Adult treatment presents different considerations than adolescent treatment, as adults have completed facial growth and may have dental restorations, missing teeth, or periodontal conditions requiring collaborative care with other dental specialists. Treatment planning must account for these factors, but age itself is not a contraindication to orthodontic therapy.
The expansion of direct-to-consumer clear aligner companies and general dental practices offering tooth straightening services has created confusion about provider qualifications. Understanding the regulatory framework and training differences helps patients make informed decisions.
In New Zealand, the term “Specialist Orthodontist” is legally protected. Only practitioners registered with the Dental Council of New Zealand in the specialist scope of practice for orthodontics may use this title. This protection exists to ensure patients can identify practitioners who have completed recognized specialist training.
General dentists may legally provide certain orthodontic treatments, including clear aligners, as these fall within the general scope of dental practice. However, general dentists cannot represent themselves as specialists or orthodontists without completing the requisite specialist training and registration.
The distinction between a specialist orthodontist and a general dentist offering tooth straightening relates to depth and breadth of training:
Specialist orthodontists complete three years of full-time postgraduate education focused exclusively on diagnosis of malocclusions, biomechanics, growth and development, and complex treatment planning. This training includes management of thousands of cases under specialist supervision.
General dentists offering orthodontic services typically complete short courses ranging from weekend seminars to several months of part-time training. These courses generally focus on appliance mechanics for straightforward cases rather than comprehensive diagnosis and treatment planning.
Certain clinical situations require specialist expertise:
Specialist orthodontists are trained to diagnose these complexities, develop appropriate treatment plans, and recognize when interdisciplinary care is necessary. They also manage complications that may arise during treatment.
Published literature in orthodontic journals suggests that specialist orthodontists achieve more predictable outcomes in complex cases and have lower rates of treatment complications. Specialist training emphasizes evidence-based practice, critical evaluation of treatment outcomes, and recognition of treatment limitations.
Patients seeking orthodontic care should verify provider qualifications to ensure they receive appropriate specialist care.
The Dental Council of New Zealand maintains a public online register of all registered dental practitioners. This register indicates:
Patients can access this register at the Dental Council website and search by practitioner name. The scope of practice will explicitly state “Orthodontic Specialist” for registered specialist orthodontists.
Orthodontists’ qualifications typically include:
Undergraduate Dental Degree:
Postgraduate Specialist Qualifications:
These post-nominal letters indicate completion of recognized specialist orthodontic programs. Short course certifications or company-specific training programs do not constitute specialist orthodontic qualifications.
While not mandatory, membership in the New Zealand Association of Orthodontists (NZAO) indicates a practitioner meets specialist registration requirements and maintains professional development standards. The NZAO maintains a member directory that patients can access to find registered specialist orthodontists in their area.
Several misconceptions about orthodontic treatment persist in public understanding. Clinical evidence provides clarity on these topics.
Evidence: Orthodontic treatment can be successfully completed at any age, provided the patient has healthy periodontal tissues (gums and bone supporting teeth). The biological process of tooth movement—bone remodeling in response to applied force—continues throughout life.
Research published in orthodontic literature demonstrates that adults respond well to orthodontic treatment, though treatment may take slightly longer than in adolescents due to denser bone and lack of growth. Adult patients often exhibit high compliance and satisfaction with treatment outcomes.
The primary difference in adult versus adolescent treatment relates to the inability to utilize growth modification in adults, meaning some skeletal discrepancies require surgical correction in adults that might have been managed with growth modification in younger patients.
Evidence: Modern orthodontics offers multiple treatment modalities. Fixed appliances are available in metal, ceramic (tooth-colored), and lingual (placed on tongue side of teeth) varieties. Clear aligner systems provide an alternative for suitable cases. Removable functional appliances address certain growth-related problems in younger patients.
Treatment modality selection depends on the specific diagnosis. Clear aligners, for example, are effective for mild to moderate crowding and spacing cases but may have limitations in cases requiring significant root movement, vertical control, or rotation of certain teeth. Specialist orthodontists are trained to match treatment modality to clinical requirements rather than applying a single approach to all cases.
Evidence: As discussed previously, significant training differentials exist between specialist orthodontists (three additional years of full-time specialist education) and general dentists who may offer tooth straightening after short courses.
This training difference affects diagnostic ability, treatment planning complexity that can be managed, and problem-solving when complications arise. The regulatory framework in New Zealand acknowledges this distinction through specialist title protection and separate scopes of practice.
Evidence: While orthodontic treatment often improves smile aesthetics, clinical objectives include functional improvements:
Many orthodontic treatments address medical and functional concerns rather than purely aesthetic goals, though aesthetic improvement is a common secondary benefit.
Evidence: Treatment duration varies widely based on multiple factors including the severity of malocclusion, treatment objectives, patient age, appliance type, and patient compliance with removable appliances and elastic wear.
Simple cases may require 6-12 months of active treatment, while complex cases involving growth modification, extractions, or surgical coordination may require 24-36 months. The average treatment duration for comprehensive fixed appliance therapy typically ranges from 18-24 months.
Treatment duration should not be predetermined by marketing claims but rather by the clinical requirements of the specific case. Specialist orthodontists develop individualized treatment plans with realistic timeframe estimates based on the diagnosis and treatment objectives.
Auckland, as New Zealand’s largest city, has multiple registered specialist orthodontists in practice. Patients seeking orthodontic care in Auckland should verify specialist registration status through the Dental Council register regardless of practice location or marketing materials.
The Auckland region’s specialist orthodontists typically maintain practice standards consistent with New Zealand Association of Orthodontists guidelines and Dental Council competency requirements. Geographic location within Auckland does not indicate qualification level; specialist registration is the relevant credential.
Patients in Auckland have access to comprehensive orthodontic services including pediatric orthodontics, adolescent treatment, adult orthodontics, and interdisciplinary care coordinated with oral surgeons, periodontists, and restorative specialists practicing in the region.
Orthodontics is a dental specialty requiring three additional years of full-time postgraduate training beyond dental school. Specialist orthodontists in New Zealand are registered with the Dental Council within a protected specialist scope of practice and maintain competency through ongoing professional development.
Orthodontic treatment addresses functional and developmental concerns as well as aesthetic improvements, utilizing various appliance systems selected based on diagnosis rather than marketing or convenience. Treatment is appropriate at any age, provided adequate periodontal health exists.
Patients seeking orthodontic care should verify provider credentials through the Dental Council register, understand the training differential between specialists and general practitioners, and select providers based on qualifications rather than convenience or cost alone. Specialist orthodontic care provides diagnostic expertise, comprehensive treatment planning, and management of complex cases that may exceed the scope of general dental practice.
The evidence-based practice of orthodontics continues to evolve with advancing technology and research, but the fundamental requirement for specialized training and expertise remains constant. Informed patients who understand these distinctions can make appropriate decisions about their orthodontic care.
In 2008, Adriana graduated with a Bachelor of Dental Surgery from Santa Maria University in Caracas, Venezuela. After graduation, she worked in Venezuela in private practice, at the Orthopaedic Children’s Hospital (Dentistry/Orthodontics unit), and as a lecturer in the National Experimental University of the Armed Forces.
In the year 2011, Adriana moved to Argentina to specialise, gaining the Specialist Orthodontist degree from the University of Buenos Aires in 2013. While in Argentina, she worked as a part-time lecturer at the Orthodontics Department in the University of Buenos Aires, private practice, and at the Craniofacial Unit in the Paediatric Hospital Garrahan, looking after cleft lip new-born, children, and adolescent patients.
Adriana is a Spanish speaker. On her spare time she likes going to the beach, travelling, socialising with friends, playing video games, cooking, and going to the gym.
BDS | DClinDent | MRACDS-Orth | MOrthRCSEd
Dr Azza Al-Ani, grew up in Christchurch, is a registered specialist orthodontist working at Shakespeare Orthodontics in Auckland. You can find her at one of the clinics in the city, or at their Takapuna clinic on the North Shore.
In 2009, Azza graduated with a Bachelor of Dental Surgery with Credit from the University of Otago.
She worked as a dental house surgeon at Auckland, Greenlane and Middlemore Hospitals; and as a dental officer at Sydney’s Westmead Hospital.
In 2012, she completed the Royal Australasian College of Dental Surgeons (RACDS) primary examinations.
Before commencing her specialist training, she held a part-time Professional Practice Fellow position at the Faculty of Dentistry, while working as a dentist in private practice.
In 2016, Azza graduated from the University of Otago with a Doctor of Clinical Dentistry in Orthodontics. She passed examinations to gain memberships into the Royal Australasian College of Dental Surgeons and the Royal College of Surgeons of Edinburgh.
She is also certified with the Australasian Orthodontic Board, and is a member of the New Zealand Association of Orthodontists, and the New Zealand Dental Association.
Azza’s area of research interest is hypodontia.
She has presented about this topic at the European Orthodontic Society Congress, and at the International Association Dental Research ANZ Scientific Meeting, and has been involved in the publication of numerous articles in peer-reviewed journals.
Outside of work, Azza loves spending time with her son and Mo (her husband), socialising with family and friends, overseas travel, and tries to keep up with Mo mountain biking.
Mo is a Specialist Orthodontist. He grew up in both New Zealand and Australia.
After completing a year in Health Sciences, and later physiotherapy, he qualified as a dentist in New Zealand. He spent the next four years working alongside his father in Sydney where he practised general dentistry. Mo then returned to Dunedin to specialise, gaining his specialist degree – Clinical Doctorate in Orthodontics from the University of Otago.
During the three years of specialist training, Mo had the privilege of learning from the best. The combined clinical and academic acumen of professors, doctors and staff provided an invaluable experience.
Meanwhile, Mo published and presented significant research and clinical cases at both national and international forums, including the International Association of Dental Research, the Australasian Begg Society of Orthodontics, the European Orthodontic Society and the New Zealand Dental Association conference.
A firm believer in maintaining high clinical standards, Mo successfully completed further examinations to become affiliated with the Royal College of Surgeons (Edinburgh) and the Royal Australasian College of Dental Surgeons (Sydney).
Mo is currently a part time senior lecturer at Auckland University of Technology, a Fellow of the World Federation of Orthodontists and also holds professional memberships with the New Zealand Association of Orthodontists, the New Zealand Dental Association and American Association of Orthodontists.
He has also been involved in the supervising and lecturing of students at the Auckland University of Technology.
Outside of work, Mo enjoys the precious time with his young family and the outdoors. He especially loves mountain biking, running, fishing, diving and, in winter, snowboarding.
Traveling along with his best friend and wife (Azza) around the world has also been a big part of Mo’s life. Mo is primarily based in Shakespeare Orthodontic’s city clinics and on the North Shore.
