Pay over $350k for ortho residency?

[JacquesVallee]

I think we can all agree the state of the dental profession is in serious decline…

Big Hoss

100%. When predents have shadowed at my office I've always tried to steer all of them away from dentistry. Sadly, none of them listen. There is still this crazy misconception that all dentists are super wealthy which couldn't be further from the truth, especially for new grads.

Also, even though I went to a "cheap" state school, most of my classmates aren't even paying off their loans. Rather, they're relying on government loan forgiveness programs. The current state of dentistry is even attending some of the cheapest dental schools will still require you to go on IBR or PAYE. This isn't sustainable for an entire profession.

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[yappy]

Except omfs.

Doesn’t it have the same issues? Massive debt? Wouldn't you rather be an oms that graduated 20 years ago vs today? All the ones I know work for DSOs or their specialty’s variant.

 

[charlestweed]

I graduated during the “golden age” era (in 2001) when the average daily pay for associate orthodontists was around $800-1000/day. I worked for 3 different Corp offices. I had to see around 80-100 patients a day with only 3 ortho RDAs. I had to work as an extra RDA (doing wire changing and sterilizing instruments myself) in order to keep up with the busy schedule. I also opened my own office. When I finished work the corp offices at 6pm, I drove straight to my office to see my patients until 9pm…..my wife worked at front desk…..and my 2 yo daughter slept inside one of the consultation rooms. With a positive cash flow (from my associate jobs), running a practice, which I set up from scratch, wasn’t too stressful.

Now that the golden age is over, the number of new start cases per day has declined a lot. I only see around 50-60 patients a day at this same corp office, where I’ve worked for for 20+ years (since graduation). 50-60 patients/day is a very easy day for a veteran orthodontist like me. And the company pays me more than 2X as much now than when I was first hired. They underpaid/overworked me in the past and I didn’t realize it. As a young grad with debt, I was desperate.

With years of experience and having zero debt, the job is so easy now.

 

[Big Time Hoosier]

Now that the golden age is over

Big Hoss

 

[White_Sponge_Nevus]

Every job in dentistry, regardless of specialty, isn't as good as it was a generation ago. If you're already in dental school, do what you'd be happiest doing so long that it's feasible with the debt:income situation you'll find yourself in.

If you're not in dental school yet, try to be wary of comparing your future career to that of anyone in dentist who is over the age of 40. It is a different career for them. They faced separate challenges but not the financial ones today. Dentistry is a terrible gig compared to dentistry of the previous generation but a much better gig than most available to us now. Gotta compare it to the right things.

 

[2TH MVR]

I think we can all agree the state of the dental profession is in serious decline…

Big Hoss

I would say the business side of dentistry has changed for the worse. Mostly due to Corporates turning dentistry into a profit only business.

Most of us were attracted to dentistry (I was anyway) for the chance to start a small business, treat patients ethically, and earn a good living for all the years we toiled in school.

Fortunately .... I love the practice of orthodontics. But I get it. Easier for someone in my position (close to retirement) as compared to those young dentists, specialists justing graduating, or just a few years in the profession.

 

[Greyangel6]

I use handpieces multiple times per day. Some days it feels like all I do is go from chair to chair using handpiece. Broken brackets, removing aligner attachments, removing bands/banded appliances, removing composite after braces coming off, repairing fixed retainers, etc etc. I will often also do enameloplasty to flatten out chipped incisors, or sometimes even add small amounts of composite to teeth to make a nicer looking incisal edge. All of these things require use of a handpiece. There's some misconception out there about ortho being easy on the body. My counter is this- have you ever seen an orthodontist in their late 60s or even 70s that's still practicing? Same hunched over back that all dentists get. I knew an older orthodontist who had multiple fused discs, and couldn't move his neck anymore. He had to move his whole torso.

Owning a practice is like two jobs. One job where you show up and do your work (not easy), then another job where you have to run the clinic and figure out how to get new patients in the door. This true for anyone who runs a practice. The lifestyle is great, you get to choose which 80 hours of the week you get to work!

I'm sure they mean it figuratively because I think I would rather do what you do now with the handpiece than working on tooth #2-DB on a patient with large cheek and constantly wanting to suction.

 

[702]

Every job in dentistry, regardless of specialty, isn't as good as it was a generation ago. If you're already in dental school, do what you'd be happiest doing so long that it's feasible with the debt:income situation you'll find yourself in.

If you're not in dental school yet, try to be wary of comparing your future career to that of anyone in dentist who is over the age of 40. It is a different career for them. They faced separate challenges but not the financial ones today. Dentistry is a terrible gig compared to dentistry of the previous generation but a much better gig than most available to us now. Gotta compare it to the right things.

maybe I’m blind, but I actually think omfs is not worse than it was decades ago. Maybe even better.

More full scope surgeries in office instead of in the OR, safer anesthesia practices, better implant dentistry in general, etc. The key is to have control of supply and demand of doctors id say, which omfs has done better than probably anyone else in all dentistry

 

[White_Sponge_Nevus]

maybe I’m blind, but I actually think omfs is not worse than it was decades ago. Maybe even better.

More full scope surgeries in office instead of in the OR, safer anesthesia practices, better implant dentistry in general, etc. The key is to have control of supply and demand of doctors id say, which omfs has done better than probably anyone else in all dentistry

You may be right... I was thinking more in the terms of purchasing power in every day life as well as an OMFS practice with current cost of living: income, as well as increased debt. But I do keep hearing of incredible jobs out there in areas that aren't overrun with current OMFS, and know a lot of retirements are on the horizon that will keep opportunities good for the people coming out over the next 10 years

 

[JacquesVallee]

What I love about OMFS is they don't drastically increase the number of residency spots and make pay to play programs like virtually every other dental specialty has done. They do a good job at keeping the barrier to entry very high, especially with keeping the CBSE. Ortho used to be the dream, but now programs like the Georgia school of Orthodontics take forty residents per class. I know OMFS around me who clear 7 figures while many of the younger Orthos around me have trouble staying busy or even finding full time work.

 

[New_Vegas]

What I love about OMFS is they don't drastically increase the number of residency spots and make pay to play programs like virtually every other dental specialty has done. They do a good job at keeping the barrier to entry very high, especially with keeping the CBSE. Ortho used to be the dream, but now programs like the Georgia school of Orthodontics take forty residents per class. I know OMFS around me who clear 7 figures while many of the younger Orthos around me have trouble staying busy or even finding full time work.

This is very true. If I could do it again I would not go into ortho.

 

[JacquesVallee]

This is very true. If I could do it again I would not go into ortho.

What would you do if you could go back?

 

[New_Vegas]

What would you do if you could go back?

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

 

[OncePreDent]

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

have you ever thought about going back for OMFS?

 

[charlestweed]

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

How about quitting ortho and going back to practicing general dentistry? I know a general dentist who works at the same Corp with me who travels to multiple offices.....and he only does pedo.

 

[JacquesVallee]

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

Yeah I understand where you're coming from. Hopefully, you don't have too much in loans and can just try to make the most out of Ortho.
I'd also recommend endo as a specialty to any dental student reading this as well.