Can an orthodontist check for and find cavities? While orthodontists are trained dentists, their primary clinical focus is on aligning teeth and correcting jaw structure. The general dentist acts as the primary care provider for overall oral health, including the prevention, diagnosis, and treatment of tooth decay. Orthodontic tools and procedures are optimized for movement, not comprehensive restorative checks. This specialization makes the general dentist’s role irreplaceable during treatment.
Understanding the Orthodontist’s Primary Focus
The orthodontist’s expertise lies in the biomechanics of tooth movement and the management of facial development. After dental school, they complete two to three years of specialized residency training focused entirely on misaligned teeth and bite problems (malocclusion). Their daily practice centers on adjusting appliances like braces and clear aligners to achieve proper alignment and function. Orthodontic appointments are typically short, focused visits designed to progress the treatment plan. Their time is not allocated for the detailed, tooth-by-tooth examination required to detect early-stage decay.
How Decay is Detected in an Orthodontic Setting
An orthodontist or hygienist performs visual inspections during routine appointments, especially when appliances are adjusted. They look for signs of decalcification, which appears as white spots on the enamel where plaque accumulates, often around brackets or bands. Decalcification is an early indicator of mineral loss that can progress into a cavity.
Imaging and Referral Protocol
Orthodontic treatment uses specialized X-rays, such as panoramic or cephalometric films, to visualize the jaw and skull structure. While crucial for planning, these large-view images lack the resolution needed to reliably detect small cavities between teeth. If a suspicious area is noted visually or on the films, the orthodontist refers the patient to their general dentist for definitive diagnosis and treatment.
The Necessity of Continued General Dental Care
Regular dental visits are necessary throughout orthodontic treatment. Appliances create new traps for food and plaque, increasing the risk of decay and gum inflammation. The general dentist provides professional cleanings and plaque removal, which is challenging to do at home with braces. They routinely take diagnostic X-rays, specifically bitewing radiographs, which are the standard for finding cavities. Bitewing X-rays detect interproximal decay—cavities between teeth—which are impossible to see on broader orthodontic films, and the general dentist performs the necessary restorative procedures.