I'm about to start dental school and all I see is the debt ( I want to be a general dentist at present). Is an associate position salary reasonable? I just want to see a light at the end of the tunnel.
Is Dentistry on the Decline
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I really dont know the answer to your question; however, I am encouraged about dentistry due to the reletive success of the practice owners I've shadowed and the level business they have in this crappy economy.
In the hight of the recession (09) the ADA privite practice survey said that the average dentist GP that owned their practice earned ~200k.
I'm not trying to paint some rainbow picture but these are the impressions I've been getting. Lets hope the economy keeps growing.
Edit: I dont live in LA or NY.
In the hight of the recession (09) the ADA privite practice survey said that the average dentist GP that owned their practice earned ~200k.
I'm not trying to paint some rainbow picture but these are the impressions I've been getting. Lets hope the economy keeps growing.
Edit: I dont live in LA or NY.
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No, dentistry at the moment is the best deal in healthcare if you love/learn to love teeth, in my opinion. The ADA has a spine and keeps the insurance companies in check to reimburse dentists fairly.
Dentist mean compensation is basically the same as for primary care physicians. http://jans.ctsnet.org/content/sign...ysician-hourly-wages-exist-across-specialties (survey conducted 2004-2005 so might be slightly higher now)
Dentist mean compensation is basically the same as for primary care physicians. http://jans.ctsnet.org/content/sign...ysician-hourly-wages-exist-across-specialties (survey conducted 2004-2005 so might be slightly higher now)
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Depending on your debt and financial backbone. Most students dont take out 100% in loans, they usually have family support and if thats not an option you can always pursue the military route. However, even if you dont get any help most early level dentists make at least 100K which is usually enough to cover your loans. You can always spread the loans out over 30 years and your income is dependent on how many hours a week you want to work. If you dont feel your're making enough, you can always work more. Or you can always get married and have a spouse help you out.
Catching my drift? There are endless ways to repay the debt. You should be focused on making the best of your d-school experience and becoming an excellent practitioner. The rest will follow.
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Really? I've always thought of this as the exception rather than the rule. Someone wanna make a poll thread about this?
All the predents I know (n=4) will need to take out loans for 'living' in addition to the fees and tuition. Seriously, who has the funds to bank role somone else in another cities living expenses in professional school. I imagine there are some but I dont think they would be the majority.
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Keep in mind that a decade ago, it didn't cost a lot to go to dental school and it was much more affordable to own a house. I only had to borrow $92k to get my DDS degree from UCLA. A USC student only had to borrow about $200-250k for his/her DDS degree. I bought my first house for $348k. Now, this same house costs $600-650k.
A decade ago, new grads only got paid $300-350/day and yet, many of them were very happy with their jobs. When they weren't happy working for their bosses, they simply quit and they could easily find another job. Many of them bought nice cars and houses right after dental school. When I saw many of my classmates enjoyed their lifestyle as general dentists, I was so jealous of them because I still had to do 2 more years of ortho residency. Their success often made me wonder if doing ortho was really worth it.
Things are much worse now in California. The CA board exam was very hard to pass and this had discouraged a lot of dentists from other states to move to CA. Ever since the CA board accepted the Western dental board, 1yr GPR, and reciprocity 5-6 years ago, dentists from other states have moved to CA in large number. I hear that Florida starts to accept the NERB. If this is true, I predict that Florida will face the same oversaturation problem that CA dentists are facing right now.
Many dental chains in CA (Gentle Dental, SmileCare, Brightnow etc) have recognized that many dentists are struggling to find jobs; therefore, they stop paying their associate dentists the guaranteed daily rate and start paying them the percentage of the collection….25% of $0 (HMO plan) = $0😱.
I have 2 questions about practicing in CA if you don't mind.
How are speciality practices doing compared to general dentistry in CA?
I understand the major metropolitan hubs are extremely over saturated right now (SF bay area, LA) but what about the smaller cities 30min-1hr away from them? How about the suburban neighborhoods around those areas? Basically, how far into the "boonies" do you have to go to avoid the saturation problem? Thank you.
Take this as a positive. This means that there are open posititons and a shortage of dentists in other parts of the country. People value their teeth, health, and looks all over this country. The economic situation is much better in other states and dentistry is less competitive to my knowledge. As someone from CA, I encourage fellow students not to be afraid to move to areas of the country where there are a need for dentists and business is good. There are beautiful and desirable places to live all over the U.S.
The demand for dental care is on the rise. As long as high fructose corn syrup is subsidized by the government, there will be a strong demand for dentistry. However, people who can afford to pay for dental care is on the sharp decline. This is the real problem. In general, the people who need the most dental care, have the least ability to pay for it.
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There are a lot of specialists here in CA as well.
In CA, the specialists are doing better than the general dentists because in addition to working for themselves at their own offices, they can supplement their incomes by working at different GP offices (and dental chains) as in-house specialists. The specialists in CA can do just as well (or better than) as the specialists in other states if they are willing to work hard and travel to different offices. The reason why many new grad specialists are complaining that they can't find jobs after graduation is they are not willing to travel and to take risk. When my wife first started her job at a GP office as an in-house periodontist, she didn't know if her GP boss paid her a fair salary or not…. but she was willing to work hard and to take risk…and that's how she managed to pay off her student loans and had her own perio office sooner than many periodontists who graduated before her.
I travel as far as Moreno Valley (about 60-70 miles east of LA)….and there are a lot of dentists and specialists here and the surrounding areas as well. A couple of my friends worked in rural areas in Bakersfield and Modesto right after graduation and they are doing very well.
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Because there are more big corporate dental offices and private dental offices in highly populated states like CA and Texas than in smaller, less populated states. And big corporate offices dont like to refer cases out; they hire in-house ortho, endo, OS, pedo, perio to handle difficult cases for them. More GP offices in CA mean better opportunity for the specialists to get more referrals from the GPs. More GP offices in CA mean more GPs who want to hire the specialists to work for them.
A few orthodontists, who practice in smaller states, told me that there are not enough patients to keep them busy at one location. They wish there are dental chain offices nearby their cities so they can apply for part time jobs. I know an orthodontist from Utah who flies to Arizona every month to work for a Western Dental office in AZ.
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California is letting more dentists come into the state to address the "Access to Care".
In the 80's CA allowed foreign trained dentists to come to the state and as long as they pass the California state board exam they could practice.
More recently as Charles said, CA allows even more dentists to come into the state.
As of last week, CA senates passed the mid-level providers bill. This bill would allow someone who's graduated from high school to study for 2 more years, and be able to extract teeth, drill, fill, even make dentures. This is not just the expanded function RDA's. These mid-level providers or also known as "Dental therapists" can operate independently without dentist supervision.
There are already so many dentists, especially new grads that have trouble finding work. Imagine when these "dental therapists" come out, they will essentially put all the young dentists out of work.
Kellogg Foundation and some non-profits are behind this push to bring "access to care" to rural areas. It never works. It's not a matter of number of trained professionals to address the issue, it is really distribution of dentists. These liberal agendas think that dentistry should be free.
Washington state also has a similar bill. The Washington state Academy of General Dentistry works very hard holding the ground, good job to them. Hopefully it won't turn into another California.
In the 80's CA allowed foreign trained dentists to come to the state and as long as they pass the California state board exam they could practice.
More recently as Charles said, CA allows even more dentists to come into the state.
As of last week, CA senates passed the mid-level providers bill. This bill would allow someone who's graduated from high school to study for 2 more years, and be able to extract teeth, drill, fill, even make dentures. This is not just the expanded function RDA's. These mid-level providers or also known as "Dental therapists" can operate independently without dentist supervision.
There are already so many dentists, especially new grads that have trouble finding work. Imagine when these "dental therapists" come out, they will essentially put all the young dentists out of work.
Kellogg Foundation and some non-profits are behind this push to bring "access to care" to rural areas. It never works. It's not a matter of number of trained professionals to address the issue, it is really distribution of dentists. These liberal agendas think that dentistry should be free.
Washington state also has a similar bill. The Washington state Academy of General Dentistry works very hard holding the ground, good job to them. Hopefully it won't turn into another California.
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at the national level ADA is against the mid-level provider providing irreversible procedures. CDA(California Dental Association) does not have the balls to advocate vocally against this.
The California Academy of General Dentistry and the California Association of Oral and Maxillofacial Surgeons oppose Senate Bill 694. Now I know who is friend and who's foe.
CDA members should seriously voice their concern.
http://investmentwatchblog.com/sb-694-bill-would-explore-new-tier-of-dental-provider-for-california/
The California Academy of General Dentistry and the California Association of Oral and Maxillofacial Surgeons oppose Senate Bill 694. Now I know who is friend and who's foe.
CDA members should seriously voice their concern.
http://investmentwatchblog.com/sb-694-bill-would-explore-new-tier-of-dental-provider-for-california/
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At Pre-dental forum, we have a post about California SB bill introducing mid-level practitioners.
http://forums.studentdoctor.net/showthread.php?t=886536
I'm so fired up about this although I'm not in CA or from CA. I know this would eventually affect other states. ... I don't think many pre-dents get this... pretty sad but anyways...
I have a question for Dr.Charles or anyone that can answer this.
I think that all the metro/desirable locations are saturated with dentists. What should a new grad do? Of course, moving to rural areas pretty much guarantee financial success. However, as a young single guy, it is a social suicide. What kinda of advice can you give us? I know this is a million dollar question but you seems to know how dentistry is going throughout the nation.
PS Oh ya. one more. Do you think that once economy is better (assuming 5 years from now on) dentistry will be back again like it was 2006ish??
http://forums.studentdoctor.net/showthread.php?t=886536
I'm so fired up about this although I'm not in CA or from CA. I know this would eventually affect other states. ... I don't think many pre-dents get this... pretty sad but anyways...
I have a question for Dr.Charles or anyone that can answer this.
I think that all the metro/desirable locations are saturated with dentists. What should a new grad do? Of course, moving to rural areas pretty much guarantee financial success. However, as a young single guy, it is a social suicide. What kinda of advice can you give us? I know this is a million dollar question but you seems to know how dentistry is going throughout the nation.
PS Oh ya. one more. Do you think that once economy is better (assuming 5 years from now on) dentistry will be back again like it was 2006ish??
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I don't think its social suicide at all. I am also a young guy and you get to know people in the town and they are friendly to you as you help them out with their maladies. Also, small town people are generally more friendly than big city people.
You're thinking about this all wrong. The country girls will be in awe of your dental skills and and big city flare. You'll be the king of the town! lol.
PS: Is it likely to make 250k as a orthodontist working 3 days/wk, charles tweed?
PS: Is it likely to make 250k as a orthodontist working 3 days/wk, charles tweed?
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Are there hot chicks in rual areas? NO
Are there good clubs and bars to go to pull girls? NO
Are there good sports bar to watch games with your buddies, beers and some food? NO
Are there a stadium where I can watch baseball, football, ice hockey, or baseketball? NO
Are there decent restaurants and places to go on a date and mingle? NO
All you do is milking cows and gathering hay after dental work? YES
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Okay, well youre being a little harsh...and i think youre picturing a very very small town. If youre near a college town you just eliminated all your gripes.
Ps - who calls it ice hockey? Were you comparing it with all the field hockey being watched at sports bars these days?
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Are there outdoor activities where you can meet girls without being intoxicated in the city? NO
Are there enough parking spots where you can actually enjoy restaurants and/or stadiums where you don't pay $20 for parking or have to constantly run to the meter? NO
Are your kids going to get run over by cars on the street with homeless people constantly asking you for change in the country? NO
Is there hiking, skiing, gun shooting, camping, swimming in lakes in the country where you can take a girl? YES
Are there plenty of frozen lakes where you can play your ice hockey in the country? YES
It all depends on what you enjoy in life.
And yea I don't really care about sports except for skiing/paintballing/hiking so that kinda solves that one for me lol.
touche my friend.
reading your post and then reading mine again make me realize how ignorant and biased I am lol.
hmmm maybe I need to be more flexible since we can't have all considering how dentistry is going.
nice post though especially from New Yorker! 🙂
reading your post and then reading mine again make me realize how ignorant and biased I am lol.
hmmm maybe I need to be more flexible since we can't have all considering how dentistry is going.
nice post though especially from New Yorker! 🙂
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I grew up in a rural area and go to college in a big college town and I've got to say.. I like the rural area way better...
The big city has more stuff to do and way more restaurants and people but rural area.. is way safer, WAY less traffic (traffic is the ONLY thing that can make me angry.. literally), and living in a average size town about 30 minutes away from a big city is just as nice..
I am down for the rural-average size town instead of the massive cities!! but thats just me.. plus you save TONS of money by not living in a metropolitan area
The big city has more stuff to do and way more restaurants and people but rural area.. is way safer, WAY less traffic (traffic is the ONLY thing that can make me angry.. literally), and living in a average size town about 30 minutes away from a big city is just as nice..
I am down for the rural-average size town instead of the massive cities!! but thats just me.. plus you save TONS of money by not living in a metropolitan area
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Sure, you can stay in big cities and do well if you dont owe a lot of money and continue to live like a student 3-5 years after graduation. You may not be able to buy a house right away. You should not borrow more money from the bank. Instead, you should use the money that you save from working as an associate to set up your own office. Cant work for someone else forever. You have to own a practice.
Many of my friends, who are general dentists and dental specialists, are doing well here in CA not because they all have great business skills. They do well because didnt spend a lot of money to build their offices and they have tried to keep the overhead as low as possible. For example, I only spent $35k to convert an OBGYN office into an ortho/perio office. My wifes co-resident also spent a similar amount to convert a chiropractic office into a perio office. My sister, who is a general dentist, only pays $1300/month for her office rent. My friend, a USC dental grad, only has 2 chairs in his office and 1 dental assistant, who performs both front and back duties.
By keeping the overhead low, we can keep more of our hard earned money. By keeping the overhead low, we can keep our fees low and get more case acceptance from our patients. Id rather work hard and see higher volume of patients than sitting around doing nothing. Unlike many of my ortho colleagues who open up fancy offices in the rich areas to target the middle and upper income families, my offices are in poor areas and we see mostly kids from low-income families.
It is incorrect to assume that when you charge lower fees than the dentist down the street, your work must be poor and substandard. Dentistry (especially orthodontics) is an art. Good treatment outcomes depend on the doctors clinical judgment and hand skills. If you are honest, do good work, charge affordable fees, your patients will refer their friends and relatives to your office.
I cant predict what dentistry will be like in 10-15 years. I always assume that things will get worse because of the opening of new dental schools and mid-level providers. This is why I work hard now to pay off the home mortgage debt. When I am 100% debt-free, I wont have to worry about the future.
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how many years has it been since you grad'ed Charles if you dont mind me asking?
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Guys, stop reminiscing about 2006 and the previous golden age of dentistry. The party was over when the money ran out!
What were the ADA average earnings in 06 vs 2010? I heard the golden age is over but I have not seen any data to suggest that the average dentist in years <2007 earned a substantial amount more than they do now. I'm not coy - I'm just curious.
one thing that I know is that dental school costs at least 40% less. Now Insurance company lowered reimbursement rates. More dental schools has opened up and has been pumping more dentists out. Now we need to worry about mid-level providers (please check Pre-dental forum califironia bill). Corporate dentistry started blooming in recent years.
Lastly, in 2006, dentists used to retire when its time. Now they never do.
Lastly, in 2006, dentists used to retire when its time. Now they never do.
Good points. I didn't know that insurance has lowed rates.
Lets hope that around the time we graduate the economy has been on the mend and the stock market allows dentists to make comfortable exit from the workplace.
One observation: Why are there so many CA people on this forum? I almost feel like everyone should state at the onset they're from CA while posting. From the sound of it the state is in terrible condition. Any plans on getting out?
Lets hope that around the time we graduate the economy has been on the mend and the stock market allows dentists to make comfortable exit from the workplace.
One observation: Why are there so many CA people on this forum? I almost feel like everyone should state at the onset they're from CA while posting. From the sound of it the state is in terrible condition. Any plans on getting out?
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Got my DDS in the late 90s and my ortho certificate in the early 2000s….....and schools like NOVA, UNLV, Western, Midwestern, ECU, Roseman, Lecom, ASDOH didn't even exist.
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Thank you. Yea, I've always been a country boy at heart but can't have everything right away! Have to finish my opto public school first (18k tuition a year). I love how the New York tax payers help pay my tuition and then I'll just leave this high tax state and say see ya suckaz.
Totally agree with you and I grew up in the city however I go outside the city every weekend to enjoy nature.
Lol traffic pisses me off so much in NYC that I just speed like crazy, cut people off and I haven't used turn signals in like 4 years lol. There are no rules here. Police enforcement is almost non-existent and you can do basically whatever you want. The only thing you have to watch out for are meter maids and red-light cameras. However because the traffic is so terrible during rush hour I only use my car for leisure and I take the subway to get to class. Its kind of convenient to be able to study in the subway.
As soon as I go outside the city people are so courteous on the road and in general that I change my attitude completely, drive safely and courteously and just feel generally less stressed.
Hello Kobe08,
I think this is a great question.
My story: I ended up with over $250,000 loan. I studied on the East Coast, BU graduated in 2008.
When I started out I could not pay my loan and it went up close to $300,000.
I finally caught up on my finances in the last year and for the last 6 mo, I am paying double payments.
Still, I will have to pay my loan another 3.5 yrs at least.
Meaning, all together for the first 7 yrs of my career I have no money for myself.
I earn $9000-10,000/mo
Most of it is put towards Uncle Sam and my loan and I am left with about $2000 for my bills etc..which is not a lot.
Then by the time I paid it back I want to start a family.
I would just like to say that talking about paying back a student loan and actually doing it feels very different.
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If you goto any GP offices around Socal, you will notice that the general dentist only does the prep and the rest is left for the dental assistant to finish... even fabricating a temporary crown. These are not "expanded function"... they are just dental assistants with high school degree. They also do scaling and prophylaxis
and when my patients come back, I see subgingival calculus all over the place. 👎 I guess the dental board wants to make it legal to have these people do what they are already doing... perhaps a lot of pressure from the corporate dental offices? Who needs doctor to make diagnosis? My corporate office manager once jokingly asked me, why do we even need to take initial records for orthodontic patients? Just put them braces on and charge them! 😱- Joined
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you are 4 years out of school and making 100k-120k
is this the norm? may i ask where you are practicing?
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I'm pretty sure thats the norm if you are still an associate dentist.. You probably wont be making more till you have your own practice or working for a dental chain or get partner or something
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I am in Los Angeles and I hear a lot of dentists complaining about their practices and I see a lot of dental offices closing down or going banckrupt. One of the reasons is that after insurances and healthcare cuts people pay out of their own pocket and its hard times for everybody. And of course a lot of old school dentists are not willing or able to implement new technologies and online marketing. So my guess is that the business aspect of the dental field is shifting and not everybody is on top of the changes. But all things aside if you find a associate position than the pay is decent (about $400 - $650 a day)
I don't think you should rely on a rich spouse. You should rely on yourself and facts.
The challenges of starting out in the field and paying back a huge loan are often not discussed amongst colleagues because people are afraid it will make them look weak.
30yrs mortgage also does not sound promising. It will feel like a burden.
One should work to live and not live to work.
Work life balance is very important and you can only plan if you know the real facts.
And the fact is talking about paying back a loan and actually doing it feels different.
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I work 4 days a week, 9 to 5 30. It does not matter where I work from the perspective that a lot of my friends say the same things.
Dentists with stronger financial support have an easier time with repaying the loan and practice owners make more money.
Even then, if you own a practice, it is important to have associates, hygienists to really make the big cash.
Dentists with stronger financial support have an easier time with repaying the loan and practice owners make more money.
Even then, if you own a practice, it is important to have associates, hygienists to really make the big cash.
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do you have the option to work 5-6 days if you wanted to?
Not in this job.I occasionally do 5 days but mainly 4. It is a great job.
I have clinical independence and I am part of a great team.
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I didnt mean a millionaire spouse, I meant a 50K a year type spouse, that can at least contribute something to help.
PS paying back a loan is no different than paying a mortgage. Thats why you went to school and thats why you're paying the loan back. You shouldnt be afraid of the $$$, but be fiscally smart or conservative. Dont spend what you dont have, dont go to that 400K school vs. you're in-state 200K school, don't buy a BMW or 700K house or 10K vacation, live within your means and control the debt. Even if your monthly PMT is 3K a month, most entry level dentists earn 5K a month (post tax) so its not that difficult to pay off your debt in 10 years and then start making bank.
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can you quantify big cash?
Is it unrealistic to believe/expect that after my state school (should be ~140k in debt) and then if I get an ortho residency (I know more debt 🙁 ~100k) that making about 200-300k/yr at some point within the first 5 years of practice is a possibility?
*I'm very flexible about where I want to live. Where ever there is market demand I will be there.
*I'm very flexible about where I want to live. Where ever there is market demand I will be there.
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Yes. Specializing gives you a much higher starting salary on average. If you think you can match to ortho then this is the route you should pursue...forget med school 😀
Now let's wait for someone from Southern California to post about how dentists and orthodontists are all homeless there.
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Here's something for you since you believe all IM work 35 hours a week 😀 this is straight from an MD so I hope you believe it since I see you read a lot on the MD forums and are probably more interested in that route.
http://benbrownmd.wordpress.com/
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