Throughout our profession's history, orthodontists have claimed to produce quality outcomes, but have we? In 1934, Dr. Allan Brodie wrote that at that time orthodontists were not producing better outcomes than dentists. How do we know if we are? Outcomes assessments are necessary to understand the efficacy of our treatment. This is just as true for orthodontics as it is for the business world. Orthodontic outcomes assessments published in peer-reviewed journals demonstrate that a significant number of patient outcomes fail to reach generally accepted goals. Numerous iatrogenic factors may increase the likelihood of treatment failures, including a failure to: 1) set specific, evidence-based facial, skeletal and dental treatment objectives, 2) a focus on techniques instead of science, 3) establish proper A-P anchorage, 4) control the vertical dimension, 5) regularly assess treatment outcomes. Understanding that orthodontics is at its core a science, and using that science in our treatment significantly improve our treatment outcomes.