Don't go to Dental School

[ajj70]

It's an interesting point you made, and you are correct in that money invested now will play a large role in the future. That's why the Rule of 72 is so amazing.

Just to play the Devil's Advocate, I would argue that the money you save by taking a gap year and going to a significantly cheaper state school ($126k as @EasTexan put it) will more than counteract the benefit of an extra year of wages, even after interest.

Here's my reasoning: 1) You're in less debt. 2) Loans are at 7% right now....so by not taking out those loans, you are paying yourself a guaranteed 7%. Where in the market can I get a guaranteed 7% right now? My investment fund is returning an average of 9% per year, but that is an average over time. One year it returns 12%. Another only 5%. If there is a crash tomorrow, it'll return even less. Not reliable for short-term at all!

In light of these considerations, I think that it is a solid decision to wait a year and save $126K + the 7% interest on that, guaranteed.

Ok, lets look at the figures, figuring the future value of $10,000, at your 7%, would be $1,382,368.78 in 35 years. In 34 years that would be $1,282,587.65 So a difference of $99,781. That is just a $10,000 investment, would be double that if you invested $20,000, or, the extra cost to buy your practice waiting a year....you can't look at short term dollars for long term investments....but thats a different thread . Historical stock market returns since the inception of the stock market is 8%. For your 12% if that is a stock fund, that's great, if the 5% is a bond fund, that is great too. You can't just go by those numbers. Then factor in simply that one less year of income vs taking out another year or loans or whatever you will do during that gap, not to mention the cost of applying for dental school. Hopefully the person in question get into one of the state schools, but its pretty short sighted to only apply to 3 schools and hope for the best.

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[ajj70]

You better be careful though, markets are on a tightrope and that crash could occur tomorrow

All the more reason to get into dental school faster, interest rates will drop if there is another big crash, real estate is especially cheep during down markets (aka buying your practice or land/building for a practice), having money to invest when the market is down is HUGE!!! The last big crash in 2008 the market was down to 6500, it's in the 17,500 range now....those that were sinking money into the market after the crash are doing REALLY well now!

 

[Incis0r]

Ok, lets look at the figures, figuring the future value of $10,000, at your 7%, would be $1,382,368.78 in 35 years. In 34 years that would be $1,282,587.65 So a difference of $99,781. That is just a $10,000 investment, would be double that if you invested $20,000, or, the extra cost to buy your practice waiting a year....you can't look at short term dollars for long term investments....but thats a different thread . Historical stock market returns since the inception of the stock market is 8%. For your 12% if that is a stock fund, that's great, if the 5% is a bond fund, that is great too. You can't just go by those numbers. Then factor in simply that one less year of income vs taking out another year or loans or whatever you will do during that gap, not to mention the cost of applying for dental school. Hopefully the person in question get into one of the state schools, but its pretty short sighted to only apply to 3 schools and hope for the best.

I'm afraid I don't understand your calculation. $10,000 @ 7% over 35 years should be (10,000)*1.07^35 = $106.7K correct? How did you get $1.3M?

Is there a different formula you used for future value?

 

[bjpenn]

Except you didn't factor in future dollars of investment money from earning money a year or two earlier and that is where it really makes a difference, when you retire, not the first 10 years.

Ha what investment money will you have your first two years out of school ?

 

[ajj70]

I'm afraid I don't understand your calculation. $10,000 @ 7% over 35 years should be (10,000)*1.07^35 = $106.7K correct? How did you get $1.3M?

Is there a different formula you used for future value?

The magic of compound interest. It's not just a flat 7% of 10,000 each year. I used an online calculator but you have to remember, you are earning money on the money you earned each year too so after the first year its 10,000 x 7%, so 10,700, then the next year it would be 10,700 x 7%....assuming it's compounded annually and that would depend on the account, it could be compounded monthly...which it probably was in the example.....

 

[ajj70]

Ha what investment money will you have your first two years out of school ?

You are foolish if you don't factor that into your living costs...for the reason posted above. Learn the adage "pay yourself first" well and practice that always!

 

[johnho771]

This thread paints a so so outlook on Ortho. What about other specialties? Are some hurting while others are thriving?

 

[Bernie Sanders]

This thread paints a so so outlook on Ortho. What about other specialties? Are some hurting while others are thriving?

I think perio's prospects are starting to improve now that implants are becoming more common and the demand for them is more common.
I heard endo has been taking a hit though because due to technology, more and more GPs are able to do endo themselves, and only refer the hard 2nd molar/3rd molar root canals to the endodontists.
OMFS is doing well and probably always will

 

[gators2014]

lol. his statement was pretty sarcastic sounding

agreed lol

 

[gators2014]

Go ahead then! Knock yourself out! Good Luck.

I am a dental student I am not turning back. You remind me of the jerk physicians who treated me like crap when I was a nurse. You are a miserable human being and I feel sorry for you.

 

[charlestweed]

This thread paints a so so outlook on Ortho. What about other specialties? Are some hurting while others are thriving?

The orthodontists, who can adjust to the changes (such as more GPs doing ortho, 6-month smiles, increase in the number of chain offices, openings of new dental/ortho schools etc), should be fine and continue to thrive. Many of the successful ones that I know have their own offices and also travel to work part time at other offices. The orthodontists, who are unwilling to make changes and continue to run their practices the same old way (i.e. no traveling, no insurance, only fee for service, high end clientele, and just stay at one office location etc), tend to think negatively about their profession.

 

[Bernie Sanders]

The orthodontists, who can adjust to the changes (such as more GPs doing ortho, 6-month smiles, increase in the number of chain offices, openings of new dental/ortho schools etc), should be fine and continue to thrive. Many of the successful ones that I know have their own offices and also travel to work part time at other offices. The orthodontists, who are unwilling to make changes and continue to run their practices the same old way (i.e. no traveling, no insurance, only fee for service, high end clientele, and just stay at one office location etc), tend to think negatively about their profession.

But isn't "no traveling, no insurance, only fee for service, high end clientele, and just staying at one office location" in addition to the income, MOST of what makes ortho attractive as a specialty?

 

[fancymylotus]

But isn't "no traveling, no insurance, only fee for service, high end clientele, and just staying at one office location" in addition to the income, MOST of what makes ortho attractive as a specialty?

Times are changing. Either adapt and change with them, or don't complain when your profit margins tank.

 

[charlestweed]

But isn't "no traveling, no insurance, only fee for service, high end clientele, and just staying at one office location" in addition to the income, MOST of what makes ortho attractive as a specialty?

Many new grad orthodontists have tried to run their practice this way because they think like you: good lifestyle, high income patients, low patient volume, and least amount of work. After graduation, they worked at chain offices but they couldn't deal with the high volume of patients there. They think that with the DDS, MS degrees, they shouldn't have to sit down to change the wires. That should be the assistant's job. They couldn't get along well with the chain's assistants and managers so they quit their jobs. When they set up their own offices, they chose the high income location and pay ridiculously high rent for their offices. They spent 300-400k on high tech gadgets to attract high income patients. And then they realized the high income patients they hope to attract are just as bad (ie highly demanding, price shopping, having low pay HMO plans, failure to make payment on time etc) and they felt disappointed about the way their profession is heading.

The orthodontists, who don't mind traveling to multiple offices (GP offices, chain offices, other ortho offices....whatever is available for them), are usually the happier ones. They have lower expectation and are less picky about choosing their associate jobs. They do whatever it takes to support their family. Having high student loan forces them to work harder. Working at the busy chains and seeing high volume of difficult cases help them gain more clinical experience and make them better clinicians. When they are ready to set up their own practices, they know what to buy what not to buy. With the experience they gained from working at busy chains, they know how to run their own offices more efficiently without having to spend a lot of money. These orthodontists tend to think more positively about their profession.

Things that make ortho more attractive than other specialties are easy job, good hours, no needle, no blood, no dental phobic patient, mostly healthy kids, patients love to come to see their orthodontists, can survive without GP referrals etc.

 

[ncide]

Things that make ortho more attractive than other specialties are easy job, good hours, no needle, no blood, no dental phobic patient, mostly healthy kids, patients love to come to see their orthodontists, can survive without GP referrals etc.

I routinely see dental phobic patients, and removing an RPE from a patient who doesn't want a band remover in his mouth or is scared of the staff placing pressure on his teeth is not fun. But you're right, you generally see less phobia than other specialties.

You also tend to see some foul mouths because you mostly see kids with appliances. They already have poor brushing habits for the most part and we put more appliances on that catch food and allow plaque to grow.

 

[CharlestonToothCompany]

What do you propose we do? I've taken the long route to dental school, and from all of the forums I've belonged to (and still do) here is a rough breakdown of what professionals in various fields have to say:

Piloting forums: Do not go into this career field. We are glorified bus drivers and we'll all be replaced by machines in the coming decade.
Air traffic control forums: After Reagan broke our union this profession went down hill. The golden years are behind us and we'll all be replaced by automation in the coming decade!
Musician forums: Do not go into this profession if you know what's good for you! Do something that makes money and then do music as a side gig.
Computer programmers (that is my current occupation): If these recent grads keep flooding the market we'll see the continued erosion of our collective incomes! Everyone thinks they can code these days!
Medical forums: Go into dentistry!
Law forums: This is the worst professional experience imaginable! We can't pay back our loans and there are no constraints on the number of graduating lawyers! We should adopt a model more like the AMA / ADA!!
PA forums: This is a good gig if you can get past the fact that you don't have much autonomy and you end up doing a lot of first assists and paperwork...
Veterinarians: Don't even think about this profession unless you can keep your arm up a cow for hours on end only to earn a modest salary with a ridiculous debt burden!

You suggested starting a business. That's easier said than done. What kind of business shall we start? Do we have a market for our idea? Are we any good at what we do? Are you aware of the failure rate of first time businesses? Where do we come up with the capital?!

You guys keep talking about markets and how the one which exists doesn't make sense, but in reality, it makes perfect sense. Dentists have the LOWEST loan default rate of any professional (97%+ repay their loans). As long as dentists are seen as a worthy investment by the powers that be, well, dentists will have to shoulder the unfortunate burden of a market which views them as a reliable cash cow always primed for milking.

I think you make a lot of great points, and I think that more could be done to reign in the supply/demand of dentists. But suggesting that we just magically do something else is really not doing any of us any good. What exactly should we do? Invent the next Facebook? Almost every profession is hurting right now in one way or another. What amazes me though is to read back on old articles and see that they have all been hurting for a long time (even in the 'golden' years). In some respects it really is a matter of perspective.

Cello,

So it appears that 8 years after you commented on this thread, you did pursue your goal of becoming a practicing dentist. Now that you are on this side of the “fence”, do you feel that I (and my colleague, Firm) may have been correct?

 

[Cello]

Cello,

So it appears that 8 years after you commented on this thread, you did pursue your goal of becoming a practicing dentist. Now that you are on this side of the “fence”, do you feel that I (and my colleague, Firm) may have been correct?

Whether it's worth it to be a dentist has always been dependent on who is asking the question. There is just way too much variability, and no one can really know how much they will like being a dentist until they do it. What is true without a doubt is that the risk is higher now than it has ever been. The risk of me not liking dentistry when I graduated was a $480,000 student loan with a 2.4% interest rate. The risk for some students today can be as high as what, $700-$800k? What are the interest rates like today on private loan consolidations, 4-5%? That level of debt at that interest rate is crushing. It may not be impossible, but it will be very difficult for a very long time, and it may lead to financial ruin for many. However, most students will not take on that kind of student loan debt, so I don't want to speak to the extreme as though it represents the majority. For the most part, students will probably graduate with $300-500k student loan debt, and that is definitely manageable on a dentist's income.

For me personally, becoming a dentist was absolutely worth it. In fact, I love being a dentist. I didn't know if I would, but thankfully I do. In fact, I can't see me being happier doing anything else. I love improving people's lives, and using my knowledge, education, and my hands to treat patients. It turns out, I'm also pretty good at it. Dentistry is an extremely rewarding profession. Just last month, we completed a life-changing surgery on a patient (AOX upper / lower). We used photogrammetry and a 3D printer to create temporary fixed dentures for her. The technology available to us today is mindblowing. This young woman's life has been completely transformed for the better. We are privileged to be able to do this sort of thing for our patients. I don't know of any other profession that could afford this level of satisfaction or fulfillment to me. Seeing what my wife goes through in medicine, I know that I definitely wouldn't find the same level of satisfaction there.

I started my own practice this year. I have spent the last year learning everything from contract law, to building layouts, electrical, ergonomics, interior design, dental equipment, dental supply ordering, etc. Then, there is the entrepreneurial aspect. I have learned how to do my own marketing, both digital and print, and I built my own website. I am learning book-keeping, accounting, and I have had to learn how to manage my team. There are so many pitfalls, and the stress is so intense, but I really love what I'm doing. Wearing so many different hats is exciting to me because it keeps things interesting (and stressful beyond belief). I wonder every day if we will make enough money this month to cover our costs. So far we haven't, but that's what you expect with a 5-month old startup. This is by far the most stressful thing I have ever done in my life. But, I would do it all over again if asked. Why? Because most acquisitions suck these days. DSOs gobble up all the good practices and leave scraps for the rest of us. Sure, you can find a gem here and there, but then you often inherit someone else's problems, culture, and vision. I wanted to paint my own Mona Lisa, not buy it from someone else.

So, if you are like me, then dentistry is worth it. Some caveats though, which make my situation different from students right now.
1.) My wife is a physician, and that allows me to take risks (and get loans) that other recent graduates can't. I know that I am fortunate in this regard, and it affords me the security I needed to start my own practice.
2.) I graduated with $480k in student loan debt. We put our money into stocks, because we prefer 9% returns on the market to paying down student loans. However, that was possible because my student loan interest rate is 2.4% - Those interest rates are long gone, so the calculus has changed.
3.) I secured a business loan with a 3.6% interest rate. Again, those interest rates are long gone.

The financial conditions modern dental students face are entirely different from what I did. It sounds crazy to say it, because I graduated just 3 years ago, but COVID and high interest rates have impacted our profession heavily. Yes, tuition is higher, but more importantly, interest rates are higher. Also, banks are more reluctant to lend you money, so starting / buying a practice is more difficult now than it was for me, just one year later.

In summary - I love being a dentist, it was absolutely worth it for me, and I would 100% do it again. But, YMMV.

 

[PikminOC]

Whether it's worth it to be a dentist has always been dependent on who is asking the question. There is just way too much variability, and no one can really know how much they will like being a dentist until they do it. What is true without a doubt is that the risk is higher now than it has ever been. The risk of me not liking dentistry when I graduated was a $480,000 student loan with a 2.4% interest rate. The risk for some students today can be as high as what, $700-$800k? What are the interest rates like today on private loan consolidations, 4-5%? That level of debt at that interest rate is crushing. It may not be impossible, but it will be very difficult for a very long time, and it may lead to financial ruin for many. However, most students will not take on that kind of student loan debt, so I don't want to speak to the extreme as though it represents the majority. For the most part, students will probably graduate with $300-500k student loan debt, and that is definitely manageable on a dentist's income.

For me personally, becoming a dentist was absolutely worth it. In fact, I love being a dentist. I didn't know if I would, but thankfully I do. In fact, I can't see me being happier doing anything else. I love improving people's lives, and using my knowledge, education, and my hands to treat patients. It turns out, I'm also pretty good at it. Dentistry is an extremely rewarding profession. Just last month, we completed a life-changing surgery on a patient (AOX upper / lower). We used photogrammetry and a 3D printer to create temporary fixed dentures for her. The technology available to us today is mindblowing. This young woman's life has been completely transformed for the better. We are privileged to be able to do this sort of thing for our patients. I don't know of any other profession that could afford this level of satisfaction or fulfillment to me. Seeing what my wife goes through in medicine, I know that I definitely wouldn't find the same level of satisfaction there.

I started my own practice this year. I have spent the last year learning everything from contract law, to building layouts, electrical, ergonomics, interior design, dental equipment, dental supply ordering, etc. Then, there is the entrepreneurial aspect. I have learned how to do my own marketing, both digital and print, and I built my own website. I am learning book-keeping, accounting, and I have had to learn how to manage my team. There are so many pitfalls, and the stress is so intense, but I really love what I'm doing. Wearing so many different hats is exciting to me because it keeps things interesting (and stressful beyond belief). I wonder every day if we will make enough money this month to cover our costs. So far we haven't, but that's what you expect with a 5-month old startup. This is by far the most stressful thing I have ever done in my life. But, I would do it all over again if asked. Why? Because most acquisitions suck these days. DSOs gobble up all the good practices and leave scraps for the rest of us. Sure, you can find a gem here and there, but then you often inherit someone else's problems, culture, and vision. I wanted to paint my own Mona Lisa, not buy it from someone else.

So, if you are like me, then dentistry is worth it. Some caveats though, which make my situation different from students right now.
1.) My wife is a physician, and that allows me to take risks (and get loans) that other recent graduates can't. I know that I am fortunate in this regard, and it affords me the security I needed to start my own practice.
2.) I graduated with $480k in student loan debt. We put our money into stocks, because we prefer 9% returns on the market to paying down student loans. However, that was possible because my student loan interest rate is 2.4% - Those interest rates are long gone, so the calculus has changed.
3.) I secured a business loan with a 3.6% interest rate. Again, those interest rates are long gone.

The financial conditions modern dental students face are entirely different from what I did. It sounds crazy to say it, because I graduated just 3 years ago, but COVID and high interest rates have impacted our profession heavily. Yes, tuition is higher, but more importantly, interest rates are higher. Also, banks are more reluctant to lend you money, so starting / buying a practice is more difficult now than it was for me, just one year later.

In summary - I love being a dentist, it was absolutely worth it for me, and I would 100% do it again. But, YMMV.

Yes so you aren't the sole breadwinner and have access to money due to your physician wife. That may be different for other dentists.

 

[Thehighwind87]

Whether it's worth it to be a dentist has always been dependent on who is asking the question. There is just way too much variability, and no one can really know how much they will like being a dentist until they do it. What is true without a doubt is that the risk is higher now than it has ever been. The risk of me not liking dentistry when I graduated was a $480,000 student loan with a 2.4% interest rate. The risk for some students today can be as high as what, $700-$800k? What are the interest rates like today on private loan consolidations, 4-5%? That level of debt at that interest rate is crushing. It may not be impossible, but it will be very difficult for a very long time, and it may lead to financial ruin for many. However, most students will not take on that kind of student loan debt, so I don't want to speak to the extreme as though it represents the majority. For the most part, students will probably graduate with $300-500k student loan debt, and that is definitely manageable on a dentist's income.

For me personally, becoming a dentist was absolutely worth it. In fact, I love being a dentist. I didn't know if I would, but thankfully I do. In fact, I can't see me being happier doing anything else. I love improving people's lives, and using my knowledge, education, and my hands to treat patients. It turns out, I'm also pretty good at it. Dentistry is an extremely rewarding profession. Just last month, we completed a life-changing surgery on a patient (AOX upper / lower). We used photogrammetry and a 3D printer to create temporary fixed dentures for her. The technology available to us today is mindblowing. This young woman's life has been completely transformed for the better. We are privileged to be able to do this sort of thing for our patients. I don't know of any other profession that could afford this level of satisfaction or fulfillment to me. Seeing what my wife goes through in medicine, I know that I definitely wouldn't find the same level of satisfaction there.

I started my own practice this year. I have spent the last year learning everything from contract law, to building layouts, electrical, ergonomics, interior design, dental equipment, dental supply ordering, etc. Then, there is the entrepreneurial aspect. I have learned how to do my own marketing, both digital and print, and I built my own website. I am learning book-keeping, accounting, and I have had to learn how to manage my team. There are so many pitfalls, and the stress is so intense, but I really love what I'm doing. Wearing so many different hats is exciting to me because it keeps things interesting (and stressful beyond belief). I wonder every day if we will make enough money this month to cover our costs. So far we haven't, but that's what you expect with a 5-month old startup. This is by far the most stressful thing I have ever done in my life. But, I would do it all over again if asked. Why? Because most acquisitions suck these days. DSOs gobble up all the good practices and leave scraps for the rest of us. Sure, you can find a gem here and there, but then you often inherit someone else's problems, culture, and vision. I wanted to paint my own Mona Lisa, not buy it from someone else.

So, if you are like me, then dentistry is worth it. Some caveats though, which make my situation different from students right now.
1.) My wife is a physician, and that allows me to take risks (and get loans) that other recent graduates can't. I know that I am fortunate in this regard, and it affords me the security I needed to start my own practice.
2.) I graduated with $480k in student loan debt. We put our money into stocks, because we prefer 9% returns on the market to paying down student loans. However, that was possible because my student loan interest rate is 2.4% - Those interest rates are long gone, so the calculus has changed.
3.) I secured a business loan with a 3.6% interest rate. Again, those interest rates are long gone.

The financial conditions modern dental students face are entirely different from what I did. It sounds crazy to say it, because I graduated just 3 years ago, but COVID and high interest rates have impacted our profession heavily. Yes, tuition is higher, but more importantly, interest rates are higher. Also, banks are more reluctant to lend you money, so starting / buying a practice is more difficult now than it was for me, just one year later.

In summary - I love being a dentist, it was absolutely worth it for me, and I would 100% do it again. But, YMMV.

Tdlr: I have a lot of debt, but my physician wife has a great income. I hope to pay off my loans and debts when my practice starts chugging along but until then we are living off my spouses income which is prob in range of 200-300K+

No offense but this is pretty out of touch.

Majority of new grads will be busy juggling big debts as the sole breadwinner and taking on the stress among it. There’s no “backup per say”’unless you are rich to begin with, and or have a spouse who inherently brings in a lot of money to make up for your loss of income.

 

[OMSRealWeebHours]

And I thought medicine seemed rough, working dead end shifts to live while being under the thumb of a corporation is the last thing I want with my life. Guess I should be grateful to be in Med school

 

[Cello]

Tdlr: I have a lot of debt, but my physician wife has a great income. I hope to pay off my loans and debts when my practice starts chugging along but until then we are living off my spouses income which is prob in range of 200-300K+

No offense but this is pretty out of touch.

Majority of new grads will be busy juggling big debts as the sole breadwinner and taking on the stress among it. There’s no “backup per say”’unless you are rich to begin with, and or have a spouse who inherently brings in a lot of money to make up for your loss of income.

No offense taken, but I was very honest and pointed out the fact that my spouse is a high income earner, so I'm not sure that makes me out of touch. Everyone I know who has done a startup is in the same situation as me. Actually, this is why most of the dental startups I know of these days were started by female dentists with husbands who are physicians or in tech.

Bottom line, if you aren't in a situation like I am, you won't likely be starting a dental practice. Actually, with business loan rates what they are today, and banks being as stingy as they are now, very few dentists will be doing startups. Period. I doubt they would give me a loan right now with interest rates as high as they are, construction costs, etc. You can still do a startup with a DSO if you want to, but that's because they take the risk and stake you.

I was lucky to get my loan just at the tail end of the low interest period, right after banks opened up lending again after taking a hiatus during COVID. There was a very narrow window, and I seized the opportunity.

With regards to my situation, let me make something clear:

I would be making way more money if I chose to climb the corporate ladder. In fact, I would probably be making $300-400k this year if I stuck with the corporate route. I would work my 34-36 hours per week, and forget about the office when I left.

Instead, I am making $0 while we live off my wife's income. I also work 6-7 days per week. I hope my startup pays off, but the fact is this is a gamble. Some might even say it is stupid. Time will tell. So, it is easy to be critical of my situation, but we have made a pretty significant sacrifice as a family, and that really shouldn't be overlooked.

 

[Cello]

And I thought medicine seemed rough, working dead end shifts to live while being under the thumb of a corporation is the last thing I want with my life. Guess I should be grateful to be in Med school

It's not all bad. Let me give you the possibilities for those dentists who are willing to be employed.

Dental School Classmate #1 (c/o 2019): Works at a large top 3 DSO - bought into a cosmetic practice that grossed $2.4 million at the time of acquisition. He owns a minority percentage of course, but the DSO has a very interesting sidecar investment strategy, which allows "owner" doctors to invest into the company's private stock. As an associate with this same DSO, I was offered an ownership opportunity which I turned down, but I saw how much money these owner docs made from the sidecar investment and wow, they made a ton. In fact, Dental School Classmate #1 is making very good money from the practice he bought into, but he is actually making even more from his DSO investments. I would probably have made more money as an owner with this particular DSO than I will with my own office, but I just don't have a personality that works well if I'm not in charge.

Dental School Classmate #2 (c/o 2019): Only wants to do implants. Spent the last 4 years working for an implant / denture DSO. He is doing full-arch fixed cases regularly, and last I heard he is averaging 6-10 arches per month. He spent $40k on a private course to learn to place zygomas and pterys, so he is definitely out there gunning. He also did IV sedation right out of school, and started his own traveling sedation business where he makes great money doing IV sedations for other dentists.

Dental School Classmate #3 (c/o 2020): Went to work for a regional dental group where he worked 3 days per work, 12-hours per day. He landed a spot at one of their highest producing offices, and he crushed it. He would have grossed $450k take-home his first year out of school. But, this guy is a machine, so he volunteered to take another full-time 12-hour / 3 day per week shift and ended up making over $800k in his first year out of dental school working 6 days per week, 12-hours per day. He also picked up shifts at a cosmetic practice on his single day off each week. Definitely not the lifestyle for me, but even with just one of those jobs he was doing quite well.

Dental School Classmates (c/o 2020): A group of guys in my class went rural for a group out in Oklahoma that bills medical insurance for anything even remotely surgical. I'm told that the lowest any of them made in their first year was $350k. They all did very well, and they had a great work/life balance.

Plenty of cases of dentists not doing this well though. On average, I would guess most of my classmates were earning around $120-$150k their first year out of school.

As far as quality of life in medicine goes, good luck.

 

[D1Bound]

It's not all bad. Let me give you the possibilities for those dentists who are willing to be employed.

Dental School Classmate #1 (c/o 2019): Works at a large top 3 DSO - bought into a cosmetic practice that grossed $2.4 million at the time of acquisition. He owns a minority percentage of course, but the DSO has a very interesting sidecar investment strategy, which allows "owner" doctors to invest into the company's private stock. As an associate with this same DSO, I was offered an ownership opportunity which I turned down, but I saw how much money these owner docs made from the sidecar investment and wow, they made a ton. In fact, Dental School Classmate #1 is making very good money from the practice he bought into, but he is actually making even more from his DSO investments. I would probably have made more money as an owner with this particular DSO than I will with my own office, but I just don't have a personality that works well if I'm not in charge.

Dental School Classmate #2 (c/o 2019): Only wants to do implants. Spent the last 4 years working for an implant / denture DSO. He is doing full-arch fixed cases regularly, and last I heard he is averaging 6-10 arches per month. He spent $40k on a private course to learn to place zygomas and pterys, so he is definitely out there gunning. He also did IV sedation right out of school, and started his own traveling sedation business where he makes great money doing IV sedations for other dentists.

Dental School Classmate #3 (c/o 2020): Went to work for a regional dental group where he worked 3 days per work, 12-hours per day. He landed a spot at one of their highest producing offices, and he crushed it. He would have grossed $450k take-home his first year out of school. But, this guy is a machine, so he volunteered to take another full-time 12-hour / 3 day per week shift and ended up making over $800k in his first year out of dental school working 6 days per week, 12-hours per day. He also picked up shifts at a cosmetic practice on his single day off each week. Definitely not the lifestyle for me, but even with just one of those jobs he was doing quite well.

Dental School Classmates (c/o 2020): A group of guys in my class went rural for a group out in Oklahoma that bills medical insurance for anything even remotely surgical. I'm told that the lowest any of them made in their first year was $350k. They all did very well, and they had a great work/life balance.

Plenty of cases of dentists not doing this well though. On average, I would guess most of my classmates were earning around $120-$150k their first year out of school.

As far as quality of life in medicine goes, good luck.

I’m sorry but there’s zero chance I’m ever recommending someone to a GP for a zygomatic or pterygoid implant

 

[Cello]

I’m sorry but there’s zero chance I’m ever recommending someone to a GP for a zygomatic or pterygoid implant

I used to think this way. Now, I want to know how many arches they do. Specifically, how many zygos / pterys do they place. Most of the specialists in my area may do a handful of zygo cases each year, IF they do them at all (many don't). There are GPs at the major implant centers, teaching at the big implant courses in town, who are doing them weekly, in some cases, multiple per week. Reps matter.

I also prefer to have someone come into my office who can do the surgery and the restorative for these complex cases, because I want them to have complete control over the entire case from start to finish. I don't know of any surgeons who come into the office, use photogrammetry, design prosthesis and 3D print, etc. There is nothing more frustrating (or expensive) than an implant failure on AO4 and a surgeon who blames the dentist for improper loading / not managing bruxism / perio problems / etc.

 

[DMD12345]

I used to think this way. Now, I want to know how many arches they do. Specifically, how many zygos / pterys do they place. Most of the specialists in my area may do a handful of zygo cases each year, IF they do them at all (many don't). There are GPs at the major implant centers, teaching at the big implant courses in town, who are doing them weekly, in some cases, multiple per week. Reps matter.

I also prefer to have someone come into my office who can do the surgery and the restorative for these complex cases, because I want them to have complete control over the entire case from start to finish. I don't know of any surgeons who come into the office, use photogrammetry, design prosthesis and 3D print, etc. There is nothing more frustrating (or expensive) than an implant failure on AO4 and a surgeon who blames the dentist for improper loading / not managing bruxism / perio problems / etc.

Fair points. What’re your thoughts on GPs doing I.V. sedation?

 

[Cello]

Fair points. What’re your thoughts on GPs doing I.V. sedation?

As long as they are well trained, and they stick to their state laws (moderate sedation, not deep or GA), then I think it can be safe. Actually, it is theoretically safer than OCS, because with IV you can titrate and push emergency / rescue drugs with immediate effect. I question doing a complex surgery and simultaneously overseeing sedation though, as the safest situation would be to have someone dedicated to each. A dentist I used to work with (who is an OS from another country) had a patient die during OCS a few months ago (patient was way beyond moderate sedation). Anesthesia / sedation can be scary, because it only takes one incident like that to end your career. His license is currently suspended.

 

[OMSRealWeebHours]

It's not all bad. Let me give you the possibilities for those dentists who are willing to be employed.

Dental School Classmate #1 (c/o 2019): Works at a large top 3 DSO - bought into a cosmetic practice that grossed $2.4 million at the time of acquisition. He owns a minority percentage of course, but the DSO has a very interesting sidecar investment strategy, which allows "owner" doctors to invest into the company's private stock. As an associate with this same DSO, I was offered an ownership opportunity which I turned down, but I saw how much money these owner docs made from the sidecar investment and wow, they made a ton. In fact, Dental School Classmate #1 is making very good money from the practice he bought into, but he is actually making even more from his DSO investments. I would probably have made more money as an owner with this particular DSO than I will with my own office, but I just don't have a personality that works well if I'm not in charge.

Dental School Classmate #2 (c/o 2019): Only wants to do implants. Spent the last 4 years working for an implant / denture DSO. He is doing full-arch fixed cases regularly, and last I heard he is averaging 6-10 arches per month. He spent $40k on a private course to learn to place zygomas and pterys, so he is definitely out there gunning. He also did IV sedation right out of school, and started his own traveling sedation business where he makes great money doing IV sedations for other dentists.

Dental School Classmate #3 (c/o 2020): Went to work for a regional dental group where he worked 3 days per work, 12-hours per day. He landed a spot at one of their highest producing offices, and he crushed it. He would have grossed $450k take-home his first year out of school. But, this guy is a machine, so he volunteered to take another full-time 12-hour / 3 day per week shift and ended up making over $800k in his first year out of dental school working 6 days per week, 12-hours per day. He also picked up shifts at a cosmetic practice on his single day off each week. Definitely not the lifestyle for me, but even with just one of those jobs he was doing quite well.

Dental School Classmates (c/o 2020): A group of guys in my class went rural for a group out in Oklahoma that bills medical insurance for anything even remotely surgical. I'm told that the lowest any of them made in their first year was $350k. They all did very well, and they had a great work/life balance.

Plenty of cases of dentists not doing this well though. On average, I would guess most of my classmates were earning around $120-$150k their first year out of school.

As far as quality of life in medicine goes, good luck.

I'm just trying to cope that I will not be overworking myself into an early grave in medicine and can pretend my career path is more satisfying than others

 

[Cello]

I'm just trying to cope that I will not be overworking myself into an early grave in medicine and can pretend my career path is more satisfying than others

One word: Dermatology.

 

[PikminOC]

No offense taken, but I was very honest and pointed out the fact that my spouse is a high income earner, so I'm not sure that makes me out of touch. Everyone I know who has done a startup is in the same situation as me. Actually, this is why most of the dental startups I know of these days were started by female dentists with husbands who are physicians or in tech.

Bottom line, if you aren't in a situation like I am, you won't likely be starting a dental practice. Actually, with business loan rates what they are today, and banks being as stingy as they are now, very few dentists will be doing startups. Period. I doubt they would give me a loan right now with interest rates as high as they are, construction costs, etc. You can still do a startup with a DSO if you want to, but that's because they take the risk and stake you.

I was lucky to get my loan just at the tail end of the low interest period, right after banks opened up lending again after taking a hiatus during COVID. There was a very narrow window, and I seized the opportunity.

With regards to my situation, let me make something clear:

I would be making way more money if I chose to climb the corporate ladder. In fact, I would probably be making $300-400k this year if I stuck with the corporate route. I would work my 34-36 hours per week, and forget about the office when I left.

Instead, I am making $0 while we live off my wife's income. I also work 6-7 days per week. I hope my startup pays off, but the fact is this is a gamble. Some might even say it is stupid. Time will tell. So, it is easy to be critical of my situation, but we have made a pretty significant sacrifice as a family, and that really shouldn't be overlooked.

If everyone you know is in the same situation that should cover everyone else then too

 

[CharlestonToothCompany]

Whether it's worth it to be a dentist has always been dependent on who is asking the question. There is just way too much variability, and no one can really know how much they will like being a dentist until they do it. What is true without a doubt is that the risk is higher now than it has ever been. The risk of me not liking dentistry when I graduated was a $480,000 student loan with a 2.4% interest rate. The risk for some students today can be as high as what, $700-$800k? What are the interest rates like today on private loan consolidations, 4-5%? That level of debt at that interest rate is crushing. It may not be impossible, but it will be very difficult for a very long time, and it may lead to financial ruin for many. However, most students will not take on that kind of student loan debt, so I don't want to speak to the extreme as though it represents the majority. For the most part, students will probably graduate with $300-500k student loan debt, and that is definitely manageable on a dentist's income.

For me personally, becoming a dentist was absolutely worth it. In fact, I love being a dentist. I didn't know if I would, but thankfully I do. In fact, I can't see me being happier doing anything else. I love improving people's lives, and using my knowledge, education, and my hands to treat patients. It turns out, I'm also pretty good at it. Dentistry is an extremely rewarding profession. Just last month, we completed a life-changing surgery on a patient (AOX upper / lower). We used photogrammetry and a 3D printer to create temporary fixed dentures for her. The technology available to us today is mindblowing. This young woman's life has been completely transformed for the better. We are privileged to be able to do this sort of thing for our patients. I don't know of any other profession that could afford this level of satisfaction or fulfillment to me. Seeing what my wife goes through in medicine, I know that I definitely wouldn't find the same level of satisfaction there.

I started my own practice this year. I have spent the last year learning everything from contract law, to building layouts, electrical, ergonomics, interior design, dental equipment, dental supply ordering, etc. Then, there is the entrepreneurial aspect. I have learned how to do my own marketing, both digital and print, and I built my own website. I am learning book-keeping, accounting, and I have had to learn how to manage my team. There are so many pitfalls, and the stress is so intense, but I really love what I'm doing. Wearing so many different hats is exciting to me because it keeps things interesting (and stressful beyond belief). I wonder every day if we will make enough money this month to cover our costs. So far we haven't, but that's what you expect with a 5-month old startup. This is by far the most stressful thing I have ever done in my life. But, I would do it all over again if asked. Why? Because most acquisitions suck these days. DSOs gobble up all the good practices and leave scraps for the rest of us. Sure, you can find a gem here and there, but then you often inherit someone else's problems, culture, and vision. I wanted to paint my own Mona Lisa, not buy it from someone else.

So, if you are like me, then dentistry is worth it. Some caveats though, which make my situation different from students right now.
1.) My wife is a physician, and that allows me to take risks (and get loans) that other recent graduates can't. I know that I am fortunate in this regard, and it affords me the security I needed to start my own practice.
2.) I graduated with $480k in student loan debt. We put our money into stocks, because we prefer 9% returns on the market to paying down student loans. However, that was possible because my student loan interest rate is 2.4% - Those interest rates are long gone, so the calculus has changed.
3.) I secured a business loan with a 3.6% interest rate. Again, those interest rates are long gone.

The financial conditions modern dental students face are entirely different from what I did. It sounds crazy to say it, because I graduated just 3 years ago, but COVID and high interest rates have impacted our profession heavily. Yes, tuition is higher, but more importantly, interest rates are higher. Also, banks are more reluctant to lend you money, so starting / buying a practice is more difficult now than it was for me, just one year later.

In summary - I love being a dentist, it was absolutely worth it for me, and I would 100% do it again. But, YMMV.

Cello,

I am happy for you. I also enjoy what I do, the clinical side of things. What I do not enjoy is the economics of Orthodontics.

I think you realize just how well the “stars” lined up for you. And if the dice had to be rolled again, Lady Luck may turn smile away. Unless I am making wild assumptions without any basis in fact, I think you would say that the vast majority of your classmates are not as fortunate. You would have a better feel for this, but would you agree that, of those who did not go to a residency, the majority went to work for a DSO?

What I am trying to get across is that for the average Joe/Jane, the reality of dentistry is not what they were thinking it would be when they were considering entering (like you and others in this thread that were pre-dental). The only way for them to be woken up is for people like me and my colleague Firm to try to warn. The problem is that confirmation bias blinds pre-dentals to what “those in the know” are trying to say.

Will everyone experience the economic pain I have been trying to warn? No, look at yourself and others who seem to be thriving. But I think that most will feel a level of economic discomfort that they were not anticipating, some perhaps very painfully.

I think the bell curve of dentists’ economic prosperity has been distorted by DSOs, insurance companies, student loans and dental school admissions.

And can you imagine those who are only doing it “for the money”. Those who really hate dentistry, or will discover that they hate it once they are out? Can you imagine the drudgery of a life like that? I can see a lot of those who see no way out except...

The only light at the end of the tunnel that I can foresee is that these DSOs usually collapse under the weight of their own inefficiencies. But that will not happen in the next ten years. Maybe twenty. Maybe.... well look at medicine, maybe it won’t get better.

I really wish I could find a way to get dentists, especially newer ones, to explain the realities to pre-dentals. If you can think of a logistical way it can be done, let me know.

 

[Cello]

What I am trying to get across is that for the average Joe/Jane, the reality of dentistry is not what they were thinking it would be when they were considering entering (like you and others in this thread that were pre-dental). The only way for them to be woken up is for people like me and my colleague Firm to try to warn. The problem is that confirmation bias blinds pre-dentals to what “those in the know” are trying to say.

Will everyone experience the economic pain I have been trying to warn? No, look at yourself and others who seem to be thriving. But I think that most will feel a level of economic discomfort that they were not anticipating, some perhaps very painfully.

I think the bell curve of dentists’ economic prosperity has been distorted by DSOs, insurance companies, student loans and dental school admissions.

And can you imagine those who are only doing it “for the money”. Those who really hate dentistry, or will discover that they hate it once they are out? Can you imagine the drudgery of a life like that? I can see a lot of those who see no way out except...

The only light at the end of the tunnel that I can foresee is that these DSOs usually collapse under the weight of their own inefficiencies. But that will not happen in the next ten years. Maybe twenty. Maybe.... well look at medicine, maybe it won’t get better.

I really wish I could find a way to get dentists, especially newer ones, to explain the realities to pre-dentals. If you can think of a logistical way it can be done, let me know.

I think many dentists lack perspective. I am a non-traditional student. I survived the recession working labor jobs, working 7-day 12-hour rotating shifts in the burning sun while operating heavy machinery. I did a few stints in retail as well, working with angry and entitled customers every day while pushing shopping carts around parking lots. I worked some dirty, smelly, difficult jobs throughout my 20s, endured plenty of abuse (my boss strangled a coworker as we watched in horror at one job) and didn't decide on dentistry until later. In fact, it was SDN that turned me towards dentistry.

I'm not going to tell anyone that dentistry is all roses. I have had angry patients, tough cases, failures, and it can take a toll on your back and neck. But, dentistry is infinitely better than any job I had before this. So, my positive outlook may in fact be from the perspective I have achieved from working really crummy jobs for ~10 years before dental school.

As far as thriving, I wouldn't say I am thriving... yet. I am definitely taking a huge gamble, and it has eroded my stomach lining. I am doing everything I can to bring patients in the door, and to ensure we can make payroll. I still haven't taken a paycheck, I fired my first employee just 2 weeks into ownership, and I may be firing another one just 5 months later. We took the leap into full-arch dentistry, only to learn that the ROI isn't nearly as good as we had hoped after all of the costs are accounted for. This is a tough gig, and running your own business makes it even tougher. Initially, our production grew by leaps and bounds, which meant I didn't need to associate. However, we have been slow lately, so I may have to pick up a part-time gig somewhere to subsidize the practice. It's not all roses here, I assure you. But I didn't expect it to be either. I also believe that anything worth doing is hard work.

I am happy to share my experiences with pre-dentals so they go into this field with eyes wide open. Again, having perspective from the myriad jobs I did before dental school, I still think it's a pretty awesome career. But, it isn't perfect. The thing is, I can't think of anything better. Everyone is struggling right now. No one wants to work, inflation is taking a bite out of everyone's income, interest rates are making it impossible to purchase a home or get a business loan, there is violence everywhere and it keeps getting worse, a recession is increasingly likely, and jobs that were traditionally held in high regard (medicine, education, tech) are seeing layoffs, pay cuts, and debasement. The trends we are seeing in dentistry may just be a larger phenomenon that has affected the greater economy.

Cello,

I am happy for you. I also enjoy what I do, the clinical side of things. What I do not enjoy is the economics of Orthodontics.

I think you realize just how well the “stars” lined up for you. And if the dice had to be rolled again, Lady Luck may turn smile away. Unless I am making wild assumptions without any basis in fact, I think you would say that the vast majority of your classmates are not as fortunate. You would have a better feel for this, but would you agree that, of those who did not go to a residency, the majority went to work for a DSO?

My circumstances dictated the course I took.

Here's how things could have been very different for me.

My friend who landed the highly productive job making $450k on a 3-day schedule? I turned that job down before he interviewed for it. Why? Because my spouse is a busy physician, and we hardly see each other except on weekends. She didn't want me working 12-hours on a Saturday while she plays mom, and I didn't want that either. I was offered that job, turned it down, and my classmate took it. Also, I am a bit of a workaholic, and I could definitely see myself doing something similar and working the same kind of 6-day schedule he did, but again, my physician wife, who works 60-70 hours per week, didn't like the idea of never seeing me, and neither did I. If I were single without kids, then I would 100% have done something like that. So, although my wife is a high-income earner, I had to make considerations based on our marriage, our children, and her career.

Also, because my wife works on a contract, she can't just move on a dime. Plus, she is a sub-specialist, so she has to be somewhere with a large catchment area / dense population to support her specialty. This is the antithesis of the ideal scenario for me, as I would much rather have bought a cash-flowing practice in a rural area within 1-hour of a city.

So, the tradeoff in our situation was that she supports me, while I do my darndest to compete in one of the most competitive markets in the US with a startup. It's not all roses on my end, I assure you. The stress of starting up in a competitive dental market definitely offsets the security of a spouse who earns good money. I would have preferred to buy in a low-competition place, perhaps somewhere in the Midwest or the South.

I worked for 3 different DSOs before starting my own. That was over a 3-year period. One of those DSOs was actually pretty good. The other two were horrendous. If anyone wants to know which DSOs to avoid based on my own experiences and those of my colleagues, I am happy to share that privately. The DSO I found to be quite good was MB2. You still aren't a true owner when you buy-in, but they definitely respect the doctors, they don't push numbers, there are no quotas, and they don't dictate treatment. Also, their opportunities for investments are unmatched from what I can tell. DSOs aren't all bad, but there are certainly some very bad ones out there. I should add that not every MB2 office is the same, because they operate as a loose confederation of practices, each operating under their own philosophy, vision, values, etc. I was fortunate to be one of the only solo associates in the nation they employed. In fact, I believe I may have been the only one remaining when I left.

The economics today are worse than they were when I started on the path to becoming a dentist. If I were looking at a $700-800k loan, I would probably have tried to go somewhere cheaper, even if it meant applying again next year. When I was applying, $500k was my ceiling, because I knew that with my spouse's income and my plans to buy / start a practice within 2-3 years, anything more than that would have been very difficult.

If everyone you know is in the same situation that should cover everyone else then too

Almost everyone I know who has done a startup. There is one exception, and that's the guy who was taking home $800k his first year out of school. But, he had to provide a personal guarantee. In my case, me and my wife both had to provide personal guarantees. Generally speaking, banks won't give business loans for a startup of any kind (in any industry) without a personal guarantee. A personal guarantee only means something if you have sufficient financial resources to back it up. This, coupled with high interest rates and construction costs is why I don't foresee many dentists doing startups anytime soon.

 

[PikminOC]

I think many dentists lack perspective. I am a non-traditional student. I survived the recession working labor jobs, working 7-day 12-hour rotating shifts in the burning sun while operating heavy machinery. I did a few stints in retail as well, working with angry and entitled customers every day while pushing shopping carts around parking lots. I worked some dirty, smelly, difficult jobs throughout my 20s, endured plenty of abuse (my boss strangled a coworker as we watched in horror at one job) and didn't decide on dentistry until later. In fact, it was SDN that turned me towards dentistry.

I'm not going to tell anyone that dentistry is all roses. I have had angry patients, tough cases, failures, and it can take a toll on your back and neck. But, dentistry is infinitely better than any job I had before this. So, my positive outlook may in fact be from the perspective I have achieved from working really crummy jobs for ~10 years before dental school.

As far as thriving, I wouldn't say I am thriving... yet. I am definitely taking a huge gamble, and it has eroded my stomach lining. I am doing everything I can to bring patients in the door, and to ensure we can make payroll. I still haven't taken a paycheck, I fired my first employee just 2 weeks into ownership, and I may be firing another one just 5 months later. We took the leap into full-arch dentistry, only to learn that the ROI isn't nearly as good as we had hoped after all of the costs are accounted for. This is a tough gig, and running your own business makes it even tougher. Initially, our production grew by leaps and bounds, which meant I didn't need to associate. However, we have been slow lately, so I may have to pick up a part-time gig somewhere to subsidize the practice. It's not all roses here, I assure you. But I didn't expect it to be either. I also believe that anything worth doing is hard work.

I am happy to share my experiences with pre-dentals so they go into this field with eyes wide open. Again, having perspective from the myriad jobs I did before dental school, I still think it's a pretty awesome career. But, it isn't perfect. The thing is, I can't think of anything better. Everyone is struggling right now. No one wants to work, inflation is taking a bite out of everyone's income, interest rates are making it impossible to purchase a home or get a business loan, there is violence everywhere and it keeps getting worse, a recession is increasingly likely, and jobs that were traditionally held in high regard (medicine, education, tech) are seeing layoffs, pay cuts, and debasement. The trends we are seeing in dentistry may just be a larger phenomenon that has affected the greater economy.



My circumstances dictated the course I took.

Here's how things could have been very different for me.

My friend who landed the highly productive job making $450k on a 3-day schedule? I turned that job down before he interviewed for it. Why? Because my spouse is a busy physician, and we hardly see each other except on weekends. She didn't want me working 12-hours on a Saturday while she plays mom, and I didn't want that either. I was offered that job, turned it down, and my classmate took it. Also, I am a bit of a workaholic, and I could definitely see myself doing something similar and working the same kind of 6-day schedule he did, but again, my physician wife, who works 60-70 hours per week, didn't like the idea of never seeing me, and neither did I. If I were single without kids, then I would 100% have done something like that. So, although my wife is a high-income earner, I had to make considerations based on our marriage, our children, and her career.

Also, because my wife works on a contract, she can't just move on a dime. Plus, she is a sub-specialist, so she has to be somewhere with a large catchment area / dense population to support her specialty. This is the antithesis of the ideal scenario for me, as I would much rather have bought a cash-flowing practice in a rural area within 1-hour of a city.

So, the tradeoff in our situation was that she supports me, while I do my darndest to compete in one of the most competitive markets in the US with a startup. It's not all roses on my end, I assure you. The stress of starting up in a competitive dental market definitely offsets the security of a spouse who earns good money. I would have preferred to buy in a low-competition place, perhaps somewhere in the Midwest or the South.

I worked for 3 different DSOs before starting my own. That was over a 3-year period. One of those DSOs was actually pretty good. The other two were horrendous. If anyone wants to know which DSOs to avoid based on my own experiences and those of my colleagues, I am happy to share that privately. The DSO I found to be quite good was MB2. You still aren't a true owner when you buy-in, but they definitely respect the doctors, they don't push numbers, there are no quotas, and they don't dictate treatment. Also, their opportunities for investments are unmatched from what I can tell. DSOs aren't all bad, but there are certainly some very bad ones out there. I should add that not every MB2 office is the same, because they operate as a loose confederation of practices, each operating under their own philosophy, vision, values, etc. I was fortunate to be one of the only solo associates in the nation they employed. In fact, I believe I may have been the only one remaining when I left.

The economics today are worse than they were when I started on the path to becoming a dentist. If I were looking at a $700-800k loan, I would probably have tried to go somewhere cheaper, even if it meant applying again next year. When I was applying, $500k was my ceiling, because I knew that with my spouse's income and my plans to buy / start a practice within 2-3 years, anything more than that would have been very difficult.


Almost everyone I know who has done a startup. There is one exception, and that's the guy who was taking home $800k his first year out of school. But, he had to provide a personal guarantee. In my case, me and my wife both had to provide personal guarantees. Generally speaking, banks won't give business loans for a startup of any kind (in any industry) without a personal guarantee. A personal guarantee only means something if you have sufficient financial resources to back it up. This, coupled with high interest rates and construction costs is why I don't foresee many dentists doing startups anytime soon.

That's a lot of privilege needed to start a dental office then

 

[Thehighwind87]

I think many dentists lack perspective. I am a non-traditional student. I survived the recession working labor jobs, working 7-day 12-hour rotating shifts in the burning sun while operating heavy machinery. I did a few stints in retail as well, working with angry and entitled customers every day while pushing shopping carts around parking lots. I worked some dirty, smelly, difficult jobs throughout my 20s, endured plenty of abuse (my boss strangled a coworker as we watched in horror at one job) and didn't decide on dentistry until later. In fact, it was SDN that turned me towards dentistry.

I'm not going to tell anyone that dentistry is all roses. I have had angry patients, tough cases, failures, and it can take a toll on your back and neck. But, dentistry is infinitely better than any job I had before this. So, my positive outlook may in fact be from the perspective I have achieved from working really crummy jobs for ~10 years before dental school.

As far as thriving, I wouldn't say I am thriving... yet. I am definitely taking a huge gamble, and it has eroded my stomach lining. I am doing everything I can to bring patients in the door, and to ensure we can make payroll. I still haven't taken a paycheck, I fired my first employee just 2 weeks into ownership, and I may be firing another one just 5 months later. We took the leap into full-arch dentistry, only to learn that the ROI isn't nearly as good as we had hoped after all of the costs are accounted for. This is a tough gig, and running your own business makes it even tougher. Initially, our production grew by leaps and bounds, which meant I didn't need to associate. However, we have been slow lately, so I may have to pick up a part-time gig somewhere to subsidize the practice. It's not all roses here, I assure you. But I didn't expect it to be either. I also believe that anything worth doing is hard work.

I am happy to share my experiences with pre-dentals so they go into this field with eyes wide open. Again, having perspective from the myriad jobs I did before dental school, I still think it's a pretty awesome career. But, it isn't perfect. The thing is, I can't think of anything better. Everyone is struggling right now. No one wants to work, inflation is taking a bite out of everyone's income, interest rates are making it impossible to purchase a home or get a business loan, there is violence everywhere and it keeps getting worse, a recession is increasingly likely, and jobs that were traditionally held in high regard (medicine, education, tech) are seeing layoffs, pay cuts, and debasement. The trends we are seeing in dentistry may just be a larger phenomenon that has affected the greater economy.



My circumstances dictated the course I took.

Here's how things could have been very different for me.

My friend who landed the highly productive job making $450k on a 3-day schedule? I turned that job down before he interviewed for it. Why? Because my spouse is a busy physician, and we hardly see each other except on weekends. She didn't want me working 12-hours on a Saturday while she plays mom, and I didn't want that either. I was offered that job, turned it down, and my classmate took it. Also, I am a bit of a workaholic, and I could definitely see myself doing something similar and working the same kind of 6-day schedule he did, but again, my physician wife, who works 60-70 hours per week, didn't like the idea of never seeing me, and neither did I. If I were single without kids, then I would 100% have done something like that. So, although my wife is a high-income earner, I had to make considerations based on our marriage, our children, and her career.

Also, because my wife works on a contract, she can't just move on a dime. Plus, she is a sub-specialist, so she has to be somewhere with a large catchment area / dense population to support her specialty. This is the antithesis of the ideal scenario for me, as I would much rather have bought a cash-flowing practice in a rural area within 1-hour of a city.

So, the tradeoff in our situation was that she supports me, while I do my darndest to compete in one of the most competitive markets in the US with a startup. It's not all roses on my end, I assure you. The stress of starting up in a competitive dental market definitely offsets the security of a spouse who earns good money. I would have preferred to buy in a low-competition place, perhaps somewhere in the Midwest or the South.

I worked for 3 different DSOs before starting my own. That was over a 3-year period. One of those DSOs was actually pretty good. The other two were horrendous. If anyone wants to know which DSOs to avoid based on my own experiences and those of my colleagues, I am happy to share that privately. The DSO I found to be quite good was MB2. You still aren't a true owner when you buy-in, but they definitely respect the doctors, they don't push numbers, there are no quotas, and they don't dictate treatment. Also, their opportunities for investments are unmatched from what I can tell. DSOs aren't all bad, but there are certainly some very bad ones out there. I should add that not every MB2 office is the same, because they operate as a loose confederation of practices, each operating under their own philosophy, vision, values, etc. I was fortunate to be one of the only solo associates in the nation they employed. In fact, I believe I may have been the only one remaining when I left.

The economics today are worse than they were when I started on the path to becoming a dentist. If I were looking at a $700-800k loan, I would probably have tried to go somewhere cheaper, even if it meant applying again next year. When I was applying, $500k was my ceiling, because I knew that with my spouse's income and my plans to buy / start a practice within 2-3 years, anything more than that would have been very difficult.


Almost everyone I know who has done a startup. There is one exception, and that's the guy who was taking home $800k his first year out of school. But, he had to provide a personal guarantee. In my case, me and my wife both had to provide personal guarantees. Generally speaking, banks won't give business loans for a startup of any kind (in any industry) without a personal guarantee. A personal guarantee only means something if you have sufficient financial resources to back it up. This, coupled with high interest rates and construction costs is why I don't foresee many dentists doing startups anytime soon.

How do you think your life would be if you didn't have a spouse who supports you? Lets say for the average person: doing a startup while juggling 2-3 toddlers and a mortgage with no real surplus income coming in?

Your situation is really unique and not relevant to the current market of new grad dentists. So let's reverse the situation and say your wife is stay-at-home and or maybe a work from home making 80-100k as a WFH engineer paying 2-3k for child care etc. That's more relevant...so I'm curious to know how you think it would be like?

 

[PikminOC]

How do you think your life would be if you didn't have a spouse who supports you? Lets say for the average person: doing a startup while juggling 2-3 toddlers and a mortgage with no real surplus income coming in?

Your situation is really unique and not relevant to the current market of new grad dentists. So let's reverse the situation and say your wife is stay-at-home and or maybe a work from home making 80-100k as a WFH engineer paying 2-3k for child care etc. That's more relevant...so I'm curious to know how you think it would be like?

I'm.thinking then he would go corporate

 

[Cello]

That's a lot of privilege needed to start a dental office then

When I was making $15/hour to get my ass kicked handling molten asphalt all day in the scorching heat, I managed to save $35k over a 2.5-year period. This was how I paid to go back to school for pre-dental. I lived in a slum, my neighbor was shot in the face, my car was broken into, a homeless guy assaulted me on my own doorstep, but I lived there so I could save as much money as possible. Yes, it was such a privilege. You do what you have to do to achieve your goals. I guess I was "privileged" enough to have a tough job while many of my classmates had parents who paid their tuition, bought them BMWs, and handed them cash-flowing dental practices after graduation. My parents couldn't afford to help me. I'm definitely not going to apologize or self-flagellate for marrying an amazing woman who happens to be a physician.

How do you think your life would be if you didn't have a spouse who supports you? Lets say for the average person: doing a startup while juggling 2-3 toddlers and a mortgage with no real surplus income coming in?

Your situation is really unique and not relevant to the current market of new grad dentists. So let's reverse the situation and say your wife is stay-at-home and or maybe a work from home making 80-100k as a WFH engineer paying 2-3k for child care etc. That's more relevant...so I'm curious to know how you think it would be like?

I was asked via PM to respond in this thread about my situation. I am not here to speak on behalf of others, because their experience is their own. I explained in my last post what I would do if circumstances were different.

 

[CharlestonToothCompany]

It was I who asked Cello to comment on this thread as I was keenly interested in how he viewed things now. I feel we may be being unkind in our assessment. Was he blessed in ways which others could not hope for? Yes, but I could tell in his responses that there was also an ambition that the average pre-dental will not have that allowed him to excel. And as we have just learned, he had to go through some cr@ply things earlier. Which, in a certain light, might be seen for a driving force for his ambition to succeed.

My point in bringing this thread up was to see what one doc’s journey to the “other side” was like. I believe that while he admits he was blessed, he also understands that others may not find themselves on the same path.

 

[OMSRealWeebHours]

One word: Dermatology.

I've certainly been looking into which specialties have the best balance and derm + PM&R seem good, but isn't derm competitive?

 

[Big Time Hoosier]

but isn't derm competitive?

Big Hoss

 

[ktv24]

View attachment 375106

Big Hoss

you're absolutely my favorite account on this website.
- big hoss enthusiast

 

[askadds]

Just in case some are still confused, from an article in AGD:

"the average net income for general price practice dentists in 2010 was $249,254. In 2020 it was 204,477. You can bend the truth however you want but the reality of the situation its been a decade and our incomes are about the same while vast majority of salaries have doubled and cost of living has gone up equally to match incomes. I feel so sorry for new generations of dentists, getting hustled big time.

 

[Thehighwind87]

Just in case some are still confused, from an article in AGD:

"the average net income for general price practice dentists in 2010 was $249,254. In 2020 it was 204,477. You can bend the truth however you want but the reality of the situation its been a decade and our incomes are about the same while vast majority of salaries have doubled and cost of living has gone up equally to match incomes. I feel so sorry for new generations of dentists, getting hustled big time.

Reminds me of greater fool theory.

 

[CharlestonToothCompany]

Just in case some are still confused, from an article in AGD:

"the average net income for general price practice dentists in 2010 was $249,254. In 2020 it was 204,477. You can bend the truth however you want but the reality of the situation its been a decade and our incomes are about the same while vast majority of salaries have doubled and cost of living has gone up equally to match incomes. I feel so sorry for new generations of dentists, getting hustled big time.

With that being said, would you do it all again if you were predental TODAY knowing what you know now?

 

[Thehighwind87]

With that being said, would you do it all again if you were predental TODAY knowing what you know now?

Dentistry is in its final stage before people start waking and realize hey maybe being a ups driver for 170k with zero debt is a better idea then going to school for 8 years for 500k and a declining income year over year as a dentist.

 

[askadds]

With that being said, would you do it all again if you were predental TODAY knowing what you know now?

No I would not. I look around me and professions around making 250k for 1/4 of the work make wonder I chose this profession. A lot of people bring up that we only work 4 days on average but let me tell you all something, 4 days a week as an owner is on par to 60 hours/week of work at a regular job. You are clinician, HR, janitor and everything else in between. Wisen up guys/gals, demand change!

 

[D1Bound]

Dentistry is in its final stage before people start waking and realize hey maybe being a ups driver for 170k with zero debt is a better idea then going to school for 8 years for 500k and a declining income year over year as a dentist.

This is tough to hear. Granted, UPS drivers look like they work really hard in and out of the truck in different weather. But it’s tough to hear they’re making as much as an associate dentist. They’re making more actually with no debt. They still can’t touch an owner dentist or a specialist’s salary though.

 

[Thehighwind87]

This is tough to hear. Granted, UPS drivers look like they work really hard in and out of the truck in different weather. But it’s tough to hear they’re making as much as an associate dentist. They’re making more actually with no debt. They still can’t touch an owner dentist or a specialist’s salary though.

Owner dentist… 500k student loans… 500k-1mil practice for a “chance” to become an owner dentist and NO guarantee of making that lucrative money. 1-1.5 mil of loans with 8 years of schooling plus 2-3 years of associating minimum before buying a practice.

Versus ups driver in a union making 170k.

Yeah sure owner dentist such a great opportunity.

 

[D1Bound]

Owner dentist… 500k student loans… 500k-1mil practice for a “chance” to become an owner dentist and NO guarantee of making that lucrative money. 1-1.5 mil of loans with 8 years of schooling plus 2-3 years of associating minimum before buying a practice.

Versus ups driver in a union making 170k.

Yeah sure owner dentist such a great opportunity.

The UPS driver has time and compound interest on their side as well. Slog it out as a UPS driver from 22-32 investing heavily and you’re sitting okay.
Dentistry is really looking like a raw deal these days. The delayed gratification is so much and when you graduate you have to be ready to continue to live poor.

 

[charlestweed]

Just in case some are still confused, from an article in AGD:

"the average net income for general price practice dentists in 2010 was $249,254. In 2020 it was 204,477. You can bend the truth however you want but the reality of the situation its been a decade and our incomes are about the same while vast majority of salaries have doubled and cost of living has gone up equally to match incomes. I feel so sorry for new generations of dentists, getting hustled big time.

The vast majority of the salaries have increased significantly but they are still nowhere near the dentist’s 200+k/year salary. In 2010, I paid my manager $35k/yr. Now, my manager makes $55k/yr and she’s still living paycheck to paycheck. Rents and home prices in CA have gone up significantly in recent years. Many have to leave CA for more affordable housing and lower cost of living.

I know $200k salary working as a dentist is not much if one has $500+k student loan debt and is the only person who works in the family. Both husband and wife have to work, especially now when everything is much more expensive. I think dentistry is still a good field if you have parents who help pay for a portion (ie housing and food) of the total cost of education. A lot of dental students say the majority of their dental classmates have parents who help them do that. I wouldn’t recommend dentistry to anyone who think that dentistry is an easy highly paid job and he can just work 4 days/wk after graduation.

 

[charlestweed]

No I would not. I look around me and professions around making 250k for 1/4 of the work make wonder I chose this profession.

Please name one profession that allows you to make $250k and only requires 1/4 as much work/responsibility as dentistry. If it’s so easy, then why do majority (nearly 80%) of the people in America make less than $100k/year? It’s tough to make a good living nowadays. That’s why a lot people, who have the real world experience like Cello, decided to go back to school for dentistry.

A lot of people bring up that we only work 4 days on average but let me tell you all something, 4 days a week as an owner is on par to 60 hours/week of work at a regular job.

This is only true at the beginning when your practice doesn’t have enough patients and you can’t afford to hire a lot of staff. When you own a practice, you actually work less and make more than when you work as associate. You see less patients and make more per day because you get to screen out the patients, whom you don’t want to treat….ie medicaid, HMO, PITA patients etc. You control your own work schedule. When you work for the corps, you have to work 8 (or more) hours and see a lot more patients per day (and get paid small fraction of what you produce)….and many patients have medicaid and HMO.

You are clinician, HR, janitor and everything else in between. Wisen up guys/gals, demand change!

You'd save a lot in overhead if you do all of these tasks yourself instead of hiring additional staff. Most dentist owners I know don't want to do any of these. Some don't even want to clean their patients' teeth and would rather sit around.....and pay big bucks to hire the hygienist to do the teeth cleanings for them.

 

[Big Time Hoosier]

My brother is a sales rep for a dental product company. He probably makes more money than many, if not most, of the GPs he takes care of. Oh, and he doesn’t typically leave his house until 9:00-10:00 am and probably wraps up by 4:00 pm. And, he’s always winning free trips from his company to places like France and Mexico because he’s good at what he does. Meanwhile, I’m applying SDF to a screaming 2 year old…

Big Hoss