Last minute doubts

[Mocizzle]

---

Members don't see this ad.

Hi everyone, I recently got into a great dental school and was excited to go, but I've been doing a ton of research before I drop this deposit and take the loan out to make sure if I want this and can't help but feel each day that passes i'm more unsure than the last. I would like to point people to the comments at the bottom of this blog Why to not choose dentistry • Become A Dentist

some of my issues I would like answered if possible by practicing dentists

1. There seems to be this concern of having to 'convince' patients of procedures that they need as opposed to them actually needing/wanting it in and of themselves
2. A high chance for unethical practice especially as a fresh graduate working as an associate due to owners hounding you to 'produce' more even if the patient doesn't need it
3. The lack of patient satisfaction resulting in personal dissatisfaction since apparently "everyone hates the dentist" and ironically I kind of hate going to the dentist too, but it's because i understand i need to that I do go voluntarily
4. It seems so many practicing dentists are just straight up depressed, (even my own said he almost snapped 2x and went into finance or something)
5. Seems more and more the idea of owning your own practice is becoming increasingly difficult and having to work in more rural areas is becoming more of a reality

Pros: Great lifestyle, paid per procedure as opposed to a flat salary so $$ goes up with experience, working with your hands is fun, relieving people of pain is rewarding (but it seems most patients whom are in a well educated area wouldn't be in pain for the most part)

It seems the top three concerns are mitigated by going into a specialty, however to be completely honest the only specialty I like is oral surgery, which i think would be amazing to be completely honest and is really the only thing keeping me in this game and from quitting

I can't help but think maybe i'd feel happier if I just went into medicine?
cons of medicine though: unless you match into a specialty catering to lifestyle you're work life balance is terrible. We have family friends who are cardiologists whom I cannot imagine are making anything less than half a million but openly claim they work on avg 70+ hour weeks. Wth? I aint doing that ish for 2 million idc. I wouldnt mind sucking it up for a period of residency but that would not be palatable as a permanent thing.
But it seems with medicine maybe I wouldn't have to deal with this same b.s that dentistry is? I don't really care about work being 'fun' I just want it to be decent, make me feel fulfilled, and give me a good lifestyle; i'll even take a paycut to have the previous things I mentioned. Opthamology seemed cool, or cardiology but at half the hours seemed great? I'd probably never own my clinic as a dentist does but at least i'd be in a hosptial/multiclinic in a nice city area with full benefits. What turns me off is i'd hate the idea of being in family med or primary care, or being an internist working 50+ hours weeks. Also it would take me another 2 years to get into medical due to me needing some clinical experience and taking the mcat, my science gpa is 4, total like 3.9, academically i'm confident (always been good student) i got a 99.8% on my DAT and of course the mcat is much harder but feel confident i could do mid tier and up God willing

I honestly just feel so uneasy, taking the pre med classes everything felt fine, shadowing felt fine too. Do the dentists I shadowed just have it good? Is it because I never really thought about it this much? Should i just put my head down and grind and hope i get into a specialty i want? Or hop ship and just go medicine?

any advice would be great thanks

 

[luisfigo]

1. You don't have to go "that" rural to do well, there are plenty of suburbs, and medium to large size towns around the major cities that are 30 min drive away
2. A lot of dentists love their jobs, I've never met a single one that regretted it,(yet) most don't have to "convince" their patients of anything, they present options, assistants are often the ones who deal with pricing
3. there is not a "high chance" of unethical practice unless you're already planning chasing money at the patient's expense, and you're only a new grad once, nothing says you have to work corporate forever
4. There a lot of people that love their dentist, the majority I would say
5. You have the ability to practice however you want as a general dentist, only want to do dentures, oral surgery, endo, ortho? that's up to you
6. You honestly know nothing about oral surgery and if you even like pulling teeth or any of the other procedures or specialties; you've never done it
7. The people that hate dentistry go into it for the wrong reasons and were not honest with themselves during the process about why they were doing it
8. If you like treating, helping, interacting with people you're probably going to like it
9. I'm also in Texas where dentists are slaves to debt

 

[Mocizzle]

1. You don't have to go "that" rural to do well, there are plenty of suburbs, and medium to large size towns around the major cities that are 30 min drive away
2. A lot of dentists love their jobs, I've never met a single one that regretted it,(yet) most don't have to "convince" their patients of anything, they present options, assistants are often the ones who deal with pricing
3. there is not a "high chance" of unethical practice unless you're already planning chasing money at the patient's expense, and you're only a new grad once, nothing says you have to work corporate forever
4. There a lot of people that love their dentist, the majority I would say
5. You have the ability to practice however you want as a general dentist, only want to do dentures, oral surgery, endo, ortho? that's up to you
6. You honestly know nothing about oral surgery and if you even like pulling teeth or any of the other procedures or specialties; you've never done it
7. The people that hate dentistry go into it for the wrong reasons and were not honest with themselves during the process about why they were doing it
8. If you like treating, helping, interacting with people you're probably going to like it
9. I'm also in Texas where dentists are slaves to debt

tbh this post is refreshing but as for oral surgery specifically, i have shadowed and even assisted, its a great lifestyle, money, fun procedures with ranging difficulty from simple/complex extractions to jaw reconstruction and you can choose where you want to be
I love the work of dental or atleast it's pretty good, it's just these extraneous factors that are bothering me

 

[dentistspec123]

You are very smart and very right to be concerned. Committing to a career and dental school especially is a huge deal. Your total loan amount matters and you've taken a great first step, stepping back and analyzing the situation before you commit. I am a practicing Pedo in a upperish middle class suburb an hour outside a major north east metro, I am also almost 3 years out of residency so am a younger dentist and can give you a current perspective probably unlike the older dentists you shadowed. I will throw my 2cents in.

1. There seems to be this concern of having to 'convince' patients of procedures that they need as opposed to them actually needing/wanting it in and of themselves
This will vary definitely by the population you serve. If you are going to deal with weller-to-do folks in a upper class suburb you WILL get pushback from treatment. Younger families and parents I deal with also have higher pushback as this newer generation questions everything and think WebMD gives them authority over their kids treatments (for me as a pedo). However, state insurance patients in the inner city are less likely to pushback treatment but of course reimbursements will be lower. This is a multi-faceted concern but overall I would say you don't overtly need to convince anyone anything. However, when I worked as a general dentist for a year, I definitely did feel forced to sell treatments from my bosses as an associate, especially in lower caries populations. More aesthetic cases = more $$. But at the end of the day you don't need to do it but you will just make/produce less
2. A high chance for unethical practice especially as a fresh graduate working as an associate due to owners hounding you to 'produce' more even if the patient doesn't need it
See above, yes this is true, but not every boss/owner is like this but they are definitely out there and sadly you wont know until you start working for them. I had a job like this, and I left quickly. If you are not comfortable doing it LEAVE. It will be a waste of your time and it will test your ethics but do not fall into this.
3. The lack of patient satisfaction resulting in personal dissatisfaction since apparently "everyone hates the dentist" and ironically I kind of hate going to the dentist too, but it's because i understand i need to that I do go voluntarily
I would say most of my patients/parents are appreciative and do enjoy going to the dentist. You will have those patients who will never forget to tell you "I hate coming here" "I hate the dentist so that's why my son hates the dentist.". I don't think this is that much of an issue however.
4. It seems so many practicing dentists are just straight up depressed, (even my own said he almost snapped 2x and went into finance or something)
10000% this is something dental students and myself included overlook before I choose this profession. This is huge especially if you are an extrovert like me. Dentistry is very isolating. I repeat, dentistry is ISOLATING. You are usually working as a sole provider, with no peers. Your other workers at your jobs are your assistant or hygienist or front desk and at the end of the day even as an associate you are their superior. As an associate your boss/owner hired you so they can work less or give you the ****ty hours so don't expect most to want to work along side you and mentor you; you will most likely be working alone most days in a small private practice running from chair to chair with little downtime and no socializing. After work don't expect to go on happy hours with your coworkers as they are not your equivalents. Even as an MD working in a hospital you will interact with other doctors, go on rounds, talk to and work with nurses, PAs, other departments, review cases at the hospital boards/meetings. I have doctor and nurse and PA friends and they have a much livelier work environment. When they have downtime in the hospital they socialize in their unit or do this or that....when you have downtime at your dental office your stressing by yourself about your low production that day with nobody else to relate to you. This aspect of dentistry coupled with massive amounts of debt, patient stresses etc can definitely lead to depression.
5. Seems more and more the idea of owning your own practice is becoming increasingly difficult and having to work in more rural areas is becoming more of a reality
Yes this is absolutely true. All metro areas are saturated, period. If you want to practice dentistry in a major metro as a fresh grad associate and have over 400,000 in loans, absolutely forget it. I have friends who associate in LA and NYC and they are either on pay as you earn with no foreseeable debt payback in their future as their interest accrues higher than their payments and are basically in denial. I also have friends who are working their ass off 6 days a week, evenings, 4-5 jobs to pay back their loans. The ones that aren't doing either had their education paid for. I wouldn't necessarily say going rural is necessary but going to a small town is most likely to maximize your profit as long as the area can sustain a dentist/has a moderate-high income of most residents. (PS are you willing to move to a small town? even more isolating) The days of just setting up shop and people coming to you are long long gone. Opening a practice is not a sure fire way to success. Also do you know where to find a dental practice broker? how to evaluate a practice's overhead or profitability. How to appraise a practice? What the average insurance reimbursements of a practice is for the location you are in? NO dental school will not teach you this, but you will be expected to know this when purchasing or running a practice. Straight up, ownership is hard and you will have to teach yourself a whole side of business you are not trained for. It is stressful, time consuming, and risky. The benefit can pay off but the risk is much much higher in this day in age. I know one of my friends whos struggling to get his off the ground, saddling over 750000 in debt. Don't be fooled by outside looks of wealth, not everyone can be successful in business, and dentistry at the end of the day is a business too.

Pros: Great lifestyle, paid per procedure as opposed to a flat salary so $$ goes up with experience, working with your hands is fun, relieving people of pain is rewarding (but it seems most patients whom are in a well educated area wouldn't be in pain for the most part)
This is a double edged sword. $$ goes up with experience and speed but there is alot not under your control. Patients cancel, people evade payments, this is not a perfect world where everyone shows up and everyone pays on time. You will feel every cancellation especially as an associate and even when youre busy, hustling dentistry will get tiring. Some days you just won't want to drill a 1mm box class 2 filling. Your eyes and back will hurt, this is a physically demanding and very intricate/precise profession and unfortunately one based on commission. You do NOT get paid if the patient doesnt show up or doesnt pay. There is no ceiling on how much you can make but there also isnt much of a safety net either. Dentistry sometimes will feel like probably the most unstable healthcare career there is. If you are a hospital doctor and your unit is slow and you only see two patients, you STILL get paid, you STILL get benefits, you STILL can take a sick day or paid vacation day. Dentistry will not give you any of this security, you grind it out, produce and make money, but must provide yourself with your own benefits, taking a vacation will cost you not only the money spent on the vacation but money lost on production, you will be behind retirement savings than most of your friends in the business, tech or medical hospital sector for the sole fact that they will get 401k matching and you won't. In short, you can make money, but its hard to scale in dentistry and it definitely isn't a "safe bet" profession. I wish someone told me this when I decided to do this. Please take this part seriously before you consider dentistry.

Working with your hands is fun, but again dentistry is physically demanding. Relieving patient's pain IS rewarding.

At the end of the day dentistry in my opinion is still OK. No great anymore at all but "OK." My advice to you is to really figure out your personality type, your end goal location, and your risk tolerance/debt load. If you like being in a high energy environment with tons of people, tons of coworkers etc, dentistry will not provide you with that, expect small solo days at the office with pretty repetitive procedures. If you are from a metro and think "O I will just move to a small town and make it work" think again, your young self now will be more willing to do things than your older self later. If you have any inclination that you may need to be in a metro like me (due to family, friends, spouse, ps your spouse in most any other profession for example will need to be near a metro while you will need to be near the opposite) I would not lean toward dentistry. Finally, if your debt load is somewhere around 200,000 dentistry I would say would still have a decent benefit to outweigh risk. Any debt load over 400,000 I would NOT recommend this profession. Period.

Best of luck.

 

[artist2022]

Moving to where you'd get more responses from dentists

 

[321931]

Alot of people have answered questions here that are well thought out. But I will address something else::
I can't help but think maybe i'd feel happier if I just went into medicine?

I will answer these three thoughts into one answer. Times change. Turn on the news. Do you see whats happening in Washington DC. It's called social movements in the healthcare arena- aka Universal Healthcare. We have worked with a model of insurance for a long time, but there is movement within the people, and progressives that want to change the way medicine in this country is done. Forget about what I tell you. Forget about what the old dentist who has been practicing for 30 years and has all his debts paid off and can retire tommorow. Because you will not face those same challenges as me or the old dentist- and you will ALSO not reap the the same rewards we have gone through.

When you graduate from school you will be a new dentist 2023/medical school 2025ish. Today's compensation is based on today's dentistry/medicine model. What happens if that model changes? What happens if we do adopt a universal healthcare policy and you are paid like a physician 80-100k euro Germany/UK....45k Euro Dentist. Do you think just because the healthcare model changes and you have a boatload of debt that it will be forgiven?

Noone has the answers for this, but I do personally think the healthcare arena will change in the upcoming decade. I don't think it will be as drastic as the european system, but there has to be changes. Medicine is expensive. The family of four can't even meet their deductible while paying expensive premiums every month. Don't be surprised if the healthcare industry changes and don't be surprised if you are working longer hours, seeing more patients for less compensation as a result.

While there is no clear consensus on what will change, or if it will ever change...my bet is that it will change. And my bet is medicine will get the worse end of it. So I'm glad to be a dentist.

 

[setdoc7]

I will echo the lonely part of being a dentist, even if you work in a group practice, when you are working, you are working alone. Dentistry can be fun, and it can be very rewarding, but you will have to find your own way if you are not part of a dental family.

 

[deleted923283]

It seems the top three concerns are mitigated by going into a specialty, however to be completely honest the only specialty I like is oral surgery, which i think would be amazing to be completely honest and is really the only thing keeping me in this game and from quitting

Do not go to dental school assuming you'll become an oral surgeon. Lots of kids do that, and they end up very very disappointed. The chances of getting accepted to the programs are low already, and life throws you around in ways you cannot predict during dental school - don't set yourself up for tragedy. The question you need to answer (to yourself) right now: Are you comfortable with the future of becoming a dentist?

 

[ab117]

I think your concerns are valid, but I also think they can all be mitigated by making sure you do research. Don’t take a sketchy job, don’t move somewhere where you’ll have to compromise your standards to make enough money to live there, do your best to know what you’re getting yourself into before taking steps and I’d bet you’ll be fine.

I was interested in both dental and medicine since years ago. As I did more research I had the same concerns as you about long work weeks, always being an employee, etc on the med side and decided to go to dental school with OMFS as my goal. I feel like there’s a stigma about stupid clueless predents thinking they know they want to be surgeons when they’ve never even drilled teeth, but I think the same argument applies to anyone trying to decide they want to become a dentist over a doctor or vice versa, or an engineer over either, or anything. People change careers all the time because they go into things and don’t end up loving it, and it’s just about impossible to know how you’ll feel about a career before being in it for years. Shadowing doesn’t even scratch the surface of knowing whether or not you’ll like something after you’ve been doing it for 20 years. All you can do is find out all you can about things that seem interesting and then pick one to try for. If you read OMFS topics here on the forums, you’ll see that many D3s/D4s applying and interviewing, current residents, and practicing surgeons were participating in threads as predents or D1s and they came to dental school specifically to become OMFS. Also, since starting dental school, I’ve never encountered anything like the dismissive attitude towards naive prospective specialists that I often see on SDN. The OMFS faculty, other faculty, and upperclassmen have been very encouraging to me and the other 5-6 D1s interested in surgery. However, I also believe that making a decision like that could be very foolish without a high level of confidence that you have the ability to get A’s in most if not all classes, that you will stay motivated enough to get those grades through all 4 years of school and to do well on the CBSE and then go on to a difficult residency program for several more years.

It requires some self examination and if you’re not sure about your capacity and/or drive you may find yourself in a less favorable situation in four years than you expected if you get accepted to one expensive school and have a hard time with your loans after graduating. Realistically, that’s going to happen to a lot of people currently in and applying to dental school and that’s why if anyone in this thread starts talking about more about whether or not it’s worth it for you to pick dent over med to bank on getting into OMFS, @Big Time Hoosier is going to show up and rightfully tell you, probably not unless you get into a cheaper school. Obviously I just admitted I did the same thing, but I went into it after trying to carefully evaluate my realistic ability to achieve that goal and decided it was worth the risk. Also, I’m absolutely not trying to sound like “ending up” as a GP is an appropriate thing to say or that being a GP is less desirable or anything, tons of people smarter than me would rather be a GP than a surgeon, it’s a question of personal interest, not ability or hierarchy. I’m just framing this from the perspective of someone intending to specialize because it’s what aligns with my interests.

 

[Mocizzle]

I think you’re concerns are valid, but I also think they can all be mitigated by making sure you do research. Don’t take a sketchy job, don’t move somewhere where you’ll have to compromise your standards to make enough money to live there, do your best to know what you’re getting yourself into before taking steps and I’d bet you’ll be fine.

I was interested in both dental and medicine since years ago. As I did more research I had the same concerns as you about long work weeks, always being an employee, etc on the med side and decided to go to dental school with OMFS as my goal. I feel like there’s a stigma about stupid clueless predents thinking they know they want to be surgeons when they’ve never even drilled teeth, but I think the same argument applies to anyone trying to decide they want to become a dentist over a doctor or vice versa, or an engineer over either, or anything. People change careers all the time because they go into things and don’t end up loving it, and it’s just about impossible to know how you’ll feel about a career before being in it for years. Shadowing doesn’t even scratch the surface of knowing whether or not you’ll like something after you’ve been doing it for 20 years. All you can do is find out all you can about things that seem interesting and then pick one to try for. If you read OMFS topics here on the forums, you’ll see that many D3s/D4s applying and interviewing, current residents, and practicing surgeons were participating in threads as predents or D1s and they came to dental school specifically to become OMFS. Also, since starting dental school, I’ve never encountered anything like the dismissive attitude towards naive prospective specialists that I often see on SDN. The OMFS faculty, other faculty, and upperclassmen have been very encouraging to me and the other 5-6 D1s interested in surgery. However, I also believe that making a decision like that could be very foolish without a high level of confidence that you have the ability to get A’s in most if not all classes, that you will stay motivated enough to get those grades through all 4 years of school and to do well on the CBSE and then go on to a difficult residency program for several more years.

It requires some self examination and if you’re not sure about your capacity and/or drive you may find yourself in a less favorable situation in four years than you expected if you get accepted to one expensive school and have a hard time with your loans after graduating. Realistically, that’s going to happen to a lot of people currently in and applying to dental school and that’s why if anyone in this thread starts talking about more about whether or not it’s worth it for you to pick dent over med to bank on getting into OMFS, @Big Time Hoosier is going to show up and rightfully tell you, probably not unless you get into a cheaper school. Obviously I just admitted I did the same thing, but I went into it after trying to carefully evaluate my realistic ability to achieve that goal and decided it was worth the risk. Also, I’m absolutely not trying to sound like “ending up” as a GP is an appropriate thing to say or that being a GP is less desirable or anything, tons of people smarter than me would rather be a GP than a surgeon, it’s a question of personal interest, not ability or hierarchy. I’m just framing this from the perspective of someone intending to specialize because it’s what aligns with my interests.

I think this is beautiful, to clarify I never hated GP at all! I think youre right, with some research I could get out of some of the predicaments i've seen. Best case scenario I get in and get my dream job, worst case ill be happy as a dentist and make it work, or maybe ill like another specialty who knows

 

[ab117]

I think this is beautiful, to clarify I never hated GP at all! I think youre right, with some research I could get out of some of the predicaments i've seen. Best case scenario I get in and get my dream job, worst case ill be happy as a dentist and make it work, or maybe ill like another specialty who knows

And that's exactly my point. @Ivy.ch right above me is also absolutely correct even though I said kinda the exact opposite of what he did. Lots of these people don't even get into dental school when they tell everyone in undergrad they're going to be an OMFS. Lots try at first and get straight B's D1 and never apply cause they assume (maybe correctly maybe not) that they won't be competitive. I'd be relatively willing to bet though, that the ones who do some serious self examination and plenty of research before making decisions are highly represented among current residents and practicing surgeons.

 

[ab117]

honestly if it were my son/daughter and it was between medicine vs general dentistry, i'd say medicine 100%. being an employee is actually a good thing (ie stability especially in major cities). also, no way medicine is as physically demanding as general dentistry! last but not least, if you are into ego and pride, then MD carries heckuhvuhlot more prestige than DMD/DDS. oh yeah med school is on average cheaper than dental school let alone their paid residency.

it def muddies the water when it becomes medicine vs specialty like OMFS or peds..., then id say you can't go wrong with either

I think you're right that being an employee can be an advantage, but I also think it's definitely true that being an owner also can be an advantage. It's much, much less common in medicine anymore from what I understand, while it's a completely viable option in dental. To a lot of people, that's a huge pro for dent and huge con for med.

 

[TanMan]

Hi everyone, I recently got into a great dental school and was excited to go, but I've been doing a ton of research before I drop this deposit and take the loan out to make sure if I want this and can't help but feel each day that passes i'm more unsure than the last. I would like to point people to the comments at the bottom of this blog Why to not choose dentistry • Become A Dentist

some of my issues I would like answered if possible by practicing dentists

1. There seems to be this concern of having to 'convince' patients of procedures that they need as opposed to them actually needing/wanting it in and of themselves
2. A high chance for unethical practice especially as a fresh graduate working as an associate due to owners hounding you to 'produce' more even if the patient doesn't need it
3. The lack of patient satisfaction resulting in personal dissatisfaction since apparently "everyone hates the dentist" and ironically I kind of hate going to the dentist too, but it's because i understand i need to that I do go voluntarily
4. It seems so many practicing dentists are just straight up depressed, (even my own said he almost snapped 2x and went into finance or something)
5. Seems more and more the idea of owning your own practice is becoming increasingly difficult and having to work in more rural areas is becoming more of a reality

Pros: Great lifestyle, paid per procedure as opposed to a flat salary so $$ goes up with experience, working with your hands is fun, relieving people of pain is rewarding (but it seems most patients whom are in a well educated area wouldn't be in pain for the most part)

It seems the top three concerns are mitigated by going into a specialty, however to be completely honest the only specialty I like is oral surgery, which i think would be amazing to be completely honest and is really the only thing keeping me in this game and from quitting

I can't help but think maybe i'd feel happier if I just went into medicine?
cons of medicine though: unless you match into a specialty catering to lifestyle you're work life balance is terrible. We have family friends who are cardiologists whom I cannot imagine are making anything less than half a million but openly claim they work on avg 70+ hour weeks. Wth? I aint doing that ish for 2 million idc. I wouldnt mind sucking it up for a period of residency but that would not be palatable as a permanent thing.
But it seems with medicine maybe I wouldn't have to deal with this same b.s that dentistry is? I don't really care about work being 'fun' I just want it to be decent, make me feel fulfilled, and give me a good lifestyle; i'll even take a paycut to have the previous things I mentioned. Opthamology seemed cool, or cardiology but at half the hours seemed great? I'd probably never own my clinic as a dentist does but at least i'd be in a hosptial/multiclinic in a nice city area with full benefits. What turns me off is i'd hate the idea of being in family med or primary care, or being an internist working 50+ hours weeks. Also it would take me another 2 years to get into medical due to me needing some clinical experience and taking the mcat, my science gpa is 4, total like 3.9, academically i'm confident (always been good student) i got a 99.8% on my DAT and of course the mcat is much harder but feel confident i could do mid tier and up God willing

I honestly just feel so uneasy, taking the pre med classes everything felt fine, shadowing felt fine too. Do the dentists I shadowed just have it good? Is it because I never really thought about it this much? Should i just put my head down and grind and hope i get into a specialty i want? Or hop ship and just go medicine?

any advice would be great thanks

I get the feeling that you are uneasy about the tough parts of dentistry. Your top 3 concerns are NOT mitigated by going into a specialty. You still have to sell procedures. Just because you're a specialist, does not mean that you don't have to sell. Also, if you're going into corporate, you have your targets too.... and patients don't automatically love you because you're a specialist.

I don't see why anyone would want to go into medicine. There's so much more schooling and work. The opportunity cost is staggering of forgoing dentistry for medicine. Medicine might be more stable, but if you had to go to an extra 3-5 years of school, that's 6-10% of your prime lifespan (assuming you live to be 50).

If your objective is prestige and job satisfaction, I get the sense that you might be better served in medicine/academics. If you value flexibility, family time, and money, dentistry would be a better choice. I work 33 hours a week making more than most family practice docs. I don't know much about the specialties of medicine, but I think you might be hard pressed to find a physician that works 33 hours a week netting 1M+/year.

Answers to your questions:
1. There seems to be this concern of having to 'convince' patients of procedures that they need as opposed to them actually needing/wanting it in and of themselves

There is nothing wrong in convincing patients to get treatment that the need or want. Any service based industry is based on selling. If you don't sell, you don't eat. I think you are asking the wrong question. The real question is: Does the patient really need what you are recommending? If you doubt yourself as a doctor, it shows when you present treatment. I believe in everything I present, and if the patient doesn't want to get it done, they can get a second opinion. I learned to stop chasing a sale when I have other patients waiting for me.

2. A high chance for unethical practice especially as a fresh graduate working as an associate due to owners hounding you to 'produce' more even if the patient doesn't need it

Yes, very high chance in corporate. You need to produce to make money. Are you going to make up work to produce, or will you find enough legitimate dentistry to perform. I don't think you can blame the owner as much as yourself. There's definite pressure, but it's often the associate's greed that will be the prime motivating factor.

3. The lack of patient satisfaction resulting in personal dissatisfaction since apparently "everyone hates the dentist" and ironically I kind of hate going to the dentist too, but it's because i understand i need to that I do go voluntarily

I wouldn't want a prostate exam, but if I had to, I'll get it... same deal. I don't care what people think of me when I'm seeing them or working on them. You're providing a service that everyone needs and if they choose to demonstrate that in a childish manner, then that's their problem. If a patient says it jokingly, I go along with the joke. If a patient is serious about it, I have a serious talk about whether they want to be there or not. If not, then they should be sedated. I try and set professional boundaries early for difficult patients. As an emergency dentist, most patients LOVE you when you get them out of pain.

4. It seems so many practicing dentists are just straight up depressed, (even my own said he almost snapped 2x and went into finance or something)

Yes. Unfortunately, a lot of dentists are on illicit drugs, one died in my area recently of an OD. Some of my professors in dental school were on drugs until they had their licensed suspended and eventually ended up teaching. I'm lucky that my demographics aren't that picky. When I get a string of picky/difficult patients, I think to myself, no wonder dentists want to kill themselves. I'd kill myself if all my patients were like this. My frustration goes away when I say goodbye to my last patient and I see the production of the day.

5. Seems more and more the idea of owning your own practice is becoming increasingly difficult and having to work in more rural areas is becoming more of a reality

It's difficult if you want to stay in a major metro area. If you go into a suburban/rural area, there's still plenty of opportunity.

 

[Mocizzle]

I get the feeling that you are uneasy about the tough parts of dentistry. Your top 3 concerns are NOT mitigated by going into a specialty. You still have to sell procedures. Just because you're a specialist, does not mean that you don't have to sell. Also, if you're going into corporate, you have your targets too.... and patients don't automatically love you because you're a specialist.

I don't see why anyone would want to go into medicine. There's so much more schooling and work. The opportunity cost is staggering of forgoing dentistry for medicine. Medicine might be more stable, but if you had to go to an extra 3-5 years of school, that's 6-10% of your prime lifespan (assuming you live to be 50).

If your objective is prestige and job satisfaction, I get the sense that you might be better served in medicine/academics. If you value flexibility, family time, and money, dentistry would be a better choice. I work 33 hours a week making more than most family practice docs. I don't much about the specialties of medicine, but I think you might be hard pressed to find a physician that works 33 hours a week netting 1M+/year.

Answers to your questions:
1. There seems to be this concern of having to 'convince' patients of procedures that they need as opposed to them actually needing/wanting it in and of themselves

There is nothing wrong in convincing patients to get treatment that the need or want. Any service based industry is based on selling. If you don't sell, you don't eat. I think you are asking the wrong question. The real question is: Does the patient really need what you are recommending? If you doubt yourself as a doctor, it shows when you present treatment. I believe in everything I present, and if the patient doesn't want to get it done, they can get a second opinion. I learned to stop chasing a sale when I have other patients waiting for me.

2. A high chance for unethical practice especially as a fresh graduate working as an associate due to owners hounding you to 'produce' more even if the patient doesn't need it

Yes, very high chance in corporate. You need to produce to make money. Are you going to make up work to produce, or will you find enough legitimate dentistry to perform. I don't think you can blame the owner as much as yourself. There's definite pressure, but it's often the associate's greed that will be the prime motivating factor.

3. The lack of patient satisfaction resulting in personal dissatisfaction since apparently "everyone hates the dentist" and ironically I kind of hate going to the dentist too, but it's because i understand i need to that I do go voluntarily

I wouldn't want a prostate exam, but if I had to, I'll get it... same deal. I don't care what people think of me when I'm seeing them or working on them. You're providing a service that everyone needs and if they choose to demonstrate that in a childish manner, then that's their problem. If a patient says it jokingly, I go along with the joke. If a patient is serious about it, I have a serious talk about whether they want to be there or not. If not, then they should be sedated. I try and set professional boundaries early for difficult patients. As an emergency dentist, most patients LOVE you when you get them out of pain.

4. It seems so many practicing dentists are just straight up depressed, (even my own said he almost snapped 2x and went into finance or something)

Yes. Unfortunately, a lot of dentists are on illicit drugs, one died in my area recently of an OD. Some of my professors in dental school were on drugs until they had their licensed suspended and eventually ended up teaching. I'm lucky that my demographics aren't that picky. When I get a string of picky/difficult patients, I think to myself, no wonder dentists want to kill themselves. I'd kill myself if all my patients were like this. My frustration goes away when I say goodbye to my last patient and I see the production of the day.

5. Seems more and more the idea of owning your own practice is becoming increasingly difficult and having to work in more rural areas is becoming more of a reality

It's difficult if you want to stay in a major metro area. If you go into a suburban/rural area, there's still plenty of opportunity.

Can you explain more on emergency dentistry? I believe honestly this is the ticket for what I need
(High patient + personal satisfaction, complexity of cases, lack of needing to 'sell' procedures, etc) what do you think?

 

[Greyangel6]

Can you explain more on emergency dentistry? I believe honestly this is the ticket for what I need
(High patient + personal satisfaction, complexity of cases, lack of needing to 'sell' procedures, etc) what do you think?

I'm a D4 graduating in 2 weeks so I don't have working experience to offer any advice. But I hope I can clarify "emergency dentistry" for you since it's a model that I have looked to pursue before but is unrealistic and limiting. For me, it means being able to do what it takes to relieve patient of pain temporarily until they see a specialist/GP that can restore - cases such as restoration fell out, infection, trauma, etc. or definitively (extraction, pulpectomy).

You've already stated the pros. Let me tell you about the cons of ONLY doing emergency dentistry
1) not competitive compared to private offices/corporate - you will see job postings and resumes that list being able to manage emergency as one of the skillsets. So aside from doing emergency dentistry, these offices also offer MORE than what you do in your emergent care clinic.

2) low production compared to many other aspects of dentistry - you're limiting yourself in terms of procedures that you do, especially since you won't be doing the high production cases such as crowns, bridges, implants, etc.
A mentor once told me that typically the money made from fillings and cleanings is to pay taxes, pay for staff, pay landlord, etc., the money made from prosth (crowns, bridges, dentures, etc.) is to pay for your house, your car and your family.

3) complexity of the cases will depend on many things but mostly need of the patient. For example, if your clinic is near a homeless shelter, you won't make any money doing endo, bridges or crowns since there's not enough need. Most likely you will be prescribing antibiotics, pain meds, and simple extraction.

4) liability - you don't want to do anything that you are not trained extensively on, especially with an emergency. You're basically marrying the complications that arises if you decide to treat the patient with procedures that are out of your scope (your license could be on the line if you mess up).

5) you're dealing with people in pain. Pain often makes some patients extremely difficult to examine and to treat. A patient grabbed my hand while I was giving anesthesia (extremely dangerous!!). Another patient bit me while I was palpating the painful area. Looking back at these experiences, I don't want to only do emergency haha.

I am not saying don't pursue emergency dentistry lol. I'm saying to make it part of your skillset. Good luck deciding.

 

[2TH MVR]

@Mocizzle

You have valid concerns about dentistry. I can only offer opinions from someone who has practiced orthodontics for the last 26 years.

I originally wanted to go into medicine. I chose dentistry because I did not want to deal with life and death decisions. I felt that my outgoing, extroverted personality was more suited to dentistry. During D2 of DS .... I realized that I was just not interested in general dentistry. I felt like a tooth technician. Therefore I decided to pursue orthodontics.

In my opinion ... the overlying problem with dentistry as a whole is that you ultimately become a SALESPERSON in convincing your patients to buy your product (dentistry, ortho, whatever ......). Maybe this is less so for OMFS and that is because OMFS is more related to medicine than dentistry IMO. Everything else in dentistry. SALES. Different levels of treatment options. Want a filling. You can do a cheap composite filling. How about a nice porcelain style filling. Different levels of restorations. How about ortho? Aligners. Different braces: self ligating, clear brackets, gold brackets, ss brackets. For an additional $100 you can get gold coated or teflon coated wires. Missing a tooth? Partial, bridge, implant .... all different costs for individual budgets. Patients walk into the ortho office. I'm trying to convince patients to buy my product (straight teeth). Yes .... ortho is elective along with other cosmetic procedures, but many dental procedures (RCT, infections, perio disease, deep caries, etc. etc. are not elective, but necessary for proper health. But patients do not necessarily see it this way. They are bombarded with advertising comparing prices to dental procedures.

I never went into dentistry/ortho to become a salesperson. Most areas of medicine do not involve SELLING. Not talking about elective cosmetic surgery, derm, etc. etc. Medicine as a whole is more about diagnosis and treatment and less about different levels of treatments at different costs. You don't see (most) medical doctors selling their product. I want to be a good doctor .... not a saleperson. I want patients to choose my services based on my reputation as a good dentist .... not because my name pops up 1st on a google search, or I offered braces for $99 per month.

The other positive to dentistry is ... or shall I say .... was autonomy in owning your own practice. As another poster corrected stated .... this is not easy to do in a saturated, urban area. Too much competition with EVERYONE SELLING their products. Corps have HUGE marketing budgets to attract new patients. But even the Corps are having issues competing with other Corps. I see it everyday. I work Corp. Our new patient starts are on the decline since there is another Corp nearby that has cut their ortho fee to around $3000. Our ortho fee is higher .... as it should be. Patients don't care about my experience or qualifications or personality. All they care about is the PRICE.

So .... the question for you is. Do you want to sell dentistry or practice medicine? They are entirely different.

 

[deleted659902]

As an emergency dentist, most patients LOVE you when you get them out of pain.

until they see the bill

 

[desertrat12]

Still a student, so I've got no real world experience. But I went through a similar process as you, just in reverse order. I took the MCAT, did well, applied, etc..ended up jumping ship for dentistry... At the time I thought I was making the exact best decision, now going into my 3rd yr of dental school and looking back, I realize I'd probably be just as happy in medicine. For a large part of the first semester, I felt I should have done medicine. I no longer think that. If career decision regret/doubt creeps into my mind its the regret that I chose healthcare, rather than finance or tech... here are just a few questions that helped me decide dentistry over medicine, as well as where my initial thought process was incorrect.

1. I loved shadowing surgeons (both medical and oral surgeons). Most surgical fields are very competitive, medicine or dentistry. If I ended up not being a strong enough applicant for surgery, would I be happier as a family doc, or a general dentist?

1a. This isn't entirely true though, there are LOTS of fields in medicine. The choice isn't a surgeon or family practice. And with enough determination, you likely could get accepted to a surgical field OR something else awesome like emergency med, anesthesia, etc...Its also not true in dentistry. Your option isn't just oral surgeon or general dentist. Lots of other specialties. I came into school thinking I would HATE end (looking back I have no clue why I thought that). Well now that I've done some endo, turns out I REALLY like it. So much so that its made me questions my desire for oral surgery. Also, perio is awesome, peds is pretty cool...unfortunately you won't know what you want until school. But you've got to make some decision, so shoot for what is most interesting to you, and adjust along the way if neccesary.

2. I thought dentistry would be great for family, much better hours, etc...

2a. Still true for dentistry, but I did not realize that is it ALSO true for doctors if they want it. Plenty of docs out there choosing less shifts, or fewer hours. Bottom line, the choice simply isn't dentstry and great lifestyle vs internist with 50+ hour weeks.

3. Would I be willing to move to areas of need in order to do well in dentistry? ...I thought so 3 years ago...but now?

3a. I still think so, but it is much more complicated. I've got a wife, and kids, and life comes and brings different perspectives that you often can't anticipate. Luckily my family is supportive of the "go where there is need" mentality, but it still makes the decision more difficult.



Good luck in your decision...just don't try and convince or rationalize yourself out of what you really do want to do - whether that be medicine or dentistry.

 

[Mocizzle]

@Mocizzle

You have valid concerns about dentistry. I can only offer opinions from someone who has practiced orthodontics for the last 26 years.

I originally wanted to go into medicine. I chose dentistry because I did not want to deal with life and death decisions. I felt that my outgoing, extroverted personality was more suited to dentistry. During D2 of DS .... I realized that I was just not interested in general dentistry. I felt like a tooth technician. Therefore I decided to pursue orthodontics.

In my opinion ... the overlying problem with dentistry as a whole is that you ultimately become a SALESPERSON in convincing your patients to buy your product (dentistry, ortho, whatever ......). Maybe this is less so for OMFS and that is because OMFS is more related to medicine than dentistry IMO. Everything else in dentistry. SALES. Different levels of treatment options. Want a filling. You can do a cheap composite filling. How about a nice porcelain style filling. Different levels of restorations. How about ortho? Aligners. Different braces: self ligating, clear brackets, gold brackets, ss brackets. For an additional $100 you can get gold coated or teflon coated wires. Missing a tooth? Partial, bridge, implant .... all different costs for individual budgets. Patients walk into the ortho office. I'm trying to convince patients to buy my product (straight teeth). Yes .... ortho is elective along with other cosmetic procedures, but many dental procedures (RCT, infections, perio disease, deep caries, etc. etc. are not elective, but necessary for proper health. But patients do not necessarily see it this way. They are bombarded with advertising comparing prices to dental procedures.

I never went into dentistry/ortho to become a salesperson. Most areas of medicine do not involve SELLING. Not talking about elective cosmetic surgery, derm, etc. etc. Medicine as a whole is more about diagnosis and treatment and less about different levels of treatments at different costs. You don't see (most) medical doctors selling their product. I want to be a good doctor .... not a saleperson. I want patients to choose my services based on my reputation as a good dentist .... not because my name pops up 1st on a google search, or I offered braces for $99 per month.

The other positive to dentistry is ... or shall I say .... was autonomy in owning your own practice. As another poster corrected stated .... this is not easy to do in a saturated, urban area. Too much competition with EVERYONE SELLING their products. Corps have HUGE marketing budgets to attract new patients. But even the Corps are having issues competing with other Corps. I see it everyday. I work Corp. Our new patient starts are on the decline since there is another Corp nearby that has cut their ortho fee to around $3000. Our ortho fee is higher .... as it should be. Patients don't care about my experience or qualifications or personality. All they care about is the PRICE.

So .... the question for you is. Do you want to sell dentistry or practice medicine? They are entirely different.

How much is the "selling" a part of dentistry? my dentist never sold me anything tbh he just told me the diagnosis and my options, same with the dentist i shadowed, never felt he had to sell a thing? then again they didnt really do cosmetics

 

[TanMan]

Can you explain more on emergency dentistry? I believe honestly this is the ticket for what I need
(High patient + personal satisfaction, complexity of cases, lack of needing to 'sell' procedures, etc) what do you think?

There's different levels of emergency. Most dentists do emergency dentistry, but few do only emergency dentistry. An emergency is usually a combination of subjective and objective perceptions. There's all sorts of emergencies as well. There's pediatric, maxillofacial trauma, single tooth, bridge fell out, etc... With every emergency, there is usually more than one way to solve the emergency. You still have to present and you should convince the patient what you think is best for them (selling the procedure).

I'm a D4 graduating in 2 weeks so I don't have working experience to offer any advice. But I hope I can clarify "emergency dentistry" for you since it's a model that I have looked to pursue before but is unrealistic and limiting. For me, it means being able to do what it takes to relieve patient of pain temporarily until they see a specialist/GP that can restore - cases such as restoration fell out, infection, trauma, etc. or definitively (extraction, pulpectomy).

You've already stated the pros. Let me tell you about the cons of ONLY doing emergency dentistry

2) low production compared to many other aspects of dentistry - you're limiting yourself in terms of procedures that you do, especially since you won't be doing the high production cases such as crowns, bridges, implants, etc.
A mentor once told me that typically the money made from fillings and cleanings is to pay taxes, pay for staff, pay landlord, etc., the money made from prosth (crowns, bridges, dentures, etc.) is to pay for your house, your car and your family.

3) complexity of the cases will depend on many things but mostly need of the patient. For example, if your clinic is near a homeless shelter, you won't make any money doing endo, bridges or crowns since there's not enough need. Most likely you will be prescribing antibiotics, pain meds, and simple extraction.

4) liability - you don't want to do anything that you are not trained extensively on, especially with an emergency. You're basically marrying the complications that arises if you decide to treat the patient with procedures that are out of your scope (your license could be on the line if you mess up).

5) you're dealing with people in pain. Pain often makes some patients extremely difficult to examine and to treat. A patient grabbed my hand while I was giving anesthesia (extremely dangerous!!). Another patient bit me while I was palpating the painful area. Looking back at these experiences, I don't want to only do emergency haha.

I am not saying don't pursue emergency dentistry lol. I'm saying to make it part of your skillset. Good luck deciding.

What you say is mostly true. Emergencies are part of the services you provide as a dentist. Your hygiene is your turnkey profit center, your ops/emergencies are the core of your income.

1) not competitive compared to private offices/corporate - you will see job postings and resumes that list being able to manage emergency as one of the skillsets. So aside from doing emergency dentistry, these offices also offer MORE than what you do in your emergent care clinic.

- True, you need to do all sorts of dentistry to make money.

2) low production compared to many other aspects of dentistry - you're limiting yourself in terms of procedures that you do, especially since you won't be doing the high production cases such as crowns, bridges, implants, etc.
A mentor once told me that typically the money made from fillings and cleanings is to pay taxes, pay for staff, pay landlord, etc., the money made from prosth (crowns, bridges, dentures, etc.) is to pay for your house, your car and your family.

- True and False. Pediatric traumas/emergencies are not profitable unless you got a mouthful of caries to do 20 SSC's on or something to that extent. Maxillofacial traumas aren't that profitable either. Lots of time required, relatively low reimbursements. Surgical repositioning of teeth, splinting, etc... barely worth my time. The real profit center of emergencies is RCTBUCrown, emergency bridges (patient's bridge fell off, needs an rct on the abutment(s), post(s), and bridge), and emergency ext/graft/implant. RCTBUCrown can be worth as much as 5k/doctor hour.

I do not agree that it is low production. It can be low production if you do all sorts of emergencies. If you focus on the profitable emergencies, it can be very profitable.

3) complexity of the cases will depend on many things but mostly need of the patient. For example, if your clinic is near a homeless shelter, you won't make any money doing endo, bridges or crowns since there's not enough need. Most likely you will be prescribing antibiotics, pain meds, and simple extraction.

Some cases can definitely be complex, but most are one shot deals. A lot of times, you may have two areas that need to be treated simultaneously (i.e #18/19 RCTBUCrown or EXT/graft/implant). Vicinity does not necessarily mean you're going to get people from that immediate area.

Even if all you get are homeless people, 1 min emergency exam + rx is not bad if you got hundreds going on at the same time at reasonable fee schedules.

4) liability - you don't want to do anything that you are not trained extensively on, especially with an emergency. You're basically marrying the complications that arises if you decide to treat the patient with procedures that are out of your scope (your license could be on the line if you mess up).

Not necessarily unless it's a major trauma. You're more likely married to a patient doing an all on X case/FMR than 1 rctbucrown. Patient broke their jaw, send them to an OS. Pediatric trauma patient or irreversible pulpitis on a single tooth, refer to peds. TMJ issues, OFP referral. So yea... you refer because it's not worth your time, beyond your skillset and/or below your reimbursement threshold.

5) you're dealing with people in pain. Pain often makes some patients extremely difficult to examine and to treat. A patient grabbed my hand while I was giving anesthesia (extremely dangerous!!). Another patient bit me while I was palpating the painful area. Looking back at these experiences, I don't want to only do emergency haha.

You warn them ahead of time that the injection is going to hurt a lot, especially when they are in pain. I tell them, it's like putting a fire out with a fire extinguisher. You're going to feel a ton of pain when this injection goes in, but you are going to feel a lot better when I'm done. People in pain are more willing to pay. To prevent hand grabbing, you let the patient know to never grab your hand as it's the most dangerous thing they can do. If they grab your hand, you can refer them out. If they can't tolerate anesthetic like a mature adult, they should probably be sedated. If they can't afford sedation, then they need to suck it up.

When a patient bites you, they usually don't mean it unless they are a kid. The patient feels bad that they bit you. You joke about it and move on. Build a relationship based on being compassionate even if they bite you... and they are more willing to pay if they bit you.

until they see the bill

LOL, yea, but they are happy that you got them out of pain. Their finances are not my concern

How much is the "selling" a part of dentistry? my dentist never sold me anything tbh he just told me the diagnosis and my options, same with the dentist i shadowed, never felt he had to sell a thing? then again they didnt really do cosmetics

Either your dentist is so good at selling that it doesn't even seem like selling, he/she has staff that sells for him/her, or they just don't make that much money (or their patients are all receptive without selling).

 

[TanMan]

Looking at all this info makes the practice of orthodontics look like a walk in the park. TanMan, if you could have specialized without the "penalty" of spending additional schooling or going into debt, wouldn't you have chosen ortho for the lifestyle, the ease and relaxed nature of work, the relatively cooperative/calm patient base, less of a need for direct advertising but the ability to so should you choose to, and most importantly professional satisfaction from delivering dramatic, visible, and lasting smile transformations for the patients? Also add in the fact that there is virtually no strenuous work involved, allowing you to work longer if you chose to without the worry of disability. Or would you still have gone the GP route?

That makes it more palatable in going into orthodontics. However, I think you are understating some of the downsides as well. Orthodontics is under attack by commoditization and first to go during an economic downturn. You still need a lot of direct advertising since GP's are attacking orthodontists as well.

Professional satisfaction? What about professional frustration of having to deal with non-compliant patients, poor OH, teeth not moving the way you want them to move, unrealistically picky patients, broken brackets, and having to deal with that for a year or two continuously. It's easier work, but I don't really want to work for the rest of my life. I could have an army of assistants doing the ortho work, but I have that right now as a GP. I don't get as much satisfaction with a "dramatic, visible, lasting smile transformation" than I do getting a patient out of pain in a single visit.

Also, you have to work hard in dental school if you have to specialize. Having to suck up to everyone and being a gunner. Working harder just to spend extra years/more debt to limit my practice? No thanks.