Typically, for the dentists that do practice orthodontics, they refer cases based on complexity. If it's too challenging for them, given their lower volume and experience, they'll send the patients to you.

However, general dentists don't see the volume of patients that I do. A great dentist might see only five patients a day - I'm just estimating here - but they likely never see double digits. They won't even see 10 patients a day because they are doing procedures like crowns, bridges, root canals, or implants, which means they spend hours with one patient. Therefore, they don't tend to understand patient vibes as well as I do. This is where they run into problems, because they keep trying to assure the patient of their capabilities, rather than focusing on the suitability of the patient.

As an adult, when I hear about clear aligners, I think they can do the same job but look better. Why wouldn't almost everyone prefer aligners over braces?

Maybe 10 years ago, nobody asked for aligners. Back then, they came for orthodontic treatment. It took people like us to introduce aligners to them, and they would always be surprised that their complex dental issues could be treated with them. In the last seven or so years, I think patients believe that all cases can be treated with clear aligners because of the marketing.