Field of dentistry with the best outlook

[D1Bound]

If you were to advise someone on a particular aspect of dentistry to go into purely based on job security and return on investment, what would you say?

---

Members don't see this ad.

 

[Molar Whisperer]

If you were to advise someone on a particular aspect of dentistry to go into purely based on job security and return on investment, what would you say?

Purely anecdotal, I haven't heard of many OMFSs struggle financially unless they have a divorce, law suit, or similar. ROI is hard to predict depending on how much your student loans are.

 

[D1Bound]

Purely anecdotal, I haven't heard of many OMFSs struggle financially unless they have a divorce, law suit, or similar. ROI is hard to predict depending on how much your student loans are.

I'm military so I would have the option to specialize while in service and not have to pay tuition for dental school or residency,

 

[yappy]

Oms or pediatrics

 

[Molar Whisperer]

I'm military so I would have the option to specialize while in service and not have to pay tuition for dental school or residency,

You're in better position than a lot of dentists with sky high loans. Military residency counts towards your retirement and after 20+ yrs of service, you can count on lifetime pension. My endodontic mentor triple dipped with Military, SS and his DMO pay.

 

[DavesNotHere]

Oms or pediatrics

Super speculation on my part...but i’d always be worried peds dental gets lumped into the more than likely expansion of m4a on the horizon.

 

[D1Bound]

Super speculation on my part...but i’d always be worried peds dental gets lumped into the more than likely expansion of m4a on the horizon.

What is M4A?

 

[Saddleshoes]

What is M4A?

Medicare For All

 

[yappy]

Super speculation on my part...but i’d always be worried peds dental gets lumped into the more than likely expansion of m4a on the horizon.

I don’t know too much about running a specialty pediatric office but Medicaid reimbursement isn’t too bad for children in my state. I think pediatrics is a solid specialty if you enjoy treating children. Many programs offer a stipend as well.

To your point, I agree that children are the most likely and greatest deserving of public support for their dental needs. I don’t think that will be a problem for the specialty so long as the fee schedule is fair.

 

[Mauricio45]

What are your guys' thoughts on ortho? Especially as more and more dentists these days doing invisigln or 6 months smiles. Ortho probably isn't as lucrative as it once was.

I like endo. But worry for the future of specialty with implants becoming more of a popular option.

I can definitely see pedo and OS being in high demand.

 

[PerioDont]

What are your guys' thoughts on ortho? Especially as more and more dentists these days doing invisigln or 6 months smiles. Ortho probably isn't as lucrative as it once was.

I like endo. But worry for the future of specialty with implants becoming more of a popular option.

I can definitely see pedo and OS being in high demand.

I don't think any field of dentistry is as lucrative as it once was.

But IMO there will always be a need for specialists. Most endo offices are booked in my area for 4-6 weeks out. busy busy. I think most of the major specialties are still great, ortho, endo, OMS, Perio.

Idk about orofacial pain, Radiology, path etc. feels like most of them end up in academics

 

[yappy]

What are your guys' thoughts on ortho? Especially as more and more dentists these days doing invisigln or 6 months smiles. Ortho probably isn't as lucrative as it once was.

I like endo. But worry for the future of specialty with implants becoming more of a popular option.

I can definitely see pedo and OS being in high demand.

I think if you keep your debt low, and do what you like the best, you’ll be solid.

 

[charlestweed]

I think if you keep your debt low, and do what you like the best, you’ll be solid.

Yes. Not only the student loan......you should try to borrrow less to build your practice as well. A dental practice doesn't have to cost $3-400k to build. You can have a nice one for less than half or 1/3 of that amount. When you owe less and have less bills to pay, you will enjoy your job more. With low overhead, you won't stress out over things like empty appt book, competition, recession, and flu pandemic etc. That's why I don't believe in purchasing an office building and get stuck there. I think it's easier to start a small office with low rent first. You can move and get bigger office space when your practice gets busier later. In 13 years, I've relocated 4 times....and my patients follow me.

 

[PerioDont]

Yes. Not only the student loan......you should try to borrrow less to build your practice as well. A dental practice doesn't have to cost $3-400k to build. You can have a nice one for less than half or 1/3 of that amount. When you owe less and have less bills to pay, you will enjoy your job more. With low overhead, you won't stress out over things like empty appt book, competition, recession, and flu pandemic etc. That's why I don't believe in purchasing an office building and get stuck there. I think it's easier to start a small office with low rent first. You can move and get bigger office space when your practice gets busier later. In 13 years, I've relocated 4 times....and my patients follow me.

Do you think that's because you are a specialty practice though? in ortho my understanding is you basically turn over the majority of your pt pool every few years.

I would think location changes would matter more for GP offices that are established in a community

 

[charlestweed]

Do you think that's because you are a specialty practice though? in ortho my understanding is you basically turn over the majority of your pt pool every few years.

I would think location changes would matter more for GP offices that are established in a community

If you take good care of your patients, they will follow you and they continue to refer their friends and relatives to you. My sister is a GP. She sold her practice (leasehold sale) to another GP and moved all her patients to another office location 8 miles away. The reason for this move was she bought her own building. Since I did ortho at her office, I had to move my patients as well.

My wife's GP boss is building a brand new office, which is located about 2 miles away from his current office. He also bought this new building (fully paid off). He will close the current office and move all of his patients to the new location in May or June (depending on the city approval). Since he is a big HMO provider in the area, the patients who have the HMO plans will have to continue to go see him and his in-house specialists for treatments.

As long as you don't move too far away, you will be fine. For one of my office relocations, I had to change the office's phone number because the new office is in a different city and the phone company didn't allow me to keep the same number. The solution was easy....I just ported my old office's number to the Verizon cell phone and then I used the Verizon service to forward this number to the new office's number.

 

[PerioDont]

If you take good care of your patients, they will follow you and they continue to refer their friends and relatives to you. My sister is a GP. She sold her practice (leasehold sale) to another GP and moved all her patients to another office location 8 miles away. The reason for this move was she bought her own building. Since I did ortho at her office, I had to move my patients as well.

My wife's GP boss is building a brand new office, which is located about 2 miles away from his current office. He also bought this new building (fully paid off). He will close the current office and move all of his patients to the new location in May or June (depending on the city approval). Since he is a big HMO provider in the area, the patients who have the HMO plans will have to continue to go see him and his in-house specialists for treatments.

As long as you don't move too far away, you will be fine. For one of my office relocations, I had to change the office's phone number because the new office is in a different city and the phone company didn't allow me to keep the same number. The solution was easy....I just ported my old office's number to the Verizon cell phone and then I used the Verizon service to forward this number to the new office's number.

So he paid cash for the custom build out ground up? In california guessing this was super expensive.

 

[charlestweed]

So he paid cash for the custom build out ground up? In california guessing this was super expensive.

Yup. Everything was paid off....his house, investment properties, cars etc. He graduated from LLU 20+ years ago (2-3 years before us). He had some student loan debts. He borrowed additional loan to purchase an existing office, where he practices right now. My wife met him when they both worked as associate GPs at the same dental office (my wife was a resident….she moonlighted on the weekend). After my wife’s graduation, he asked her to come work at his office. After the financial success that my wife partly helped contribute, he hired in-house OS, endo, pedo, and ortho to work him. Now at 50+, he wants to have his own office building. The current office has been there more than 40 years....and it’s really old.

Yeah, it's very expensive to buy commercial building now. My sister bought hers for only $1.02 million in 2008. The size parking lot is so big that my sister uses half of it to build 2 dettached homes. It's zoned for both commercial and residential purposes.

 

[Molar Whisperer]

If you take good care of your patients, they will follow you and they continue to refer their friends and relatives to you.

I wish that were true at my PNW metro area. Since I worked at my last DMO in 2002, I constantly get new patients who changed insurances and "had" to come see us. They would rave how much they liked their last dentist but couldn't afford to see him/her anymore. We have a large Capitation presence and it really undercuts the private dentists. Perhaps the best scenario is to avoid Capitation areas.

 

[2TH MVR]

It's been said many times. Pick a profession that you will enjoy practicing for a lifetime. There are plenty of jobs for both generalists and specialists.
Every specialty has it's pros and cons.

Endo is great if you like small staffs, low overhead, high $$ return on single procedures. But jeez. Looking for canals and staring into a small hole all day.
Ortho is fun if you like lots of activity, tons of patients in a single day, multi-tasking, short appts, lots of delegation, easiest on the body, don't need magnification or loupes. But you better be extroverted and like to talk ..... since you will be talking to patients and their parents ALL DAY.
Pedo. Um. No thanks. I am so thankful there are dedicated pediatric dentists out there helping the kids. The older I get .... the more I like working on teenagers and older.
OMFS. Seems to be the holy grail right now. But what about those pesky exodontists popping up everywhere? What about everyone trying to do implants?
Perio. Again. Not for me. Not a huge fan of the patient base. Implants are the savior of this specialty.

Lets not forget about the general dentist. You can practice anywhere. Do anything. Specialists will be knocking at your door looking for referrals.

Pick what you will like to do as a profession.

 

[D1Bound]

It's been said many times. Pick a profession that you will enjoy practicing for a lifetime. There are plenty of jobs for both generalists and specialists.
Every specialty has it's pros and cons.

Endo is great if you like small staffs, low overhead, high $$ return on single procedures. But jeez. Looking for canals and staring into a small hole all day.
Ortho is fun if you like lots of activity, tons of patients in a single day, multi-tasking, short appts, lots of delegation, easiest on the body, don't need magnification or loupes. But you better be extroverted and like to talk ..... since you will be talking to patients and their parents ALL DAY.
Pedo. Um. No thanks. I am so thankful there are dedicated pediatric dentists out there helping the kids. The older I get .... the more I like working on teenagers and older.
OMFS. Seems to be the holy grail right now. But what about those pesky exodontists popping up everywhere? What about everyone trying to do implants?
Perio. Again. Not for me. Not a huge fan of the patient base. Implants are the savior of this specialty.

Lets not forget about the general dentist. You can practice anywhere. Do anything. Specialists will be knocking at your door looking for referrals.

Pick what you will like to do as a profession.

It seems like if someone can handle the intensive training for OMS then it would be the best choice for that individual for both the cool factor and the money.

 

[mmc12]

don’t forget that OMFS has the greatest stress IMO (post-op complications, risk of malpractice, etc). These can’t just be disregarded.

 

[Big Time Hoosier]

Regardless of specialty, if you’re willing to go where others aren’t and there’s a need, that’s where you’ll find riches beyond your wildest dreams.

Big Hoss

 

[deleted1082923]

don’t forget that OMFS has the greatest stress IMO (post-op complications, risk of malpractice, etc). These can’t just be disregarded.

mo money, mo problems

 

[D1Bound]

This.

Osteomyelitis, osteoradionecrosis, MRONJ, iatrogenic jaw fractures, paresthesia/anesthesia, sedation complications (seizures, respiratory depression and death), extremely high dental anxiety patients, the most medically compromised patients...

What's with all of these syndromes? I thought all that surgery comprised of was wizzies and slamming an implant or two

 

[PerioDont]

What's with all of these syndromes? I thought all that surgery comprised of was wizzies and slamming an implant or two

ummmm...no.

what you are thinking of might be a weekend course for GPs. a 4-6 year OMFS residency covers much, much more than simply implants and 3rds.

 

[Smiqqqqq]

I don’t know too much about running a specialty pediatric office but Medicaid reimbursement isn’t too bad for children in my state. I think pediatrics is a solid specialty if you enjoy treating children. Many programs offer a stipend as well.

To your point, I agree that children are the most likely and greatest deserving of public support for their dental needs. I don’t think that will be a problem for the specialty so long as the fee schedule is fair.

I would recommend staying as far away from this specialty as possible.
It is very likely that soon this will be fully covered by Medicaid and there will be a critical drop in compensation. Next will be the expansion of scope and the creation of new forms of therapists, hygienists, assistants, etc. The army of assistants will be happy to jump into the profession for $ 5 more per hour and so on(and you'll pay for their funded education). GP will be using pedo as a promotion of their office at a loss. And existing pedo specialists will return to general practice.
Overseas I saw this, people do not want to spend an extra $ 1 if there is a free coverage for them, and especially for children. Seen young enthusiasts fleeing pedo into professions such as hairdresser for this reason (at least they weren't in debts for education).
Hopefully that's not gonna happen, but I'm pessimistic about that specialty.

 

[PerioDont]

I would recommend staying as far away from this specialty as possible.
It is very likely that soon this will be fully covered by Medicaid and there will be a critical drop in compensation. Next will be the expansion of scope and the creation of new forms of therapists, hygienists, assistants, etc. The army of assistants will be happy to jump into the profession for $ 5 more per hour and so on(and you'll pay for their funded education). GP will be using pedo as a promotion of their office at a loss. And existing pedo specialists will return to general practice.
Overseas I saw this, people do not want to spend an extra $ 1 if there is a free coverage for them, and especially for children. Seen young enthusiasts fleeing pedo into professions such as hairdresser for this reason (at least they weren't in debts for education).
Hopefully that's not gonna happen, but I'm pessimistic about that specialty.

Overall I agree that peds is heading towards being fully covered by Medi and CHIP programs. Peds is a high volume game. Large offices, many chairs at once, many staff, and seeing entire families at a time. Then OR for the ones that desire to do it. Then dealing with the parents is often harder than the kids themselves.

However I find it very hard to believe that a pediatric dentist would even consider becoming a hairdresser.

 

[Smiqqqqq]

Overall I agree that peds is heading towards being fully covered by Medi and CHIP programs. Peds is a high volume game. Large offices, many chairs at once, many staff, and seeing entire families at a time. Then OR for the ones that desire to do it. Then dealing with the parents is often harder than the kids themselves.

However I find it very hard to believe that a pediatric dentist would even consider becoming a hairdresser.

I also do not think that a US dentist will have to be a hairdresser, but I saw it in another country (and there are many such countries).

I know very well what a pedo office is.
In a nutshell, I would steer clear of pediatrics if I saw it as a 20+ year career. The likelihood of a strong decrease in reimbursement, full payment by the state and overlapping procedures with middle personnel is the highest in it. Pedo cannot offer aesthetic and expensive procedures either, and parents do not want this, many people expect that everything should be free for their children. What I see in the US and in many countries where I have lived or visited is that there is always a niche for sophisticated, high-end dentistry with the highest service, going far beyond basic skills. It's the safest bet. My $0.02.

 

[2TH MVR]

I also do not think that a US dentist will have to be a hairdresser, but I saw it in another country (and there are many such countries).

I know very well what a pedo office is.
In a nutshell, I would steer clear of pediatrics if I saw it as a 20+ year career. The likelihood of a strong decrease in reimbursement, full payment by the state and overlapping procedures with middle personnel is the highest in it. Pedo cannot offer aesthetic and expensive procedures either, and parents do not want this, many people expect that everything should be free for their children. What I see in the US and in many countries where I have lived or visited is that there is always a niche for sophisticated, high-end dentistry with the highest service, going far beyond basic skills. It's the safest bet. My $0.02.

Your logic makes sense when it comes to low income patients. Most middle and upper class families will probably steer clear of the medicaid/access/Denti-cal/etc/etc facilities. If I had young kids .... they are going to see a TRUSTED pediatric dentist.

 

[D1Bound]

ummmm...no.

what you are thinking of might be a weekend course for GPs. a 4-6 year OMFS residency covers much, much more than simply implants and 3rds.

Sarcasm of course

 

[Cold Front]

If you were to advise someone on a particular aspect of dentistry to go into purely based on job security and return on investment, what would you say?

For me, choosing dentistry was a great decision.. because some personal experiences made me realize it was the right field. Not my parents. Not some article on a magazine. Not my local dentist. But it was from a place of taking a break and personal time off after college to make the decision.

Dentistry can be lucrative if you have strong business motivation and experience. Majority of dentists went to dental school directly after college. And before college, directly from high school. It is very difficult to appreciate the field and it’s
potential by most dentists through the traditional path. Because the path of becoming a dentist is very exhausting to catch up with yourself and look at the big picture.

I went to dental school as a non traditional student. I was age 28. I took 7 years break between college and dental school. I did some odd jobs. I traveled. I had a snapshot of what it’s like to work in different fields and experience struggles of life before choosing dentistry. I was super motivated by the time I applied to dental school. An opportunity to have a secure profession, but also one that offered a range of other opportunities if I approached it the right way. That’s exactly how I ended up owning dental offices and other businesses.

Many of my former classmates hate the profession because they didn’t evaluate their goals early enough, and highly assumed the profession as a field free of distributions and financial stress. It wasn’t their fault entirely. The education process from high school to dental school didn’t give them enough time to thoroughly plan, evaluate and understand what they were getting themselves into. The fear of missing out is one of the biggest reasons of why people apply to dental school right after college.

All the advise in the world can’t match what someone learns for themselves through different experiences. Parents are too naive to think their kids should get into dental school and everything will be on autopilot form there with dentistry. Not entirely true. I think one needs to evaluate their choices and life first before blindly listening to all sorts of advise. It’s too much noise to cut through. If I could do it all over again, I would take the time off between college and dental school - maybe a year or 2 at the minimum. Get acquainted with people and experiences that will help you discover few things that can guide you in the right direction in life. I’m not suggesting that one should go to a road trip in India or South America to find themselves. Just catch a really long break in your own community if possible, take a step back and experience something that doesn’t involve “all academics” aspect of life. It can feel like a bubble when you finish school, then jump to another school, etc. You become too institutionalized. Your mind and goals will be through a lens that most dentists see things through.

Choose dentistry wisely.

 

[gryffindor]

You asked about job security and ROI. Then answer to both of those is to graduate, go where they need a dentist and can afford one, and be a GP. There are still such areas in the US.