I will have to agree somewhat that only back and forth for orientation isn't very efficient.
If you want complete controll you'd have to have 6 buttons for all cardinal rotation directions though.
The CTRL+scroll is a nice way to speed things up but it has its flaws:
However, after a few weeks of building, I become rather comfortable with CTRL + scrolling to rotate the blocks.
For me it took even longer to master because I never realized I actually could do that (silly). It seems to be a bit of an advanced user thing, not sure if it is intended as such.
I know of one completely different system to handle orientation when placing (i.e. minecraft's change orientation depending on what part of the previous block you clicked on) but that also has some flaws (having to reach/look at a certain face of a block to place a wedge the way you want it or having to place extra "helper" blocks to achieve certain orientations) It's better for early users but hinders those with greater building ambitions.
There probably isn't a perfect way to do this, but improving it like this certainly can't hurt.
Also slightly related: would also help if you could
actually always see what way your block is oriented