By the numbers

Any statement about the ability of the specialty to meet the future demand for orthodontic care based merely on a ratio of the projected number of orthodontists to the projected population is an oversimplification. Still, some inferences can be drawn from the data presented in this article. To be as prudent as possible, we will limit the scope of the discussion to the next 10 years. 1. It seems likely that the annual number of orthodontic graduates will remain about the same. 2. Considering the slow increase in the average age of orthodontists, the death rate will increase slightly, but not significantly. 3. The average annual number of retirees will be somewhere between 125 (the current rate) and 359 (the maximum projected by the JCO Retirement Survey). 4. The above assumptions would leave no less than 7,500 practicing orthodontists in the United States in 10 years. 5. The number of children age 9-17 will increase by 5-10%. In a worst-case scenario, could 7,500 orthodontists meet the orthodontic demand 10 years from now? The 1997 JCO Orthodontic Practice Study reported the annual median number of case starts to be 180. Multiplied by 9,000 orthodontists, that would equal 1,620,000 case starts. If we project a 10% increase in demand, there could be 1,782,000 case starts 10 years from now--an average of 238 starts per year for 7,500 orthodontists. Respondents to the Practice Studies have consistently indicated that they could handle 50 additional case starts with no increase in staff or facilities, which would mean current orthodontists could accommodate an average of 230 case starts. Moreover, orthodontic productivity is likely to increase due to delegation and improved technology. In conclusion, even if the sharp increase in the number of annual retirements anticipated in the JCO Retirement Survey turns out to be correct, it seems unlikely that it will affect the ability of the specialty to accomplish its mission in the foreseeable future.