Software Engineer to Dentist

[softwaredentist]

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I graduated last year from computer science in university and came into one of the worst possible job markets of all time. I worked as a barista, in retail, as a busboy, reseller, and a tutor. All working inconsistent hours and minimum wage. At one point I had 3 part time jobs. I applied to 500 jobs, and while I got some interviews couldn’t land a single one (and I was also open to relocating). I also tried starting up 3 separate businesses on the side and they all failed due to various reasons. I finally got a full time job in IT because my friend was able to influence his company to hire me, and I was severely underpaid and then got laid off after several months due to company restructuring. I’ve been unemployed now for several months as I am unable to relocate to a high cost of living city where most jobs are and trying to plan out my next steps.

This past year changed what I want. I went into tech when there was no LLMs producing code and a job market that was less saturated, but the landscape shifted right as I was finishing school. I don't want to spend 40 years staring at a screen, moving cities for employers, and competing with offshoring and AI tooling. My eyes already hurt. I want a stable, high income job I can work well into my 50s, enough to support a large family, without constantly having to move my family around.

I’ve landed upon the following paths from my research:
1. Certified Anesthesiologist Assistant (fast schooling, have most pre-reqs done, not too much debt burden, high income, but low ownership potential since I’d work in hospitals, and I would probably have to travel a lot)
2. Certified Registered Nurse Anesthetist (same as CAA - fast schooling, most pre-reqs done, not too much debt, high income, autonomy and flexible contracting).
3. Med school + specialty (anesthesiologist) - massive amount of study and sacrifice. The thought of med school actually terrifies me because it’s another 13-15 years of lost income and massive sacrifice until attending but once you finish you are practically irreplaceable in your job and guaranteed job security for life.
4. GP Dentist with possibility to specialize (minimum $500K of debt + 4 - 8 year timeline depending on whether I specialize) - offers ownership potential and high income, autonomy, but physically taxing.

I think software knowledge is valuable, but the skill on it’s own is useless without a service or business to actually apply this knowledge to so I’ve been trying to determine what else I can study to complement my skill set.

I thought dentistry could be a good career for me because it’s entrepreneurial, a solid recurring service that is in high demand for health reasons, the path is not as long as medicine, and I can open up my own practice. My software and sales skills complement the skill of a dentist because it’s more like operating a business that offers a recurring physical service. However, I’ve talked to some dentists in my area who I know and they told me to be very careful about the tuition since dental school is very expensive now and dental salaries are decreasing due to insurance reimbursement.

I calculated the cost of attending the cheapest in state school (assuming I can get admitted) and I would graduate with roughly $350K-$450K of debt, and upon further specializing it would be closer to $600K-$700K, on top of the lost income, which makes pursuing dentistry an unwise financial investment. My idea was to continue trying to build some businesses to pay it off since I still need 1-2 years to finish the pre-requisites and if I can save up a cash pile of $100K - $200K it wouldn’t be as bad, especially if I invest some of the money so I can earn interest as I work through dental school. Regardless, I still have 1-2 years of pre-requisites before I can make a decision on any of these careers. I’m leaning mostly towards dentistry to open up a small private practice, but I think the anesthesiology path is interesting because you can work as a contractor and the idea of setting my own hours and still making a decent amount of money is great.

Any advice or guidance?

 

[schmoob]

Go for CRNA or Dental Hygienist. CRNAs make great money and is better quality of life. You won’t have the dental school debt.

 

[Rush_motion]

Go for CRNA or Dental Hygienist. CRNAs make great money and is better quality of life. You won’t have the dental school debt.

Personally I’d rather be a dentist with a military scholarship than to be a hygienist or crna. Or I’d be a cop making close to or more than 300 k a year with overtime pay.

 

[softwaredentist]

Go for CRNA or Dental Hygienist. CRNAs make great money and is better quality of life. You won’t have the dental school debt.

What if I can save up and pay off the debt as soon as I graduate?

 

[ChalkyMilk]

If you can pay off the debt then going dental isn't a bad option. Competition is easier in rural areas compared to big name cities. If possible, choose a cheap state school or military HPSP.

 

[2TH MVR]

I would consider the CRNA route. As you said. Less debt. Faster to obtain. Good money.

With all these Corporate Dental Groups .... opening a private dental office is becoming harder and harder. It can be done, but when you consider the debt to become a dentist and then to buy/build a private practice. Lots of stress.

 

[JacquesVallee]

Do not do dentistry unless you're doing HPSP.

 

[SuxDrugs&Rocuronium]

I would consider the CRNA route. As you said. Less debt. Faster to obtain. Good money.

With all these Corporate Dental Groups .... opening a private dental office is becoming harder and harder. It can be done, but when you consider the debt to become a dentist and then to buy/build a private practice. Lots of stress.

Is it faster though? Going back for a BSN, 1+ year ICU experience and then 2-3 CRNA school? And then be working in a hospital for the rest of your career?

 

[mangler]

Is it faster though? Going back for a BSN, 1+ year ICU experience and then 2-3 CRNA school? And then be working in a hospital for the rest of your career?

Forreal. Do all the people recommending CRNA know how it works? You have to do all the prerequisites for nursing school, complete nursing school, work as an ICU nurse possibly for multiple years, before even applying to competitive CRNA school.

Although I will say there are plenty of lucrative outpatient options for CRNA like GI, optho, OMFS, etc.

 

[Rush_motion]

Forreal. Do all the people recommending CRNA know how it works? You have to do all the prerequisites for nursing school, complete nursing school, work as an ICU nurse possibly for multiple years, before even applying to competitive CRNA school.

Although I will say there are plenty of lucrative outpatient options for CRNA like GI, optho, OMFS, etc.

Most of those who recommend are general dentists looking plainly at numbers and have never seen them work.

I would personally choose crna over AA because the recertification is less often. There is also more autonomy with being a crna than AA.
However I’d strongly choose neither.
You’re treated exactly like what your title is - a nurse or assistant.

Furthermore what happens if you don’t become a crna? It’s competitive. Are you okay being a floor male nurse ?

To the OP - Is grad school AI not an option for you ? I have a good friend who has made a ton of money doing AI.

 

[Molar Whisperer]

CRNA can be an unpredictable route since only a small percentage gets selected similar to OMFS, and top medical specialties. Since most of your software industries are located in exciting, high COL areas, dentistry will be unsustainably saturated there. If dentistry is my only option and I'm not of a minority group, I would establish state residency in a cheap, Red, MAGA state with a dental school and apply there. Try to get the least amount of loans possible. From my observations, the young generation may not understand how debt really cripples and believe that is the only way since all their peers are in the same boat. After Dental School, practicing in the least saturated areas may make the most career sense since you eat what you kill. Unfortunately living in those areas especially if you like ethnic foods, and have a family can be miserable. I should know, I grew up in that kind of area.

 

[SuxDrugs&Rocuronium]

CRNA can be an unpredictable route since only a small percentage gets selected similar to OMFS, and top medical specialties. Since most of your software industries are located in exciting, high COL areas, dentistry will be unsustainably saturated there. If dentistry is my only option and I'm not of a minority group, I would establish state residency in a cheap, Red, MAGA state with a dental school and apply there. Try to get the least amount of loans possible. From my observations, the young generation may not understand how debt really cripples and believe that is the only way since all their peers are in the same boat. After Dental School, practicing in the least saturated areas may make the most career sense since you eat what you kill. Unfortunately living in those areas especially if you like ethnic foods, and have a family can be miserable.

This probably isn’t what you meant by only a small number may be selected but just want to clarify that CRNA competitiveness =/= OMFS omfs or any medical specialty competitiveness

 

[schmoob]

Personally I’d rather be a dentist with a military scholarship than to be a hygienist or crna. Or I’d be a cop making close to or more than 300 k a year with overtime pay.

The cop thing is a good deal. No tuition, great money earlier on and if you put on Sgt within a few years you make even better money. Great benefits and a pension.

Honestly if you want to really map it out, join the military as an officer for 20 years and retire. Then become a cop for 20 years and then retire. Then collect 2-4 passive sources of income until you die and enjoy your golden years.

If I didn’t become a dentist I would’ve stayed in the Navy and chosen this path

 

[New_Vegas]

The cop thing is a good deal. No tuition, great money earlier on and if you put on Sgt within a few years you make even better money. Great benefits and a pension.

Honestly if you want to really map it out, join the military as an officer for 20 years and retire. Then become a cop for 20 years and then retire. Then collect 2-4 passive sources of income until you die and enjoy your golden years.

If I didn’t become a dentist I would’ve stayed in the Navy and chosen this path

Working for 40 years sounds awful. Hopefully I can retire from dentistry after working 15 years or less. Trying to reach that 10M threshold as fast as possible so I can GTFO of this career.

 

[JacquesVallee]

Working for 40 years sounds awful. Hopefully I can retire from dentistry after working 15 years or less. Trying to reach that 10M threshold as fast as possible so I can GTFO of this career.

How's your practice going, man? Really hoping things work out for you.

 

[Torshammer]

Working for 40 years sounds awful. Hopefully I can retire from dentistry after working 15 years or less. Trying to reach that 10M threshold as fast as possible so I can GTFO of this career.

How did you come to that figure of 10M in order to retire? Just curious.

 

[New_Vegas]

How's your practice going, man? Really hoping things work out for you.

Grew it a little bit too fast. Created a monster.

 

[New_Vegas]

How did you come to that figure of 10M in order to retire? Just curious.

400k per year in income based on 4% rule. Yes I know that's overly simplistic and a little conservative on withdrawal rate

 

[schmoob]

Working for 40 years sounds awful. Hopefully I can retire from dentistry after working 15 years or less. Trying to reach that 10M threshold as fast as possible so I can GTFO of this career.

I have to work. Not just for the money but for purpose. I’m kind of like a German Shepherd. Without a job to do I can become destructive. Either that or I’ll just sit around sedentary and watch TV until I die.
I’ll probably spend my golden years working part time or be just another 80 year old clinical faculty just to get out of the house.

 

[2TH MVR]

400k per year in income based on 4% rule. Yes I know that's overly simplistic and a little conservative on withdrawal rate

WOW. You plan on living extravagantly. Good for you. You can still live a great life with less than 10M.

 

[schmoob]

WOW. You plan on living extravagantly. Good for you. You can still live a great life with less than 10M.

Nothing wrong with that😁
We shouldn’t live to work
We should work to live.

 

[JacquesVallee]

I have to work. Not just for the money but for purpose. I’m kind of like a German Shepherd. Without a job to do I can become destructive. Either that or I’ll just sit around sedentary and watch TV until I die.
I’ll probably spend my golden years working part time or be just another 80 year old clinical faculty just to get out of the house.

I know a former general dentist who after he sold his practice and retired was so bored he worked as a cashier.

 

[Life of Pablo]

For anyone recommending CRNA, you just don’t understand. Seriously. Do NOT go to nursing school to become a CRNA. Being a nurse is NOT fun. No offense. I’m OMS. I see all the new grad nurses wanting to becoming CRNAs on the ICU floors in the hospital and it SUCKS. If you can become a general dentist, do it. Way better than the CRNA route. Wayyyyy better. Income potential and autonomy as a general dentist beats anything a CRNA can do.

If you still fidn that you’re in love with anesthesia while in dental school, then you can do dental anesthesiology….or better yet, OMS 😀

 

[Rush_motion]

For anyone recommending CRNA, you just don’t understand. Seriously. Do NOT go to nursing school to become a CRNA. Being a nurse is NOT fun. No offense. I’m OMS. I see all the new grad nurses wanting to becoming CRNAs on the ICU floors in the hospital and it SUCKS. If you can become a general dentist, do it. Way better than the CRNA route. Wayyyyy better. Income potential and autonomy as a general dentist beats anything a CRNA can do.

If you still fidn that you’re in love with anesthesia while in dental school, then you can do dental anesthesiology….or better yet, OMS 😀

Yeah if cost of tuition is a concern just to the military scholarship. Come out with no debt.
From what I’m told the military service is super relaxed.
The GPs do anything to get out of treating patients and do minimal work while they have to fulfill their commitment. There is zero incentive to work hard.

 

[charlestweed]

Working for 40 years sounds awful. Hopefully I can retire from dentistry after working 15 years or less. Trying to reach that 10M threshold as fast as possible so I can GTFO of this career.

There are not a lot of jobs out there that enable you to save $10M with just 15 years of working. If you can accomplish this in 15 years, you easily belong to the top 1% income earning group. I had worked 6 days/wk for 20 years straight (from age 29-49) and I wasn't able to save that much. Until now, at 54, I still have to work 4 days/wk to pay for my kid's med school education, my health insurance, property taxes etc. Dentistry, especially your field (orthodontics), is a great career, isn't it? I wonder why you hate dentistry so much and think that it was a mistake to go into this field.

 

[charlestweed]

WOW. You plan on living extravagantly. Good for you. You can still live a great life with less than 10M.

I agree. But if you have kids and want to save for them, pay for their expensive college and professional school education, and help them with a down payment on their first house (because with today's crazy home prices, young people can't afford to buy one) etc, then you will need at least $10M.

 

[charlestweed]

I know a former general dentist who after he sold his practice and retired was so bored he worked as a cashier.

When I am older, I'd rather work 1-2 days/wk as a dentist than as a cashier. Being a dentist, no one (including my boss) can tell me what to do. I can work as much or as little as I want. Unlike a cashier, I don't have to clock in, clock out nor have to wait for the boss to tell me when I can take a 15-minute break.

Practicing dentistry is fun when you don't need the money....when you don't have any more debt to pay back. If an unreasonable patient yells at me or threatens to sue me or file a board complaint on me....go ahead, sue me, I don't care. I used to be afraid of these things. But now with no debt, I don't care. I've always tried to do my best to take care of my patients. It's very rewarding when you turn an ugly smile into a beautiful one. People have hugged me all the time when I took off their braces. People cried (because of joy) when my wife replaced their missing teeth with implants.

 

[gryffindor]

This path is a grind. I own 2 private practices in stupid competitive areas. I still like teeth and ortho. However, people have gone off the rails. The advent of the Internet, social media, and now these AI searches has made everyone an expert. This has only gotten worse as I've progressed in my career. Often I'm having to fight their internet knowledge to prove why I, the actual expert who has been studying teeth for 26 years, am correct and that is exhausting. Once I had to tell a dad that the reason my opinion didn't agree with all the internet research his teen was doing on her case is because I'm so busy actually dealing with patient care and finances + raising some kids of my own, I don't have time to create and post cute, esthetic videos of my opinions & expertise on social media!

Anyways, I had to contemplate leaving dentistry about 10 years ago due to some bad personal health stuff. That's when I realized there are only 2 paths available to me to make money no matter what industry I am in - I can either be an employee for someone or I can be the business owner. That's it. I seriously considered leaving to return to school and study something else but ultimately decided to remain as a business owner in dentistry. You mentioned you started 3 businesses and failed. Why? What happened? Going into private practice will just be running another business but the stakes for failing will be soul crushing because of the high loans to go through dental school + open/buy a private practice.

There is a real need in dentistry for setting up and maintaining computers. Is that a business you could do with your existing knowledge? I recently had a new server put in and don't understand a single thing of how it was done and how we moved off the new server. All I know is I paid for it. Whenever my staff have questions about why their printer or computer is acting this way or that, I have the office manager contact the local-ish IT firm that handle these things for me. I have no interest in learning about computers but I cannot function without the several that I own either. I'm not even into 3D printing yet because I can't manage yet another IT component to this business. Gone are the days when offices operated like how charlestweed still operates - a little bit of digital and a lot more paper and plaster. Almost every dental office needs an IT department to manage their existing and future hardware and keep up with software changes etc. AI can't do that.

 

[softwaredentist]

This path is a grind. I own 2 private practices in stupid competitive areas. I still like teeth and ortho. However, people have gone off the rails.

Yeah, but people have gone off the rails in society in general, it’s the same in other professions. Employers now juice employees and except them to kiss their ass. At least you have the prestige, respect, job security, and income that comes with being a healthcare provider. And I imagine that you don’t need to relocate because you can’t really be laid off since you have so much work. Not a bad problem to have. I promise you, being unemployed with no money and having to constantly relocate around the country is a lot more stressful than having control over your own destiny. Also, kissing corporations asses to keep your job sucks.

That's when I realized there are only 2 paths available to me to make money no matter what industry I am in - I can either be an employee for someone or I can be the business owner. That's it.

Yes, except being a business owner for most businesses suck because you are competing against tons of people.

You mentioned you started 3 businesses and failed. Why? What happened?

There is a real need in dentistry for setting up and maintaining computers. Is that a business you could do with your existing knowledge?

All my businesses failed very quickly because I am learning what the market values and what businesses are too competitive.
One of the businesses I failed at was actually trying to start up an IT MSP for dentists, exactly the problems you’re discussing. IT MSP is overcrowded and will only get worse with AI and outsourcing. Imagine an AI doing everything you can do but much better and reducing demand for your profession entirely. I’m not interested in continuing that path.

I’m curious since you own 2 private practices in a competitive area, can’t you just find new grads, train them, and have them work while you manage the operation? Sounds like you are sitting on a gold mine. You don’t even need to practice as much, just come check their work to make sure they’re doing a good job and train them, then once they quit and leave just go back and hire more.

 

[softwaredentist]

When I am older, I'd rather work 1-2 days/wk as a dentist than as a cashier. Being a dentist, no one (including my boss) can tell me what to do. I can work as much or as little as I want. Unlike a cashier, I don't have to clock in, clock out nor have to wait for the boss to tell me when I can take a 15-minute break.

Practicing dentistry is fun when you don't need the money....when you don't have any more debt to pay back. If an unreasonable patient yells at me or threatens to sue me or file a board complaint on me....go ahead, sue me, I don't care. I used to be afraid of these things. But now with no debt, I don't care. I've always tried to do my best to take care of my patients. It's very rewarding when you turn an ugly smile into a beautiful one. People have hugged me all the time when I took off their braces. People cried (because of joy) when my wife replaced their missing teeth with implants.

Yeah it’s a beautiful career and profession. The problem is having excessive debt, then you are enslaved for life. Starting up a clinic costs money, you have to pick the right area, and you have to have the initial training in the first place which requires 1-2 years of work as an associate dentist, and if you have $600K of debt when you start practicing, you’re looking at 10 years to pay off that debt operating at a massive volume of patients a day. It’s risky because if you don’t have patients or the area becomes oversaturated, your debts will eat you alive.

 

[softwaredentist]

Grew it a little bit too fast. Created a monster.

Hey New_Vegas, I’m curious how long ago did you graduate from your ortho residency? What’s the story behind you setting up your practice? Like did you get a loan out of school or just start it from scratch, associate for a couple years and then buy one? I am very interested in orthodontistry, but I feel like it’s oversaturated in urban areas. I don’t see how I would be able to pay off debts of dental school that reach $600K-$700K starting off as an ortho if I still need to get into dental school. This is why I would likely have to do the military scholarship if I decide to go down this path of dental school.

 

[charlestweed]

Yeah it’s a beautiful career and profession. The problem is having excessive debt, then you are enslaved for life. Starting up a clinic costs money, you have to pick the right area, and you have to have the initial training in the first place which requires 1-2 years of work as an associate dentist, and if you have $600K of debt when you start practicing, you’re looking at 10 years to pay off that debt operating at a massive volume of patients a day. It’s risky because if you don’t have patients or the area becomes oversaturated, your debts will eat you alive.

Dental education is indeed expensive. DDS/DMD is probably the most expensive degree. Because it’s so expensive and so long, I often tell many young kids (many of them are my ortho patients, who want to become an orthodontist) to choose the cheapest no name local public college for their undergrad study. They should live with their parents and try to earn a BS degree debt free. They should apply for dental school ASAP and don’t take any gap year etc. Sadly, most young 18 yo HS kids (including my own kids) don’t take my advice. They want to go to famous (and super expensive) undegrad colleges like USC, Duke, UPenn and move as far away from their parents as possible.

If you want to pursue dentistry, be prepare to work 6 days/wk for the first couple of years….be prepared to live a like a student for a few years after graduation. If you are not willing to do so, then I think you should pursue another career as some of the above poster suggested. We (both my wife and I) graduated 25+ years ago with much less debt (only $450k combine debt) than today new grads. And yet, we both still had to work 6 days/wk right after graduation. My wife stopped working 6 days after we had our 2 children. But I had worked 6 days/wk for 20 years straight (from ages 29-49) because I hated debt …because I wanted to pay all my loans off ASAP…..and because I didn’t want to live like a student and wanted to have a nice doctor’s lifestyle. My sister, who’s a general dentist, worked 7 days/week when she opened her office from scratch….worked Sat and Sundays at her own office and 4 days/wk for a dental corp office.

At least dentistry offers you job stability and good income that allows you to pay back the debt. I’d rather be a dentist with $500k debt than having a BS degree in History or Music with under $100k debt. Don't worry about not having enough patients to work on. You will always have enough patients to keep yourself busy if you are willing to travel to work at more than one office. The question is how hard are you willing to work?

Since you have lived on your own and worked in the real world for a few years, I am sure you know by now that things (rent, grocery, utility, insurance, gas price etc) are getting more and more expensive and that having a good stable job is important. You know how hard it is to find a good paying job. You know how hard it is to start a business. Many young college students (including my own kids), who are living on borrowed (or their parent’s) money, don’t have the kind of experience that you have. You are way ahead of them in this regard. I think you will be fine.

 

[JacquesVallee]

I’d rather be a dentist with $500k debt than having a BS degree in History or Music with under $100k debt.

I wouldn't want to be in either of these situations. Both are terrible.

 

[schmoob]

At least you have the prestige, respect, job security, and income that comes with being a healthcare provider.

I think you have a romanticized idea of dentistry. The prestige and respect mean nothing. Like who cares what other people think of my job?
Don’t overestimate the job security either. I’ve been fired a bunch of times. Especially with corporate and PE in dentistry, you will get fired in a heartbeat. You are expendable and are valued less than a hygienist.
If you really want to change careers, I strongly urge you to look into a trade like electrition, plumber, pipe fitter. No debt and you’re making money right away

 

[charlestweed]

I wouldn't want to be in either of these situations. Both are terrible.

At least a dentist can make several millions ($4-5M for an average associate dentist…..and the sky’s the limit for an owner dentist with great business skill) in a span of 30-40 years of practicing. This should be enough for him/her to pay back his/her debt obligations + own a decent house (or a condo in HCOL area) + have some $$$ in the Roth and other retirement accounts. If a dentist can’t make $4-5M in his life time, there must be something wrong with his clinical skill, or his work ethic, or his physical health, which prevents him from working.

Yes, $500k debt is a lot. Sometimes having some debt is not a bad thing. Facing adversity (student loan debt, working for an unreasonable boss, traveling long distance to work etc) in life actually helps increase one's chance at success. Debt forces a dentist to run a lean and mean low overhead office. Debt motivates a dentist to work harder so he can get out of debt faster. And hard work (higher patient volume, more complex procedures) helps the dentist improve his clinical skills/ learn new skills, which enable him to produce more. Being a specialist, I have opportunities to work with a lot of general dentists. The super dentists….the ones who can perform complex procedures (implants, 3rd molar exts, endos, perio surgeries etc) are usually the hard working ones.

Last week my wife sent her former boss a text asking how his son, who recently graduated from dental school, was doing at the practice. And this was what he said about his son to my wife: “Lazy”. “He doesn’t want to work hard and he’s on vacation right now.” My wife’s former boss is a GP, who currently owns a very busy practice that employs traveling OS, pedo, perio, ortho, and endo. After Covid, he expanded by buying a $2.2M office building. My wife met her former boss at a dental office, where they worked together as associate dentists. He was a recent grad working 6 days a week. My wife was still a perio resident and she moonlighted there. When he was ready to open his own practice, he asked my wife to come work for him as an in-house perio.

 

[New_Vegas]

Hey New_Vegas, I’m curious how long ago did you graduate from your ortho residency? What’s the story behind you setting up your practice? Like did you get a loan out of school or just start it from scratch, associate for a couple years and then buy one? I am very interested in orthodontistry, but I feel like it’s oversaturated in urban areas. I don’t see how I would be able to pay off debts of dental school that reach $600K-$700K starting off as an ortho if I still need to get into dental school. This is why I would likely have to do the military scholarship if I decide to go down this path of dental school.

I worked for less than a year as an associate then bought a practice. I bought the practice a little over two years ago. It was a small practice with a high overhead in a saturated major metropolitan city. It was what was available to me through a connection, so I just went for it. The first year was tough. I could hardly pay myself. So much of the money was just going to the bank. I was so sick and tired of being poor. So, I dedicated myself to learning business. I went to every conference imaginable. Ever spare second I had I was learning about how I could attract more patients to my business and how I could grow the practice. I had to fire some of the old doc's staff (they didn't want to work hard), and the others quit themselves. Good. I have all new staff I hired now. With my own staff, I am met with zero resistance. With new staff, the practice started to grow. It grew at an insane rate, that I didn't even know was possible. I was working more than 80 hours per week. Most of that time was me working behind the scenes, on the practice. I rehauled everything in the practice. All of the old systems that the previous doc had were garbage. I changed everything. Including the building, getting better equipment, etc.

I studied the competition. I figured out what the office were doing around me, and what I could do to be better than them. Then, I executed. I put a lot of budget into marketing. Went to local community events. Sponsored events. Held a megaphone to the public saying "hey, we exist".

Last month, July, I had 198 new patient exams. You know how many exams I had in all of 2024? 205. By mid April of this year, I had more starts than I had in all of 2024, the year that I took over. When I took over, we were seeing about 20 patients per day. Now, we're seeing over 80. We're probably in the top 5% or higher of production for all orthodontic offices in the country. I don't really know how we grew so fast, but it was probably some combination of luck, hard work, and figuring out what my community needed.

Today I started 8 new cases and only finished one. That worries me a little bit. I don't know how I'm going to be able to see all these patients in 12 months from now, when these starts accumulate. I'm probably going to have to hire an associate. That's not something I ever wanted to do. I have a knack for business, but I'm not the best at managing people. I have to hire people to help me with that. That's why I'm not thrilled about getting an associate.

I don't think I could replicate this same success again if I tried. Likewise, as soon as it has come, it could easily go. That's business. It's cutthroat out there. Especially with ortho nowadays. If I knew then, what I know now, I would not choose this path again. I've probably aged 8 years in these past two years.

I don't recommend anybody going into dentistry and becoming an owner if you don't have an entrepreneurial spirit. Its more business than it is dentistry. One thing that has helped me grow so much was that I figured out that other orthodontists aren't very good at business. There's an online orthodontic startup group that I'm a part of. Many orthodontists who do startups only have one chairside assistant after 2 years, working maybe one or two days per week. They certainly aren't making enough to pay themselves at that rate. I've seen others saying that they are on the verge of failing, because they have ran out of working capital, and are unable to make enough revenue to pay their bills and pay back their loans. I think a lot of those people who did startups probably shouldn't have, due to lack of business acumen.

It is SO much easier to just show up to work as an employee, do your work, then go home. Having a business is so much harder than that. That's why I recommend people go into higher paying fields, like oral surgery, over orthodontics. That way you don't feel like you have to be a business owner to be successful. Also, I recommend people go into medicine over dentistry for that same reason. Easier to get a higher paying job working as an employee. The only doctors that make less money than dentists are the primary care fields in medicine, pretty much everyone else makes more as a doctor. So that's why I say go that route.

I want to get out of the field as soon as possible because all the stuff that goes into running a business kinda sucks. I'd rather be on a golf course, or on a beach somewhere. I don't care, I could be fine doing nothing, unlike some people. Good for you Schmoob, I'm glad you find fulfillment in your work. Maybe when I retire, I will be bored, I don't know. All I know is that I can't see myself doing this for much longer than 10-15 more years.

 

[Bentley242]

I worked for less than a year as an associate then bought a practice. I bought the practice a little over two years ago. It was a small practice with a high overhead in a saturated major metropolitan city. It was what was available to me through a connection, so I just went for it. The first year was tough. I could hardly pay myself. So much of the money was just going to the bank. I was so sick and tired of being poor. So, I dedicated myself to learning business. I went to every conference imaginable. Ever spare second I had I was learning about how I could attract more patients to my business and how I could grow the practice. I had to fire some of the old doc's staff (they didn't want to work hard), and the others quit themselves. Good. I have all new staff I hired now. With my own staff, I am met with zero resistance. With new staff, the practice started to grow. It grew at an insane rate, that I didn't even know was possible. I was working more than 80 hours per week. Most of that time was me working behind the scenes, on the practice. I rehauled everything in the practice. All of the old systems that the previous doc had were garbage. I changed everything. Including the building, getting better equipment, etc.

Congrats to all of your hard work paying off.

I am wondering, after going through all of that and changing the processes and everything, whether you think it would have been better for you to have just started your own practice from scratch rather than buying one?

 

[softwaredentist]

I worked for less than a year as an associate then bought a practice. I bought the practice a little over two years ago. It was a small practice with a high overhead in a saturated major metropolitan city. It was what was available to me through a connection, so I just went for it. The first year was tough. I could hardly pay myself. So much of the money was just going to the bank. I was so sick and tired of being poor. So, I dedicated myself to learning business. I went to every conference imaginable. Ever spare second I had I was learning about how I could attract more patients to my business and how I could grow the practice. I had to fire some of the old doc's staff (they didn't want to work hard), and the others quit themselves. Good. I have all new staff I hired now. With my own staff, I am met with zero resistance. With new staff, the practice started to grow. It grew at an insane rate, that I didn't even know was possible. I was working more than 80 hours per week. Most of that time was me working behind the scenes, on the practice. I rehauled everything in the practice. All of the old systems that the previous doc had were garbage. I changed everything. Including the building, getting better equipment, etc.

I studied the competition. I figured out what the office were doing around me, and what I could do to be better than them. Then, I executed. I put a lot of budget into marketing. Went to local community events. Sponsored events. Held a megaphone to the public saying "hey, we exist".

Last month, July, I had 198 new patient exams. You know how many exams I had in all of 2024? 205. By mid April of this year, I had more starts than I had in all of 2024, the year that I took over. When I took over, we were seeing about 20 patients per day. Now, we're seeing over 80. We're probably in the top 5% or higher of production for all orthodontic offices in the country. I don't really know how we grew so fast, but it was probably some combination of luck, hard work, and figuring out what my community needed.

Today I started 8 new cases and only finished one. That worries me a little bit. I don't know how I'm going to be able to see all these patients in 12 months from now, when these starts accumulate. I'm probably going to have to hire an associate. That's not something I ever wanted to do. I have a knack for business, but I'm not the best at managing people. I have to hire people to help me with that. That's why I'm not thrilled about getting an associate.

I don't think I could replicate this same success again if I tried. Likewise, as soon as it has come, it could easily go. That's business. It's cutthroat out there. Especially with ortho nowadays. If I knew then, what I know now, I would not choose this path again. I've probably aged 8 years in these past two years.

I don't recommend anybody going into dentistry and becoming an owner if you don't have an entrepreneurial spirit. Its more business than it is dentistry. One thing that has helped me grow so much was that I figured out that other orthodontists aren't very good at business. There's an online orthodontic startup group that I'm a part of. Many orthodontists who do startups only have one chairside assistant after 2 years, working maybe one or two days per week. They certainly aren't making enough to pay themselves at that rate. I've seen others saying that they are on the verge of failing, because they have ran out of working capital, and are unable to make enough revenue to pay their bills and pay back their loans. I think a lot of those people who did startups probably shouldn't have, due to lack of business acumen.

It is SO much easier to just show up to work as an employee, do your work, then go home. Having a business is so much harder than that. That's why I recommend people go into higher paying fields, like oral surgery, over orthodontics. That way you don't feel like you have to be a business owner to be successful. Also, I recommend people go into medicine over dentistry for that same reason. Easier to get a higher paying job working as an employee. The only doctors that make less money than dentists are the primary care fields in medicine, pretty much everyone else makes more as a doctor. So that's why I say go that route.

I want to get out of the field as soon as possible because all the stuff that goes into running a business kinda sucks. I'd rather be on a golf course, or on a beach somewhere. I don't care, I could be fine doing nothing, unlike some people. Good for you Schmoob, I'm glad you find fulfillment in your work. Maybe when I retire, I will be bored, I don't know. All I know is that I can't see myself doing this for much longer than 10-15 more years.

It sounds like you went into dentistry thinking that all you would have to do is sit in a chair and treat patients, and you didn’t realize that you would be required to do all the other stuff like marketing, sales, managing staff, hiring, accounting, software, making huge decisions, etc. I’m going into dentistry not only because I think it could be an interesting and rewarding career. I definitely plan on specializing, but even just owning a general dentist practice could be a good idea. I’m going into dentistry because I’m also interested in the business aspect.

The problem is I’m in my late 20s. I wouldn’t be a full dentist until my mid to late 30s. If I work for 1-2 years to associate to learn the ropes and then start up my own practice I would be in my 40s, and I don’t know how feasible that is to start up my own clinic at 40. It might be better to just not specialize and do a general dentistry office so I can start up my own practice in my mid 30s, and in the meantime try to accumulate as much cash as possible to not graduate with any debt.

 

[softwaredentist]

At least a dentist can make several millions ($4-5M for an average associate dentist…..and the sky’s the limit for an owner dentist with great business skill) in a span of 30-40 years of practicing. This should be enough for him/her to pay back his/her debt obligations + own a decent house (or a condo in HCOL area) + have some $$$ in the Roth and other retirement accounts. If a dentist can’t make $4-5M in his life time, there must be something wrong with his clinical skill, or his work ethic, or his physical health, which prevents him from working.

Yes, $500k debt is a lot. Sometimes having some debt is not a bad thing. Facing adversity (student loan debt, working for an unreasonable boss, traveling long distance to work etc) in life actually helps increase one's chance at success. Debt forces a dentist to run a lean and mean low overhead office. Debt motivates a dentist to work harder so he can get out of debt faster. And hard work (higher patient volume, more complex procedures) helps the dentist improve his clinical skills/ learn new skills, which enable him to produce more. Being a specialist, I have opportunities to work with a lot of general dentists. The super dentists….the ones who can perform complex procedures (implants, 3rd molar exts, endos, perio surgeries etc) are usually the hard working ones.

Last week my wife sent her former boss a text asking how his son, who recently graduated from dental school, was doing at the practice. And this was what he said about his son to my wife: “Lazy”. “He doesn’t want to work hard and he’s on vacation right now.” My wife’s former boss is a GP, who currently owns a very busy practice that employs traveling OS, pedo, perio, ortho, and endo. After Covid, he expanded by buying a $2.2M office building. My wife met her former boss at a dental office, where they worked together as associate dentists. He was a recent grad working 6 days a week. My wife was still a perio resident and she moonlighted there. When he was ready to open his own practice, he asked my wife to come work for him as an in-house perio.

I’m fine with a small amount of debt, but when the debt is $600K, you are raising a family, and dental associate pay is like $120K, this is not a situation I would want to get into. The sheer stress would probably kill me. The max I’m comfortable with would be graduating with something like $200K debt and paying it off after a year or two of working. So I’m trying to figure out how I could save up money to graduate dental school without any debt.
$600K is insane. Without even factoring in compounding interest, I would have to make 120 installments of 5,000$+.

 

[JacquesVallee]

The max I’m comfortable with would be graduating with something like $200K debt and paying it off after a year or two of working.

This is wise. However, you won't pay off 200k in a "year or two". Plan for five years at least, if you pay it off faster, great, but it's much harder than you realize.

It sounds like you went into dentistry thinking that all you would have to do is sit in a chair and treat patients, and you didn’t realize that you would be required to do all the other stuff like marketing, sales, managing staff, hiring, accounting, software, making huge decisions, etc. I’m going into dentistry not only because I think it could be an interesting and rewarding career. I definitely plan on specializing, but even just owning a general dentist practice could be a good idea. I’m going into dentistry because I’m also interested in the business aspect.

Everybody goes into dentistry thinking they are going to own, myself included. I realized I don't have it in me to be an owner. Luckily, my debt load was low, and I was able to pay off my loans working as an associate. If I had to guess, in my class, maybe 10% now own? Very small percentage. Odds are, you won't but of course as a pre-dent you'll tell yourself you will.

 

[charlestweed]

I’m fine with a small amount of debt, but when the debt is $600K, you are raising a family, and dental associate pay is like $120K, this is not a situation I would want to get into. The sheer stress would probably kill me. The max I’m comfortable with would be graduating with something like $200K debt and paying it off after a year or two of working. So I’m trying to figure out how I could save up money to graduate dental school without any debt.
$600K is insane. Without even factoring in compounding interest, I would have to make 120 installments of 5,000$+.

Unfortunately, the total cost of attendance is over $500k for most dental schools.....unless you're a Texas resident and attend a dental school in Texas. It'll be a lot more than $5000/month for $600k debt. My wife and I owed $450k and our monthly repayment amount was around $5500. This wasn't an issue for us because we had 2 doctor's incomes in our household.

You're right, with an associate income of $120k/yr (and if you plan to work this way for the rest of your life....no job change, no practice ownership), it will not be enough. I think you know the answer to your own question. There's no point of wasting your time and money on taking prerequisite classes now if you think dentistry is too expensive for you. If you plan to get married and have kids, having a single income in a household will not be enough. Kids are expensive. Financial stress is one of the leading causes of divorce.

 

[New_Vegas]

It sounds like you went into dentistry thinking that all you would have to do is sit in a chair and treat patients, and you didn’t realize that you would be required to do all the other stuff like marketing, sales, managing staff, hiring, accounting, software, making huge decisions, etc. I’m going into dentistry not only because I think it could be an interesting and rewarding career. I definitely plan on specializing, but even just owning a general dentist practice could be a good idea. I’m going into dentistry because I’m also interested in the business aspect.

The problem is I’m in my late 20s. I wouldn’t be a full dentist until my mid to late 30s. If I work for 1-2 years to associate to learn the ropes and then start up my own practice I would be in my 40s, and I don’t know how feasible that is to start up my own clinic at 40. It might be better to just not specialize and do a general dentistry office so I can start up my own practice in my mid 30s, and in the meantime try to accumulate as much cash as possible to not graduate with any debt.

You can do whatever you want. If you would be starting that late, I don’t think it would be worth it. You're going to have more debt than you realize, and everything is going to be a lot harder than you realize. Good luck.

 

[JacquesVallee]

Yes, $500k debt is a lot. Sometimes having some debt is not a bad thing.

For your median dental graduate, it is financially devastating. Yes, *insert anecdote about a USC grad who picked himself up by his bootstraps to pay off his 700k of dental student loans by eating rice and beans and living in a dental office working 7 days a week for 10 years* but we have to talk to the median dental graduate. Frankly, I'm not willing to work 6 days a week as a dentist. Too physically and emotionally exhausting. Dentistry is a hard job.

And this was what he said about his son to my wife: “Lazy”.

Really gross to bash your son like that to somebody. How dare he have the audacity to take a vacation after grinding in school for his entire life! But again, this is just an anecdote. Boomers like to pretend their wealth comes from their hard work when the dental landscape has changed drastically for the worse in the last 20 years. Every study shows the decline of dentistry. It's undeniable.

 

[charlestweed]

For your median dental graduate, it is financially devastating. Yes, *insert anecdote about a USC grad who picked himself up by his bootstraps to pay off his 700k of dental student loans by eating rice and beans and living in a dental office working 7 days a week for 10 years* but we have to talk to the median dental graduate. Frankly, I'm not willing to work 6 days a week as a dentist. Too physically and emotionally exhausting. Dentistry is a hard job.

Fair enough. I’ve told many predents (we’re currently helping 3 of them to get in) to be prepared to work 6 days/wk if they plan to take out $5-600k loans. If they are not willing to do so, then they shouldn’t pursue this field. Either work like that or learn to become a good (and fast) clinician who can perform complex procedures, which allow him/her to work less with higher pay. Gotta make good income in order to deal with the massive amount of student loan debt, which cannot be discharged by filing a bankruptcy. This debt will stay with you forever, unless you pay it off, become disable, or die.

My friend, who's a GP, is currently working as a traveling exodontist. He doesn’t have his own office but because of his surgical skill, he makes a lot more than many practice owners (including myself) out there. For him to get to this skill level, he had to work very hard.....like working 6-7 days a week. He’s a nontraditional student. He got his DDS in his mid 30s. He is now in his late 50s....still working very hard.

Really gross to bash your son like that to somebody. How dare he have the audacity to take a vacation after grinding in school for his entire life! But again, this is just an anecdote. Boomers like to pretend their wealth comes from their hard work when the dental landscape has changed drastically for the worse in the last 20 years. Every study shows the decline of dentistry. It's undeniable.

Nah, we, “tiger” Asian parents, bash our kids to our friends all the time. But we are also very proud of our kids' accomplishments. We are very lucky that our kids are going to school, earn a professional degree and will have a stable career. A lot of kids at their age don't work, don't go to school, take gap years, and don't have any plan for their future. My wife's former boss got to bash his own son because he paid for his son’s dental education (3 yrs of tuition + living expenses at UOP were not cheap). He got to bash his own son because he, himself, used to work 6 days/wk….as soon as he got his dental license, he went straight to work….no vacation time. His kid is actually in a much better financial shape now than when he was at his kid’s age. The kid graduated from dental school with zero debt and he will inherit his dad’s successful dental practice.

 

[Rush_motion]

If they are not willing to do so, then they shouldn’t pursue this field. Either work like that or learn to become a good (and fast) clinician who can perform complex procedures, which allow him/her to work less with higher pay. Gotta make good income in order to deal with the massive amount of student loan debt, which cannot be discharged by filing a bankruptcy. This debt will stay with you forever, unless you pay it off, become disable, or die.

My friend, who's a GP, is currently working as a traveling exodontist. He doesn’t have his own office but because of his surgical skill, he makes a lot more than many practice owners (including myself) out there.

This is the problem with student loan debt and the pressure to produce. Instead of referring cases out to appropriate specialist providers, I see too often general dentists try to perform complex surgery and end up with complications. I’ve seen it all. The absolute worst is when general dentists and periodontist take a weekend course for iv sedation and end up with anesthesia complications.

I’m curious to know - this friend of yours Charles - does he offer IV sedation ? If yes would you allow him to sedate your kid in med school and have him remove his wisdom teeth ?

 

[charlestweed]

This is the problem with student loan debt and the pressure to produce. Instead of referring cases out to appropriate specialist providers, I see too often general dentists try to perform complex surgery and end up with complications. I’ve seen it all. The absolute worst is when general dentists and periodontist take a weekend course for iv sedation and end up with anesthesia complications.

I’m curious to know - this friend of yours Charles - does he offer IV sedation ? If yes would you allow him to sedate your kid in med school and have him remove his wisdom teeth ?

I don’t have any problem with GP's performing complex procedures, including complex ortho cases. If they are taking good care of their patients for much lower cost, this is a good thing. Like most traveling exodontists, my friend only uses local anesthesia to extract teeth. He doesn’t have an IV certificate. Before this, he was a managing dentist for a big corp office. During his time there, he learned how to extract teeth from an in-house surgeon by looking at the angulations of the impacted teeth. And then he looked at how these extracted teeth were sectioned. To be certified to become an exodontist, the corp office required him to book 6 patients and he had to perform the extractions under the observation of the corp’s OS. And he did exactly that. After he finished the second case, the OS told him that he had seen enough and granted him exodontist status. This wasn’t a formal certification….it’s just a requirement by the corp because they don't want any lawsuits. If you think working for big corp is unsafe, you’re wrong. It’s actually the opposite. Corp offices actually try to do a lot of things to avoid law suits. All of their informed consents are very well written by their lawyers. All of their assistants have the required license and only perform the duties that are allowed by the board.

After gaining enough extraction experience, my friend then quit working for the Corp office and became a full time traveling exodontist. Without IV sedation, he’s able to see a lot more patients than what an OS can. This friend of mine is also very good at endo (according to many of the dentists, whom he mentored). But he prefers extractions.

My former classmate/roommate is an OS. He took out my son’s third molars under local anesthesia. He’s semi-retire and no longer does IV sedation in his practice. I didn’t ask him why.

 

[2TH MVR]

I’ve landed upon the following paths from my research:
1. Certified Anesthesiologist Assistant (fast schooling, have most pre-reqs done, not too much debt burden, high income, but low ownership potential since I’d work in hospitals, and I would probably have to travel a lot)
2. Certified Registered Nurse Anesthetist (same as CAA - fast schooling, most pre-reqs done, not too much debt, high income, autonomy and flexible contracting).
3. Med school + specialty (anesthesiologist) - massive amount of study and sacrifice. The thought of med school actually terrifies me because it’s another 13-15 years of lost income and massive sacrifice until attending but once you finish you are practically irreplaceable in your job and guaranteed job security for life.
4. GP Dentist with possibility to specialize (minimum $500K of debt + 4 - 8 year timeline depending on whether I specialize) - offers ownership potential and high income, autonomy, but physically taxing.

What about a PA (Physician Assistant) ?

 

[JacquesVallee]

What about a PA (Physician Assistant) ?

Debt to income ratio isn't great, but otherwise a decent field. Also, like dentistry, is very saturated in desirable areas.

 

[New_Vegas]

This is the problem with student loan debt and the pressure to produce. Instead of referring cases out to appropriate specialist providers, I see too often general dentists try to perform complex surgery and end up with complications. I’ve seen it all. The absolute worst is when general dentists and periodontist take a weekend course for iv sedation and end up with anesthesia complications.

I’m curious to know - this friend of yours Charles - does he offer IV sedation ? If yes would you allow him to sedate your kid in med school and have him remove his wisdom teeth ?

I would NOT. Would definitely refer to an oral surgeon.

 

[softwaredentist]

This is the problem with student loan debt and the pressure to produce. Instead of referring cases out to appropriate specialist providers, I see too often general dentists try to perform complex surgery and end up with complications. I’ve seen it all. The absolute worst is when general dentists and periodontist take a weekend course for iv sedation and end up with anesthesia complications.

I’m curious to know - this friend of yours Charles - does he offer IV sedation ? If yes would you allow him to sedate your kid in med school and have him remove his wisdom teeth ?

That is all of healthcare now. Healthcare has become a joke because of debt and greed, you walk into any doctor's office and they want to get you on a procedure or recurring plan as soon as you walk in. God bless the honest doctors who don't go surgery happy on patients just to charge or meet quotas.