1 year of practicing. Q&A

[P7898]

Ask away.

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[todentornottodent]

How much of your debt have you paid off?

 

[monkeydog]

What was the learning experience jump like going from new grad to practicing?

Did you go rural or urban, what made you choose either or?

How are are you prioritizing student loans vs hobbies vs work life balance

 

[carabelliscusp]

Corp? Private?
Salary vs hours per week?
Is this your first job or have you switched?

 

[Saddleshoes]

What do you wish your dental school had prepared you better to handle?

 

[Thehighwind87]

Ask away.

Is it everything that you thought it would be? New Porsche 911? 4 day work week making 300k? Golfing on the weekends? Private country club events? Live in a country club with all the other millionaires? Do you practice in Los Angeles Beverly Hills working on veneers all day long?

That was my "perception of dentistry" when I first graduated. To answer your question:

I drove a pre-owned Honda,
I worked 6 days a week-scraped about 200k- but if I had settled with 4-5 days- probably make like 150 or less.
I was exhausted on the weekends so no golfing
No country club- was to poor for that
Lived with my parents, and lived with friends. 4 roomates sorta deal 500$ rent.
Did not practice in LA- I practiced 3 hours away from LA in the middle of nowhere with nothing to do.
Bounced around 3 jobs doing fill and drill- no veneers. Every job that hired me- screwed me over- low collections, gave me all the crap cases that noone else wanted, poached all the bigger cases, no benefits/hired as independent contractor.

Now things are better- but man my perception changed quickly.

How did your first year go?

 

[juniordentist]

Is it everything that you thought it would be? New Porsche 911? 4 day work week making 300k? Golfing on the weekends? Private country club events? Live in a country club with all the other millionaires? Do you practice in Los Angeles Beverly Hills working on veneers all day long?

That was my "perception of dentistry" when I first graduated. To answer your question:

I drove a pre-owned Honda,
I worked 6 days a week-scraped about 200k- but if I had settled with 4-5 days- probably make like 150 or less.
I was exhausted on the weekends so no golfing
No country club- was to poor for that
Lived with my parents, and lived with friends. 4 roomates sorta deal 500$ rent.
Did not practice in LA- I practiced 3 hours away from LA in the middle of nowhere with nothing to do.
Bounced around 3 jobs doing fill and drill- no veneers. Every job that hired me- screwed me over- low collections, gave me all the crap cases that noone else wanted, poached all the bigger cases, no benefits/hired as independent contractor.

Now things are better- but man my perception changed quickly.

How did your first year go?

This is the same perception I had prior to dentistry, and is exactly why people take on so much debt to be a dentist. Once you graduate and realize how hard it is you start trying to warn predents not to take on so much debt.

 

[charlestweed]

Is it everything that you thought it would be? New Porsche 911? 4 day work week making 300k? Golfing on the weekends? Private country club events? Live in a country club with all the other millionaires? Do you practice in Los Angeles Beverly Hills working on veneers all day long?

That was my "perception of dentistry" when I first graduated. To answer your question:

I drove a pre-owned Honda,
I worked 6 days a week-scraped about 200k- but if I had settled with 4-5 days- probably make like 150 or less.
I was exhausted on the weekends so no golfing
No country club- was to poor for that
Lived with my parents, and lived with friends. 4 roomates sorta deal 500$ rent.
Did not practice in LA- I practiced 3 hours away from LA in the middle of nowhere with nothing to do.
Bounced around 3 jobs doing fill and drill- no veneers. Every job that hired me- screwed me over- low collections, gave me all the crap cases that noone else wanted, poached all the bigger cases, no benefits/hired as independent contractor.

Now things are better- but man my perception changed quickly.

How did your first year go?

My perception was very different. I didn’t expect to have nice car like a 911 because it was way beyond the range that I could afford with an associate income of only $250-300/day (or $70-80k/year), which was the average 20+ years ago. Opening my own office was never in my mind because I didn’t think I could do it. This was the reason why I sold all of my dental/ortho instruments to my classmates/co-residents. I was content with such associate dentist’s income for the rest of my life. To me, it’s still many times better than my parents’ salaries….it’s still around 1.5-2x the salaries of the engineers. A nice flagship Acura sedan (at that time, it was an Acura Legend) would be fine for me.

And then in my D3 year, I met my girlfriend, who is now my wife. She went to a very expensive cross town rival dental school. Of all the well paid dental specialties out there, she picked the worst one, perio. I didn’t dissuade her because I didn’t want to hurt her feeling. I knew our combined student loan debt would be very bad. The dream of having a nice Acura was shattered. Well, it’s ok….a brand new Honda Accord would be fine…it’s still many times better than the car that my dad drove.

After graduation, my wife and I both had very well paid associate jobs. A year later, we bought a perio practice. I was very surprised at how great of a periodontist my wife was….clinically and business-wise. She has so many friends, who are general dentists. Without her great income, we wouldn’t have been able to afford to buy our first house so quickly (3 months after graduation). Four years later, I started my own office. The fear of failure (I didn’t trust myself) forced me to keep the overhead as low as possible. It turned out keeping the overhead low has been one my strengths and this helped me expand my business to 4 different locations. Now, it’s only 3….I recently closed one. Life has been good.

OP, sorry to derail the thread. We’d love to hear your responses.

 

[Let me out!]

Love this thread!

Tell us more!

 

[Molar Whisperer]

During my 4th yr at DS (1998), I interned at this high end solo practice and was really impressed with the dentist's exceptional level of patient care. He really inspired me to practice high end dentistry. Back then, the saying is "don't worry, the money will come where ever you practice." After I completed 4 yrs USAF with no DS loans, I moved to the highly competitive and saturated Pacific NW. I got into an associate job at a large Corp with the goal of getting my own practice. I wanted to get good at all the core procedures and work on doing more lucrative ones. After 9 months, the company wanted to lay me off but wanted to keep me as a general dentist doing full time root canals. I can still pick and choose which cases to do and which to refer. I thought that was a once in a lifetime opportunity for me to get good at RCTs and then start my practice. I started making good money with very little stress and produced over $1 M on my 2nd year. Presently 21 yrs later, I still don't have my own practice and am hoping to get into teaching gigs. I know they are low paying but my house is all paid off and I have more financial flexibility other than my kids getting into college.

The reality of the saying "the money will come" was short sided. It may come in the less saturated areas. In areas where the Cost Of Living is very expensive, people do not want to pay out of pocket for dentistry. My Medical surgeon goes to wherever his wife has dental coverage which is Kaiser. The high end dentist's main clientele are the ones from Old Money where it is handed down multiple generations. New Money follows the internet trend of fast and cheap Amazon dentistry.

For those considering DS, it may seem cool shadowing the successful older dentists and orthodontists with their 911s. Chances are, the older ones didn't have the high student loans the younger generation will face and the realities of early dental careers are way more difficult than even 10 yrs ago. I feel bad for the students who shadow me doing RCTs because they think it is fast and easy money. I think a more accurate depiction is to shadow those in Aspen and other DSOs.

 

[Thehighwind87]

During my 4th yr at DS (1998), I interned at this high end solo practice and was really impressed with the dentist's exceptional level of patient care. He really inspired me to practice high end dentistry. Back then, the saying is "don't worry, the money will come where ever you practice." After I completed 4 yrs USAF with no DS loans, I moved to the highly competitive and saturated Pacific NW. I got into an associate job at a large Corp with the goal of getting my own practice. I wanted to get good at all the core procedures and work on doing more lucrative ones. After 9 months, the company wanted to lay me off but wanted to keep me as a general dentist doing full time root canals. I can still pick and choose which cases to do and which to refer. I thought that was a once in a lifetime opportunity for me to get good at RCTs and then start my practice. I started making good money with very little stress and produced over $1 M on my 2nd year. Presently 21 yrs later, I still don't have my own practice and am hoping to get into teaching gigs. I know they are low paying but my house is all paid off and I have more financial flexibility other than my kids getting into college.

The reality of the saying "the money will come" was short sided. It may come in the less saturated areas. In areas where the Cost Of Living is very expensive, people do not want to pay out of pocket of dentistry. My Medical surgeon goes to wherever his wife has dental coverage which is Kaiser. The high end dentist's main clientele are the ones from Old Money where it is handed down multiple generations. New Money follows the internet trend of fast and cheap Amazon dentistry.

For those considering DS, it may seem cool shadowing the successful older dentists and orthodontists with their 911s. Chances are, the older ones didn't have the high student loans the younger generation will face and the realities of early dental careers are way more difficult than even 10 yrs ago. I feel bad for the students who shadow me doing RCTs because they think it is fast and easy money. I think a more accurate depiction is to shadow those in Aspen and other DSOs.

At least you got paid doing RCT.

My first gig- I was doing fillings for FREE. Yes you heard that right. 0 PAY.

That's when I learned about HMO. Yeah no thanks.

 

[Molar Whisperer]

At least you got paid doing RCT.

My first gig- I was doing fillings for FREE. Yes you heard that right. 0 PAY.

That's when I learned about HMO. Yeah no thanks.

Was this in SoCal? Back in the 90s I heard California was bringing in 3rd world dentists and paying them less than $200/day.

 

[D1Bound]

Is it everything that you thought it would be? New Porsche 911? 4 day work week making 300k? Golfing on the weekends? Private country club events? Live in a country club with all the other millionaires? Do you practice in Los Angeles Beverly Hills working on veneers all day long?

That was my "perception of dentistry" when I first graduated. To answer your question:

I drove a pre-owned Honda,
I worked 6 days a week-scraped about 200k- but if I had settled with 4-5 days- probably make like 150 or less.
I was exhausted on the weekends so no golfing
No country club- was to poor for that
Lived with my parents, and lived with friends. 4 roomates sorta deal 500$ rent.
Did not practice in LA- I practiced 3 hours away from LA in the middle of nowhere with nothing to do.
Bounced around 3 jobs doing fill and drill- no veneers. Every job that hired me- screwed me over- low collections, gave me all the crap cases that noone else wanted, poached all the bigger cases, no benefits/hired as independent contractor.

Now things are better- but man my perception changed quickly.

How did your first year go?

Can this be highlighted on the pre dental and dental section?

 

[Blueshirts]

You still like crown and bridge? What CE have you taken or plan on taking?

 

[P7898]

How much of your debt have you paid off?

Great question. With no interest payments I split up my debt and investments (mostly towards investments). I graduated with $160k in student loans and probably before the interest starts back up I will have $120k left.

But I also managed to invest a ton so there are pros and cons.

 

[P7898]

What was the learning experience jump like going from new grad to practicing?

Did you go rural or urban, what made you choose either or?

How are are you prioritizing student loans vs hobbies vs work life balance

Practicing - you are more worried about clinically acceptable work vs perfection. Of course perfection is the goal but I do not lose sleep over it if it is not achieved.

I am rural/suburban area.

I have been prioritizing investing vs paying student loans due to the interest deferral. However I been paying some of them (the high interest loans first to maximize my return). So before interest starts again in September I will have about $120k left.

Hobby wise I play golf, work out, travel, and do whatever I want. But I also work very very hard during the week 4.5 days. So work hard play hard. But of course you have to stay well rested and take good care of your body to do this job well in my opinion.

 

[P7898]

Corp? Private?
Salary vs hours per week?
Is this your first job or have you switched?

I did both. Corp and then a group practice owned by dentists. The one owned by dentists is way better. More organized. Ethics first.
Salary is variable. My first year of practice was around $270k as an associate But it varies of course. I just do bread and butter dentistry with extractions and Invisalign.
Income in dentistry is all about predictability (how fast and well can this be done - keep to a specialist standard) and stay away from things that will take me too long even if they are very profitable. This method has worked well.
I am in my second job. I started at a corp and then switched.

 

[P7898]

What do you wish your dental school had prepared you better to handle?

My dental school prepared me very well. No specialty residency is a huge thing for dental students. I wish I had more Invisalign education. Case selection and when to refer cases.

 

[P7898]

Is it everything that you thought it would be? New Porsche 911? 4 day work week making 300k? Golfing on the weekends? Private country club events? Live in a country club with all the other millionaires? Do you practice in Los Angeles Beverly Hills working on veneers all day long?

That was my "perception of dentistry" when I first graduated. To answer your question:

I drove a pre-owned Honda,
I worked 6 days a week-scraped about 200k- but if I had settled with 4-5 days- probably make like 150 or less.
I was exhausted on the weekends so no golfing
No country club- was to poor for that
Lived with my parents, and lived with friends. 4 roomates sorta deal 500$ rent.
Did not practice in LA- I practiced 3 hours away from LA in the middle of nowhere with nothing to do.
Bounced around 3 jobs doing fill and drill- no veneers. Every job that hired me- screwed me over- low collections, gave me all the crap cases that noone else wanted, poached all the bigger cases, no benefits/hired as independent contractor.

Now things are better- but man my perception changed quickly.

How did your first year go?

No prosche 911. I live very basic. I don’t not live in Beverly Hills - I like the country/Suburbia.

Very humbling to practice real world dentistry. But life is all about adapting and changing points of views for the better so it has been a rewarding experience for me.

 

[P7898]

My perception was very different. I didn’t expect to have nice car like a 911 because it was way beyond the range that I could afford with an associate income of only $250-300/day (or $70-80k/year), which was the average 20+ years ago. Opening my own office was never in my mind because I didn’t think I could do it. This was the reason why I sold all of my dental/ortho instruments to my classmates/co-residents. I was content with such associate dentist’s income for the rest of my life. To me, it’s still many times better than my parents’ salaries….it’s still around 1.5-2x the salaries of the engineers. A nice flagship Acura sedan (at that time, it was an Acura Legend) would be fine for me.

And then in my D3 year, I met my girlfriend, who is now my wife. She went to a very expensive cross town rival dental school. Of all the well paid dental specialties out there, she picked the worst one, perio. I didn’t dissuade her because I didn’t want to hurt her feeling. I knew our combined student loan debt would be very bad. The dream of having a nice Acura was shattered. Well, it’s ok….a brand new Honda Accord would be fine…it’s still many times better than the car that my dad drove.

After graduation, my wife and I both had very well paid associate jobs. A year later, we bought a perio practice. I was very surprised at how great of a periodontist my wife was….clinically and business-wise. She has so many friends, who are general dentists. Without her great income, we wouldn’t have been able to afford to buy our first house so quickly (3 months after graduation). Four years later, I started my own office. The fear of failure (I didn’t trust myself) forced me to keep the overhead as low as possible. It turned out keeping the overhead low has been one my strengths and this helped me expand my business to 4 different locations. Now, it’s only 3….I recently closed one. Life has been good.

OP, sorry to derail the thread. We’d love to hear your responses.

No problem. The thread is here for all to share.

My experience has been positive. But I make more than average probably because I like rural areas. I don’t have much debt (compared to the average). So my view point is very different than others - much like dental school.

Dental school - there are soo many in equities in what students learn. Some can do like 15 endos while others do 3. But this is much like the real world. You hussle, do as best as you can for your patients, always do the right thing, and finances will come.

But of course I do not have $300k+ loans. If I did I would work 6 days a week instead of 4-5. But the profession has been good to me so far.

 

[P7898]

You still like crown and bridge? What CE have you taken or plan on taking?

I do a lot of crown and bridge. Mostly single crowns. I do a lot of cast metal and resin partial dentures. People just can’t afford dental implants where I live. They are expensive anyways.

I just take free CE. I am no CE hero. I do a little bit of all procedures (Endo, ext, pedo, Invisalign) but I refer if 1) my quality won’t be up to specialists standards 2) it will take me more than 1 hour (without me leaving the room) because this will not be a good patient experience or productive.

 

[P7898]

In a nutshell it’s about minimal debt load and having a work schedule that you can do consistently for a long period of time and be productive.

The biggest thing I can offer is when you look at contracts know how you will get paid. Know the difference between collections and adjusted production. And read the fine print as what defines “collections” or “adjusted production”.

 

[LFA20]

No problem. The thread is here for all to share.

My experience has been positive. But I make more than average probably because I like rural areas. I don’t have much debt (compared to the average). So my view point is very different than others - much like dental school.

Dental school - there are soo many in equities in what students learn. Some can do like 15 endos while others do 3. But this is much like the real world. You hussle, do as best as you can for your patients, always do the right thing, and finances will come.

But of course I do not have $300k+ loans. If I did I would work 6 days a week instead of 4-5. But the profession has been good to me so far.

Two big things:
- Much lower than average student debt
- Rural

Most new grads have much higher than 300k debt and not willing to go rural…

When you say you make more than average working rural is it above or below $250k?

 

[Molar Whisperer]

No problem. The thread is here for all to share.

My experience has been positive. But I make more than average probably because I like rural areas. I don’t have much debt (compared to the average). So my view point is very different than others - much like dental school.

Dental school - there are soo many in equities in what students learn. Some can do like 15 endos while others do 3. But this is much like the real world. You hussle, do as best as you can for your patients, always do the right thing, and finances will come.

But of course I do not have $300k+ loans. If I did I would work 6 days a week instead of 4-5. But the profession has been good to me so far.

Working and living Rural is the trifecta of having a more productive practice with fewer DSO presence (Not For Long), paying lower Cost of Living ($800 annual property tax at my home town vs my $11k) , and possibly having lower litigation risk. The exception is if you're Asian. For an Asian family to thrive in all life aspects in the US, we have to live in areas like Pacific NW, Cali LA/Bay Area, NYC/Boston, or TX Dallas/Houston. My kids were never told to go back to where we came from.

Rural can also be misleading. We have a rural town about 2.5 hrs away having 15k population with almost 30 dentists (about 1 dentist per 500 people). I briefly worked rural about 1.5 hrs away and basically had no patients and needed to find another gig. Less desirable small towns within 3 hrs away have bad Meth and drug problems.

My rural setting growing up was the epitome of undesirable. In early '22 before the massive interest rate hike, we sold my father's 3000 sq ft house for almost half what he put in for $190k. Back in the early 80s, my dad had to pony up twice due to the builder going bankrupt in the middle of building our house. The town's median income was $27k according to the most recent census. I struggled big time in college even after taking 4 yrs of HS chemistry which I realized was Mickey Mouse level.

I applaud @P7898 for handling the real world dental transition so well.

 

[P7898]

Two big things:
- Much lower than average student debt
- Rural

Most new grads have much higher than 300k debt and not willing to go rural…

When you say you make more than average working rural is it above or below $250k?

Above. But of course I would consider my first job to be rural/suburban. I am now at another job where it is truly rural.

 

[P7898]

Working and living Rural is the trifecta of having a more productive practice with fewer DSO presence (Not For Long), paying lower Cost of Living ($800 annual property tax at my home town vs my $11k) , and possibly having lower litigation risk. The exception is if you're Asian. For an Asian family to thrive in all life aspects in the US, we have to live in areas like Pacific NW, Cali LA/Bay Area, NYC/Boston, or TX Dallas/Houston. My kids were never told to go back to where we came from.

Rural can also be misleading. We have a rural town about 2.5 hrs away having 15k population with almost 30 dentists (about 1 dentist per 500 people). I briefly worked rural about 1.5 hrs away and basically had no patients and needed to find another gig. Less desirable small towns within 3 hrs away have bad Meth and drug problems.

My rural setting growing up was the epitome of undesirable. In early '22 before the massive interest rate hike, we sold my father's 3000 sq ft house for almost half what he put in for $190k. Back in the early 80s, my dad had to pony up twice due to the builder going bankrupt in the middle of building our house. The town's median income was $27k according to the most recent census. I struggled big time in college even after taking 4 yrs of HS chemistry which I realized was Mickey Mouse level.

I applaud @P7898 for handling the real world dental transition so well.

Thank you. I would say that suburban areas would be great too to practice in. But of course suburban areas that have small rural like towns 30 mins to 1 hour away.

 

[P7898]

Everyone is school gets fixated on the big higher end procedures. When they should be worried about doing bread and butter dentistry as good as possible.

Even my friends who are in more suburban areas are doing well but that’s all they do - bread and butter. No full mouth rehab, no implants, no wires and brackets. It is all about sending your patients to get the best care with the best clinicians. If you just stay in your lane (bread and butter with excellent care) and do that - I have no doubt many will be successful.

Of course if you’re in city areas then money may not be as good but if you stay long enough it’s all about reputation. Patients know when you care about them versus not and if you show this as much as possible - these are the key to success in dentistry my opinion.

 

[Pablo Sanchez]

Ask away.

Sounds like you’re doing great! Congrats! I graduated at the same time of you and am doing pretty similarly. Practicing within 30 mins of a major metro.

Keep working hard! This is a fantastic field if you can limit your student loan debt and work hard/learn quickly. There’s always bread and butter dentistry to be done!

 

[LFA20]

Above. But of course I would consider my first job to be rural/suburban. I am now at another job where it is truly rural.

You mainly do bread and butter? (operative, crowns, removable, simple exo/endo)

 

[P7898]

You mainly do bread and butter? (operative, crowns, removable, simple exo/endo)

Yes I do. I am well trained in surgical extractions however I do not compete with OS. Anything from third molars and molar extractions I typically refer to OS if they will be challenging. However if they are erupted and mobile I’ll do it. Again, what’s best for the patient and what’s most predictable for you. Plus you have hygiene to look at as well. I do FM extractions but only on Perio patients or patients with root tips that I think will fail right out.

Endo I do everything except molars. Again, I can do molars but not worth my time or headache. I can do a quad of composite restorations in less time than molars.

I refer a good amount.

 

[LFA20]

Yes I do. I am well trained in surgical extractions however I do not compete with OS. Anything from third molars and molar extractions I typically refer to OS if they will be challenging. However if they are erupted and mobile I’ll do it. Again, what’s best for the patient and what’s most predictable for you. Plus you have hygiene to look at as well. I do FM extractions but only on Perio patients or patients with root tips that I think will fail right out.

Endo I do everything except molars. Again, I can do molars but not worth my time or headache. I can do a quad of composite restorations in less time than molars.

I refer a good amount.

Thank you!

 

[P7898]

Just some food for thought. If I were applying to dental school and then getting a job this would be the big highlights if you want to be a good GP out of the gate (my opinion):

1) No specialty residencies at the school
2) >$250k Debt
3) work in suburban or rural areas
4) get a daily guaranteed amount $$ vs % of production
5) Don’t expect mentorship - so focus on all the skills you learned in dental school. I wouldn’t add anymore skills until you do not sweat over bread and butter procedures.
6) Always do what’s best for the patient - not your wallet.
7) Be humble and always listen to someone like you know nothing.

 

[LFA20]

Just some food for thought. If I were applying to dental school and then getting a job this would be the big highlights if you want to be a good GP out of the gate (my opinion):

1) No specialty residencies at the school
2) >$250k Debt
3) work in suburban or rural areas
4) get a daily guaranteed amount $$ vs % of production
5) Don’t expect mentorship - so focus on all the skills you learned in dental school. I wouldn’t add anymore skills until you do not sweat over bread and butter procedures.
6) Always do what’s best for the patient - not your wallet.
7) Be humble and always listen to someone like you know nothing.

I am 5 years out and this is an important one. Never assume/judge when you see something you don't like. There is a reason why that happened in the first place. Bad days happen to everyone.

 

[P7898]

I am 5 years out and this is an important one. Never assume/judge when you see something you don't like. There is a reason why that happened in the first place. Bad days happen to everyone.

Exactly never judge work. Always assume the clinician tried their best and relay to the patient.