How much do orthodontic therapists earn?

Chrystal Sharp outlines how the earning potential of orthodontic therapists varies across the country and within the profession.

The earning potential for an orthodontic therapist varies across the UK. I have found that this is a hot topic, especially in different community forums where comparisons are often searched for. Each company is different, and orthodontic therapists vary in their roles, responsibilities, experience and job circumstances.

My belief with a pay structure is knowing how to value yourself, setting your worth and understanding your contributions to the clinic from a financial, workflow efficiency and overall patient care aspect. If you align yourself with clinics that allow you to work to your full potential, harbouring your clinical and financial growth, your pay should continue to reflect your worth.

Within the UK, pay differs largely for a multitude of reasons. When looking at advertised positions online, orthodontic therapist roles tend to advertise across London and the UK at between £30 to £45 per hour on a self employed basis. Though the earning potential can be much greater than that, so let’s delve into what we need to consider about how the pay for orthodontic therapists may differ and why, and how to set your worth.

Initial considerations

Let’s start from whether you are self-employed or employed. If you are self-employed, you may earn more due to the forfeit of other benefits, such as paid annual leave, paid bank holidays and maternity leave. This should be taken into account when setting your hourly rate.

If you’re employed, it may be hourly or salaried. If salaried, it’s worth ensuring it’s for a set amount of hours, incorporating a day rate that is beneficial to you. Being employed will have its benefits in which every month you have a security of what you’re earning, along with the benefits of paid annual leave, bank holidays and maternity leave, but often you may be at a loss of your time unless you have defined hours and a set day rate with overtime incorporated in.

Location also plays into the overall rate of pay. Usually within London, the rate would be higher as the cost of living and running a business is greater than other areas of the UK. The cost of dental treatment is also sometimes at an increased price in the city in comparison to other clinics within the UK.

Another point to consider from the offset is whether your orthodontic therapy course was funded by your mentoring orthodontist/orthodontic clinic, or if you self funded. If it’s the latter, then you’re more likely to be able to start on a higher hourly wage than if you’re under contract for a period of time to pay back the course fee in time worked. In this case, your rate of pay may take time to increase. I would advise ensuring that your rate increases every year you’re under this type of contract.

NHS, private and hospital settings

Are you working within the NHS, private or mixed clinic? If you’re working within a private clinic, the orthodontist/dentist is charging per patient. If you’re working within the NHS, there may be a pay scale limit.

Each NHS clinic will differ due to the size of the contract they hold. There may be less opportunities for the pay to increase as there is an overall budget being adhered too, as your main role is to increase the efficiency in allowing the orthodontist to achieve the UOAs required for that contract. Starting your orthodontic therapy career within the NHS can be beneficial due to a heavier exposure to an array of orthodontic appliances and diary/procedure time management.

Within a hospital setting, the pay structure is usually on an employed basis with your pay rate being structured through a banding system. Overall, this role can be excellent for your academic learning and exposure to complex cases such as orthognathic cases, though the pay can be very low in comparison to other positions.

The band your pay falls under as an orthodontic therapist would be difficult to change, especially where additional certification training for the role is not currently available. The current hospital band for an orthodontic therapist is band 7, though I have seen positions advertised at band 6. The pay rate within the hospital is up to £28 per hour. Overall, the hospital will have some benefits such as an NHS pension, a steadier working day (as appointments tend to have longer allocated times), standard working hours, access to standard paid maternity leave and annual leave.

After exploring all the above factors for the orthodontic therapist pay structure, so much can be incorporated into rates of pay and this is why it differs so drastically. Comparison is difficult due to everyone’s circumstance being totally different.

How can orthodontic therapists increase their rate?

A great place to start is with your personal development plan. As an essential part of the patient journey, I’m always looking to enhance my daily practice by working to my top potential and utilising my full scope of practice, which in turn can create more time in the prescribing clinician’s diary and accelerate business growth and profitability.

The below points encompasses working to your full potential and can help set a personal development plan for you. They are also leading points of discussion when it comes to rate of pay:

Confidence: working to a high standard – is there more exposure or experience you require on certain orthodontic procedures or systems that will then aid your rate to increase and reflect this additional experience?
Ambition:a drive to become better at what you do – if you want your rate of pay to increase, you will need to want to make changes
Investment: honing your skills and investing in related courses to further develop and refine your clinical knowledge and skills
Upskilling: adapting your skillset to stand out and stay ahead of the curve with the ever-changing technology
Niche: finding enjoyment within your scope and becoming a master of a skill
Autonomy: creating control and responsibility of your clinical work and diary
Support: create change and enhance your development along with business needs and patient care
Variety: maintaining your fundamentals and aligning yourself with like-minded clinics so as not to deskill
Gratification: loving what you do and using this to give back within your clinic may be in the form of staff training or setting the standard of care required
Incentives: eg a bonus scheme – discuss possibilities for this
Full potential: are you working to your full potential and utilising your full scope of practice? If not, are there avenues within your practice to allow that? If so, this could increase the practice efficiency and profitability
Goal alignment: is your current clinic aligning with your overall professional development plan/goals?

Could the pay of orthodontic therapists change?

When comparing the orthodontic therapist role to similar DCP roles, such as a dental therapist or dental hygienist, there seems to be two popular pay pathways: hourly rate or percentage. Percentage works the same as an associate dentist whereby with each procedure you carry out you receive a percentage of the fee – usually around 40 to 45%.

I think orthodontic therapists could potentially work this way in the future if the appointment workflow and payment allocation structure was set up correctly within the clinic. With more of us qualifying and the role becoming more popular, I’m excited to see this role develop along with the hope of more post qualification progressional pathways being opened, and the potential for our remuneration to increase.

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