How has your view of dentistry changed over time

[PikminOC]

Do you have any experiences with dental corporations? I've worked at 4 different ones and all 4 have their disadvantages.

Yes my husband is a dentist

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[Molar Whisperer]

Yes my husband is a dentist

What area and what struggles does he experience?

 

[ToothJockey]

Yes my husband is a dentist

Based on your view of dentistry I'm guessing your husband is miserable because he chose dentistry

Is he a GP or specialist? Associate or Practice Owner? How much in student loans did he graduate with?

Just my experience but all the dentists I have interacted with seem to love their life. They are all older practice owning dentists who graduated with little in student loans and do well for themselves.

I have a feeling that the new wave of unhappy dentists are ones that graduate with 400k+ in student loans and are in unfullfilling career situations (low paying associate job or a failing practice)

 

[CaffineDoc24]

Should post medical and residency questions in those forums

Everything I read on there seems mostly negative. Not sure if people are just venting or are basically saying my concerns are valid and true.

 

[Molar Whisperer]

Everything I read on there seems mostly negative. Not sure if people are just venting or are basically saying my concerns are valid and true.

It's harder for newer grads and students. You got the rising tuition (my tuition in the mid 1990s was $10k a year in state). You got the saturation of dentists (already in the mid 1990s in many areas along the West Coast). You got the 3rd party insurance taking advantage of us. I mentioned this at another thread. 1) try for military or NHSC tuition assistance, 2) consider less saturated areas (less desirable), 3) try to secure different sources of income such as spousal, side gigs, extra work, passive, etc.

 

[Orka]

Everything I read on there seems mostly negative. Not sure if people are just venting or are basically saying my concerns are valid and true.

Part of it is true, it's not as glamorous as people make it out to be. Getting into dental school is the easy part, getting through dental school is the hard part.

 

[CaffineDoc24]

So I just finished shadowing a periodontist, and I actually liked it much more then general dentistry (I’m surprised, because when considering medicine surgery really didn’t seem like my thing. I guess I liked this more because it wasn’t really cutting organs, just bloody haha). My question is, how hard is it to get a perio residency(or any of the dent residencies)? What is dent residency like? Are they hell like med residencies? I know for most of them you have to pay.

 

[bracketbuster68]

So I just finished shadowing a periodontist, and I actually liked it much more then general dentistry (I’m surprised, because when considering medicine surgery really didn’t seem like my thing. I guess I liked this more because it wasn’t really cutting organs, just bloody haha). My question is, how hard is it to get a perio residency(or any of the dent residencies)? What is dent residency like? Are they hell like med residencies? I know for most of them you have to pay.

Pretty doable to get into perio residency. Not as hard as ortho or omfs, but obviously you will have to be a good candidate to get in

 

[yappy]

So I just finished shadowing a periodontist, and I actually liked it much more then general dentistry (I’m surprised, because when considering medicine surgery really didn’t seem like my thing. I guess I liked this more because it wasn’t really cutting organs, just bloody haha). My question is, how hard is it to get a perio residency(or any of the dent residencies)? What is dent residency like? Are they hell like med residencies? I know for most of them you have to pay.

Periodontal residency is very achievable. However, most programs don't pay. Worse than that, you will likely end up needing to pay and survive on loans during residency. If you wish to do perio it is very advisable that you figure out how to pay for dental school via scholarship and/or get into a cheap school. One thing I always appreciated about perio is that there is a lot of literature to support what they do. It's grounded in science and they back up what they do. I don't think the residency is that challenging in terms of hours compared to OMS or medical specialties. Commercially, the specialty seems like a mixed bag. Some say that traditional perio is not thriving right now and that implants are being placed by GPs and OMS that complete with perio. However, if it's something you really enjoy, and are interested in it, I don't think that should deter you. You just need to figure out how to not rack up too much debt (easier said than done) so none of that matters.

OP, I just wanted to point that if you're considering perio then you're talking about 4 years of dental school + 3 yrs of residency (likely unpaid). Perio is a great specialty but this route is not too different than doing medicine where many of the residencies are three years too. I'm just pointing out that you're really not making your life much easier by doing dentistry and a specialty. Medicine is not a harder route it's just different - make sure you pick what you like most.

 

[Orka]

So I just finished shadowing a periodontist, and I actually liked it much more then general dentistry (I’m surprised, because when considering medicine surgery really didn’t seem like my thing. I guess I liked this more because it wasn’t really cutting organs, just bloody haha). My question is, how hard is it to get a perio residency(or any of the dent residencies)? What is dent residency like? Are they hell like med residencies? I know for most of them you have to pay.

Perio is a great specialty, I'm considering going into it myself. Luckily it's not as competitive as the other specialties like ortho and omfs.

 

[CaffineDoc24]

Perio is a great specialty, I'm considering going into it myself. Luckily it's not as competitive as the other specialties like ortho and omfs.

Yeah, I like it because it involves a lot of biology, something I felt general dentistry was lacking for me (as someone who was going into medicine, this might be a good best of both worlds scenario)

 

[CaffineDoc24]

Periodontal residency is very achievable. However, most programs don't pay. Worse than that, you will likely end up needing to pay and survive on loans during residency. If you wish to do perio it is very advisable that you figure out how to pay for dental school via scholarship and/or get into a cheap school. One thing I always appreciated about perio is that there is a lot of literature to support what they do. It's grounded in science and they back up what they do. I don't think the residency is that challenging in terms of hours compared to OMS or medical specialties. Commercially, the specialty seems like a mixed bag. Some say that traditional perio is not thriving right now and that implants are being placed by GPs and OMS that complete with perio. However, if it's something you really enjoy, and are interested in it, I don't think that should deter you. You just need to figure out how to not rack up too much debt (easier said than done) so none of that matters.

OP, I just wanted to point that if you're considering perio then you're talking about 4 years of dental school + 3 yrs of residency (likely unpaid). Perio is a great specialty but this route is not too different than doing medicine where many of the residencies are three years too. I'm just pointing out that you're really not making your life much easier by doing dentistry and a specialty. Medicine is not a harder route it's just different - make sure you pick what you like most.

Totally get that it’s not much shorter than some med specialties. But most non-primary care ones are longer. However, I’m not really basing my decision completely on length of schooling.

When shadowing this perio, I noticed he had much less bureaucratic bs that I’ve seen docs deal with. The patient comes in, gets the procedure done, pays, and leaves. At least the dents that I know, insurance is much less common in their practices than in medicine. There is no coding, calling the insurance company before each patient comes and make sure what you’re doing is covered, no extensive EMR recording. Best of all, he could charge what he wants and isn’t told by an insurance company what he can bill. If a patient comes in and is less fortunate, he would give them a discount.

Of course all of this doesn’t matter if you hate the job. Just some stuff to consider. Please tell me if I’m wrong about any of that, but this is what I’ve seen/heard from others. Also this is comparing self employed physicians and dents. I have no experience with employed doctors.

 

[CaffineDoc24]

It's harder for newer grads and students. You got the rising tuition (my tuition in the mid 1990s was $10k a year in state). You got the saturation of dentists (already in the mid 1990s in many areas along the West Coast). You got the 3rd party insurance taking advantage of us. I mentioned this at another thread. 1) try for military or NHSC tuition assistance, 2) consider less saturated areas (less desirable), 3) try to secure different sources of income such as spousal, side gigs, extra work, passive, etc.

Yeah dental tuition is tough. The DO school I go into tho is one of the most expensive. They estimate ~450k cost including everything, including living. Tuition is 75k a year but goes up 7% a year.

 

[PikminOC]

What area and what struggles does he experience?

He's not a dentist anymore.

 

[endodonia]

Yes my husband is a dentist

He's not a dentist anymore.

I assume I'm not the only one curious of why.

 

[Molar Whisperer]

Totally get that it’s not much shorter than some med specialties. But most non-primary care ones are longer. However, I’m not really basing my decision completely on length of schooling.

When shadowing this perio, I noticed he had much less bureaucratic bs that I’ve seen docs deal with. The patient comes in, gets the procedure done, pays, and leaves. At least the dents that I know, insurance is much less common in their practices than in medicine. There is no coding, calling the insurance company before each patient comes and make sure what you’re doing is covered, no extensive EMR recording. Best of all, he could charge what he wants and isn’t told by an insurance company what he can bill. If a patient comes in and is less fortunate, he would give them a discount.

Of course all of this doesn’t matter if you hate the job. Just some stuff to consider. Please tell me if I’m wrong about any of that, but this is what I’ve seen/heard from others. Also this is comparing self employed physicians and dents. I have no experience with employed doctors.

A lot of procedures in perio are elective such as implants, tissue grafting, and laser procedures. It may be equivalent to Hollywood plastics where no ins will cover. For primary dental care, we deal with ins similarly to medical. We had this ins based in Hawaii that would never answer billing calls. Out of all the advanced countries in the world, the US system is the most EFed Up not including the malpractice sue hungry lawyers. My Canadian DS classmate lives on the border of Detroit and he asked why there are so many billboards of lawyers ready to sue.

 

[PikminOC]

Better for OP to talk to more recent dentists. Older dentists have much less pressure overall.

 

[CaffineDoc24]

Better for OP to talk to more recent dentists. Older dentists have much less pressure overall.

Yeah the dentists I’ve shadowed are older. They both do very very well, but I think they were very business savvy and started when things were a little easier. Wish the perio turned me off to dentistry to make my decision easier, but instead made me like the field more.

 

[charlestweed]

So I just finished shadowing a periodontist, and I actually liked it much more then general dentistry (I’m surprised, because when considering medicine surgery really didn’t seem like my thing. I guess I liked this more because it wasn’t really cutting organs, just bloody haha). My question is, how hard is it to get a perio residency(or any of the dent residencies)? What is dent residency like? Are they hell like med residencies? I know for most of them you have to pay.

It's not hard to get accepted to a perio program. The hardest part is to get the patients to walk into your office. You need referrals from general dentists.... and it's not easy to convince them to refer their patients to you. No patient = no money = stress. If you don't like going door to door to meet the referring dentists, then you shouldn't specialize.

 

[Molar Whisperer]

It's not hard to get accepted to a perio program. The hardest part is to get the patients to walk into your office. You need referrals from general dentists.... and it's not easy to convince them to refer their patients to you. No patient = no money = stress. If you don't like going door to door to meet the referring dentists, then you shouldn't specialize.

Yeah the dentists I’ve shadowed are older. They both do very very well, but I think they were very business savvy and started when things were a little easier. Wish the perio turned me off to dentistry to make my decision easier, but instead made me like the field more.

The older periodontists already cornered the market such as referring dentists, reputation, and patients. The facts are 3rd party insurance companies are there to make money. They don't make money when they have to pay for implants, tissue grafting, and laser procedures. Getting people into your office is very unpredictable especially when you're new. When I was briefly in private practice setting, my predecessor ran people off the practice due to his unethical practices, crappy work and very high fees. Couple that with high saturation and limited ins payments, I had to get out of there.

If I were to go back in your shoes, I would consider military. I was an USAF dentist for 4 years since they paid for my school. There, you have plenty of resources and patients to build experience as well as networking with other dental sources. I would consider perio residency ( if you're interested) in the military because there are less competition for candidates and income is much higher than some paying civilian residency programs (many make you pay tuition). The disadvantage is you are committed for 10 years (4 yrs for DS, 3 yrs for perio and 3 yrs after). The advantage is you have no student loans and some left over income. At that point, you may decide on staying for 10 more yrs to get guaranteed retirement for life or leave the military. My endodontist mentor was triple dipping with his Army retirement (30 yrs), corp pay and SS. Since you won't have student loan burdens, strongly consider getting passive income from rentals and you'll be light yrs ahead of your peers.

 

[LFA20]

It's not hard to get accepted to a perio program. The hardest part is to get the patients to walk into your office. You need referrals from general dentists.... and it's not easy to convince them to refer their patients to you. No patient = no money = stress. If you don't like going door to door to meet the referring dentists, then you shouldn't specialize.

but can’t you still make good money as in house periodontist/corporate?

 

[charlestweed]

but can’t you still make good money as in house periodontist/corporate?

Yes, if you are not picky about the job offers and are willing to travel long distance and to multiple offices. Most places only have enough patients to keep you busy a few days a month. For example, the corp office, where I am at, hires perio 1 day/month, OS 2 days/month, endo 1 day/month, and ortho 6 days/month. There more job offers for ortho and OS than for perio.

 

[CaffineDoc24]

Yes, if you are not picky about the job offers and are willing to travel long distance and to multiple offices. Most places only have enough patients to keep you busy a few days a month. For example, the corp office, where I am at, hires perio 1 day/month, OS 2 days/month, endo 1 day/month, and ortho 6 days/month. There more job offers for ortho and OS than for perio.

What is perio residency like?

 

[LFA20]

What is perio residency like?

Dude he’s an orthodontist lmao

 

[CaffineDoc24]

Dude he’s an orthodontist lmao

Haha I know. You guys all seem to know everything so I assumed someone would have some insight.

 

[charlestweed]

What is perio residency like?

Not as busy as dental school. My wife had a lot of free time to moonlight on the weekends and earned extra cash. She was required to teach dental students one day a week..this gave her the opportunity to make friends with the students. These students later became GPs and some of them referred their patients to her office. She spent a lot of her free time at the prosh dept (it's right next door) and tried to learn from the prosth residents as much as possible. She also volunteered to work for the school's emergency department, where she learned how to extract 3rd molars.

 

[yappy]

passion aside, objectively which specialty residency would you prefer to enter given the choice between perio vs endo?

If there is no passion for either I would rather be a GP office owner. You don't have to go further in debt, no lost earnings, income is "close enough", you don't have to rescue referral sources or see their problem patients, and you're still free to place implants and do endo if you desire.

 

[Maintainer]

we continue to encourage them to study hard in school so they can get into a dental school or med school and will have stable jobs like us.

You should tell them to become ortho. So, they don't have to suffer from neck and back pain.

 

[2TH MVR]

If there is no passion for either I would rather be a GP office owner. You don't have to go further in debt, no lost earnings, income is "close enough", you don't have to rescue referral sources or see their problem patients, and you're still free to place implants and do endo if you desire.

Agreed about the rescue referral sources. If you're young and hungry ... sucking up for referrals is fine. As you get older .... this sucking up stuff really ....sucks. As @charlestweed mentioned ..... if you want to be a specialist .... make sure you are comfortable with asking for referrals. Some specialties are more reliant on referrals than others. Perio, endo and OMFS are probably tops on that list. Ortho is more in the middle. Pedo doesn't necessarily need outside referrals.

As for GPs placing implants. Fine if you are private practice where YOU place the implant and YOU restore it. Maybe different in a Corp setting. Our large Corp has ONE periodontist who places all of the implants. He is very good at what he does and is respected by all of the GPs. Recently some GPs have taken some outside implant CE (on their dime) to learn implants. Our Corp prefers to have the periodontist place the implants, but has been slowly allowing the GPs with CE to place some easier implants. The problem? Many of the Corp GPs I talk to are not happy about restoring an implant placed by the GP. They obviously prefer the perio's work and trust that the implant will succeed. So ...most of the GPs will not restore an implant placed by the GP so they are not involved in any issues with the implant-prosthesis in the future. Ah .. the politics of working in a large Corp.

 

[yappy]

Agreed about the rescue referral sources. If you're young and hungry ... sucking up for referrals is fine. As you get older .... this sucking up stuff really ....sucks. As @charlestweed mentioned ..... if you want to be a specialist .... make sure you are comfortable with asking for referrals. Some specialties are more reliant on referrals than others. Perio, endo and OMFS are probably tops on that list. Ortho is more in the middle. Pedo doesn't necessarily need outside referrals.

As for GPs placing implants. Fine if you are private practice where YOU place the implant and YOU restore it. Maybe different in a Corp setting. Our large Corp has ONE periodontist who places all of the implants. He is very good at what he does and is respected by all of the GPs. Recently some GPs have taken some outside implant CE (on their dime) to learn implants. Our Corp prefers to have the periodontist place the implants, but has been slowly allowing the GPs with CE to place some easier implants. The problem? Many of the Corp GPs I talk to are not happy about restoring an implant placed by the GP. They obviously prefer the perio's work and trust that the implant will succeed. So ...most of the GPs will not restore an implant placed by the GP so they are not involved in any issues with the implant-prosthesis in the future. Ah .. the politics of working in a large Corp.

It's also worth noting that the reason a corporation prefers a specialist to place the implant, rather than a gp, is so they can bill specialist fees.

 

[CaffineDoc24]

Agreed about the rescue referral sources. If you're young and hungry ... sucking up for referrals is fine. As you get older .... this sucking up stuff really ....sucks. As @charlestweed mentioned ..... if you want to be a specialist .... make sure you are comfortable with asking for referrals. Some specialties are more reliant on referrals than others. Perio, endo and OMFS are probably tops on that list. Ortho is more in the middle. Pedo doesn't necessarily need outside referrals.

As for GPs placing implants. Fine if you are private practice where YOU place the implant and YOU restore it. Maybe different in a Corp setting. Our large Corp has ONE periodontist who places all of the implants. He is very good at what he does and is respected by all of the GPs. Recently some GPs have taken some outside implant CE (on their dime) to learn implants. Our Corp prefers to have the periodontist place the implants, but has been slowly allowing the GPs with CE to place some easier implants. The problem? Many of the Corp GPs I talk to are not happy about restoring an implant placed by the GP. They obviously prefer the perio's work and trust that the implant will succeed. So ...most of the GPs will not restore an implant placed by the GP so they are not involved in any issues with the implant-prosthesis in the future. Ah .. the politics of working in a large Corp.

The referral part doesn’t bother me. Honestly, In any business there’s always gonna be some type of hustle. Feel like you have to want to be a businessman for dentistry, and if you have the drive maybe you can do well. Maybe the unhappy dentists didn’t go into dentistry for that stuff though. I’m not an expert of course, just speculating.

Saturation, at least where I live is definitely an issue, but I guess you can make a practice a little away from the city.

 

[OSOSOS]

I shadowed the most successful dental offices. The reality in my opinion? Most dentists have to work very hard, are stressed, and are generally negative on the future of single doc ownership due to debt, PPOs, DSOs being more effective at patient acquisition, HR demands, etc. yet most say they themselves are happy.

 

[Adam_W]

My story...

SCHOOL: A long marathon. I didn't let the bastards grind me down. I did not go to my graduation as my own little protest.

FIRST YEARS: I started a practice from scratch in a small farming town. I was killing it from the first month. The first 3 years were great fun. I was learning something everyday. I had a steep learning curve on the business aspects of the profession. I liked overcoming the new challenges each week. I liked being a big fish in a small pond. Years 4-7 started to look a lot like the first 3 years but no new challenges. It got old. Years 8-9, I was bored out of my mind. I was doing lots of CE at this point.

SHIFT #1: I sold my practice for a descent price and took 4 months off. (Wife and I rode our bikes across the country.) Came back to a part time job that I had always had and made it a 3 day a week job at an institution. I also worked in a blue collar clinic part time. At this point the dental thing was only a job. A very good job but only a job. I was still a little bored so I took a teaching job at the local collage, 1-2 days a week. During this time we were raising kids and that was my primary concern. Not owning a practice made me a better Daddy and Husband. I liked letting somebody else worry about the details to running the clinic. I did minimal CE at this point.

SHIFT #2: As my kids getting close the age were they would be leaving the house other possibilities came up. My part time state institution job had an early retirement option. I became eligible for a sabbatical at college. So I took the early retirement, and a sabbatical and spent a year traveling with my teenage kids. The only dentistry I did was some volunteer work. During this time I learned that I really missed taking care of people. When I came back I helped a FQHC (Community Clinic) get started, as well as returning to the teaching gig. I liked that work and was/am very good at it. At this point I didn't have to do dentistry any longer but I liked doing it under my terms. I started doing more CE at this point because dentistry had move on and I had not kept up.

SHIFT #3: It turned out that the set of dental skills I had developed during my career was just that thing that a GPR program was looking for. I am currently doing a GRP gig and my teaching gig because I fell like I am giving back to dentistry. I don't need the money but I enjoy dentistry now more than ever. Now I am the one giving the CE.

Dentistry is only a tool. If you use that tool well it can help your have a great life. If you focus on the tool rather than the bigger picture you will be miserable.

This is really great, thank you for sharing.

 

[PikminOC]

How many dentists graduate every year? How many 10 years ago?

 

[TanMan]

Hi guys, hope all is well. I just wanted to know how you guys viewed dentistry before school, throughout school, and after. How have your views, passion, and liking of the job changed? For the better? For worse? Does the love for the job become even more over time?

To the OP:

I really didn't know anything about dentistry before school. During school, I just wanted to get out because most of the time it was pointless to be there except for patient care. After school is when the fun begins.

The most important thing to realize is that the way you learned in school is not necessarily the way it works in the real world. Dentistry can be appreciated more when you compare our profession to other professions. We are lucky in that we have great hours, decent compensation, and much more autonomy than other professions. There are certain things I like about the profession such as getting people out of pain and making money. Keeping dentistry fun is the hard part. If the cases get too "interesting", that usually mean case difficulty increases, frustration level increases, and profitability decreases. I enjoy trying to be more efficient in every iteration. If it's your 10000th rctbucrn, normal is always welcome, compared to having to manage complications.

This whole covid ordeal has shown me that dentistry is very resilient in these tough times, for those who are willing to take the risk and aggressively market themselves. Everyone else who doesn't, tend to falter and sink like a slowly sinking ship. Aggregately, dentists will suffer, but there will always be winners and losers in this environment. The key is to be a winner. At this time, since I have nothing better to do due to lack of travel options, I can at least infer that dentistry > doing nothing due to lack of options. It's not a very high bar, but a bar nonetheless.