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Why Dental School is Worth It Despite the Debt

A 2022 U.S. News ranking of the 100 best jobs of 2022 places dentistry among just outside of the top 10 jobs in America. This is the first time in several years it has fallen out of the top 10. Is it time to panic about the profession of dentistry?

The report ranks occupations on a list of seven different factors, including the average dentist salary earnings, but none address the cost of dental education and the student loan debt that comes with it. For new dentists, your dental school dean probably sold you a bill of goods.

Please tell us what schools told you about loans in the comments. I'd love to compare your stories and so would the other folks hanging out here. There are all kinds of BS cliches floating around dental schools these days. I'm here to challenge them.

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Why Dental School Debt Makes Success Harder in Dentistry

So many people ask me “Is dental school worth it?” Yes, dentistry can still be a lucrative and wise financial decision. And the average dentist's salary isn't bad at all.

However, for many new dentists, the margin of error is smaller than it has ever been before. For many dental school graduates with over $400,000 in negative net worth, the only way to make dentistry worth it is through practice ownership.

Yes, dentists hire me to make a comprehensive plan to save money paying back their student loans. Before I get accused of trying to sensationalize the dental school loan problem for profit, realize that the worse this problem gets, the more clients Student Loan Planner® stands to have.

I do this job because I love helping dentists save money and increase the return on investment for their education. I want to add a dose of realism to the profession and speak up against widely held public perception.

Paying Back Dental School Debt Would Take Drastic Measures for Most

No, you will not repay your dental school loans in five to seven years, despite the average dentist salary. Your education was most likely not a wise financial investment compared to alternative paths available to someone smart enough to get into a dental program.

UNLESS… if you buy a $800,000 practice in an area with a 5000 to 1 population to dentist ratio, hire consultants to grow the practice, and work your tail off with smart financial planners and CPA's around you, then forget what I said about dentistry not being a good decision. It could be one of the best careers out there. 

The problem is that you have to be comfortable living with a large amount of debt and a high monthly payment, which leaves a narrower path to success than back when dental school cost $5,000 a year. If you're wondering if dental school is worth it, you must consider these costs.

It's the Delta Dental, DSO, and debt age of dentistry

The economics of the profession are not the best they've ever been. If only I had a dollar for each time a client told me that their dean spouted that off in a speech.

Delta Dental and other PPO insurance plans have crushed average incomes. A typical dentist made over $200,000 not too long ago.

That number is closer to $140,000 today, according to Payscale data. The difference? Fees are way lower than they used to be because your average dental office accepts a half dozen different providers.

Over the next decade, corporate Dental Support Organizations will replace thousands of small business owners with employees and retain all the profits.

I have a different rating system for the folks over at US News and the thousands of young dentists and soon-to-be dentists graduating in the next several years from public dental school or from private dental schools.

Being a dentist is the number 1 job in America for debt. Keep reading to the end though, because it doesn't have to be.

Dentistry education debt is crushing in magnitude

In my flat fee student loan consulting practice, I help professionals from all different backgrounds. I've consulted with surgeons, primary care docs, veterinarians, psychologists, nurses, teachers, lawyers, chiropractors, pharmacists, business owners, dentists, and more. 

Dental student loans are on another level and the high costs are crushing. Dentistry debt stands out because it is consistently the highest in absolute dollars of any profession I see. Check out this video below to see an example of how I help a dentist save money on their school loans.

The average dental school debt of the 354 dentists I've consulted with is $379,742. Their average salary has been about $150,000 (U.S. News lists the average dentist salary at $155,600).

If I restricted that to dentists either currently in school or who graduated in the past couple of years, the average debt would be closer to $450,000 and the average income would be closer to $120,000.

Read also: Published Cost Estimates of Dental School Are Totally Wrong

Dental education debt is also almost impossible relative to salary

So say you use my average debt and income figures for recently graduated dentists.

A typical debt to income ratio for dental education debt is therefore $450,000/$120,000=3.75. There is almost no scenario where an individual can repay this level of debt, no matter the average dentist salary.

The only path to full repayment in this scenario is owning a practice in an area where most dentists probably don't want to live. If you disagree, that's cool. Let's debate it in the comments.

There is a wide distribution around these typical numbers of course. Many dentists coming out of public programs have between $250,000 and $300,000 in student loans and are on a path to repay everything within 10 to 15 years.

However, some others from private schools owe well over $500,000. I've even consulted with some specialists graduating from residency programs who owe close to $1 million for their education.

Can you find some success stories of dentists who've moved to a rural wealthy enclave in the middle of nowhere making $400,000 a year three years out of school? Sure. I've worked with several of them. We refinanced their student loans and saved them tens of thousands in interest.

However, even these ‘unicorn' dentists would've probably been even more successful as non-dentist business owners. You also can't make an argument in favor of a profession based on how well the 0.1% are doing.

You have to look at the vast majority of cases and look at the typical result. For the thousands of dentists doomed to toil in associate positions for most of their career, that result isn't pretty.

Without the government income-driven repayment programs to fall back on for federal student loans, I estimate that 50% of today's graduating dentists would default on their loans.

That's not a stable occupation with great pay. It's one where you have an anvil hanging over your head that you're glad hasn't dropped yet. Ironically, the only way to get out of this situation is by taking on even more debt to become your own boss as a practice owner.

Read also: Five Ways Dentists Can Protect Themselves Against Student Loans

Dentistry is the Most Expensive of Any Professional or Graduate Program 

Finishing medical school is cheaper than completing a dental program. Many people even get scholarships. If you have a high balance, you can use Public Service Loan Forgiveness to pay a fraction of what you borrowed.

Veterinary school is unbelievably expensive, but dental programs and the cost of tuition still wins as the number 1 most expensive professional program. I've never heard of a vet med student being asked to spend $5,000 for a DVD with books on it. The total cost of a dental education is unmatched. 

Some of the dentists I've spoken to tell me they've seen way worse stewardship of their money in school than that.

Law school, psychology PhD programs, pharmacy school, and other graduate degree programs do not hold a candle to the absolute magnitude of the cost of becoming a dentist.

Yes, owing $200,000 and not being able to find a job as a lawyer sucks, but at least it's just $200,000.

Once you owe over $400,000 for your dental education, you're not going to be able to afford to have another “find yourself” period of life, despite the average dentist salary, especially if you have private student loans. So if you're wondering “is dental school worth it?”, think long and hard about it. 

That's a real cost, and hopefully, the admissions process weeds that out for the most part. Still, I know from consults that there are folks that would like to try something else in life besides dentistry and they can't because they have such a huge debt load the size of a mortgage.

Read also: Dentists Get Drilled on Student Loans

To US News and Others Who Believe Dentistry is the Number 1 Job in America, Look at a Couple of $500,000+ Loan Burdens

I jokingly wonder if deans at the more expensive dental programs take up a collection plate for US News for keeping talk of debt under wraps. There is a massive student loan bubble waiting to pop, and dentistry is near the top of the list.

The only thing supporting it is the income-driven repayment plans that allow folks to pay a fraction of what's owed. Change access to these income-driven plans, and there would be a crisis in the field.

Say US News adjusted their rankings for average debt level after graduation. Dentistry would not be the number 1 job in America. It might not even be in the top 100.

Praising dentistry as a high-income occupation with a great average dentist salary without mentioning student debt is like praising an owner of a 10,000 square foot home for his wealth without mentioning that the entire thing is mortgaged.

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A DDS or DMD is a Very Valuable Asset, Which is Why People Keep Paying Ever More Ridiculous Sums of Money for It

Am I being a little over the top in this post? Sure I am. Dentistry is a lot more secure from recessions, layoffs, and automation than the vast majority of jobs. There will always be a need for dentists. Folks with intense pain will always be willing to pay a lot to get it to stop. 

That's why there are so many people willing to pay premium prices that rise ever higher. There is an absence of private investors putting a cap on the borrowing limits for a dental program.

Hence, the government lends without limit and schools raise their prices to claim that money from borrowers willing to sign their names to the paper.

Is this fear-mongering just to generate business for my student loan consulting firm? No. Again, large student debt burdens are great for my business. I'm actually trying to scare away dentists from signing up as an associate at a DSO for 30 years. If you read this challenging of an article and know you still love dentistry, I'm encouraged.

Dentistry can still be rewarding, but you have to play great offense AND great defense. I specialize in the defense part of the equation.

I optimize student loan strategy for dentists so you aren't making big mistakes and paying thousands in unnecessary interest. That happens about 90%-95% of the time.

Don't Lose Heart. There is a Path Forward in Dentistry

If you're a talented young dentist, don't lose heart. I speak with dentists all the time and help them come up with a plan to tackle their student debt.

Yes, the cost of completing your dental education is outrageous. However, once you have the debt, the only route is to evaluate the best options for repayment to save the most money. Then you act on it.

I save the average dentist over $100,000 over the life of their loan payback. Most dentists leave a ton of money on the table with their student loans, and I want to pick it up and put it back in your pocket.

What do I do? I make sure you're not paying a ridiculously high interest rate when you could qualify for a much lower one. I also take a look at the actual simulated cost of the various income-driven repayment options so you'll know a personalized estimate of the tax penalty associated with loan forgiveness.

We'll talk about how to set up your student loans for maximum advantage regardless if you're a practice owner, an associate, or a fourth-year dental student.

I've spoken with everyone from brand new grads barely making $100,000 in a major metro area to DentalTown ballers making over $500,000 opening a second practice less than three years out of school. All of them had opportunities to save money on their student debt.

Even though I've spoken with some wildly successful dentists making much more than the average dentist salary, most rely on income-driven repayment to cover the cost of their dental education.

Is Dental School Worth It, Really?

Until the public realizes the truth that most new dentists aren't paying off their debt in 3 years and driving a Porsche, there will continue to be dozens of applicants for every spot in dental programs.

Once the word gets out or the federal government cuts off the unlimited dollars available in loans for dental degrees, I think we'll see a crisis of epic proportions on our hands. Until that happens, maybe US News meant to say that the number 1 job in America is being Dean of a Dental School. To me, if you're asking is dental school worth it, my answer is not as much as you might think. 

Comments

  1. L January 27, 2017 at 2:40 AM
    Reply

    lol this article makes me laugh. So having 250k of school debt and making 200k a year 5 years out of school is a bad investment? Not sure you’re the financial advisor I’d look to for advice.

    • Travis January 27, 2017 at 5:33 AM
      Reply

      For dentists graduating between 2017 onwards, I don’t think those numbers are at all representative of the average experience. The average dentist makes $170,000 a year including all the private practice owners. If you’re starting out as a corporate associate, it’ll start around $120,000 and gradually increase over several years maybe to $150,000 depending on the practice. Others can feel free to verify this for me. Also a dentist graduating in the next 4 years is going to have around $300,000 in debt on average, not $250,000. Private schools will have a lot more too. That debt number includes folks getting assistance from families or spending down savings but still borrowing some themselves. If you exclude those folks, the average debt is even higher

      • DMD503 January 27, 2017 at 6:38 AM
        Reply

        I agree with this. 120k is pretty standard for new grads in the corporate world. Especially in areas where the market is saturated. I work at a corporate office in Portland, OR, and can see the numbers of about 25 dentists in the company in my area. We are making 25% of production and about half these dentists are producing around 1500-1800 daily. There’s no way you can pay off your student loans in an urban area, where the cost of living is high, making 375-400 dollars a day. Not happening. Maybe if you move to Timbuktu where you’re the only dentist you can make a lot. But that’s not feasible for everyone

        • Travis January 27, 2017 at 2:09 PM
          Reply

          I wonder DMD503 how fast the percentage of dentists employed at a corporate office has grown in the major metro areas. Someone told me anecdotally that a DSO went from 10 offices to like 60 in Atlanta over only a couple years. Seems like corporate dentistry is exploding.

          • DMD503 January 27, 2017 at 4:38 PM

            They are growing like wildfire. There’s a DSO on every corner here. It’s a good option for new grads to get their foot in the door but it’s hard to make ends meet when you are doing discount dentistry with low compensation. Most DSO’s target a certain demographic- low to mid-range income. I think there is still a place for private practice. For people who want an experienced dentist (most dso’s hire new grads) or just don’t like corporate dental offices. But it’s definitely getting harder and harder for private, especially the ones targeting the same patient population as the DSO.

          • Travis January 27, 2017 at 9:35 PM

            @DMD503 have you seen DSOs doing good work in bringing down the cost of dental procedures for underserved populations? Where have the DSOs not done a good job in your view? Obviously working for one isn’t a good financial decision compared to practice ownership

    • Megan January 6, 2018 at 8:41 PM
      Reply

      You’re not taking the high 12%+ interest rates into account. It’s a crippling amount of debt compared to new grad income. I work in the dental profession and have witnessed much of this in my city.

      • Travis January 7, 2018 at 2:39 AM
        Reply

        12 percent? Can you go into more detail on this Megan?

    • Leo April 29, 2020 at 6:26 PM
      Reply

      Not sure why this article made the person laughed, this was a great article and very accurate with what most med/dental grads experience.

      I am a medical school grad with $509,000 in pure medical school debt (originally $350k, but with 7% interest after med school and 3 years of residency, it ballooned). My wife is a DMD from a private school and luckily has no loan debt. She makes ~$70k salary as a 3rd year associate previously working for corporate (PDS) now at a county dental program working 3 days a week. This dental debt is what drives dentist to practice aggressive dentistry so they can pay back their loans, unfortunately this also builds massive distrust in the public.

      What people don’t get is interest is what guts you. People don’t understand that FEDERAL grad loan interest rates are much higher than undergrad (6-11% compared to 3-5%). Most med/dental grads are in their early 30’s before they start making real money. We have no equity, no house, no savings, no retirement plan, etc; just pure soul crushing debt. Everyone thinks dentist and docs live lavishly, maybe 20 years ago before grad school became comically expensive. I drive around in a 10 year old Prius that I got used and I don’t plan on upgrading anytime soon.

      I owe $4000 a month in student loans with the potential of paying it off in 25 years on a REPAYE repayment plan. I am too scared to refinance as I hope that one day student loan interests will decrease or possibly be forgiven. I have 2 young kids and unless the cost of medical education changes, I will strongly advised them against a career path related to medicine/dentistry.

      • Travis Hornsby April 29, 2020 at 9:18 PM
        Reply

        If you ever need a second look on the overall strategy Leo Student Loan Planner would be happy to help review it! Glad you enjoyed the article.

      • SJDDS May 3, 2020 at 3:36 PM
        Reply

        I came across this article and wanted to share my thoughts/story. I graduated dental school and then residency in 2017. At that time, I was looking at an overwhelming total of $566,000 in student loan debt. It was really stressful to look at that number. However, reducing that number was a priority, and I worked 6 days a week for the next 2 years. I refinanced my student loan 2 years ago with SoFi for an interest rate of 4.625%, and as of today, have paid down my student loan total to $300,000. I was able to do this by not only making monthly payments, but also making additional bulk payments from my earnings. During that span, I was also able to save up enough from working to now be able to pay off that $300,000 entirely if I choose to. However, I decided instead to refinance again and now have an interest rate going forward of 3.23% fixed for the remaining $300,000. This is on a 5-year term. By doing this, I will only pay roughly an additional $25,000 in total interest over the entire 5-year term. I would rather do this, instead of paying off the loan and thus reducing my savings. I don’t consider myself special in any way. I just had a game plan, and worked hard towards it, and still continue to work hard towards it. Nonetheless, it is VERY possible to pay off student loans in 5-8 years, while also living a good life. During this time, my wife and I have taken several vacations, including traveling to Italy, Paris and Hawaii. We both drive what folks would consider to be luxury vehicles. We didn’t own a home during this period, but we are now looking into homes. I will also note that when I graduated residency, my wife and I had a total savings of roughly $20,000. So we did not start out with much. I say all this not to brag in any way, but simply to point out that, with proper planning, and working hard, you CAN live a very good life while also aggressively paying off student loan debt! I love dentistry, and would urge anyone with a passion for helping others towards it.

        • Travis Hornsby May 13, 2020 at 2:03 PM
          Reply

          Great story of perseverance. You might at some point consider a variable rate to reduce that interest rate further. You might be able to reduce it to 1 something and since you can pay it off all at once there’s no risk really. https://www.studentloanplanner.com/refinance-student-loans/

          • hailey August 14, 2020 at 9:44 PM

            Is refinancing option only available once you’re no longer in school? I’m a 4th year dental student with a crippling debt. I have tried to refinance my loan during the pandemic but either I did not have reported income to do so, or if I have a sponsor it simply said my loan (direct grad PLUS) was not eligible for refinancing

          • Amy at Student Loan Planner August 28, 2020 at 12:58 PM

            If you have crippling debt, I recommend reaching out to a student loan consultant to get a repayment plan. Student loans shouldn’t be a debt sentence.

  2. LoanDDS January 27, 2017 at 7:36 AM
    Reply

    To any skeptics out there. Every word of this article is true! I graduated from dental school four years ago with $371,000 in student loan debt. To date, the total principle with exorbitant 6.8 – 8.9% interest rates has ballooned the loans to over $455,000 while making payments under the Income-Based-Repayment program.

    Just imagine, the interest on your loans growing by just over $2200/month, all while corporate dentistry is taking over all the small profitable practices out there and starving out the competition. Companies like Aspen, Heartland and PDS come to the dental schools, recruiting dental students and promising the world and $120K salary, but the reality is they are for the most part terrible offices to work in and the salaries only last for a short intro-period. They suck all of the profit out of the practices by paying low wages to the doctor ( 20-25% of your adjusted production (which really means collections which are always lower) ).
    If you are thinking you will just buy or build your own dental practice, think again. As total loan amounts increase every year for graduates, banks are much less likely to approve for you a practice loan.
    Meanwhile, big dental insurance companies like Delta are chopping reimbursement by 50-75% for the procedures you are working so hard at to make a decent living and be able to pay back these loans. Don’t forget you have to pay 25-60% in state and federal tax before your loan payments because you are a “rich dentist” now.

    Graduates paying their loans under the Income-Driven Repayment plans will be forgiven after 20-25 years. Great right?! Wrong, because you will have to pay income taxes on the $1,000,000+ dollars forgiven. If you live in California that could be as much as 60% or $600,000! With the national debt spiraling out of control due to the previous Administration, it is only a matter of time before our tax rates go through the roof unless the current President can somehow make significant changes to the IBR (aka IDR) plans/terms and/or offer much lower interest consolidation.

    This is the current dismal truth of most new people entering our profession.
    There is a major student loan crisis coming, probably sooner rather than much later. Unless you have a wealthy family member or join the military before dental school, I would advise to goto into another career.

    • Travis January 27, 2017 at 2:07 PM
      Reply

      Hey LoanDDS, have you ever looked at switching repayment plans from IBR to something like REPAYE or PAYE? It might make a lot of sense. Could lower the payment and slow the growth of the loan from interest subsidies. That might also help with qualifying for a practice loan, as banks will look at your total debt service payment every month and less so at the total amount you owe in student debt. That’s been my experience with some people in the past as long as their payment is low the banks didn’t care. If you wanted me to take a look feel free to email me at Travis@studentloanplanner.com. I think you might be leaving money on the table

      • LoanDDS February 13, 2017 at 6:24 AM
        Reply

        Hey Travis,
        A couple years ago, I did attempt to switch to another repayment plan (PAYE) that sounded more appealing, however was deterred by my loan servicer. They told me I could not switch without first withdrawing all of my loans from the IBR program, making a standard payment (Either $5,000 or $10,000 at the time) and then switching the eligible loans to a different repayment plan. I asked if the forgiveness period (25 years, 20 years, etc.) would reset and they thought it would as well.
        Long story short, thats why I let it be. Still looking for a better way now though. I will be emailing you soon.
        Thanks

        • Travis February 16, 2017 at 2:40 PM
          Reply

          There’s also plans like REPAYE that do count the IBR payments towards REPAYE. I think the technical issue is that PAYE has a different forgiveness period. It could actually make sense to switch to PAYE or REPAYE and it depends on your situation. Feel free to hit me up at travis@studentloanplanner.com. What the rep told you is probably accurate, but IBR almost always costs a lot more than the other options if you’re going to go for the taxable loan forgiveness route. Hope that helps!

  3. RupiB January 27, 2017 at 9:32 PM
    Reply

    You are most certainly making a valid point. Private practice owners that serve PPO or EPO plans are also scrambling. Insurance companies like Delta Dental have completely monopolized the system. If a dentist ever dreams of dropping off Delta Dental the patients move over to the next dentist that takes their insurance.
    It is a vicious cycle: have the dream profession as a dentist then suffer at the expense of Insurance companies and student loans and practice mortgage etc.
    Having a Tripartite membership with ADA,CDA, Local dental society sucks almost $2k / Year and yet not sure what they do for a dentist when it comes to looking at reimbursement rates for dentists. Even a plumber or electrician makes more than a dentist and yet does not have to pay for enormous student loans.

    • Travis January 27, 2017 at 9:36 PM
      Reply

      I’ve been working on breakeven analysis comparing plumbers to medical professionals like dentist and you’re right it doesn’t look good for the highly educated.

  4. DMD503 January 27, 2017 at 10:03 PM
    Reply

    In some ways yes, PDS offers cerec crowns, so there is some leeway in what we can charge the patient since there is no lab fee. The the “Dental Plan” they offer to patients without insurance, is discounted to about what the average contracted rate for a PPO would be. On top of this, they are frequently offering 20% off promotions. I regularly do crowns for around 600 dollars, which is about half of what the private practices in the area are charging. I’m helping more people get the care they need, but also doing twice as much dentistry for the same reimbursement. The DSO’s definitely have NOT done a good job in compensating their Dr.’s or retaining good ones.

  5. Cautious Optimism | Laundry On Sundaes January 28, 2017 at 6:08 AM
    Reply

    […] my career. But now I couldn’t help but feel cynical. A more realistic picture is painted in this article instead. I know that it was written by someone who runs a business helping people with student […]

  6. Chris @ Mindful Explorer February 6, 2017 at 9:08 PM
    Reply

    Its the simple math of income vs expenses that many can’t even grasp in their daily lives. Simply doing the return on investment calculations leaves you in shock of what is needed to achieve this profession. Society places too much emphasis on degrees and social standing amongst the population. Honest jobs and even the trades are often looked down upon but they often have very little investment required to attain them that the ROI is very appealing. But people want the flashy cars and flashy houses and that flashy job title.

    • Travis February 6, 2017 at 10:01 PM
      Reply

      “My son is a plumber” just doesn’t have the same ring to it as “my son is a dentist”

  7. Some thoughts on Bubbles and Student Loans – DIY Money Stuff February 7, 2017 at 4:08 AM
    Reply

    […] is the belief that an education is worthwhile at any cost. I recently was reading about the astounding levels of debt the average dentist owes. The author of this article finds the average dentist just starting out has an average of […]

  8. The Money Wizard February 8, 2017 at 2:30 PM
    Reply

    I had always heard Dentistry was an overrated profession. Pretty crazy to see the actual stats.

    Veterinarians are a similar profession. Anecdotally, the average Vet I’ve seen graduates with about $400,000 in debt, and can expect to make barely over $100,000.

    It’s sad that the allure of a job title pulls people into something that sure smells like a scam.

    • Travis February 8, 2017 at 4:10 PM
      Reply

      My avg vet med client has a balance of $300,000. The ones who open their own practices can make $120,000-$150,000 but that’s certainly the exception. Most work in a clinic as an associate and earn between $70,000 to $100,000 for the majority of their career.

      Essentially the takeaway message is if you’re going into dentistry, you better be ready to run your own practice or you’ll never break even on the degree.

  9. Debt Ascent February 16, 2017 at 10:31 PM
    Reply

    This doesn’t paint the rosiest of pictures for the profession. My wife is a practicing dentist as an associate. She graduated from a private dental school three years ago with approximately $400k in student loan debt. You highlight some important issues. Thanks for that, but I’d like to challenge a few of your assessments:

    “No you will not repay your student debt in five to seven years.”

    A dedicated practicing dentist whose sole focus is debt reduction can absolutely pay off this amount of debt in 5-7 years with a dedicated approach. Will it come at the expense of other things? Sure. But if being debt free is important to you, it can absolutely be achieved in this time frame.

    A practicing dentist making $120k and graduating with $300k in loans (example numbers you presented in the comments) who had an effective tax rate of 22% (lets round up to 25%) would be left with $90,000 per year to live on. If the borrower did not refinance, a bulk of their loans would be at 6.8% with some perhaps as high as 8.5%. Assuming an interest rate of 7.5% and a repayment period of 6 years, that corresponds to a payment of just under $5,200/mo leaving just over $2,300/mo to live off of. Would that be difficult? Sure. Impossible? Certainly not. Extend the time frame to 7 years, and cut the rate by ~3 points by refinancing those loans and you have a payment of under $4,200 leaving $3,300+ to live on.

    “A typical debt to income ratio for dental school is therefore $450,000/$120,000=3.75. There is almost no scenario where an individual can repay this level of debt.”

    Using this more extreme ‘typical’ example of $450k debt to 120k income, let’s say this dentist fully funds a 401k, reducing their federal taxable income to $102k/yr. The effective tax rate for this borrower would be just under 18% (lets round up to 20%). This leaves $81,600 to live on. Again, assuming this borrower refinances to 4.5% for a 15 year period, their payments are approximately $3450, leaving over $3300 to live on each month WHILE ALSO maxing out their 401k.

    In each case the assumption was that there were no income increases, no other income deductions to reduce their tax rate, and without turning to IBR, PAYE, etc. Change one of a few variables in the borrower’s favor and the situation improves from there.

    Is someone living an extravagant life on $3,300/month? No. But that doesn’t mean it’s a near certainty of financial disaster if you’re a recently graduated dentist who is in this level of debt. There are options. Live within your means and take an interest in learning the principles of personal finance.

    • Travis February 16, 2017 at 11:13 PM
      Reply

      Your points are fair ones, but how many dentists and their partners do you know who are willing to live on $3300 a month much less $2300 a month? You sacrifice your entire life until your mid 20s and you finally start making a ‘real income’ right when other life demands come at you. Marriage, family, kids, wedding, purchasing a car, house, etc. and it really adds up in a hurry. Add to that the temptation that comes with having every bank in town trying to lend you whatever you want to facilitate more purchases bc you have DDS or DMD behind your name and it’s extremely challenging. I might be a little over the top in the presentation above but it’s intentional bc of how many people tout the idea that dentist is the best high income job out there and very little has been done to challenge the general public’s perception.

      Another point is that interest rates for a 15 year best case scenario for a fixed rate right now are around 5.5% not 4.5%. Also the refinancing companies are not going to offer you a good deal because of the unattractive debt to income ratio, so a dentist could not get such a low interest rate even if they wanted to. So $2300 is more accurate of what would be required than $3300. And if you’re going to have to live on 2300 a month that gradually increases to 3000 a month, then perhaps you should’ve gone to community college because you’d have come out ahead. That’s the harsh reality I want prospective dental students to be aware of before choosing dentistry as a profession.

      For those folks who already have the debt, the only path is maxing the ROI of the degree by saving them as much money as possible, and that’s where my services come in. In your wife’s case, I’d ask about future career plans and if she wants to be an associate for her career then optimizing PAYE. If she wanted to go into practice ownership then setting up REPAYE with interest subsidies to prepare for practice purchase then refinancing once you can get a good rate bc of your lower debt to income ratio

    • AL October 26, 2020 at 12:35 PM
      Reply

      What are you smoking my friend? You forgot about state income taxes. For example , in CA it would be about 12%. Also, you have to pay SS taxes 6.5% and Medicare tax 3.3%. If you add these 20% to your calculation, your 5-7 years repayment plan sounds as a pipe dream.

      • Debt Ascent October 27, 2020 at 11:45 AM
        Reply

        The numbers presented included SS and Medicare taxes. Please run the numbers yourself and see. I did not include state income taxes because not everyone has state income taxes. Yes, you’re right that someone in CA who has to pay double-digit state income taxes will have a harder time than someone else who doesn’t. However, a starting dentist in CA is likely to make a different salary than someone in a state without state income tax too.

        If we want to nail down a location with regard to taxes, let’s do the same for income and re-run the calculation if you’d like. For example, according to salary.com, the 10th percentile salary for a general dentist in California (meaning 90% earn HIGHER) is over $140k.

        Using someone in CA with a $140k income, their take-home pay is $95k (after paying $25k in federal taxes, $10k in FICA, and $10k in state taxes). That coincidentally is about the same take-home pay as the example presented above.

  10. Debt Ascent February 16, 2017 at 11:59 PM
    Reply

    Hi, thanks for the thoughtful reply. You of course bring up some very good points. The price of dental school is very high. Too high. Like I said, we know firsthand. I hope you don’t mind, but I want to thoroughly reply to your thoughts.

    “Your points are fair ones, but how many dentists and their partners do you know who are willing to live on $3300 a month much less $2300 a month?”

    My only data point is my wife. We don’t live on $3300 per month. Not even close. Then again, we have two children in a HCOL area and we aren’t trying to pay off our debt in only six years and we also have the advantage of a second income, which presumably the partner in your question above would also have. Taking away our debt payments and expenses associated w/ our children, and we spend roughly $5k between the two of us. It doesn’t scale as well down to a single person, but $3300/month for a single person for a few years isn’t that extreme I don’t think. Plus, if in the same time frame the borrower’s income scaled up an extra $20-30k (not at all unrealistic), that $3300 quickly bumps up to over $4 or $5k. I was simply presenting the case for only a single dentist responsible for themselves and the potential to be debt free in 6-7 years with a realistic (though obviously challenging) repayment strategy. It could be done. After that time frame, that dentist would be able to explode their lifestyle up to nearly $100k by themselves if they so wished.

    “You sacrifice your entire life until your mid 20s and you finally start making a ‘real income’ right when other life demands come at you. Marriage, family, kids, wedding, purchasing a car, house, etc. and it really adds up in a hurry. Add to that the temptation that comes with having every bank in town trying to lend you whatever you want to facilitate more purchases bc you have DDS or DMD behind your name and it’s extremely challenging. I might be a little over the top in the presentation above but it’s intentional bc of how many people tout the idea that dentist is the best high income job out there and very little has been done to challenge the general public’s perception.”

    All absolutely fair points. There’s always temptation for lifestyle inflation. It will come at a financial cost as it relates to paying for your past life decisions.

    “Another point is that interest rates for a 15 year best case scenario for a fixed rate right now are around 5.5% not 4.5%. Also the refinancing companies are not going to offer you a good deal because of the unattractive debt to income ratio, so a dentist could not get such a low interest rate even if they wanted to. So $2300 is more accurate of what would be required than $3300. And if you’re going to have to live on 2300 a month that gradually increases to 3000 a month, then perhaps you should’ve gone to community college because you’d have come out ahead. That’s the harsh reality I want prospective dental students to be aware of before choosing dentistry as a profession.”

    We financed our loans a little over a year ago for 2.8-3.2% variable rates for loan terms ranging from 5 years to 20 years for a couple with a debt to income ratio of over 2.5. Rates have climbed since that time, but we’re still paying under 3.5%. I chose 4.5% to include some buffer. This is a variable rate, which comes with some level of risk, but if you’re aggressive early on when balances are high the risk drops with each passing payment. In addition, our rates are capped at slightly more than what re refinanced from, so it seemed like an easy decision for us. If you were only comfortable with fixed rates, then of course payments would be higher, though the payment would increase to just under $3700, so your living costs would drop to over $3,100, and not $2,300 as you suggest.

    “For those folks who already have the debt, the only path is maxing the ROI of the degree by saving them as much money as possible. . .”

    Well said.

    Thanks for the dialogue. It’s an important subject that most dentists don’t take seriously until they’re already facing this monumental challenge.

    • Reality Check August 1, 2017 at 11:11 AM
      Reply

      “$3300/month for a single person for a few years isn’t that extreme I don’t think.”

      So says the person with two homes and combined expenses of $10,000/month…In Los Angeles, rent, utilities, car insurance and gas prices alone would eat up $3300/month for a single person. Just don’t eat and don’t get sick.

      • Debt Ascent August 8, 2017 at 7:38 PM
        Reply

        “So says the person with two homes. . .”

        The only thing I mentioned having two of are incomes and children.

        “. . .and combined expenses of $10,000/month. . .”

        I assume this is based on this statement where I said we spend roughly $5k between the two of us after considering costs for loans & our aforementioned children? For clarity, that’s $5k combined. Not each. And for added clarity, that includes all expenses related to our (singular) home.

        “In Los Angeles, rent, utilities, car insurance and gas prices alone would eat up $3300/month for a single person. Just don’t eat and don’t get sick.”

        Per the US Census, as of 2015 the gross median household salary in LA is right around $50k. After taxes, how does that compare to the $3,300/month that you assert isn’t enough to for a SINGLE person to have enough to feed themselves?

        So even cherry picking one of the most expensive US markets and using the average starting salary from the article with no geographic salary differential, I am in need of a Reality Check to think it’s not extreme that a single person could have enough to live on what the median HOUSEHOLD does in that market?

        • Travis August 10, 2017 at 7:54 PM
          Reply

          In fairness, almost no dentists and their families would be game to live on that after making the sacrifices they do for the 8 years of schooling minimum post high school. For some they’re sacrificing for even longer if they pursue GPR years or specialty programs. Hard to delay gratification forever, but I do respect the point.

        • AL October 26, 2020 at 12:41 PM
          Reply

          ….:Per the US Census, as of 2015 the gross median household salary in LA is right around $50k…..

          Yes. One person makes 100K per year and 10 persons make 10K per year. We have median 50K.
          The truth is 10K income person has non monetary subsides to cover expenses from AT&T , PG&E, food stamps , housing subsidy , subsidy for free child care and almost free medical coverage through Covered CA. These subsides combine could cost more that $3300.

  11. FBN February 17, 2017 at 5:44 AM
    Reply

    Now I know why there are crooked dentists preying on the public. My daughter recently relocated and a dentist she saw for the first time told her she had 6 cavities. She went to another dentist for a second opinion and her teeth were fine

    • Travis February 17, 2017 at 2:35 PM
      Reply

      Financial desperation definitely has the potential to push people to do things they wouldn’t otherwise. All the dentists I’ve had though have been amazing I must say. Very nice and very fair people

  12. AFT February 17, 2017 at 11:06 PM
    Reply

    So it might be a bad investment for general dentists looking at $120k starting, but what about those of us entering a specialty looking at $250-300k starting?

    • Travis February 17, 2017 at 11:09 PM
      Reply

      In that case you’re also going to be looking at doubling your student debt potentially. Orthodontists and OMFS that I work with have anywhere from $600,000 to $900,000 in debt. Endo and Perio maybe somewhere between $500,000 to $700,000. If you’re going to be in a big city then don’t expect 250k to 300k unless you’re opening your own practice. Many of the orthodontist associates in major metro areas on the coasts are not breaking 250k

      • AFT February 17, 2017 at 11:15 PM
        Reply

        Actually I am going into pediatrics, and will be paid during my residency for the next 2 years. I will have about $400k in debt, and I have seen starting jobs as high as $450k but average is more like $250-300k.

        • Travis February 18, 2017 at 7:38 PM
          Reply

          @AFT are you talking associate jobs for that income level? If so that’s impressive and you must be in a great area of the country. That’s not typical for associate pediatric dentists that I’ve spoken with unless they are running their own practice, especially the $400+ club

          • AFT February 18, 2017 at 7:48 PM

            Yes, associates first year out of residency. At several of the residency programs I went to they had surveyed last year’s class and all were in the $250-300 there first year out in CA and 300+ in Texas, so some geographical variation. No one was below $250. I saw some ads for associates in the $400 range even one at $500 but in less desirable areas for sure.

          • Travis February 18, 2017 at 8:00 PM

            A lot of the peds positions I’ve seen have been in the northeast, so maybe that’s where I’ve seen some of the lower offers. Say you went to USC or U of P in cali starting in fall of 2017 for dental school and then did a 2 year peds residency. I think it would be almost impossible to leave with less than $500k in debt by 2023 when you get out. More likely you’d be closer to $600k in debt if you don’t have any savings or family support. Even with $300k in Cali paying $70,000 to $80,000 a year for 10 years isn’t pleasant, even with salary increases. More power to the folks who do it and there are plenty out there. I’ve also seen a lot of peds dentists with debt to income ratios above 3 that will not be paying back their loans for 20 years. If you love the job and are passionate about it that’s one thing. I just don’t want people to think it’s a golden ticket and then feel trapped in 15 years when they have no choice but to work in that field

          • Guest March 24, 2018 at 2:03 PM

            Hi Travis, I’m a board certified pediatric dentist working 5 days per week. Last year my income was $165,000. I have an established practice that I own and I work as an associate at a second site. Insurance companies used to pay $130 for routine services that they now pay $68 for. My income has decreased from a high in 2006 of $220k to a low of $129k in 2014. I have missed only 1 day of work due to sickness in the last 27 years. I take off only 14 days per year for vacation ( including national holidays).
            These numbers are real. You can only teat so many patients in a day. If someone thinks they are going to make $300K treating patients I can tell you that IT CAN NOT BE DONE.

          • Travis March 26, 2018 at 4:40 AM

            Cheez that’s tough to hear. Declining insurance company reimbursement has been a major bane of the profession and is a big reason for falling incomes across the board I hear. The most successful clients I’ve had have been in areas where the insurance companies have had limited leverage and they could charge mostly cash rates.

          • Rob December 5, 2019 at 7:59 PM

            The information that you provide in regards to specialists is not at all accurate in regards to pediatric dentistry WHATSOEVER! I currently own my own office bringing in nearly $7,000,000 annually, and have 5 associates. There are at least 5 other pediatric dental offices in the same town that I am in with a total of about 20 pediatric dentists. I do not practice in a remote location nor in a city. I am 45 minutes from DC in Frederick, MD. I START my associates with a guaranteed daily rate of $1,200! I pay 33% of production and my associates produce between $4,000 and $7,000 per day, on average! My highest paid associate is paid nearly $2,200 per day, working from 8 AM to 5 PM, with a 90 minute lunch! My lowest paid associate makes over $300,000 per year and my highest over $600,000! I also own an orthodontic office where my 2 associates are paid the same minimum daily rate of $1,200 and get SIGNIFICANT bonuses every quarter, bringing their annual salaries to well over $300,000 per year! I have numerous friends across the country that are pediatric dentists and ALL of them have associates making well over $250,000 per year, on the low end. I forgot to mention too, that these annual salaries are often based on a 4 day work week, or at most 4.5 days! I have a daughter in high school interested in dentistry and I have told her what a great profession it is. I am 42 years old with two vacation homes, almost no mortgage debt, a hefty savings, and would be able to comfortable retire TOMORROW if I wanted to. DENTISTRY has afforded me this! It’s a shame that you would paint such a dismal picture, as your facts, especially in regards to pediatrics, couldn’t be further from the truth!

          • Travis at Student Loan Planner December 13, 2019 at 10:31 AM

            I think that’s a great example of the upside for sure. The article angle is a bit tongue in cheek, but we have a large enough sample size that would suggest you’re in the top 1% of the profession and your associates and friends are in the top 25%. Also if you owe $500,000 as a pediatric dentist and earn $300,000 that’s doable but it’s important to know about the debt you’ll be in first.

  13. Dmd12 February 18, 2017 at 2:30 AM
    Reply

    I am a recent associate, soon to be practice owner and a former community health dentist and faculty at two schools. I practice in a major metro/saturated area driven by imsurance and this year as an associate i took home 360,000 pay, and that is three days in a pure start up. I have never over treated but have dedicated my complete passion to dentistry. It is not a career that you can show up 9-5 put zero effort and expect to take thos salaray. I listen to podcasts on commute to work, live on forums in down time, and take quality CE. Its hard work, but projections show next year will be 600k income after debt service. And thats working 4 days a week, at the age of 30. It can be done, just it requires so much more, dental school give you just enough not to really hurt some one, not be successful

    • Travis February 18, 2017 at 7:41 PM
      Reply

      Congrats on those numbers. Not saying that no one can possibly be successful in dentistry. Just that you have to basically be willing to bust your butt and run your own small business to make the numbers work in most cases. Any tips for folks leaving school this year? Most people want the safer practice purchase route bc of the immediate cash flow. What made you go the startup route? Very unconventional but definitely has the most upside if you make the right opportunity

    • John March 11, 2017 at 12:40 AM
      Reply

      Where are you working?

    • jeff May 27, 2017 at 6:13 PM
      Reply

      Sounds like a unicorn dentist. practicing in a saturated area driven by insurance and working only 3 days in a startup and took home 360k as an associate? I call BS on that. Make sure you drop by dentaltown and make this announcement there, that’s where this belongs.

      • Travis May 27, 2017 at 6:40 PM
        Reply

        That does sound rather difficult to make the numbers work. Care to give us some more detail DMD12? Would be helpful for some of the new grads looking for light at the end of the tunnel

  14. Matthew Daugherty February 21, 2017 at 12:54 AM
    Reply

    Good article. My wife and I are both dentists with private school student loan debt. I graduated in 2010 and her in 2012. The total amount of debt is most definitely the source of all of our stresses. Its sad to think that we’ve had to put a family, purchasing a house, etc on hold while we deal with this. We have recently looked into the Federal and Statewide student loan repayment programs. The trouble we are having is finding a location for both of us. What are your thoughts on these programs. We figure, if we can find somewhere in a decent location, at least it’ll knock a chunk of our debts off.

    • Travis February 21, 2017 at 5:29 AM
      Reply

      If repaying your debt is the main priority and you’re willing to sacrifice and do whatever it takes, Oklahoma I think has got to be the best place to practice dentistry as a young dentist with debt anywhere. They give sizable state loan forgiveness and the incomes are probably second to none from what I’ve seen in consults. I had a contact there ask me to put my clients in touch with them if they wanted a $250k to $300k associate dentist job next to a reservation 2 hours drive away from the nearest town with more than 20,000 people in it. If you were willing to live in an extreme fashion, you could probably cut your debt in half in 2 years or less. I know Danny and Amber from redtwogreen.com are doing this strategy.

      • Nikki May 12, 2020 at 7:40 PM
        Reply

        Excellent article. 100% truth and the tuition and number of new dental schools opening up show no sign of slowing down. My husband and I are about 18 months away from being out of this mess and having FedLoan out of our lives. COVID-19 didn’t help.

  15. LenaPredent April 27, 2017 at 9:19 PM
    Reply

    Wow this article and the comments are very informative.

    I’m starting dental school next fall with undergraduate debt of about 40k. Is there any advice you can give me as I enter dental school and the dental field that can better prepare me to face this reality?

    • Travis April 27, 2017 at 9:26 PM
      Reply

      Where are you starting Lena? Maybe just say the type of school like private high cost or something like that so you can remain anonymous. I’d say spend a lot of time learning about the business of dentistry and how you’re going to be clinically efficient while running a small business. Perhaps some of the dentists here would like to chip in their thoughts. Definitely try to minimize the use of Grad Plus loans

    • RajT May 30, 2019 at 8:57 AM
      Reply

      I am finishing my OMS residency this June 2019 and have come to this site with desperation and pain looking at how much money I owed from Dental school (around 550K). If I had to do this ALL over again and I knew I wasn’t going to be able to specialize right away, I HIGHLY recommend joining the Navy or Air Force.

      Do HPSP, get them to pay all 4 years of school, or at least 3 years, and literally graduate debt free with exposure and all the benefits the military gives you (GI bill for your future kids, VA loan, Tricare, etc).

      If you know you’re going to specialize from day one, that’s fine as well. I would then recommend starting REPAYE right away once you get into your GPR and then all of residency. Depending on how many years left of PSLF you have left you can either work half the week at a community clinic/health center or just go active duty with the Navy or Air Force for 3-5 years post residency and essentially that counts as PSLF too.

      My BIGGEST mistake I made was NOT starting REPAYE right when I started my intern year in OMS, and now I am about to finish with a ridiculous amount of debt that could have just been paid off right away had I decided to listen to my dental school mentors who suggested I join the Navy RIGHT after dental school during residency and commit 5 years (1 year OMS internship, 4 years OMS residency, 5 years active duty Navy =10 years =120 “PSLF” payments” = debt free = happiness).

      Don’t worry though. The education bubble of today is almost exactly the same as the real estate bubble from years ago. It’s only a matter of time that something will implode in our economy and most likely the next administration will have to deal with it in a way.

      • Travis Hornsby May 30, 2019 at 5:43 PM
        Reply

        Yeah HPSP is the way to go if you’re at a U Pacific or USC kinda place. I know one OMFS resident got a gig in the national guard reserves while in training and timed it so he’d be done with minimal loss of income once he got out.

  16. Tooth doc May 2, 2017 at 2:53 AM
    Reply

    If you’re graduating with this much debt, YOURE DOING IT WRONG. Go to the cheapest dental school you can! Name dropping doesn’t matter outside of academia. Tons of dental specialties make upwards of 200k,300k. Look at ortho, perio, and ENDO. Considering the average dentist works 4 days a week and still makes this much is not bad at all. Isn’t the average American salary like 40k or something? In conclusion, THIS AUTHOR IS TRYING TO INSTILL FEAR IN YOU IN THE HOPES OF YOU HIRING HIM AS A CONSULTANT. HES FULL OF SHIT. DONT LET A NOBODY INFLUENCE YOUR DECISIONS.

    • Travis May 2, 2017 at 3:01 AM
      Reply

      Then a whole lot of people are doing it wrong. I’ve also spoken with a lot of specialists barely making $200,000. There’s a lot of need out there for a professional level analysis of student debt and I’m happy to provide it. I used to manage billions of dollars in bond portfolios going up against some of the top minds on Wall Street but I enjoy helping with student loans more. A lot easier to outperform and save 1 to 2 percent per year

    • DMD18 March 13, 2018 at 5:22 AM
      Reply

      The author is on point. Sorry.. I’m graduating from Dental school with $650k in loans. I have a masters too which I completed at a private school. Interest alone is going to be $50k a year on my loans. It’s a absolute mess. My father was a physician, I definitely feel I went the wrong route. 10 years ago Dentistry looked like a dream career. Today it really isn’t what we were told way back in undergrad in our ASDA meetings. It was some serious brain washing. It’s a expensive career option through and through. I’m sure there are exceptions, people that do amazingly well. But there are a lot of us graduating with insane loans that will follow us through our lifetimes. It’s quite sad the gov does nothing to protect individuals aiming for higher education like basically every other country in the world.

      • Travis March 19, 2018 at 1:26 AM
        Reply

        650k is rough, but with maxing your retirement accounts, saving for the tax bomb, and building wealth in your practice, you can have a very financially successful life. Obviously not as good as they tell you with that debt load, but there’s always ways to be successful. But I feel for you!

  17. JV Doc May 4, 2017 at 1:56 PM
    Reply

    How much would you say it costs for a new graduate to either open up their own practice OR purchase a practice from a retiring dentist? I’m completely taking a shot in the dark here but I would say it’s going to cost approximately $500,000 to start up a new office and depending on the charts in an established practice, you are looking at $1million+. Rough numbers, for sure, but do you feel that is accurate?

    • Travis May 4, 2017 at 3:29 PM
      Reply

      The average I’ve seen for a decent practice has been about $800,000. $1.2 million is a very large practice, $500,000 definitely on the small end. Startup cost I’ve seen is between $300,000 to $500,000 for most of the recent grads I’ve spoken with.

  18. Tyler May 24, 2017 at 6:43 PM
    Reply

    Thank you for sharing this incredibly helpful information. Reading this short article is going to save me thousands of dollars!

    • Travis May 24, 2017 at 6:54 PM
      Reply

      Awesome Tyler glad to hear it!

      • Djm October 22, 2017 at 2:11 PM
        Reply

        I can say most of the info posted here is sadly correct. I graduated in 2012 owing about $350,000 which has since increased from the high interest rate.
        Here’s my strategy for repayment and I’m hoping it works out. I’ve been working for a low income/ native American clinic getting about 20k to 25k per year for loan repayment from the feds. I’m also hoping to qualify for public service loan forgiveness which will forgive the remaining balance of my loans in 5 more years. My concerns are that Congress will get rid of the PSLF program. We will see.

        • Travis October 22, 2017 at 9:08 PM
          Reply

          Just make sure everything you have is a Direct loan and that you’ve submitted the ECF to FedLoan each year!

  19. Guest December 24, 2017 at 12:56 AM
    Reply

    Travis,

    I applaud what you’re doing, and I hope you’re wildly successful while trying to save dentists some money and guide them in the right direction. I also think every dental school should have you come to speak to prospective students or first year students for a nice fee, but I realize they’d be hard pressed to have you do that.

    • Travis December 24, 2017 at 1:29 AM
      Reply

      Thank you, though accepting money from them might compromise my objectivity. I might do it for the lower cost schools.

  20. baba March 9, 2018 at 3:57 PM
    Reply

    Hi,
    Very interesting article and most of the points are valid. So if average salary is 120K, what is average salary if you are willing to be an hour from metro area and run your own practice? Yes, most new dentists will have a huge debt but there are lucky ones who have their parents or family to help with maybe “just” 150K-200K debt.

    I think the education to ROI for dentist is still very attractive if you can focus on debt reduction for first few years (say 4-5) and not buy flashy cars, flashy homes, and flashy life style.

    Thanks again for great article!

    • Travis March 19, 2018 at 1:31 AM
      Reply

      You can do very well in an area where the economics of dentistry are attractive. The highest incomes I’ve seen have been in the 400k to 500k range for general dentists, but that’s the top 3 percent or so. Low incomes are in the 100k range. However, 120-180k is realistic as an associate long term and 150 to 250k is realistic for an owner for the majority of dentists.

  21. Goldenagedentist April 13, 2018 at 3:06 AM
    Reply

    This article is very accurate in regards to the financial outlook for dentists graduating today. All through dental school (2003 grad) my professors said we were entering the “Golden age of dentistry”. You graduate just barely knowing how to practice dentistry—hence the term practice and zero business management training. This is doing a huge disservice to our profession.
    I purchased my dental office and was sold a practice that was in shambles. There were so many undisclosed problems both with the real estate and the practice itself. You deal with a practice broker that represents both the buyer and the seller? How is that legal? The mortgage of the practice was $5500/ mo for 7 years. Those were the best terms I could get in 2004. The payment alone almost drove me to bankruptcy. And don’t forget that we’re rich now so we pay around 25k in taxes annually. Medical insurance premiums are ridiculous for business owners. It’s a good thing my children love rice and beans.
    I hired a consultant (a dentist mind you) who said he could help me with all of the problems with my practice because I lacked confidence in my own ability due to my lack of business acumen. That was another huge error my part.
    Every where you turn there are people even within our profession who are ready to take advantage of the vulnerable position new graduates are in. I’m 14 years in my practice but so much water has run under the bridge. I have no retirement and have taken off 5 weeks of vacation since I bought my office. Three of those weeks were for the birth of my last three children.
    My practice is in a rural setting and guess what? Only DSO’s have shown interest in my practice. Every graduating dentist either can’t afford to get a practice loan due to their debt load and/or only want city life. How is this going to impact our profession and dental care in this country?

    • Travis April 13, 2018 at 3:21 AM
      Reply

      They should share this comment with anyone applying to dental school as a screener for all the folks thinking it’ll be easy

      • Jen April 5, 2020 at 2:31 AM
        Reply

        What impressive imaginations so many science minded people have! It is a really fun pipedream. I get that , having had the same aspirations in 1991. Reality check is after 20 + yrs of being a “successful solo pediatric dentist “, my debt is still more than my younger sister ever acrued going to community college! Plus she was out getting paid ,and got dental experience early. Her salary is not mine , but i will never catch up to her financially. I borrowed in 1991 and am scheduled to be debt free in 2023 summer. Ill be 55 yrs old ! Dental school is not any harder than other professions. The cost is not even understood to most 22 yr olds. Theres a sense of “who cares, cause Im going to be making big bucks”. I was “the smart one ” growing up. Now its obvious who the smart one is. 29 yrs after borrowing my first check, i still am not even with her. And I have stressed some of my life away ,both in school, in pediatric residency , and owning a business. I swear to you. The stress is not worth the pay. Even if u claim to make millions, Pipe-dreamers. I frankly do not believe the numbers being tossed out. Dont lie to these kids. If I bring home $4 k a month im happy with that. She makes less than me now but goes home at 5 pm and never thinks dentistry at all. Consider what you want your life to be like. Especially women. You will sacrifice so much just becoming and then living the dr dream. I would never do it again,had Iknown . Although do love doing dentistry on kids. But now its not as much fun because I no longer pipedream , and think I can save all the children of the world. I seriously thought I would change the world after graduation. Hahahaha. New pipedream is corona virus may help with all that debt i still owe. Or bankrupt me one, right. Relax y’all im hilarious . Things are not so bad. But i would consider dental sales, or home depot management , or photography , or… debt free careers first

        • Travis Hornsby April 5, 2020 at 6:48 PM
          Reply

          If you have debt from before 2010 Jen you might want to consolidate it at studentaid.gov. The 0% interest and $0 a month payments do not count for commercially owned FFEL loans, which yours probably are.

  22. Ben April 18, 2018 at 1:17 PM
    Reply

    I will be applying to dental school in the upcoming application cycle, and I have done a little research on joining the military for repayment (as well as for serving my country). As a student loan planner, do you know much about how that works, and if so, is the military something you would recommend?

    • Travis April 20, 2018 at 5:27 AM
      Reply

      Sure I know that you need to contact the recruiters as early as possible in the cycle. Competition for these military scholarships is intense. Way more than many professional school applications in fact. They can give you four year funding or a three year HPSP scholarship I believe. I’ve seen some folks come out w 0 from the military and others who had about 70-80k.

  23. K-sw February 19, 2019 at 9:59 PM
    Reply

    I am finishing up my first year in dental school (private) and have thoroughly enjoyed the article. Fortunately, this wasn’t a huge shock to find that making money as a dentist would not be as easy as my peers always say it would be. I understand the risks and difficulties of the career, but am afraid that’s all I have. I feel that I see the problems, but have no solution. I would truly appreciate some advice for the near future.

    Thanks for the informative and interesting article.

    • Travis Hornsby February 20, 2019 at 7:47 AM
      Reply

      K I’d listen to dental podcasts like Dentistry Uncensored, Dentalpreneur, Millennial Dentist, and others. If you focus as much on learning about business as you do your craft, you’ll be in great shape.

      • 22yrold December 11, 2020 at 9:47 PM
        Reply

        Hi,
        I know this is an outdated thread but hoping your keeping an eye out. What are the quickest routes you’ve seen for a specialist setting up their own practice? How much does desire to run your own practice counter the (MANY) risks detailed here of going to dental school. Thoughts on over saturation of specialists, especially in suburban areas that are growing but still part of a major metro area??

  24. Garett February 21, 2019 at 5:32 PM
    Reply

    400k debt. NHSC Students to service 120k untaxed loan repayment over three years with base pay 130k. In addition, army reserves 75k taxed signing bonus plus 40k taxed for 6 years. Refinance, live cheap. Debt free in 5 years?

    • TK April 10, 2019 at 5:48 PM
      Reply

      You can do S2S and army reserves at the same time? What happens if the reserves deploy your reserves unit. You can’t finish your student to service contract and have to pay back with a penalty fee using your taxes income. Can anyone chime in how this works?

      • Travis Hornsby April 10, 2019 at 7:14 PM
        Reply

        Hmm I don’t know about that one actually.

        • Garett April 10, 2019 at 7:21 PM
          Reply

          I read the fine print in the S2S document. From what I understand NHSC totally allows it and specifically mentions reserves. I don’t know what the reserves would say. I would say this is an interesting option for those looking to “just grind.” Perhaps even worth a post from you Travis. Jk shhhhh

  25. Chris February 24, 2019 at 7:50 PM
    Reply

    Why no mention of military dentistry? Avoiding debt is the best repayment plan.

    I am so fortunate I received the Army HPSP. They paid full tuition plus a monthly stipend. After graduation… Over $90,000/year salary , 30 days paid vacation, full benefits, etc. with the option to moonlight in private practice on nights and weekends.

    More future students need to know about programs like this!

    • Travis Hornsby February 25, 2019 at 8:13 AM
      Reply

      I agree. Just a few weeks ago I talked a guy into taking the Air Force scholarship. Told him no debt when he gets done at 29 years old will feel fantastic. Thanks for reminder.

  26. RajT May 30, 2019 at 9:15 AM
    Reply

    I do truly want to thank you for posting this. Truly there is not much help out there for guiding dentists or specialists in the world of debt repayment. I’m finishing my OMS residency this June 2019 and have about 550K of debt from FedLoan and I can’t begin to tell you how much I dislike them. I’m sorry you also suffered a similar issue.

    I have the option to have First Republic take only 300K of my loan, but then I would have to pay them about 2.1K a month at 3.3% interest and then FedLoan under REPAYE about 1K a month at 6% interest. That’s a lot when you add it up and I decided on joining the Navy for 3 years to get board certified, gain exposure, and have a new experience so I can push ownership in a practice ASAP after I finish. Meaning my income will not be a high as most specialists in private practice. Most new graduates from residency don’t have favorable buy-in plans. The issue with all of us also is you really need to save for retirement (403b, 401k, etc) as much as possible while also trying to pay off your debt. As the saying goes, pay yourself first.

    I’m currently deciding between just doing REPAYE during my 3 years in the Navy, and then once I’m in private practice just pay it all off aggressively. This is compared to just taking First Republic and REPAYE with FedLoan and suck it up and pay 3K a month somehow during 3 years and then aggressively pay it all off. Less discretionary money means less money to actually live on and less to actually save for things that matter.

    Looking back it all, I HIGHLY recommend anyone going into a private dental school where the average debt is greater than 200K should try to join HPSP, and if they cannot then absolutely do a GPR and then work at a DSO or somewhere you know you can make around 180K annually with a comfortable (not luxurious) cost of living. There is a fantastic book called “The White Coat Investor” I recommend also reading for anyone starting dental school. There is a newer edition that is better, and more geared to today’s issues.

    • Travis Hornsby May 30, 2019 at 5:40 PM
      Reply

      It depends on where you end up if you should eventually refinance or not, but there might be an argument for you not doing that. 550k of debt with these questions is a classic consult case we help with: studentloanplanner.com/help

  27. Joe Herzog DDS July 13, 2019 at 9:19 PM
    Reply

    To all pre-dential students,
    Do not borrow a ton of money to become a dentist!
    You should join the military first and have them pay for it or stay a civilian and shovel dog crap for $50k/year. You are living a fantasy if you can believe for a second that you will have a life after borrowing hundreds of thousands of dollars.

    I am sorry, but the dental gravy train ending in the early 1990’s. I graduated from UCLA dental school in 1987 when tuition was $475.00 a quarter. It is irresponsible for dental schools to charge $90k/year in tuition and related fees when the average graduating dentist will be fortunate to make little more than $100k/year. In life timing is everything. I am sorry to inform aspiring dentists that this boat-for most applicants-sailed away years ago. Prison dentist Joe

  28. wifeyofagiraffe September 11, 2019 at 2:28 PM
    Reply

    I would like to share a story of how we stayed away from student loans in dental school. My husband and I are located in TX. We went out of state for undergrad (B.A), but did not have that much in student loans. We were lucky enough to get help from family, and to get scholarships from school. We have also both worked part time throughout college. After graduating college and getting married, we moved back to TX, lived in my parents’ old condo, where they don’t have a payment anymore. We took over paying the property tax, HOA, insurance, and maintenance, which is about $600 a month if nothing is broken. I worked full time for three years, and my husband worked part time while taking prerequisites science classes to apply for dental school. We only had and average monthly net income of $1.8k after tax/401k etc. and tuition. Luckily, my job was only 2 miles one-way, my husband’s job was 5 miles one-way, and his rode a bicycle to school. So, basically we only needed one tank of gas each month. Three years later, even with my parents’ help that we only had to pay a “discounted rent” monthly, we still had no savings. So my husband has decided to apply for the HPSP program back in 2015, which is a year early from his acceptance in dental school. It was shocking at that time, because the Air Force HPSP for 2016 HAS ALREADY GONE! So he went with the NAVY, and got the 4 year NAVY HPSP in December 2016 (Started Dental School in August 2016). HPSP scholarship is super beneficial to people who want to start a family. It offers a $20k sign on bonus, which we used to pay off our undergrad student loan right away. HPSP also pays tuition, fees and health insurance. I still worked full time until present, getting the same salary; however, with the HPSP $2k monthly stipend (depends on location), we were able to save about $1.5k every month towards our savings. In 2018, someone had no insurance, no ID hit and totaled my husband’s old car, and with the money we saved, plus insurance payment, we were able to pay a new/cheap car cash. Later, we had a baby, and we were able to pay daycare, and still have a few hundred dollars every month to put into savings. It is so much financial security for a starting family. After graduation, as far as we know, he will be able to get paid as an O-3, plus BAH, and an incentive pay for $20k. That is at least $80k.

    All points of Travis’ article is true. We have close dentists friends that are also recent graduates (in TX), most of them are only making an average of $100k/year. The total cost — tuition, fees, room/boarding to finish a 4 year dental school in my husband’s school is $246k. That does not include undergraduate student loans.

    • wifeyofagiraffe September 11, 2019 at 2:38 PM
      Reply

      I forgot to mention that HPSP has 45 days of active duty every year, which you can request to start anytime of the year as long as they have funds. During active duty, we were able to get on TRICARE, and it covered my child’s birth cost, which saved us $3k (my insurance’s out of pocket max). later our baby had to have an eye surgery, and Tricare saved us $1k here.

    • Travis Hornsby September 15, 2019 at 12:14 AM
      Reply

      The crazy part is 246k is not too bad compared to most programs.

  29. KCM May 15, 2020 at 9:58 PM
    Reply

    Thanks for this great article Travis! Truly helpful and eye-opening information (as always) and such a great resource for pre-dents, students, and dentists alike. We all have something to learn from you.

    However, I’m tired of seeing insensitive comments by people who managed to sign up with the military all up on their high horses, castigating everyone else. Lecturing the rest of us about joining the military is pointless because getting a free ride through tax payer dollars is common knowledge and OLD NEWS. Not everyone is eligible for the military due to a variety of reasons (health issues, family, etc etc), so there really is no point kicking a dead horse and repeating this cliche over and over again like a broken record. Geez. At this point, that’s just GLOATING.

    Now for the other 90% who are NOT in the military and trying to navigate this over-leveraged and bloated world of student loan debt, please DON’T LOSE HOPE. Any amount of federal student loan debt, no matter how large or insurmountable, is manageable! Don’t let anyone tell you otherwise. In fact, in 5-10 years time, fresh dental school grads won’t even be aiming to pay back all of their students loans. That’s just NOT practical and/or possible if the loans are more than 3/4/5x their annual salary. That’s where the beauty of PAYE/REPAYE/IDR plans come in! I’d be happy to set aside 50% of your entire loan amount. That’s a win, in my opinion. The only caveat is that for most people, their lifestyles tend to get more and more expensive with the relative increase in income. Bad idea if you’re an overspender and can’t control your impulses.

    Unless of course that tax bomb goes away eventually with new congress bills. 25 years is still a loooong way and the higher education bubble will most probably have burst by then. Maybe, hopefully…. 😉

    Anyway the ideal first step would be to seek financial advice specifically for student loans ASAP! All the best to everyone and may the odds be ever in our favor.

  30. MomOf3 June 24, 2020 at 12:15 PM
    Reply

    Great discussions.
    I came upon this article while researching student loans for my daughter, she will be an undergrad Junior at a private university. I feel a lot of this narrows down to discipline and good understanding of your finances, and money management.
    I am not rich by any means but I will break this down with her and set a goal of how She/we will repay these loans. I also have a Freshman this year going into Business at a private University, and one more child in 5 years.
    Assuming our Junior will owe 400K and make and average of 120K. I hope she joins a strong practice in NYC where we own a home. She can live with us, I will collect all her income (smiling-not joking), I will provide the roof and food. 90% of her taxed income will go towards her loans. I plan on having her debt free in 5 years if we choose to take less from her.
    Being an immigrant, I have made many sacrifices and struggled to be where I am today. I expect my children to do the same to accomplish the American Dream. That means less dining out, no new car, shop sales. I was not smart enough to go to college but I did know I had to save and invest. I made my $ buying an income property in NYC in the right location and at the right time. It should be easier for most of you as you already have the main thing, and that’s speaking English, so I hope. Good luck all, and stay positive.

    • Wifeyofagiraffe June 26, 2020 at 2:46 PM
      Reply

      As a immigrant and a parent, I totally understand your point of helping your daughter. However, I would suggest for your daughter to research her own student loans, and start to manager her own income as early as possible (while supervised by you). If she does everything herself, she will be well-prepared to adjust herself into this society, and build her American Dream.

    • jeff July 30, 2020 at 1:17 PM
      Reply

      your daughter should manage her own money. your managing her money in such a hard-handed fashion won’t sit well with her or anyone for too long. she has to learn how to manage her own money. or are you going to manage her money forever?

      honestly if you have to come out with 400k in this deteriorating industry you are not pursuing the American Dream. you will be stuck in an American Nightmare.

  31. Adam January 3, 2021 at 3:22 AM
    Reply

    I’m just a high school student who was researching what kind of scholarships and financial planning I’d need to get past college with little debt when I came across this. With my current plan I could easily get past undergrad debt free or close to it, but I have absolutely no idea what I’d do for dental school. There are plenty of benefits to being a dentist, but what does it matter if I’ll still be drowning in debt. If I’m not supposed to be a dentist and other medical professions are nearly as, if not more, expensive to get into, what should I do? Should I specialize? Should I become another type of medical professional? Should I just avoid medical practices as a whole? This article was extremely helpful and the comments underneath affirm that, but it simply tells you what you shouldn’t do. It doesn’t give any particular advice on what someone who wants to go into dentistry should do given this knowledge. I know the author is just a financial advisor for student loans, but if he (or anyone else who sees this) can offer any advice on what I should pursue/how to solve this issue, then it would be greatly appreciated.

    Just to be clear: If I don’t find another profession that I think will fit for me, I’m going to stick to dentistry (likely pediatrics). I don’t want to own a practice or go into the military (unless it is an absolute necessity). I do not plan to have kids until I am financially stable, I watch my money carefully, can live frugally, and plan on living with either my future partner or roommates. In my youth, I am more than willing to live in an apartment with other people. I just want to live comfortably (small house, partner, few pets) in my adult life when I am settled, and when the time comes I want to be able to take of my own and my partners parents financially. Any advice is welcome, thank you greatly for your time and consideration if you do respond.

    • Amy at Student Loan Planner January 19, 2021 at 5:44 PM
      Reply

      It’s great that you’re looking into this now! We have a pre-debt consultation where we help folks going into graduate programs so they can be fully informed financially of what the options are if you want to consider that when the time comes: https://www.studentloanplanner.com/predebt-student-loan-plan/

    • 22yrold January 19, 2021 at 7:03 PM
      Reply

      Any advice to you depends on what you want out of life and who you are – shaped by your env and what ur exposed to.

      A lot of what ur saying can change a lot – it’s easy in high school to say you’ll live and be a certain way – but what you want will (and should) change as you grow personally/professionally/academically.

      What I can say is that there are a lot of major issues on deciding to go into healthcare professions and dentistry. The other professions are Not more expensive to get into (im wondering why you say that since this article very simply stated the opppsite.)

      I’m not sure what your plans are to get thru undergrad without debt (if ur not getting any parental support?) I had friends at school who made use of all the programs out there, but most pple who get such funds don’t attend rigorous top schools (top 25 US News) which again goes to who you are/what you want and will do in life.

      Exposure is important. Go to levels.FYI and blind to look at what FAANG pays and the routes/what it takes to get there. I can tell you I know plenty of kids (IMO have done the minimum in work ethic and intelligence) and still graduate into minimum 70k starting salary in IT. Biden just announced massive increase in cyber security funding. There r tons of unfilled tech jobs – whether IT or SWE depending on you and what you can accomplish. If I were more STEM oriented that’s what I would’ve wanted to do – but dental school is more bio/concept focused where I can excel relative to everyone else. Find out what else is out there!! Idk if you live in Boston or a random town in Florida

      • Adam February 9, 2021 at 5:09 PM
        Reply

        I plan on getting through undergrad without debt by obtaining my associate’s degree in a community college and transferring to an affordable public college after that. I have applied to multiple scholarship programs and will continue to do so until I don’t have to worry about debt from my undergrad years. Also, I don’t slack on school by any means.

        Medical school is actually a bit more expensive than some dental schools in my area, and the years needed to become different professions vary enough to cause issues. Also, specialization could easily be more expensive depending on what I would go into.

        I appreciate your comment though and will consider the other jobs you mentioned.

    • Kelvin Cagman February 5, 2021 at 9:20 PM
      Reply

      If your passion is healthcare and helping others live better lives, feel free to take the risk of more student loans and bills. If you are great in Math and Science, and still are insisting on keeping the Educational Costs to a bare minimum, you can look at certain Engineering fields. The kind of Engineering would involve Public Civil Engineering, Biomedical Engineering (Think Of Developing Drugs/Medicines), Medical Device Engineering, Software Engineering, Hardware Engineering, Electronics Engineering, IT, etc. Or you can study a Science like Chemistry or Biology and get a PhD where you can do research and become either a Professor or work for a Biotech company of start a Biotech company of your own and become a pioneer which creates medicines to cure diseases.

      • Adam February 9, 2021 at 5:02 PM
        Reply

        Thank you I will look into all of your recommendations. I have been considering optometry as well as still mulling over the idea of becoming a dentist. I appreciate your comment.

        • Anonymous Poster February 9, 2021 at 7:54 PM
          Reply

          Much appreciated and good luck! Since you like the medical field, go into anything medically oriented still! Find what you like!

  32. Jesse Winters March 1, 2021 at 9:47 PM
    Reply

    What other careers would you recommend instead of dentistry that aren’t medical and earn around the same income? I’m currently a 2nd year student at ASU , I’m thinking dentist or software engineering. I want to have a comfortable life and not be limited by my income or debt . Thanks hope you are staying safe !

    • Amy at Student Loan Planner March 2, 2021 at 6:26 PM
      Reply

      We’ve got this great post about being a software engineer you might enjoy!

    • jfuwn March 2, 2021 at 8:26 PM
      Reply

      Put very little weight behind the article linked at below, it’s useless
      If you go to ASU you should have no problem getting a 3.8+ GPA for dental/Med school. Idk if Arizona’s state dental school is drowned out by ASU applicants and how competitive that is, but you should be able to get rlly good grades.

      If you’re already a second yr you couldn’t switch to a CS major, idk if ASU has degrees in IT or cyber security? There r always masters/certification programs to hell you out. A friend had a friend at ASU who got hired at Microsoft straight out of college so there are still options for career for you besides grad school, but I’d look further into that …..

  33. Mike B April 19, 2021 at 7:39 AM
    Reply

    The original article is very one sided. So Ill give you my story…

    I graduated from Dental school in 2008. I had a 4 year HPSP scholarship and spent 5 years in the Army and graduated with a total student loan debt of $26,000 from undergrad and dental school. I bought a practice in 2015 when I was 35 and have consistently made $4-500k a year since.

    Dentistry is a still a great profession. I understand things have changed though…In the past you could make bad decisions (or no decisions at all) and just coast along and be successful. That is no longer the case. You have to be business and finance minded. If you cant handle that, then graduating with $400k in debt is a death sentence. If you can, then the sky is still the limit….
    I may be the outlier, but there are many like me. Success is just not as easy or as guaranteed as it used to be.

    I blame the schools – they raised prices and at the same time saturated the market. That is a disastrous combination.

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