Peds vs. ortho

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eastcoast2021

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Hey guys,
In a bit of a bind. Was going to apply to ortho but in working with kids more at my school I’m starting to think about Pedo. What do you guys think about the job prospects on both and what their outlooks look like in the future?

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Ortho will almost certainly cost you a lot and if you do almost any amount of reading here on the forums, the outlook is rather negative. That doesn’t mean that it’s horrible or that it can’t or won’t recover, but it seems to me that it’d be a much greater risk in addition to taking on more debt. If you’re enjoying working with kids, my understanding is peds is doing great. Aren’t most or all peds programs stipend based or am I wrong there?
 
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Ortho will almost certainly cost you a lot and if you do almost any amount of reading here on the forums, the outlook is rather negative. That doesn’t mean that it’s horrible or that it can’t or won’t recover, but it seems to me that it’d be a much greater risk in addition to taking on more debt. If you’re enjoying working with kids, my understanding is peds is doing great. Aren’t most or all peds programs stipend based or am I wrong there?

You're correct, they are more likely than not to be GME supported.
 
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Hey guys,
In a bit of a bind. Was going to apply to ortho but in working with kids more at my school I’m starting to think about Pedo. What do you guys think about the job prospects on both and what their outlooks look like in the future?

Who says you cant do peds then ortho? When I was in school, there were quite a few peds residents that applied for ortho right after
 
What was their reasoning? Why not just go straight into ortho. Save time and money. By money I mean interest accrual, no opportunity cost, etc
Who says you cant do peds then ortho? When I was in school, there were quite a few peds residents that applied for ortho right after
 
What was their reasoning? Why not just go straight into ortho. Save time and money. By money I mean interest accrual, no opportunity cost, etc
I guess for the same reason that some OS residents quit their trainings and switched to ortho....and some practicing GPs went back to school for ortho. One of my co-residents joined my ortho program right after she finished her pedo residency. When you are spoiled with doing ortho, it's hard to go back to do restorative dentistry again.
 
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Besides the debt though, which does everyone think has the most potential?
Of course, it's ortho. You can get more patients by opening multiple offices and then make your staff travel with you to all the offices. Or you can work at your own offices for a few days/week and for corp offices a few days/week.
 
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Ortho is better. Money aside though. Peds probably has just as good money. But never do anything for the money...you will live a very unfulfilling life. Do it because you love it first, if the money comes then a cherry on top you have.
 
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I had the exact same thought process a few years ago. I think paeds has a better job outlook. I also think theres a lot to be said for being a specialist who treats under general anaesthesia like a pediatric dentist - as a specialist, any specialist, dentists are trying to keep everything in house, so you will often get sent patients that dentists dont want to deal with (rather than necessarilyout of their skill set) - for whatever reason, maybe it's just a difficult patient - so if you then have the luxury to treat them under GA then who cares how difficult the patient is.

However, I remember seeing a document showing how the number of paeds graduates is in the process of increasing significantly in the next 5 years or so. I would find that out exactly before doing paeds - sorry I cant remember where I saw that.

I'm in a 3 yr ortho program. I've met a couple of people at conferences who did a 2yr peds residency and then 2yr ortho. For me, I would love to do 4yrs and get both rather than 3 just to get ortho. The possibility of doing a 2 yr peds after I graduate (I'd only apply to stipend programs) is not totally off the cards either. Depends how hard it is to get a job when I graduate.

If I could do it all again, I would have only applied to 2yr ortho programs with decent tuition or stipend. If I couldnt get in (probably likely) then I would do a 2 yr paeds with the intent of then having a strong application so I can get into a good 2 yr / stipend ortho program after. Even doing 4 yrs will put you way ahead financially of a lot of people in expensive 3 yr ortho programs. The mistake I made was I wasn't patient - and my ego was too big - I did everything to make sure I got accepted into ortho my first year applying - I applied everywhere (this is advice everyone gave me at the time - it shows how committed you are to doing ortho - but now I definitely disagree - applying like this means you're more likely to get stuck accepting an expensive residency and being one of those suckers 500k in debt). I wish I had limited my applications to stipend or 2yr schools and continued working as a GP in the likely event I was rejected.
 
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I dont think theres a blanket answer to "which is better peds or ortho" but I think the way you get there changes everything.

Eg 2yr ortho stipend vs 2yr peds stipend? 100% ortho

But 2 yr peds stipend vs 250k debt 3yr ortho? 100% peds
 
I had the exact same thought process a few years ago. I think paeds has a better job outlook. I also think theres a lot to be said for being a specialist who treats under general anaesthesia like a pediatric dentist - as a specialist, any specialist, dentists are trying to keep everything in house, so you will often get sent patients that dentists dont want to deal with (rather than necessarilyout of their skill set) - for whatever reason, maybe it's just a difficult patient - so if you then have the luxury to treat them under GA then who cares how difficult the patient is.
I called for a friend, who has a special need child, and found out that not a lot of the pedo offices do IV sedation in their offices. I eventually found one pedo who brought in a dental anesthesiologist. And there were only enough patients for this dental anesthesiologist to come to work here 2 days a month. A couple of years later, I learned from my friend that this pedo sold the office to another pedo and the new pedo didn't do IV sedation.

I'm in a 3 yr ortho program. I've met a couple of people at conferences who did a 2yr peds residency and then 2yr ortho. For me, I would love to do 4yrs and get both rather than 3 just to get ortho. The possibility of doing a 2 yr peds after I graduate (I'd only apply to stipend programs) is not totally off the cards either. Depends how hard it is to get a job when I graduate.

If I could do it all again, I would have only applied to 2yr ortho programs with decent tuition or stipend. If I couldnt get in (probably likely) then I would do a 2 yr paeds with the intent of then having a strong application so I can get into a good 2 yr / stipend ortho program after. Even doing 4 yrs will put you way ahead financially of a lot of people in expensive 3 yr ortho programs. The mistake I made was I wasn't patient - and my ego was too big - I did everything to make sure I got accepted into ortho my first year applying - I applied everywhere (this is advice everyone gave me at the time - it shows how committed you are to doing ortho - but now I definitely disagree - applying like this means you're more likely to get stuck accepting an expensive residency and being one of those suckers 500k in debt). I wish I had limited my applications to stipend or 2yr schools and continued working as a GP in the likely event I was rejected.
My wife's classmate is an ortho and his wife is a pedo. They built 2 separate practices in the same professional builing. The reason they don't want to want to merge the 2 specialties into 1 practice and advertise the practice as a pedo/ortho practice is the husband wants other GP offices to refer ortho patients to him.
 
me, personally, I would do ortho. I have met 1 person in my 4 years of dentistry who had anxiety over attending their orthodontist appointment and psychologically working on terrified kids all day causing them pain ( I have met zero pediatric dentists or general dentists who treat kids who have not given a child a negative dental experience) sounds rough. You will need to have tough skin to be a pedo and exceptionally good at handling anxious patients/flooding/ be on stage and appear happy and peppy all day, everyday. I know many people who did pedo first and ran for the hills and became an orthodontist after the fact. to my knowledge the vast majority of these dual specialists practice ortho exclusively and don't look back. that should be enough to tell you what the majority of people who have done both think of the two professions. It takes a very unique person to become a pediatric dentist and I thank god everyday they exist. I, myself, would not do their job for any amount of money. that said most pediatric dentists I know make a lot of money and probably more than your average ortho. there's a study that after you make $80k a year or so and have things in your life you need more money does not make you substantially happier. don't do one over the other for money.
 
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me, personally, I would do ortho. I have met 1 person in my 4 years of dentistry who had anxiety over attending their orthodontist appointment and psychologically working on terrified kids all day causing them pain ( I have met zero pediatric dentists or general dentists who treat kids who have not given a child a negative dental experience) sounds rough. You will need to have tough skin to be a pedo and exceptionally good at handling anxious patients/flooding/ be on stage and appear happy and peppy all day, everyday. I know many people who did pedo first and ran for the hills and became an orthodontist after the fact. to my knowledge the vast majority of these dual specialists practice ortho exclusively and don't look back. that should be enough to tell you what the majority of people who have done both think of the two professions. It takes a very unique person to become a pediatric dentist and I thank god everyday they exist. I, myself, would not do their job for any amount of money. that said most pediatric dentists I know make a lot of money and probably more than your average ortho. there's a study that after you make $80k a year or so and have things in your life you need more money does not make you substantially happier. don't do one over the other for money.
Great post. I don’t know of an ortho who ever went back for residency in another specialty. I’ve heard of plenty of specialists In other fields who went back to do ortho (peds to ortho is pretty common)
 
My significant other works in a group practice and the orthodontist doesn't have enough cases so he only makes the base each year which is $220k.
 
My significant other works in a group practice and the orthodontist doesn't have enough cases so he only makes the base each year which is $220k.

If money is a priority, that Ortho should be looking for another job, or add a PT job, or start a small private practice to augment. Lots of options if $$ is a priority.
 
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works 4 days a week but in a multi-specialty
 
I do know the GPs do well. Lots of implants and Invisalign. Something the orthodontist doesn't like them doing.
 
Sounds like a non-ideal practice for an ortho to work in. Most Multi-specialty practices would delegate ortho and major surgery to...you guessed it the ortho and perio/os.
 
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Unless GPs can do it and just give them the percentage of production and decrease their overhead fixed costs on higher salaries. Sounds like a smart owner.
 
My significant other works in a group practice and the orthodontist doesn't have enough cases so he only makes the base each year which is $220k.
There are not enough cases at each of my offices either. To keep myself busy every day, I book 60-100 patients a day and work a few days a month at each office. I don't make $220k at each of my office either. To make more $$$, I have to travel to 6 different offices and work 22 days/month. Specialists like me are not rare. Perios, endos, OS's, pedos all have to travel in order to keep themselves busy.

It's impossible to fill 50-60 ortho patients in a day, 5 days a week. An ortho office that can start 25 new cases every month and charges $5000 a case should produce $1-1.5 million a year. And with 25 new starts every month, an ortho owner only needs to work 12-15 days a month and treats 50-60 patients a day. He/she can earn additional income by opening a satelite office or by working P/T for the corp on the days that he doesn't work at his/her main office.

You can do well in any specialty. If you are willing to travel and put in the same number of work hours as the typical worker in America (8 hours a day, 5 days/week), you should easily be among the top 1% income earners.
 
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How does that compare to the other specialists in the clinic?
Most offices that employs in-house specialists don't have enough patients to keep them busy 5 days/week. At one of the corp offices that I work for, I only work there 5 days/month. The OS is only there 2 days a month and the perio is only there 1 day a month.
 
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