Who makes more? Endo vs. OMFS?

[RoseEndo]

Both specialties do very well

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[fellowstudent92]

Financially, oral surgery does better than any specialty and OMFS doesn't go any where due to need for oral surgeons for doing higher risk procedures. My generation did well since we graduated with small loans and started private practice. New generation endo's have a very hard time and will have a hard time to get referrals. The only recommendation that I have is to go to programs that pay stipend and they are very few in the country. I don't think it is a good idea to spend 100k+ to do residency in this market. The same applies for ortho and perio, and managing loans are the key. So if the concern is a only financial outcome, then oral surgery will be your choice of specialty.

I will have no debt from dental school. Does that change anything? OR do you recommend not going into endo even if you like it regardless? I guess this rules out trying to get accepted to an endo program right out of dental school if going to only the stipend programs is the right move. I doubt i will get into a stipend program right out of dental school. I could just do endo as a GP too but I don't know if I like the rest of GP stuff...
I don't care just about the money but it'd be nice to work in endo where I can have also have time for other pursuits outside of dentistry.

 

[setdoc7]

Personally, I think that any GP who doesn't know how to do osseous surgery or crown lengthenings should have his/her license to practice dentistry revoked. I can't think of any procedures performed by a periodontist that couldn't or shouldn't be handled by a GP or an OMFS.

Your salary estimate seems plausible but a bit high for a perio average. At $2000 a day, that's $384k a year. Remember, of the various specialties, perio averages the least.

Not happy about the revoked statement, as I did an OMFS residency and then went back to GP. I do little osseous surgery and crown lengthening. Not worth my time. FYI for all of those listening, the ADA data is self reported. That means there is no verification and not everyone reports, including myself.

 

[BANGO]

Financially, oral surgery does better than any specialty and OMFS doesn't go any where due to need for oral surgeons for doing higher risk procedures. My generation did well since we graduated with small loans and started private practice. New generation endo's have a very hard time and will have a hard time to get referrals. The only recommendation that I have is to go to programs that pay stipend and they are very few in the country. I don't think it is a good idea to spend 100k+ to do residency in this market. The same applies for ortho and perio, and managing loans are the key. So if the concern is a only financial outcome, then oral surgery will be your choice of specialty.

Curious...why would a newer/fresh endodontist have a harder time getting referrals compared to when the older/experienced endodontists first started?

 

[786783]

Curious...why would a newer/fresh endodontist have a harder time getting referrals compared to when the older/experienced endodontists first started?

Because dentistry's not what it was like 2 decades ago. All new grads are struggling and doing what specialists used to do. If they refer out, they don't produce enough. Half a million In loans forces new dentists to take more clinical risks, do lower quality work, and overtreat.
Makes sense?

 

[Chamilitary]

Because dentistry's not what it was like 2 decades ago. All new grads are struggling and doing what specialists used to do. If they refer out, they don't produce enough. Half a million In loans forces new dentists to take more clinical risks, do lower quality work, and overtreat.
Makes sense?

That would likely lead to more teeth requiring Re-Tx due to missed anatomy, improperly cleaned/shaped/disinfected canals, and procedural complications. The question then becomes will these doctors acknowledge that the treatment rendered was suboptimal and re-tx is an option? Or will they say "root canals fail often" so you now need an implant (which they'll also do)?

 

[Endo16]

You can't go wrong with either specialty

 

[56101991]

I agree with RoseEndo that market is changing and new grads see pretty much re-Tx. As an oral surgeon, you don't need to spend 2 hours dealing with repairing perforations or removing gutta core out of the canal. Regardless of history of the tooth, you still spend 20-30 minutes to take it out but endo needs to deal with all the head ache related to past treatment of the tooth. Unfortunately market is changing and it is heart breaking for myself and endo colleagues to spend 2-3 years of research, studying,...with additional loans and then fight for re-Tx referrals from GP's. Make sure you do some research about the area you want to practice, and be smart about your choices.

Just out of curiosity, what would you say the ratio of initial RCT to retreatment referrals you/typical endo get? Has that ratio changed much over your years of practice?

 

[RoseEndo]

Choose specialty based on what you like

 

[hahadino2771]

Location, location, location.
Relationship, relationship, relationship
reputation, reputation, reputation

Endo:
-there are some recent grads producing ~2k a day b/c they are either slow or slowly building up their referral bases
-there are some experienced endodontists who do molar RCT in 30 - 40 min. Some do up to 10 - 11 RCTs a day. You can do math
-no on calls
-no weekend calls
-some of recent grads do 7 canals a day avg.
-some endo does everything from anterior to retreat & apico
-80% of my endo friend's cases are 2nd molars with limited mouth opening, apicoectomy or retreat. He has not done anterior RCT for several months. Good luck...
-I see some recent grad endos producing as low as $2000 a day to $6000 avg a day.

OMFS:
-easier to get full time positions than other dental specialties
-a lot of practices hire OS on wheel for extraction and implants b/c GPs do not want to deal with complications
-starting base salary of recent grad OMFS is 200k - 300k plus bonus in private practice. If you are in academics, then your base salary will start from 80k to 100k. It does not matter whether you have MD or not. Scope of practice is not limited to having an extra degree.
-OMFS are in reality just OS. No body wants to do max-face surgery. There is no money at all in broad scope practice. That's why all the trauma, recon, BRONJ, ORN, infection are referred out to academic institutions where residents can babysit these crazy cases all night long for weeks and months.
-Check AAOMS careerline for further details of salary and income range
-There is no money at all in maxillofacial surgery. So many renowned surgeons who complete microvasular surgery or craniofacial surgery or MD degree end up dropping hospital privileges and medical insurances so that they do not need to do tumor, recon, path, TMJ, orthognathic surgery. If you really doubt, read through some of OMFS threads on Dentaltown. Some of the most respected OMFS cancer surgeons in this country recently dropped is not doing jaw surgery any more from this year.
-if you are just doing sedation and wisdom teeth & implants all day long, then your income potential is unbeatable. I know some OMFS surgeons who do 10 - 20 sedation cases a day. full bony impaction + IV sedation in every 30 min. Sinus lift + multiple extraction + immediate grafting/ multiple implant placement in 1 hour. Your daily production will be like 30 - 40k a day. You can do math right? It is rare but it depends on how well you build up your reputation in your community and your relationship with GPs
-OMFS residents are trained to be aggressive, arrogant bastards who look down on GPs and even other specialists in dentistry. Continuing that type of mentality, ego and personality in private practice will lead you to bankrupt. GPs don't care whether you can do anal/ vaginal approaches for trauma, tumor, TMJ recon. All it matters to GPs are how well they can do oral surgery with no complications and being nice to referred patients. If patients go back to GPs and complain about OMFS's bad chairside manner and poor connection to patietns, then that is just the end of relationship and loss of referral. Be respectful to GPs and be nice to them. Take a good care of referred patients. It takes time and a lot of efforts to build up solid referral base.

 

[DDS360]

One of my brothers is an Endo and the other one OMFS. They both do great financially.

 

[786783]

Location, location, location.
Relationship, relationship, relationship
reputation, reputation, reputation

Endo:
-there are some recent grads producing ~2k a day b/c they are either slow or slowly building up their referral bases
-there are some experienced endodontists who do molar RCT in 30 - 40 min. Some do up to 10 - 11 RCTs a day. You can do math
-no on calls
-no weekend calls
-some of recent grads do 7 canals a day avg.
-some endo does everything from anterior to retreat & apico
-80% of my endo friend's cases are 2nd molars with limited mouth opening, apicoectomy or retreat. He has not done anterior RCT for several months. Good luck...
-I see some recent grad endos producing as low as $2000 a day to $6000 avg a day.

OMFS:
-easier to get full time positions than other dental specialties
-a lot of practices hire OS on wheel for extraction and implants b/c GPs do not want to deal with complications
-starting base salary of recent grad OMFS is 200k - 300k plus bonus in private practice. If you are in academics, then your base salary will start from 80k to 100k. It does not matter whether you have MD or not. Scope of practice is not limited to having an extra degree.
-OMFS are in reality just OS. No body wants to do max-face surgery. There is no money at all in broad scope practice. That's why all the trauma, recon, BRONJ, ORN, infection are referred out to academic institutions where residents can babysit these crazy cases all night long for weeks and months.
-Check AAOMS careerline for further details of salary and income range
-There is no money at all in maxillofacial surgery. So many renowned surgeons who complete microvasular surgery or craniofacial surgery or MD degree end up dropping hospital privileges and medical insurances so that they do not need to do tumor, recon, path, TMJ, orthognathic surgery. If you really doubt, read through some of OMFS threads on Dentaltown. Some of the most respected OMFS cancer surgeons in this country recently dropped is not doing jaw surgery any more from this year.
-if you are just doing sedation and wisdom teeth & implants all day long, then your income potential is unbeatable. I know some OMFS surgeons who do 10 - 20 sedation cases a day. full bony impaction + IV sedation in every 30 min. Sinus lift + multiple extraction + immediate grafting/ multiple implant placement in 1 hour. Your daily production will be like 30 - 40k a day. You can do math right? It is rare but it depends on how well you build up your reputation in your community and your relationship with GPs
-OMFS residents are trained to be aggressive, arrogant bastards who look down on GPs and even other specialists in dentistry. Continuing that type of mentality, ego and personality in private practice will lead you to bankrupt. GPs don't care whether you can do anal/ vaginal approaches for trauma, tumor, TMJ recon. All it matters to GPs are how well they can do oral surgery with no complications and being nice to referred patients. If patients go back to GPs and complain about OMFS's bad chairside manner and poor connection to patietns, then that is just the end of relationship and loss of referral. Be respectful to GPs and be nice to them. Take a good care of referred patients. It takes time and a lot of efforts to build up solid referral base.

30-40k production a day? 5 days a week, 50 weeks a year?? Everyone knows people who produce extraordinarily every once in a while. It's hard to believe that it can be done with consistency though. Some surgeons pile all the high producing cases on one or two days every month, and then make a killing Those days.

 

[anonyperson]

30-40k production a day? 5 days a week, 50 weeks a year?? Everyone knows people who produce extraordinarily every once in a while. It's hard to believe that it can be done with consistency though. Some surgeons pile all the high producing cases on one or two days every month, and then make a killing Those days.

LOL. There definitely are a number of OS who make over a millio, theres some perio's who do that too. I know of a perio who started an implant/all on 4 center and places/restores 150+ arches a year so hes doing very very well. But those are outliers.

At the corp office i briefly worked for the endo who would come in (and man he would flush through endos in about 5 hours, 20-40 mins / case), would say things like that was a 20k day.... except i know that 80% of his cases were dmo - maybe they have a much higher reimbursement for specialists?

OS's probably work 3-4 days a week on a lax schedule and make a ton of $, theres no doubting that. I've seen a few perios around me close their office b/c insurance reimbursements got too difficult and cheap. There are also perios who do very well.

OS has the most stable and highest income potential.

 

[2TH MVR]

In this environment ... I would say the OS has the better job outlook than the endo. Again .... a person should pursue an occupation based on what you like to do vs. compensation. Don't get me wrong. Compensation is very important, but if compensation is everything to you .... then there are other occupations that make better $$$$.

 

[anonyperson]

OS definitely does not have the highest income potential

Ok, what specialty would you say does?

I guess I meant the upper average of solo practitioners. There are GP's focused on cosmetics charging 3-4K / tooth and doing those cases exclusively too.

 

[anonyperson]

.

?

 

[321931]

The best business will make more. Regardless if its Endo, OS, GP, Perio, Prostho. I know GPS that earn more then 500k.

But if I had to generalize: I would say that OMFS prob has the highest earning potential.

But I still stand by my post stating that the better businessman will make the most.

 

[dcshus]

General dent has highest then ortho.

Please tell me this is a joke?? (Not the intent behind the statement but the grammar)

Ironically I'm an OMS in private practice and my partner is an Endodontist. So I feel we may have a unique insight to this question. (We own a specialty practice)

It sounds so cliche, however, I'm going to say it anyways...do what you enjoy. I know it's easy for me to say that now but it's true.
Don't get caught up in the financial statistics (especially the hearsay you find on this website)

There are too many variables that are rarely clarified before the keyboard gladiators begin making outlandish claims.
Collections vs production? Overhead?
Some other things to consider when you get out...can overhead be shared to reduce cost? Do your research to find a good healthcare cpa. (Rarely stated but can cost/save tens to hundreds of thousands of dollars annually in taxes, yes, hundreds) All these things go into take home, which is all that matters.

To answer the OP's question, OMS has a higher earning POTENTIAL. I book 20min for a set of wisdom teeth. My partner books 20min to wipe his butt. It just takes an Endodontist more time to do a less lucrative procedure. So, if the whole day was a set of 3rds every 20min, the POTENTIAL is greater for an OMS. In reality, this isnt the case (for me). I have the MRONJ case I'm managing that essentially costs me money to treat. Or the Medicaid single extraction with local that pays me $70 but takes up 15min of chair time because the pt actually wants to be numb before I take out the tooth. Or the TMD pt I have to manage so my good referrer continues to send me those wisdom teeth. So it all evens out (for the two of us it does).
However, the Endodontist has a MUCH lower overhead potential. He can run an efficient office with 3 full time staff, I need a MINIMUM of 7. Medications, IV bags/tubing/syringes/etc are expensive. He buys gotta percha and bleach (I know it's more than that, I'm kidding, obviously)

I don't know how I got sucked into this long post...I'll be back to SDN in another 3-4yrs (I don't know when my last post was before tonight). See ya

 

[toothsucker]

Oh the irony of your keyboard warrior statement. Anyways, it's fairly obvious general dent does. Just look at the massive chains and corps. As far as ortho goes, they rake. I've never heard of any OMS owners collecting over 6 mil with 40-50 overhead.

Dude... you are maybe 23 years old (assuming born in '94) and probably a pre-dent or d1. Why are you arguing with someone who is an OMS in practice with an endodontist who knows MUCH MORE about dentistry/oms/endo than you. Show a little humility and realize there is a lot you don't know yet.
By the way, most of the major corporate chains/corps aren't owned by a dentist. They are in most cases owned by an investment group or someone with a business background. There are obviously examples of dentists owning multiple practices, but if you look at mean/median/mode, every single one is higher for oms/endo over general dentist when you normalize for hours worked.

 

[dcshus]

Oh the irony of your keyboard warrior statement. Anyways, it's fairly obvious general dent does. Just look at the massive chains and corps. As far as ortho goes, they rake. I've never heard of any OMS owners collecting over 6 mil with 40-50 overhead.

Complete sentences, thank you. Nobody expects perfect grammar, yet, intelligible is nice considering we're supposed to be "professionals".
I think you are choosing outliers and not the norm, however, I can only speak to my personal situation with my Endodontist partner. Considering the title of the thread, I feel it's relative. Call me when you make your $6M/yr. I'll be happy to know you made it.

 

[2TH MVR]

I'm starting to really like this forum... Very entertaining. Please go on.

 

[Biffster]

Complete sentences, thank you. Nobody expects perfect grammar, yet, intelligible is nice considering we're supposed to be "professionals".
I think you are choosing outliers and not the norm, however, I can only speak to my personal situation with my Endodontist partner. Considering the title of the thread, I feel it's relative. Call me when you make your $6M/yr. I'll be happy to know you made it.

Is this for real?

"Complete sentences, thank you." is itself not a complete sentence. It's missing a verb. You misused a comma in the next sentence and should have put the period inside the closed quotation mark at the end of the sentence. The following two sentences should have been separated by a period since they are two distinct and complete sentences. It should read: "...norm. However, ...." I'm not sure "Endodontist" should be capitalized when used the way you used it.

 

[hahadino2771]

Thats true. Cosmetic gp gurus in high end dentistry charge 2500 - 3500 cash for each unit of crown or veneer.

Full mouth recon sometimes cost like 50 - 100k cash with those super cosmetic docs.

Ok, what specialty would you say does?

I guess I meant the upper average of solo practitioners. There are GP's focused on cosmetics charging 3-4K / tooth and doing those cases exclusively too.

 

[Biffster]

Since I got sucked into this thread anyway, I will weigh in on the topic at hand.

For a solo doctor, I would estimate oral surgery, ortho, endo and pedo all have a similar ceiling in terms of maximum earning potential. I think a solo general dentist or prosthodontist would have a lower ceiling. Your AVERAGE solo practitioner in each of these fields would break down something like this in terms of average earnings: oral surgery>endo/ortho/pedo>general/pros/perio.

In other words, I think oral surgeons earn the most on average and also have just as high of a ceiling on their earning potential as the other specialties. Having said that, I also know of pedos and orthos who have built massive practices with associates who earn far beyond what a solo practitioner could do. So the type of practice can make a big difference. General dentists could also make a boat-load of money with this kind of set up (multiple associates, perhaps multiple locations).

The last thing I would add is that if any general dentist or dental specialist is good at what they do and they practice in a decent market for dental services and they work hard then they will earn enough money that exactly how much they earn will be of little importance. I know there are many threads dealing with physician vs dentist earnings, but I also can say that, generally speaking, the dental specialists I know earn more than the physician specialists I know and the general dentists I know earn far more than your average family practitioner or pediatrician.

 

[CMistry]

I'm sure that kind of approach towards grammar makes you a gem amongst your local OMS. Doesn't matter if that ortho is an outlier, I've never even heard of an OMS making near that. Sure, OMS make great money on avg, but I have always been talking about ceilings. Anyways, you haven't affirmed that OMS can reach those numbers I stated nor denied that ortho can reach those heights. If you're skeptical, I can PM you the practices that do. Regardless, you need to chill out.

Your logic is seriously flawed. You keep assuming an OMS can't own GP offices, when in fact they can own as many as they'd like. So by your own standards the ceiling as at least equivalent. "I've never heard of an OMS making that" is just silly to even say. Then again, this is the interwebs.

 

[CMistry]

Please educate me on OMS owning multiple GP offices in practice, not theory.

You realize your glass ceiling is a theoretical concept, right? And have you ever considered that there is a reason that OMSs don't own GP offices -- and why they rather invest into their own field and have multiple OMS practices?

Good luck to you.

 

[Awarara]

If you're comparing income potential between specialties, the only thing you should be comparing is how much you can make per given time (dollars/hour). In that case, certain specialties will make more than others. Given that one person works at maximum production, then endo/omfs would make more on average than a gp.

Saying that GP makes more money because they can own multiple offices is kind of pointless. Running multiple offices is just a form of investing, which everyone else can do. It just depends where you put your extra money. GPs can use their income to open more offices. Endo can use their income to invest in other things. All else being equal, specialists will make more money on average because they have more money to invest which will net more in return. Now some GPs may have amazing business sense and make a ton of money, but specialists can say the same.

 

[RoseEndo]

I would rather to invest on buying multiple properties! You should get out of mindset of dentistry 24/7. There is a life outside dentistry and you guys need to cherish it more!