The Financial Argument For General Dentistry

[Pablo Sanchez]

A lot of the talk on here is about how dentistry is a profession going south. With rising tuition and stagnant pay there is good reason to be concerned. A common misconception is that specialization is the key to financial success. I just want to provide some positive light on the profession, and make an argument for general dentistry. To be clear, there are obviously more things to consider than finances when considering which field of dentistry you want to work in, and there are excellent opportunities as specialists as well. Below is something similar to what I posted on a thread previously, but I think it’s valuable to consider. None of this gets talked about. None of my post includes practice ownership either, in which the sky is the limit and it becomes more dependent on how well you run a business.

Here are two examples.

The first is Student A. The second is student B. Both students went to the same dental school and graduated with $250k in debt. Reasonable.

Student A went straight out and practiced as a GP. Their mindset was to work hard for the first few years while their colleagues were in residency so that they could maximize their knowledge and experience. They wanted to “work and live like a resident” their first few years. Student A worked 5 or even 6 days per week. Student A made a good amount because of this intentional work ethic. Let’s just say $200k year one, $300k year two, and $400k year three while student B was in residency (I know people may think this is high, but I know it’s possible because I’m a 2022 grad and making over $400k). So Student A averaged $300k per year while student B was in a three year residency. After taxes, Student A took home about $200k per year on average for the three years student B was in residency. Student A lived off of $50k per year and put $150k towards loans/investments. After 3 years, they have paid off their dental school debt. They are now 29, taking home $259k per year after taxes without any debt, and they’ve managed to invest $200k in the S&P500 ($600k in total earnings after tax over those three years - $150k in living expenses - $250k in student debt) They don’t touch this $200k again until retirement age of 67. Without taking into consideration any future investing, that $200k invested while student B goes to residency, grows at 10% (historical average of the S&P500). At 67 that $200k invested while student B is in residency is worth $8.8 million. Should student A continue investing, even if they cut back their annual contributions and start to increase the quality of their lifestyle, they’ll accumulate A LOT more than $8.8 million. If you don’t want to get into the nitty gritty of Student A’s situation, the key is that they have a decent income at a young age, and if they’re intentional about where they invest their money, the extra time in the market is a big benefit of general dentistry.

Student B also graduated with $250k of debt. At today’s current interest rates of grad plus loans (8%), by the time they graduate from a three year residency the balance on that $250k is $315k. They took out an additional $200k for residency. So when they graduate they are $515k in debt.

So at the age of 29, Student A has no debt and is taking home $259k after tax with $200k invested in the S&P500.

Student B has $515k in debt. They make $1,750 per day (Now this could be low for a specialist. I don’t really know. I’m just going off of what I hear for many specialists. And I’m making a lot more than I thought a general dentist associate would, so it’s possible specialists are doing much better). 5 days per week, 50 weeks per year, student B makes $437,500 per year. They take home $281k per year after taxes. So student B is making about $20k more than student A per year at the age of 29. But the interest on Student B’s $515k in loans is over $41,000 just for that first year. So JUST TO MAINTAIN the $515k in debt AND MAKE NO PROGRESS IN PAYING IT OFF Student B will have to pay $41,000. This leaves Student B at AN INCOME DISADVANTAGE compared to student A each year. Their income is $20k higher, but they need to pay $41k just to keep their loan balance the same.

Now I know everyone’s income will vary. The point is that the opportunity cost of those few early years practice as a general dentist CAN be significant. The takeaway is that there are still opportunities for massive financial success in dentistry despite the rising costs of dental school. You don’t have to specialize to be successful. You just have to be intentional. Don’t blindly take out loans. Don’t graduate and buy yourself a new Mercedes. When you’re young with the income of a dentist, you have every reason and ability to make smart investment decisions which can and will give you a quality of life you never even dreamed of having.

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[LFA20]

You’re an associate gen den making $400k??! What sort of procedures do you do?

 

[Thehighwind87]

Dentistry DOES NOT keep up with rolling inflation. Our fees are basically stuck forever plus or minus 1-2$...while the cost of living continues to increase. That's why I hedge in the markets.

Those that really don't understand this are going to watch the value of their purchasing power disappear in real time.

 

[Pablo Sanchez]

You’re an associate gen den making $400k??! What sort of procedures do you do?

Nothing too crazy. Most of what I do is bread and butter. Restos/Crown/Bridge. I place simple implant cases as of now (no sinus lifts, etc.) I do most of my own endo unless it’s a tricky molar with weird canal anatomy. No surgical wisdom tooth extractions or anything. I do surgical extractions with bone grafting if it’s like a broken down molar. Simple clear aligner cases. I’m at an office that is able to keep my schedule full and busy which is definitely a large part of it. I work pretty hard for it. But I’m paid 35% adjusted production which is pretty good.

S&P may grow at 10% historical average (30 years).

But that is misleading. 10% assumes you reinvest dividends and does not account for inflation or the income tax you must pay on those dividends.

Inflation adjusted is closer to 7% growth of the fund + income tax on dividends which is on average 2% of your funds.

You are also assuming the fund will grow at the (30 year average) what if it doesnt? What if in your lifetime this strategy completely fails and there is a huge crash?

Sure, inflation and taxes are very real things. $8.8 million when I’m 67 won’t be worth what it is today. But it will still be $8.8 million. The important thing is getting in the markets early and being consistent. Diversifying to limit risk. I’m a Bogle head so nothing too risky. I keep an emergency fund of 6 months expenses as most financial talking heads recommend.

 

[Thehighwind87]

Nothing too crazy. Most of what I do is bread and butter. Restos/Crown/Bridge. I place simple implant cases as of now (no sinus lifts, etc.) I do most of my own endo unless it’s a tricky molar with weird canal anatomy. No surgical wisdom tooth extractions or anything. I do surgical extractions with bone grafting if it’s like a broken down molar. Simple clear aligner cases. I’m at an office that is able to keep my schedule full and busy which is definitely a large part of it. I work pretty hard for it. But I’m paid 35% adjusted production which is pretty good.


Sure, inflation and taxes are very real things. $8.8 million when I’m 67 won’t be worth what it is today. But it will still be $8.8 million. The important thing is getting in the markets early and being consistent. Diversifying to limit risk. I’m a Bogle head so nothing too risky. I keep an emergency fund of 6 months expenses as most financial talking heads recommend.

6 months emergency? I keep 86 cents in my checking account... lol.

 

[Let me out!]

You’re an associate gen den making $400k??! What sort of procedures do you do?

I graduated 23, doing bread butter general dentistry with almost 400k a year. Very similar to Pablo 🤷🏻‍♂️

Really depends on the clinic.

 

[LFA20]

Are you guys in super rural areas?

 

[Pablo Sanchez]

Are you guys in super rural areas?

I practice less than 30 mins outside of one of the most populated metros in the country.

 

[charlestweed]

If you are a traditional student and earn your DDS degree at 25-26 yo, then spending another 2-3 years to specialize afterward shouldn’t be a big deal. You will have a long career ahead of you. Most specialists I know work until they are 60 and beyond. You will eventually catch up with your GP classmates. You get to save your hands and back during those 2-3 years while your GP classmates are working hard to pay back their student loans. You don’t need to deal with the stress of working and paying bills while in residency. I think of those 2-3 years of residency as 2-3 fun gap years. I really enjoyed my time at my ortho program. I traveled a lot with my co-residents. You start your career late and therefore you will retire late.

When you finish your specialty training, you won’t have to work as hard (physically and mentally) as your GP friends. You perform mostly highly paid procedures like implant placements, crown lengthenings, molar RCTs, 3rd molar extractions, treating very young children under IV sedation, starting an ortho case etc. You won’t have to spend hours and hours doing fillings, cleanings, dentures, which pay you very little.

Most of what I say here don’t apply to OMFS since it is a very long, hard and stressful residency, especially if they choose the 6 yr route….but I think it is worth it for OS’s get paid a lot. I am 52. I don’t think I am financially behind many of my GP colleagues, who are around the same age as mine. Many of the GP friends wish they can do ortho like me or perio like my wife.

 

[charlestweed]

6 months emergency? I keep 86 cents in my checking account... lol.

Do you use credit cards? Do you pay off your credit card balance every month? if yes, how do you do it with so little money in the bank?

Like Pablo, I have 6-month emergency fund in the bank and lock it up in a CD account because I have a family and 2 elderly parents to support. If I have to withdraw the cash for emergency purpose, I will have to pay a 3 month interest penalty....I don't care. So far, I haven't had to do that.

 

[LFA20]

I practice less than 30 mins outside of one of the most populated metros in the country.

Good to hear that you don't always have to go super rural to make good $$. You are an anomaly though.. and a very fast and skilled GP. Most of my associate friends make around 150k-200k in metro areas.

 

[Thehighwind87]

Do you use credit cards? Do you pay off your credit card balance every month? if yes, how do you do it with so little money in the bank?

Like Pablo, I have 6-month emergency fund in the bank and lock it up in a CD account because I have a family and 2 elderly parents to support. If I have to withdraw the cash for emergency purpose, I will have to pay a 3 month interest penalty....I don't care. So far, I haven't had to do that.

Just pay myself more from business. But as soon as I pay everything off- all excess goes to stocks.

What’s the point of holding cash? You can put it into bitcoin or stocks and get 5-10% returns yearly or even monthly.

Worst case if you have some catastrophe and need 100k immediately- you can easily sell 100k of a stock position and wire the money and it will be in your account by end of the day.

People that legit hold 50-100k in checking accounts with zero interest make me cry inside. Even savings account look sad when I look at the sp500 returns.

 

[charlestweed]

Just pay myself more from business. But as soon as I pay everything off- all excess goes to stocks.

What’s the point of holding cash? You can put it into bitcoin or stocks and get 5-10% returns yearly or even monthly.

Worst case if you have some catastrophe and need 100k immediately- you can easily sell 100k of a stock position and wire the money and it will be in your account by end of the day.

People that legit hold 50-100k in checking accounts with zero interest make me cry inside. Even savings account look sad when I look at the sp500 returns.

You made very excellent point. For the last 20+ years since I started working (at 29), I had tried to pay off all the debts that I owed from purchasing rental properties….and became debt free at 49. IMO, it’s one of the best financial decisions (beside maximizing the 401k contribution) that I’ve ever made. I bought these properties at 1/3 of their current value. And as the inflation rate rises, I can easily increase the rents to make up for that. Now that the home prices have gone up so much that I don’t think it’s worth investing in real estate anymore. For a $1M house, I would have to charge my tenant at least $6k/month in order to break even….and the average rent for such home size in my area is only around $3-3.5k/month. So I switched to investing in safe mutual fund and eft’s in recent years and loved it. I’ve slowly moved my money out of the Treasury bills and put it toward the safe stocks like VFIAX, SPY and VOO. Forget about the individual stocks like TSLA…I’ve lost so much money on it.

This morning, my sister frantically called me to ask if I could lend her $15k because she has to pay her Corporation tax, which is due this coming March 15th. She told me she was totally broke after she purchased her 9th property, a small condo in San Jose for 1.2M, two months ago. I had to rush to her house before work this morning to give her the check. Now that I read your post…I told myself: she could have just sold one of her coins…..she has like 10 bitcoins.

I still want to keep at least $100k in the bank, which is not a significant amount for person who has a stable income like myself. That’s because with that minimum amount, I can maintain a “platinum” status at my bank and I get some benefits like 2.62% cash back on all credit card purchases, 6% cashback on dinning, free safe deposit box, free cashier check purchases etc.

 

[Thehighwind87]

You made very excellent point. For the last 20+ years since I started working (at 29), I had tried to pay off all the debts that I owed from purchasing rental properties….and became debt free at 49. IMO, it’s one of the best financial decisions (beside maximizing the 401k contribution) that I’ve ever made. I bought these properties at 1/3 of their current value. And as the inflation rate rises, I can easily increase the rents to make up for that. Now that the home prices have gone up so much that I don’t think it’s worth investing in real estate anymore. For a $1M house, I would have to charge my tenant at least $6k/month in order to break even….and the average rent for such home size in my area is only around $3-3.5k/month. So I switched to investing in safe mutual fund and eft’s in recent years and loved it. I’ve slowly moved my money out of the Treasury bills and put it toward the safe stocks like VFIAX, SPY and VOO. Forget about the individual stocks like TSLA…I’ve lost so much money on it.

This morning, my sister frantically called me to ask if I could lend her $15k because she has to pay her Corporation tax, which is due this coming March 15th. She told me she was totally broke after she purchased her 9th property, a small condo in San Jose for 1.2M, two months ago. I had to rush to her house before work this morning to give her the check. Now that I read your post…I told myself: she could have just sold one of her coins…..she has like 10 bitcoins.

I still want to keep at least $100k in the bank, which is not a significant amount for person who has a stable income like myself. That’s because with that minimum amount, I can maintain a “platinum” status at my bank and I get some benefits like 2.62% cash back on all credit card purchases, 6% cashback on dinning, free safe deposit box, free cashier check purchases etc.

I dunno if this is like satire? Or sarcasm? 9th house? 1.2 million? Frantic? 15k? Rush to her house for a check when you could have ach transferred… or wired? 10 bitcoin which is like 700k… umm there’s a lot in there that I can’t sorta comprehend.

Either way grats to you and your sis for being multimillionaires.

 

[charlestweed]

I dunno if this is like satire? Or sarcasm? 9th house? 1.2 million? Frantic? 15k? Rush to her house for a check when you could have ach transferred… or wired? 10 bitcoin which is like 700k… umm there’s a lot in there that I can’t sorta comprehend.

Either way grats to you and your sis for being multimillionaires.

I believe the maximum amount you can zelle to someone at one time is $3k. And to do wire transfer it requires you to be at the bank. And my sister lives .5 mile away from me.

I guess my sister didn't want to sell her coin because she bought it when it was only like 10k. If she sells and buys a new coin to replace it, she has to pay the current price at $72k.

 

[MaxilloMaestro]

In your hypothetical, student B is getting paid $1750/day for the rest of their career, while you increased student A salary 100% over 3 years.
Most specialists will end up making a lot more than that, especially OMFS.
Even ortho/PEDs/perio/prosth…. imagine when they open their own practice.
It’s a great thing that you were extremely skilled right out of dental school. You must have had a good experience. I think, unfortunately, 60-70% of fresh grads will not be able to do the quality/scope of treatment you’re rendering without a good mentor.

 

[Pablo Sanchez]

In your hypothetical, student B is getting paid $1750/day for the rest of their career, while you increased student A salary 100% over 3 years.
Most specialists will end up making a lot more than that, especially OMFS.
Even ortho/PEDs/perio/prosth…. imagine when they open their own practice.
It’s a great thing that you were extremely skilled right out of dental school. You must have had a good experience. I think, unfortunately, 60-70% of fresh grads will not be able to do the quality/scope of treatment you’re rendering without a good mentor.

Yes, OMFS is a different beast for sure. You can work for Pacific dental and make $200k for one day per week. But the opportunity cost is still there and relevant. Student C went to OMFS residency for 6 years. At the current interest rate of 8%, by the time they’re done residency their student loan is at $400k. Student A has already invested $1.2 million in the S&P500 by the time Student C graduates residency at 32. If Student A doesn’t invest another penny over the course of their career that $1.2 million grows to $39 million by the time they’re 67 (10% return. Reinvesting dividends. Not considering tax burden for money not in tax advantaged accounts). So Student C has missed out on $39 million in opportunity cost.

Student C works as an oral surgeon and makes $600,000 per year. They’re in a higher tax bracket and take home $376,000 after tax. Assuming they live on the same amount as the general dentist who is taking home $259,000 per year after taxes, that leaves the oral surgeon an extra $117,000 per year to invest. Minus $32,000 just to pay the interest on their student loan. So assuming they don’t even make any progress in paying off their student loan, student C will invest $85,000 more per year than the general dentist starting at the age of 32. Assuming the same 10% gain and reinvestment of dividends, investing an extra $85,000 per year from the age of 32 until 67 only gets the oral surgeon $27 million compared to the $39 million student A’s investment turns into. So even with a higher income and investing $85,000 per year more than the general dentist, Student C will not be able to catch up to the 6 years of investments that student A made while student C was in residency.

Now, like I said, OMFS can make incredible money and can in many cases catch up, but it’s not a given. I’m just making the point that the opportunity cost of those early years isn’t something people should ignore.

My friends who are doing peds are getting daily guarantees less than $1500/day. They’ve been told to expect making about $1800 per day by the time they get established. Sure, their income will go up with experience, too. And they can be an anomaly as well and bring home significantly more than average money. Specializing can be the better financial decision in many cases. But those few years of opportunity cost are still significant.

And none of these scenarios consider practice ownership. The general dentist can own too. The sky is the limit once you own.

 

[Thehighwind87]

In your hypothetical, student B is getting paid $1750/day for the rest of their career, while you increased student A salary 100% over 3 years.
Most specialists will end up making a lot more than that, especially OMFS.
Even ortho/PEDs/perio/prosth…. imagine when they open their own practice.
It’s a great thing that you were extremely skilled right out of dental school. You must have had a good experience. I think, unfortunately, 60-70% of fresh grads will not be able to do the quality/scope of treatment you’re rendering without a good mentor.

I bought my practice 2 years out of dental school.

I do zero endo, zero omfs, zero pediatrics, zero cosmetic, zero speciality.

I went from 150k to 400k earnings in that timespan.

There are many practices out there that collect 1 mil on pure bread and butter dentistry on. 50-60% overhead…. That a new grad with 2 brain cells can operate. Granted the average tends to be 700-800k revenue.

Specialists have a higher earning potential as an associate, but as as an owner- all bets are off the table. Omfs is another beast all together but the other specialities- meh. 1 mil endo practice with 50-60% overhead- congrats you make the same amount as a GP. Of course I will have some specialist come here and say I do 2 mil in revenue on 15% overhead and blow those numbers out the water… but the reality is you can’t extrapolate the 1% of earners to 99%.

A quick look on my practice brokers website shows lots of GP practices making 700-1mil on 50-60% overhead...and gasp SPECIALTY PRACTICES that are collecting.... 700-1mil on 50-60% overehead... Just a quick look ...here is an ortho practice collecting 950- annual takehome 312k... and then there is a 2 mil collecting GP practice...take home 1 million!

Pablosanchez has a good point that opportunity costs is huge for specialists on top of extra debt load. The 2 years that a specialist is in school while taking on large debts plus 2-3 extra years out of school establishing themselves to buy a practice is 3-5 years where a GP that has the ball rolling is compounding money in capital markets and building wealth.

Just one year of missing out in markets can be costly. Last year Nasdaq almost up 50% literally. You can’t make up time lost.

The bottom line is that practice ownership nullifies really the income disparities between speciality and GP. And the lost opporutnity cost plus extra debt can be costly for a specialist. However IN GENERAL, specialists will have a way way way better time as a associate versus associate GP...but if you were to sit here and tell me that somehow specializing automatically means you will come out way ahead as a specialist owner- I will just have to laugh at that.

 

[Kingse]

I graduated 23, doing bread butter general dentistry with almost 400k a year. Very similar to Pablo 🤷🏻‍♂️

Really depends on the clinic.

2023 or 23 years old?

 

[Kingse]

I bought my practice 2 years out of dental school.

I do zero endo, zero omfs, zero pediatrics, zero cosmetic, zero speciality.

I went from 150k to 400k earnings in that timespan.

Wow, thats great! Can you tell me how that happened and the situation and area you worked in before ownership (urban, suburban, etc)?

 

[charlestweed]

I bought my practice 2 years out of dental school.

I do zero endo, zero omfs, zero pediatrics, zero cosmetic, zero speciality.

I went from 150k to 400k earnings in that timespan.

There are many practices out there that collect 1 mil on pure bread and butter dentistry on. 50-60% overhead…. That a new grad with 2 brain cells can operate. Granted the average tends to be 700-800k revenue.

Specialists have a higher earning potential as an associate, but as as an owner- all bets are off the table. Omfs is another beast all together but the other specialities- meh. 1 mil endo practice with 50-60% overhead- congrats you make the same amount as a GP. Of course I will have some specialist come here and say I do 2 mil in revenue on 15% overhead and blow those numbers out the water… but the reality is you can’t extrapolate the 1% of earners to 99%.

A quick look on my practice brokers website shows lots of GP practices making 700-1mil on 50-60% overhead...and gasp SPECIALTY PRACTICES that are collecting.... 700-1mil on 50-60% overehead... Just a quick look ...here is an ortho practice collecting 950- annual takehome 312k... and then there is a 2 mil collecting GP practice...take home 1 million!

Pablosanchez has a good point that opportunity costs is huge for specialists on top of extra debt load. The 2 years that a specialist is in school while taking on large debts plus 2-3 extra years out of school establishing themselves to buy a practice is 3-5 years where a GP that has the ball rolling is compounding money in capital markets and building wealth.

Just one year of missing out in markets can be costly. Last year Nasdaq almost up 50% literally. You can’t make up time lost.

The bottom line is that practice ownership nullifies really the income disparities between speciality and GP. And the lost opporutnity cost plus extra debt can be costly for a specialist. However IN GENERAL, specialists will have a way way way better time as a associate versus associate GP...but if you were to sit here and tell me that somehow specializing automatically means you will come out way ahead as a specialist owner- I will just have to laugh at that.

That’s pretty good. But you seem to be unhappy about your job based on many of your posts. You’ve repeatedly advised young pre-dents not to go into dentistry because dentists don’t get pay raise like other professions and the field is saturated. And yet, you mentioned on this post about the practice broker websites that post a lot of high production dental offices around the country. I guess money can’t buy happiness. Perhaps, practicing general dentistry is too hard (both physically and mentally) for you? Do you think you’d be happier working as a specialist?….see fewer patients….perform fewer procedures but get paid more for each procedure?

So dentistry is still a very good profession. If one can make $300-400k/yr as a practice owner, one should have no problem paying back $400-500k student loans.

 

[Thehighwind87]

That’s pretty good. But you seem to be unhappy about your job based on many of your posts. You’ve repeatedly advised young pre-dents not to go into dentistry because dentists don’t get pay raise like other professions and the field is saturated. And yet, you mentioned on this post about the practice broker websites that post a lot of high production dental offices around the country. I guess money can’t buy happiness. Perhaps, practicing general dentistry is too hard (both physically and mentally) for you? Do you think you’d be happier working as a specialist?….see fewer patients….perform fewer procedures but get paid more for each procedure?

So dentistry is still a very good profession. If one can make $300-400k/yr as a practice owner, one should have no problem paying back $400-500k student loans.

I mean I keeps it real Charles. You just choose to keep putting lipstick on the pig and find it appealing as can be.

I think in 10 years when tuition is 1 million bucks and dental incomes haven't moved much- you will still be saying all is good in the dental neighborhood!

And that's fine, that's you. I just choose to remove the lipstick on the pig and see it for what it is.

 

[MaxilloMaestro]

Yes, OMFS is a different beast for sure. You can work for Pacific dental and make $200k for one day per week. But the opportunity cost is still there and relevant. Student C went to OMFS residency for 6 years. At the current interest rate of 8%, by the time they’re done residency their student loan is at $400k. Student A has already invested $1.2 million in the S&P500 by the time Student C graduates residency at 32. If Student A doesn’t invest another penny over the course of their career that $1.2 million grows to $39 million by the time they’re 67 (10% return. Reinvesting dividends. Not considering tax burden for money not in tax advantaged accounts). So Student C has missed out on $39 million in opportunity cost.

Now, like I said, OMFS can make incredible money and catch up. I’m just making the point that the opportunity cost of those early years isn’t something people should ignore.

My friends who are doing peds are getting daily guarantees less than $1500/day. They’ve been told to expect making about $1800 per day by the time they get established. Sure, their income will go up with experience, too. And they can be an anomaly as well and bring home significantly more than average money. Specializing can be the better financial decision in many cases. But those few years of opportunity cost are still significant.

And none of these scenarios consider practice ownership. The general dentist can own too. The sky is the limit once you own.

This is a great conversation. You make a lot of good points and I think you have/will open up the minds of many young dental students who are unsure of what path they want to take after graduating.

 

[MaxilloMaestro]

Specialists have a higher earning potential as an associate, but as as an owner- all bets are off the table. Omfs is another beast all together but the other specialities- meh. 1 mil endo practice with 50-60% overhead- congrats you make the same amount as a GP. Of course I will have some specialist come here and say I do 2 mil in revenue on 15% overhead and blow those numbers out the water… but the reality is you can’t extrapolate the 1% of earners to 99%.

Endo practice with 50-60% overhead? I obviously don’t own an Endo practice but I’m pretty sure endo is way way way under that for overhead

 

[Let me out!]

Are you guys in super rural areas?

Nope, about 200k population.

 

[charlestweed]

I mean I keeps it real Charles. You just choose to keep putting lipstick on the pig and find it appealing as can be.

I think in 10 years when tuition is 1 million bucks and dental incomes haven't moved much- you will still be saying all is good in the dental neighborhood!

And that's fine, that's you. I just choose to remove the lipstick on the pig and see it for what it is.

I am talking about now….about the predents who are applying now....and the current dental students who will graduate in a few years. They will have good future ahead of them if they work hard and invest. They may have to work 5 days/wk instead of 4 days like you. Pablo Sanchez graduated only a few years ago and he is doing fine because of his work ethic and his willingness to live like a student in the beginning so he could paid off the debt ASAP. I know he only owed $250k but with his current income, he wouldn’t have any problem even if he owed 2-3x that amount. The future will be so bright for him. He is doing much better now than what I did 20+ years ago. I was drowning in $1+million debt when I was at his age.

I think when the dental tuitions go up to $1M in 10 years (or whatever number of years it will take to reach that level) from now and if the young dentists get paid the same ($150-200k for new grads) and ($3-400k for more experienced practice owners) , then dentistry won’t be worth it anymore. When that happens, you will not be the only one who will speak out against it. I will do too. I think 100% of the practicing dentists will do the same as well.

When the tuition reach $1M and dental incomes continue to stay the same, I think there will be a sharp decline in interest in applying to dental schools because the majority of the dentists (myself included) will come on this forum and tell the young students not to do it. When that happens, dental schools will either have to lower the tuition (which I haven’t seen they do that yet) or they will be forced to close due to many empty seats. Then dental schools will only be for weathly kids….kids whose parents are dentists and doctors. The example of this is the Georgia ortho program, which only accepts rich students (mostly foreign trained grads) who must show proof that they can pay for school there. Most of these rich ortho graduates will be fine after graduation since they won’t have any debt. I can’t predict what the future will be like for dentistry but I hope that the market will correct itself….. due to supply and demand.

 

[juniordentist]

I think high tuition for dentistry will continue for atleast 20 years. I think studying dentistry will go from a "good way to make a living" to a "Luxury status symbol". Like a Louis Vuitton bag.

People will study dentistry because they want to look rich. It won't be about making money. It will be about appearing rich. "Wow your dental degree is costing almost a million dollars, you must be from a rich family"

I have dental assistants, who make no money, who still buy $5000 bags. They want to look rich, even though it's a stupid financial move. I am constantly baffled by how stupid people will be to look rich to others. I think dental school degrees will fall into that category for a decade or two so before people stop applying. I can't see demand falling in our lifetime. These days people care about looking rich, more than actually being rich, and i think dental degrees will become a status symbol

 

[charlestweed]

I think high tuition for dentistry will continue for atleast 20 years. I think studying dentistry will go from a "good way to make a living" to a "Luxury status symbol". Like a Louis Vuitton bag.

People will study dentistry because they want to look rich. It won't be about making money. It will be about appearing rich. "Wow your dental degree is costing almost a million dollars, you must be from a rich family"

I have dental assistants, who make no money, who still buy $5000 bags. They want to look rich, even though it's a stupid financial move. I am constantly baffled by how stupid people will be to look rich to others. I think dental school degrees will fall into that category for a decade or two so before people stop applying. I can't see demand falling in our lifetime. These days people care about looking rich, more than actually being rich, and i think dental degrees will become a status symbol

I know a lot of people think like this about the doctor but I am not sure about the dentist. I had the same perception about the doctors as well when I was in HS. That’s why I wanted to be a doctor. I took the MCAT twice but I didn’t do well. So I had to switch to dentistry because a BS in Biology was pretty much useless. When I pursued dentistry, I didn't think dentists could make a lot of money.....I thought the salary was about the same as pharmacists and optometrists. In the original “Hangover” movie, there’s a dentist who called himself “doctor” when he greeted the hotel front desk. And his friend (played by Bradley Cooper) laughed and said to him “You’re not a doctor. You’re just a dentist.”

I think it’s dumb to risk taking out $500-600k student loan + 4 years of hard work in dental school just to earn that “Luxury status symbol.” This is dumber than the assistant who buys a $5k LV bag because at least the assistant can quit paying for credit card debt and file bankruptcy. Student loan debt stays with you forever…. unless you pay it off or have a permanent disability or die.

 

[Life of Pablo]

I think if you're a general dentist that makes 400k a year, then had you done a specialty like OMFS, you would be making 1.2M+ a year. I don't think it's fair to compare general dentists who are anomalies to an average specialist's salary.

Also, keep in mind a lot of specialists make good money and work 3-4 days a week. If they worked 5-6 days a week, their salaries would be significantly higher.

 

[Pablo Sanchez]

I think if you're a general dentist that makes 400k a year, then had you done a specialty like OMFS, you would be making 1.2M+ a year. I don't think it's fair to compare general dentists who are anomalies to an average specialist's salary.

Also, keep in mind a lot of specialists make good money and work 3-4 days a week. If they worked 5-6 days a week, their salaries would be significantly higher.

You could also reverse this logic. OMFS residents bust their ass. If a general dentist graduates from dental school and busts their ass just as hard for 6 years and makes good financial decisions, they’ll also be at a point where they can work 3-4 days per week and make very good income, much of it passive, while the specialist will have to actively earn their income.

Also, the math in my initial post accounts for the specialist working 5 days per week.

 

[juniordentist]

I know a lot of people think like this about the doctor but I am not sure about the dentist. I had the same perception about the doctors as well when I was in HS. That’s why I wanted to be a doctor. I took the MCAT twice but I didn’t do well. So I had to switch to dentistry because a BS in Biology was pretty much useless. When I pursued dentistry, I didn't think dentists could make a lot of money.....I thought the salary was about the same as pharmacists and optometrists. In the original “Hangover” movie, there’s a dentist who called himself “doctor” when he greeted the hotel front desk. And his friend (played by Bradley Cooper) laughed and said to him “You’re not a doctor. You’re just a dentist.”

I think it’s dumb to risk taking out $500-600k student loan + 4 years of hard work in dental school just to earn that “Luxury status symbol.” This is dumber than the assistant who buys a $5k LV bag because at least the assistant can quit paying for credit card debt and file bankruptcy. Student loan debt stays with you forever…. unless you pay it off or have a permanent disability or die.

The "Luxury status symbol" isn't the same for everyone. Eg, a Louis Vuitton bag is what someone with unlimited money will buy. But also the dental assistant will save up for months to buy the same bag. Ultimately, the assistant is buying the bag so they appear the same as the person with unlimited money. Do people look down on the assistant for buying the bag? No, because if you pass the person in the mall with a LV bag you don't know their financial status, but assume they are well off, which is the whole purpose of buying the bag.

It will be the same for dental school. People from wealthy families will go to dental school, their tuition paid for, walk into their parents practice, make a decent living, and have huge amounts of discretionary income, and have an upper middle class comfortable lifestyle.

But other people will go to dental school, take out loans themselves, still have the BMW and nice house and from the outside appear the same as the truly wealthy dentist from the outside, but will actually be drowning in debt. Only in 20 years when everyone else is retiring and they are broke will the truth come out. But from the outside, all dentists appear rich, and this is what people are wanting to buy

 

[charlestweed]

6

The "Luxury status symbol" isn't the same for everyone. Eg, a Louis Vuitton bag is what someone with unlimited money will buy. But also the dental assistant will save up for months to buy the same bag. Ultimately, the assistant is buying the bag so they appear the same as the person with unlimited money. Do people look down on the assistant for buying the bag? No, because if you pass the person in the mall with a LV bag you don't know their financial status, but assume they are well off, which is the whole purpose of buying the bag.

Everyone wants to look good. That’s why we, orthodontists, will always be needed to help give people beautiful smiles. And carrying nice handbags is also one of the reasons to help make the ladies look good. And that's why we have $1 Trillion in credit card debt in this country.

My wife and I are doing well financially. I think we probably make it to the top 1%. But we don’t have unlimited money. Every time my wife wants to purchase a brand name bag, she always asks me if she can get it. Of course, I always say yes to her. But she still does this out of respect. I too like wearing brand name clothes like Hugo Boss and Burberry because they fit me well and I think they look good in them. But I don’t buy them from high end Dept stores. Instead, I buy them from the outlet stores at steeply discounted prices. We still go for big sale items. We use coupons for grocery shopping. We still look for ways to save money.

It will be the same for dental school. People from wealthy families will go to dental school, their tuition paid for, walk into their parents practice, make a decent living, and have huge amounts of discretionary income, and have an upper middle class comfortable lifestyle.

All parents want their kids to have a successful career. I too want my kids to have a good stable job so they can support themselves (and their own family) when I am gone. I can’t live forever to work to support them. I want them to be more successful than I am. And helping/guiding them to follow my foothsteps to become a dentist (or doctor), which have proven to be working very well, is one of the ways to help our kids reach this goal. We don’t want our kids to have lower quality of life (after we die) than what we have given them. Hopefully, with zero student loan debt, they won’t have to work as hard as we did when we first graduated.

But other people will go to dental school, take out loans themselves, still have the BMW and nice house and from the outside appear the same as the truly wealthy dentist from the outside, but will actually be drowning in debt. Only in 20 years when everyone else is retiring and they are broke will the truth come out. But from the outside, all dentists appear rich, and this is what people are wanting to buy

Yes, I was guilty of this when I was a young grad. Yes, I was a big show off, especially when I learned that my first job paid me $200 more per day than what I hoped to get. I did not just lease any BMW…. I only leased the top flagship ones. I told myself “hey, only 1 workday on Saturday is enough for me to cover the lease payment for the car.” Another reason was YOLO. And since I worked all 4 Saturdays in a month, I should still be at least 3-workday (worth in salary) richer than the colleagues who chose to not to work on Saturdays. Now, with less income (because I no longer work 6 days/wk), I don’t drive BMWs and Mercedes anymore. Now, I drive electric cars to save $$$ on gas and maintenance. I bought the Model X to replace the more expensive BMW X7 and this is our weekend car. I still keep the same 5-yo Tesla, which it is probably worth in the low $30k, for my daily commute….the autopilot significantly reduces the stress of driving.

There is no such thing as good debt. But I think being/drowning in debt was the main motivation that helped push me to work the way that I did. Hard work helped bail me out of debt. I am glad that I graduated early enough and have enough time to fix many of my earlier mistakes. I only heard of Dave Ramsey recently. Had I known about him and his teaching sooner, I wouldn’t have thrown away money on cars and other luxury items the way that I did. I would be debt free a lot sooner, instead of at the age of 49.

Juniordentist, it’s good that you have the full understanding of this problem at this young age. You will do very well.

 

[planisphere]

If you are a traditional student and earn your DDS degree at 25-26 yo, then spending another 2-3 years to specialize afterward shouldn’t be a big deal.

Would you then NOT recommend postgrad specialization to those untraditional students who entered dschool very late, like get their degrees at 35 - and rather just get into the field as a GP ASAP considering they lost ten years of working time? (and still have the same 4-year tuition debt)

 

[Smile2thetop]

It’s not all about money. I’m sure some people would be much happier working as specialists or yearn for the extra education and expertise and they’ll willingly take even a financial loss to do so.

 

[Thehighwind87]

It’s not all about money. I’m sure some people would be much happier working as specialists or yearn for the extra education and expertise and they’ll willingly take even a financial loss to do so.

Yep that explains why people go into large loans like 1 mil+ for their happier jobs.

 

[SuxDrugs&Rocuronium]

A lot of the talk on here is about how dentistry is a profession going south. With rising tuition and stagnant pay there is good reason to be concerned. A common misconception is that specialization is the key to financial success. I just want to provide some positive light on the profession, and make an argument for general dentistry. To be clear, there are obviously more things to consider than finances when considering which field of dentistry you want to work in, and there are excellent opportunities as specialists as well. Below is something similar to what I posted on a thread previously, but I think it’s valuable to consider. None of this gets talked about. None of my post includes practice ownership either, in which the sky is the limit and it becomes more dependent on how well you run a business.

Here are two examples.

The first is Student A. The second is student B. Both students went to the same dental school and graduated with $250k in debt. Reasonable.

Student A went straight out and practiced as a GP. Their mindset was to work hard for the first few years while their colleagues were in residency so that they could maximize their knowledge and experience. They wanted to “work and live like a resident” their first few years. Student A worked 5 or even 6 days per week. Student A made a good amount because of this intentional work ethic. Let’s just say $200k year one, $300k year two, and $400k year three while student B was in residency (I know people may think this is high, but I know it’s possible because I’m a 2022 grad and making over $400k). So Student A averaged $300k per year while student B was in a three year residency. After taxes, Student A took home about $200k per year on average for the three years student B was in residency. Student A lived off of $50k per year and put $150k towards loans/investments. After 3 years, they have paid off their dental school debt. They are now 29, taking home $259k per year after taxes without any debt, and they’ve managed to invest $200k in the S&P500 ($600k in total earnings after tax over those three years - $150k in living expenses - $250k in student debt) They don’t touch this $200k again until retirement age of 67. Without taking into consideration any future investing, that $200k invested while student B goes to residency, grows at 10% (historical average of the S&P500). At 67 that $200k invested while student B is in residency is worth $8.8 million. Should student A continue investing, even if they cut back their annual contributions and start to increase the quality of their lifestyle, they’ll accumulate A LOT more than $8.8 million. If you don’t want to get into the nitty gritty of Student A’s situation, the key is that they have a decent income at a young age, and if they’re intentional about where they invest their money, the extra time in the market is a big benefit of general dentistry.

Student B also graduated with $250k of debt. At today’s current interest rates of grad plus loans (8%), by the time they graduate from a three year residency the balance on that $250k is $315k. They took out an additional $200k for residency. So when they graduate they are $515k in debt.

So at the age of 29, Student A has no debt and is taking home $259k after tax with $200k invested in the S&P500.

Student B has $515k in debt. They make $1,750 per day (Now this could be low for a specialist. I don’t really know. I’m just going off of what I hear for many specialists. And I’m making a lot more than I thought a general dentist associate would, so it’s possible specialists are doing much better). 5 days per week, 50 weeks per year, student B makes $437,500 per year. They take home $281k per year after taxes. So student B is making about $20k more than student A per year at the age of 29. But the interest on Student B’s $515k in loans is over $41,000 just for that first year. So JUST TO MAINTAIN the $515k in debt AND MAKE NO PROGRESS IN PAYING IT OFF Student B will have to pay $41,000. This leaves Student B at AN INCOME DISADVANTAGE compared to student A each year. Their income is $20k higher, but they need to pay $41k just to keep their loan balance the same.

Now I know everyone’s income will vary. The point is that the opportunity cost of those few early years practice as a general dentist CAN be significant. The takeaway is that there are still opportunities for massive financial success in dentistry despite the rising costs of dental school. You don’t have to specialize to be successful. You just have to be intentional. Don’t blindly take out loans. Don’t graduate and buy yourself a new Mercedes. When you’re young with the income of a dentist, you have every reason and ability to make smart investment decisions which can and will give you a quality of life you never even dreamed of having.

While I think this is a decent take, I also noticed some important things that should be addressed more.

First, an income of 400k as an associate is not as common as some people might think. - also you assumed an increase of $100k per year for the general dentist, but no increase for the specialist. Many associate specialists are making much more than $400k per year

Also many residencies (not just omfs are paid, not tuition based. Omfs, peds, anesthesia, path etc are some of the more commonly paid residencies.

Interest accruing during residency also is kind of a moot point now with the SAVE plan. During residency the minimum payment is low, so the remaining betters is paid by the government. I’m currently in a 3 year residency, and won’t accrue any interest thanks to the SAVE plan, with a monthly payment of $0.

I also think the assumption of student A investing ~$150k and living off of $50k is unrealistic. There may be a small minority that can do that, but they’re definitely outliers.

I don’t think that the reason for specializing should be a solely financial one, but I do think that on average a specialist will come out ahead, even if it’s not by a ton. If a specialist grinds the same way a new grad GP does, they can make a ton of money and surpass most GPs with smart investments.

 

[Thehighwind87]

While I think this is a decent take, I also noticed some important things that should be addressed more.

First, an income of 400k as an associate is not as common as some people might think. - also you assumed an increase of $100k per year for the general dentist, but no increase for the specialist. Many associate specialists are making much more than $400k per year

Also many residencies (not just omfs are paid, not tuition based. Omfs, peds, anesthesia, path etc are some of the more commonly paid residencies.

Interest accruing during residency also is kind of a moot point now with the SAVE plan. During residency the minimum payment is low, so the remaining betters is paid by the government. I’m currently in a 3 year residency, and won’t accrue any interest thanks to the SAVE plan, with a monthly payment of $0.

I also think the assumption of student A investing ~$150k and living off of $50k is unrealistic. There may be a small minority that can do that, but they’re definitely outliers.

I don’t think that the reason for specializing should be a solely financial one, but I do think that on average a specialist will come out ahead, even if it’s not by a ton. If a specialist grinds the same way a new grad GP does, they can make a ton of money and surpass most GPs with smart investments.

It really hurts to see the amount of sad information out there.

The bottom line for me- aside from omfs- is that business puts everyone on an equal level. And the amount of lost opportunity cost with more debt can be detrimental to a specialist.

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Just put in any specialist practice for sale, and a GP practice for sale. You will some specialists collecting anywhere from 500k to 1.5 million… and the same with a GP. You would think that a specialist collecting 500-700k is unheard of but it’s not.

Business puts everyone on equal playing field. Those that don’t understand that don’t understand business or don’t own a practice.

The only big benefit is associating as a specialist but who wants to do that long term.

 

[SuxDrugs&Rocuronium]

It really hurts to see the amount of sad information out there.

The bottom line for me- aside from omfs- is that business puts everyone on an equal level. And the amount of lost opportunity cost with more debt can be detrimental to a specialist.

Find Dental Practices & Offices for Sale | Henry Schein Dental

Our selection of Dental Practices & Office for Sale is updated constantly, and we have many Consultants available to help you.

dentalpracticetransitions.henryschein.com

Just put in any specialist practice for sale, and a GP practice for sale. You will some specialists collecting anywhere from 500k to 1.5 million… and the same with a GP. You would think that a specialist collecting 500-700k is unheard of but it’s not.

Business puts everyone on equal playing field. Those that don’t understand that don’t understand business or don’t own a practice.

The only big benefit is associating as a specialist but who wants to do that long term.

Yeah I was specifically addressing the original post, which is from an associate perspective. Obviously ownership changes things.

You also have to take into account that specialists tend to have lower overhead, so even if they’re collecting the same, take home may be higher. There’s also # of days/week to look at. Specialists usually can produce more if the amount of days worked is the same.

 

[charlestweed]

Would you then NOT recommend postgrad specialization to those untraditional students who entered dschool very late, like get their degrees at 35 - and rather just get into the field as a GP ASAP considering they lost ten years of working time? (and still have the same 4-year tuition debt)

The one thing that none of us can control (nor be able to predict) is our own health. It continues to decline as we get older….no matter how good you are at exercising and controlling your diet. I’ve seen many people who are younger than me and already have problems with their hands, back, and other systemic problems like heart disease, high BP, high blood sugar etc. For this reason, it’s best to work as hard as you can when you’re young and healthy. When you start school late and owe a lot in student loan, you put your family/children at great financial risk. This is because of the limited amount of time that you can work to pay off debt and to save for your retirement. Even if you have the desire to work for as long as possible, you may not be able to do so because of your declined health. You haven’t seen the decline yet because your are still in your mid 30s. Wait until you become old like me, 52, you’ll know what I am talking about. I’ve have had this darn elbow pain (I think it’s called lateral epicondylitis) for months and it doesn’t go away….and my doctor has also warned me about my high cholesterol and A1C numbers.

If you are single and have nobody to support, you can do whatever you want. My roommate (also a dental classmate) started dental school at 36. He got accepted to an endo program straight out of school. He was single and had no kid. Because he had saved lot from his previous engineering job, he didn’t have any student loan debt. He bought a nice house right after residency. He told me that he’s glad that he didn’t have to do general dentistry. He travelled to work at multiple offices. He didn’t have his own office. He later married a middle aged lady, who had no kid either. She’s a general dentist. So this marriage was a huge bonus for him. He must be 65-66 yo now. I don’t know if he’s still working or not.

 

[dentalinthemental]

Sometimes I feel as though people who specialized try to justify their decision by making general dentistry seem awful. Specifically, the orthodontists on SDN… not sure why.

I’m with Pablo on this one. I’d say about 90% of my graduating class is VERY happy with their decision to remain a GP. For every general dentist who ‘wished’ they had specialized, there’s about 5+ who are happy as hell they didn’t. Multiple people who were top 10 in my class who happily chose general dentistry and haven’t looked back. Myself being one of them.

I think private equity taking a firm grasp on dentistry has shifted the market completely. There is an influx of pediatric specific DSOs hiring “peds” general dentists. Orthodontists in corp often travel between 3-5+ offices to fill a schedule. And so on.
A business savvy owner GP can make very similar income. Likewise, if a general dentist has health problems, it is possible to function as an owner for multiple GP practices (or even just one), focus in on TMD/sleep dentistry, etc.

 

[Thehighwind87]

Sometimes I feel as though people who specialized try to justify their decision by making general dentistry seem awful. Specifically, the orthodontists on SDN… not sure why.

I’m with Pablo on this one. I’d say about 90% of my graduating class is VERY happy with their decision to remain a GP. For every general dentist who ‘wished’ they had specialized, there’s about 5+ who are happy as hell they didn’t. Multiple people who were top 10 in my class who happily chose general dentistry and haven’t looked back. Myself being one of them.

I think private equity taking a firm grasp on dentistry has shifted the market completely. There is an influx of pediatric specific DSOs hiring “peds” general dentists. Orthodontists in corp often travel between 3-5+ offices to fill a schedule. And so on.
A business savvy owner GP can make very similar income. Likewise, if a general dentist has health problems, it is possible to function as an owner for multiple GP practices (or even just one), focus in on TMD/sleep dentistry, etc.

It’s a combination of ego… specializing… being top 10 etc. Don’t get me wrong- specializing is hard as hell and it’s quite a journey, but the bottom line is that even though one specializes- it doesn’t equate to higher income as a BUSINESS owner.

Go to any practice transition website locally and nationally- and you will see specialists collecting the same revenue with same overhead as GP. You will have outliers in the millions in both specialist and general dentists. One could argue that specialists have an easier time becoming that outlier but imo, that is a moot point.

If we were all associating then yes OFC- specialists have a huge leg up. But in business? No. Just no.

Ironically what ends up happening to a lot of specialists is that there isn’t many good speciality practices for sale- and or the buy in opps are limited and or the amount of goodwill isn’t worth it- as specialists get their patients from referalls…… that they end up doing a startup. Which can mean paltry income for a few years to build up referall base.

Do you know how expensive a speciality start up is? It’s expensive.

So tack that onto student loans and deferred income/opp cost and the amount is massive. There are plenty of decent 700-1mil practices for sale as a GP that is easy to take over.

 

[SuxDrugs&Rocuronium]

Do you know how expensive a speciality start up is? It’s expensive.

So tack that onto student loans and deferred income/opp cost and the amount is massive. There are plenty of decent 700-1mil practices for sale as a GP that is easy to take over.

Startup cost is very specialty dependent. Some specialties are going to be similar to a general practice, other specialties can be much, much cheaper.

And if there are so many 700-1mil practice for sale that are easy to take over, why isn’t everyone doing it?

 

[White_Sponge_Nevus]

Out of curiousty, where in the country are you guys seeing OMFS practices collecting $1-1.5 million per year per doc? I have never met/heard of someone collecting this little as a practice owner/partner. Assuming you are referring to collections prior to overhead getting taken out, not pre-tax & post overhead pay

 

[Pablo Sanchez]

While I think this is a decent take, I also noticed some important things that should be addressed more.

First, an income of 400k as an associate is not as common as some people might think. - also you assumed an increase of $100k per year for the general dentist, but no increase for the specialist. Many associate specialists are making much more than $400k per year

Also many residencies (not just omfs are paid, not tuition based. Omfs, peds, anesthesia, path etc are some of the more commonly paid residencies.

Interest accruing during residency also is kind of a moot point now with the SAVE plan. During residency the minimum payment is low, so the remaining betters is paid by the government. I’m currently in a 3 year residency, and won’t accrue any interest thanks to the SAVE plan, with a monthly payment of $0.

I also think the assumption of student A investing ~$150k and living off of $50k is unrealistic. There may be a small minority that can do that, but they’re definitely outliers.

I don’t think that the reason for specializing should be a solely financial one, but I do think that on average a specialist will come out ahead, even if it’s not by a ton. If a specialist grinds the same way a new grad GP does, they can make a ton of money and surpass most GPs with smart investments.

You make some really good points here!

All I know is my own situation. I’m not anything special. Now, not even two years out of school, I’m making over $400k and investing over $225,000 per year. It wasn’t that difficult to build up to that.

But yes, no matter what field of dentistry you work in, your salary is going to go up as you gain experience. I honestly think a specialist starting at $437,000 as I used in my example is generous to begin with. The point is not about the salary in the end. The point is about the opportunity cost that a specialist gives up to pursue their residency. It does not matter to me who makes more money in the end. I hope everyone here is very successful. But I think that people should more often consider how significant the opportunity costs can be to pursue a residency. It translates to millions of dollars whether there is interest accumulating on your loans or not.

 

[Thehighwind87]

Startup cost is very specialty dependent. Some specialties are going to be similar to a general practice, other specialties can be much, much cheaper.

And if there are so many 700-1mil practice for sale that are easy to take over, why isn’t everyone doing it?

They go for sale- but are pretty much sold immediately or before it hits the market. My practice that sold was 1 million on 50% collections aka 500k take home. I had to put an offer in 1st week of it on the market.

Owner had multiple offers 1st week.

If I sold my 1 mil practice today on 50% overhead, it would be sold tommorow. Easy.

 

[Silver_arrow]

The point is about the opportunity cost that a specialist gives up to pursue their residency. It does not matter to me who makes more money in the end. I hope everyone here is very successful. But I think that people should more often consider how significant the opportunity costs can be to pursue a residency. It translates to millions of dollars whether there is interest accumulating on your loans or not.

This is absolutely correct.

For those who practiced prior to covid and purchased real estate in the right locations ended up being way ahead.

This is just one example.

In my circle of practicing omfs with experience under their belt (didn’t graduate recently)… the money is not really an important discussion any longer. We often talk about about family etc. I see many colleagues who had to put starting a family on hold and some colleagues ended up not having as many kids as they wanted. The amount of years in residency definitely takes its toll.

The opportunity cost is not just limited to finances, it’s also on family. But certainly yes, the lost financial opportunity cost is tremendous especially if you did say a perio residency at usc and had to fork over a fortune.

 

[Pablo Sanchez]

Another thing to note is this is not a pissing war between general dentists and specialists. This has been a great conversation about the opportunity costs of going to residency. Specialists make a lot of sacrifices (sometimes more than they realize), both financial and personal, and each individual dental student is going to have to weigh the pros and cons for their unique situation. Either way, if you work hard and make sound financial decisions, dentistry can provide you the opportunity to make millions and millions of dollars without significant sacrifice. There are not too many fields out there where this remains the case.

I think the takeaway is that dentistry is a thriving field, no matter which area you choose to specialize in. Limit your debt and spend your first few years investing properly, and then you’ll be able to scale back, work however much you want to, and you’ll have the money to do whatever you want.

Graduate, work an easy schedule, spend money on luxuries like trips, cars, and status symbols, and you will do yourself a significant financial disservice.

TIME is your best friend in the market, so the sooner you get the ball rolling the more exponential the benefit will be. Once you have millions of dollars generating passive income for you, the world will become your oyster. I was fortunate to have had the opportunity to make sound financial decisions early on in dental school, which will benefit me the rest of my life.

I hope that this thread helps students and dentists alike realize the potential we all have. It comes out to tens and tens of millions of dollars.

 

[Silver_arrow]

TIME is your best friend in the market, so the sooner you get the ball rolling the more exponential the benefit will be.

Very good advice here.

I would strongly argue that money now, especially for a young family, is far more beneficial, than money later on. You will never get these years and time back.

 

[D1Bound]

I spoke with an oral surgeon directly and he said there’s not a GP out there that could touch his income. Another OS said owning GP offices was more income for him. His circumstances were a little different though. Whatever that’s worth.

 

[Molar Whisperer]

I agree that time is both good for money growth (opportunity costs) and bad for family dynamics especially for women. I've been acquainted with a few women over 40 who are hoping to start families. We all have our individual needs, passions, and ambitions. I teach my kids that money can buy choices and the more money you have, the more choices. I choose not to be a slave to money. I had a difficult relationship with my dad. He and his best friend both physicians worship money trying to impress others, etc. I can understand their perspective. In Asian, if you have no money, you're looked down upon. That is why many Asians and other similar minded immigrants in the US strive to drive fancy cars and live in fancy homes. I know I'm in the top 5% but not top 1%. We still live like we're in the bottom 50% utilizing coupons, discounts, clearance sales, and if being in the top 5% is not enough, then we're too spoiled. IMO, it is very difficult for the average young generation to reach the top 5%.

I spoke with an oral surgeon directly and he said there’s not a GP out there that could touch his income. Another OS said owning GP offices was more income for him. His circumstances were a little different though. Whatever that’s worth.

I try not to talk to OMFS outside of dentistry. For me, they seem to look down on GPs.

You’re an associate gen den making $400k??! What sort of procedures do you do?

Where I'm located in the West Coast (PNW), it is very difficult for GPs and specialists to make good income. The exception is OMFS where there is a statewide shortage (not enough people want to commit 4 or 6 yrs). My favorite periodontist decided to quit her private practice of 15 yrs and work for a DSO. My personal GP dentist couldn't pay himself for the first 2 months after he moved to a cheaper location last fall. I will assume less expensive areas in the Midwest, the Plains and the South may have more dentist friendly income. In my area, many people are struggling to pay their living exp. My wf wants us to move out of the area (to a more expensive Asian one).