Background <p>Determinants of orthodontist selection in the modern era remain inconsistent, especially roles of online versus traditional factors. This study compared social media, offline reputation, and orthodontist characteristics associated with orthodontist selection.</p> Methods <p>This cross-sectional analytical study was conducted among 330 working-age adults seeking orthodontic treatment (mean age 29.9 ± 3.3 years). Participants completed a validated three-part questionnaire: 1) demographic data and social media usage behavior; 2) factors associated with orthodontist selection, categorized into three domains: social media (e.g., credibility, online presence), offline reputation (e.g., awards, word-of-mouth), and orthodontist characteristics (e.g., caring, education, working age); and 3) the decision-making process of orthodontist selection, which served as the dependent variable. Responses in Parts 2 and 3 were rated on a five-point Likert scale. Stepwise multiple linear regression analysis was applied to identify significant factors (<i>P</i> &lt; 0.05).</p> Results <p>Instagram, Facebook, and TikTok were the most frequently used platforms, with peak activity during night hours (20:01–00:00; 35.2%). Five variables were significantly associated with orthodontist selection. The strongest predictor was orthodontist’s online presence (β = 0.200, <i>P</i> &lt; 0.001), followed by perceived caring (β = 0.170, <i>P</i> = 0.004), word-of-mouth recommendations (β = 0.139, <i>P</i> = 0.007), educational background (β = 0.136, <i>P</i> = 0.016), and working age orthodontist (β = 0.130, <i>P</i> = 0.013). The model explained 21% of the variance.</p> Conclusions <p>Patients perspective in orthodontist selection is related to a combination of these domains. While an online presence demonstrated the strongest correlation, offline reputation and orthodontist characteristics remain critical factors.</p>