How much debt is too much?

[Flossaraptor]

This topic has been discussed to no end on here, and for good reason too. I know debt is a huge factor when looking at dental schools. However, I want to know how much debt is too much for a specialist? Mainly referring to omfs/perio/endo . I want to point out that I’m not in dental school yet, but I have been accepted to a few schools and I just want to know at what loan amount is it no longer worth it for a person to pursue a specialty like omfs. This is all hypothetical. So before I get crucified for talking about being an oral surgeon before dental school, I’m purely asking about this out of curiosity. Thanks all, I appreciate all of the awesome feedback and free advice I see on here.

---

Members don't see this ad.

 

[deleted1082923]

This topic has been discussed to no end on here, and for good reason too. I know debt is a huge factor when looking at dental schools. However, I want to know how much debt is too much for a specialist? Mainly referring to omfs/perio/endo . I want to point out that I’m not in dental school yet, but I have been accepted to a few schools and I just want to know at what loan amount is it no longer worth it for a person to pursue a specialty like omfs. This is all hypothetical. So before I get crucified for talking about being an oral surgeon before dental school, I’m purely asking about this out of curiosity. Thanks all, I appreciate all of the awesome feedback and free advice I see on here.

If you do a 4 year omfs you get paid all 4 years. So you actually incur zero debt for pursuing omfs. Omfs typically earn the most too, so I’d say usually regardless of the amount of dental school debt you will do well financially.
Now if you go to a 3 yr ortho program like the Georgia one and take on another 300k of loans (plus interest) on top of your dental school debt… that’s probably not worth it financially. Especially since ortho doesn’t make what it used to due to things like Invisalign and clear aligners.

 

[deleted903013]

OMFS do very well financially. However, do not justify ridiculously priced dental schools on the off chance you'll match OMFS. The question you need to be asking yourself is if you can justify attending these schools as a GP.

 

[D1Bound]

If you do a 4 year omfs you get paid all 4 years. So you actually incur zero debt for pursuing omfs. Omfs typically earn the most too, so I’d say usually regardless of the amount of dental school debt you will do well financially.
Now if you go to a 3 yr ortho program like the Georgia one and take on another 300k of loans (plus interest) on top of your dental school debt… that’s probably not worth it financially. Especially since ortho doesn’t make what it used to due to things like Invisalign and clear aligners.

I will say, while you do not pay tuition for OMFS, you will accrue more debt because you won’t be able to fight off the interest while in residency. If there was a sure fire way to go straight to OMFS I would think 600-700k would be no issue, but it’s a gamble for sure. GP or specialist I think students should just be prepared to move their life to wherever the big money is and get ready to slog it out 6 days a week until the loans are cleaned up. But who would really do this? People will get married, they’ll be tired of having crappy furniture, many just don’t have the will power at the end of dental school. Dental school is a mental game academically

 

[bracketbuster68]

If you do a 4 year omfs you get paid all 4 years. So you actually incur zero debt for pursuing omfs. Omfs typically earn the most too, so I’d say usually regardless of the amount of dental school debt you will do well financially.
Now if you go to a 3 yr ortho program like the Georgia one and take on another 300k of loans (plus interest) on top of your dental school debt… that’s probably not worth it financially. Especially since ortho doesn’t make what it used to due to things like Invisalign and clear aligners.

This is flat out wrong, except the Georgia part.

You’ll incur 4-6 years of interest and lost opportunity cost. New ortho grad jobs range from 250-400K, 4 days a week typically. I’ve seen associate postings for 500K and there are plenty of owners making 7 figures.

 

[deleted1082923]

This is flat out wrong, except the Georgia part.

You’ll incur 4-6 years of interest and lost opportunity cost. New ortho grad jobs range from 250-400K, 4 days a week typically. I’ve seen associate postings for 500K and there are plenty of owners making 7 figures.

That's not what I hear from Ortho residents at my program (a Northeast school). You might be talking about the midwest or less desirable areas. Let's be real, you can make great money even in general dentistry if you go to a random, isolated rural area of the US.

In terms of lost opportunity cost, you could say the same about Ortho-3 years of interest and lost opportunity cost. This is not even counting the fact that the vast majority of Ortho programs require tuition... Ortho seems like a scam to me. As of now, the nation is also producing way more Orthodontists than it needs.

With moonlighting, it is common to make 150-200k as an OMFS resident. So your salary isn't limited by what the hospital pays you.

It's well known that Ortho's best days are behind it.

 

[bracketbuster68]

That's not what I hear from Ortho residents at my program (a Northeast school). You might be talking about the midwest or less desirable areas. Let's be real, you can make great money even in general dentistry if you go to a random, isolated rural area of the US.

In terms of lost opportunity cost, you could say the same about Ortho-3 years of interest and lost opportunity cost. This is not even counting the fact that the vast majority of Ortho programs require tuition... Ortho seems like a scam to me. As of now, the nation is also producing way more Orthodontists than it needs.

With moonlighting, it is common to make 150-200k as an OMFS resident. So your salary isn't limited by what the hospital pays you.

It's well known that Ortho's best days are behind it.

I’m an ortho resident and these are on the east and west coast. You have no idea what you’re talking about. As far as moonlighting goes, it’s way easier to do it as an ortho resident than an omfs. I’d love to see what OMFS are moonlighting, commonly making 150-20k a year.

 

[bergus95]

This is flat out wrong, except the Georgia part.

You’ll incur 4-6 years of interest and lost opportunity cost. New ortho grad jobs range from 250-400K, 4 days a week typically. I’ve seen associate postings for 500K and there are plenty of owners making 7 figures.

Show me 1, 500k a year job post

 

[CaliDDS1986]

It's well known that Ortho's best days are behind it.

The golden goose it was in the late 90s early 00s different ballgame than today. Ortho is like the girl that used to be hot in high school. Now she’s 20 years older, gained some weight, maybe has a moustache. Everybody knows her name, but not everyone thinks she’s hot anymore.

 

[deleted1047421]

I’m an ortho resident and these are on the east and west coast. You have no idea what you’re talking about. As far as moonlighting goes, it’s way easier to do it as an ortho resident than an omfs. I’d love to see what OMFS are moonlighting, commonly making 150-20k a year.

I’ve had many colleagues moonlight during omfs residency. However they were dual degree.

In general no four year omfs resident will moonlight. There is both not enough time and programs typically don’t allow that.

In life there will always be exceptions though.

 

[bracketbuster68]

I’ve had many colleagues moonlight during omfs residency. However they were dual degree.

In general no four year omfs resident will moonlight. There is both not enough time and programs typically don’t allow that.

In life there will always be exceptions though.

Right. How much are they working? We typically work weekends if we moonlight. It's not a lot of money.

 

[deleted1047421]

Right. How much are they working? We typically work weekends if we moonlight. It's not a lot of money.

It varies from resident to resident.

From what I’ve heard from my close friends they did volume based exodontia under local.

 

[D1Bound]

The golden goose it was in the late 90s early 00s different ballgame than today. Ortho is like the girl that used to be hot in high school. Now she’s 20 years older, gained some weight, maybe has a moustache. Everybody knows her name, but not everyone thinks she’s hot anymore.

That is so spot on. When I got older and realized ortho wasn't AS gravy as it was it was an eye opener

 

[bracketbuster68]

The golden goose it was in the late 90s early 00s different ballgame than today. Ortho is like the girl that used to be hot in high school. Now she’s 20 years older, gained some weight, maybe has a moustache. Everybody knows her name, but not everyone thinks she’s hot anymore.

 

[CaliDDS1986]

View attachment 349240

Blind leading the blind, nice! In the Northeast tri state area most probably get a job full time if lucky with diamond braces. They pay about 250k, other places can pay as low as 900-1200 per day. You probably can tops out at 300k as an Ortho associate really grinding, but you could do that as a GP too. So opportunity cost comes into play big time.

 

[Big Time Hoosier]

The golden goose it was in the late 90s early 00s different ballgame than today. Ortho is like the girl that used to be hot in high school. Now she’s 20 years older, gained some weight, maybe has a moustache. Everybody knows her name, but not everyone thinks she’s hot anymore.

Big Hoss

 

[Xtract]

It varies from resident to resident.

From what I’ve heard from my close friends they did volume based exodontia under local.

Sounds like Baylor, do they do this with a private practice dentist? Plan all exts on a certain day and have the OMS resident come in that specific day?

 

[702]

That's not what I hear from Ortho residents at my program (a Northeast school). You might be talking about the midwest or less desirable areas. Let's be real, you can make great money even in general dentistry if you go to a random, isolated rural area of the US.

In terms of lost opportunity cost, you could say the same about Ortho-3 years of interest and lost opportunity cost. This is not even counting the fact that the vast majority of Ortho programs require tuition... Ortho seems like a scam to me. As of now, the nation is also producing way more Orthodontists than it needs.

With moonlighting, it is common to make 150-200k as an OMFS resident. So your salary isn't limited by what the hospital pays you.

It's well known that Ortho's best days are behind it.

Know a few dozen omfs residents. Not a single one making 150-200k moonlighting. Never heard of one making that either.

 

[bergus95]

Know a few dozen omfs residents. Not a single one making 150-200k moonlighting. Never heard of one making that either.

I have never heard of anyone making close to that either. Those that can even moonlight are doing so in their med school years

 

[Cold Front]

This topic has been discussed to no end on here, and for good reason too. I know debt is a huge factor when looking at dental schools. However, I want to know how much debt is too much for a specialist? Mainly referring to omfs/perio/endo . I want to point out that I’m not in dental school yet, but I have been accepted to a few schools and I just want to know at what loan amount is it no longer worth it for a person to pursue a specialty like omfs. This is all hypothetical. So before I get crucified for talking about being an oral surgeon before dental school, I’m purely asking about this out of curiosity. Thanks all, I appreciate all of the awesome feedback and free advice I see on here.

Practicing dentist here. Since this is all hypothetical, let me respond with some real world perspective. To answer “how much loan is too high?” question, the answer would be “it depends”... you may also have to consider being an average specialist in that context. Let me give you couple of examples of specialist friends I know;

Friend 1: Graduated with me from the same class in 2010. He did 3 years ortho residency in Colorado directly after dental school. Graduated with a total 600k in student loans. He opened a practice about 5 years ago, paid all off his student loans, owns a home, and makes a decent income about 300-400k/yr. The last 12 months was rough for him; staff quitting for better pay somewhere else (he was paying his financial coordinator 75k/yr, she left him for a better pay, most of his assistants left too for the same reason), he constantly complains about how traditional ortho is still good but some patients are shifting to aligners and treatments in his office slowly moved away from traditional braces. He complains about stagnant dental insurance reimbursements relative to high inflation and the increasing overhead (specially payroll), etc. He doesn’t think ortho was truly worth it from today’s perspective, and if he had known what he knows now, he would pick a different career (maybe in tech?) and make as much money with far less headaches that owning a dental office headaches. He’s 41 now.

Friend 2: Graduated from DS in 2013 with about 250k. Worked about 5 years as a general dentist and couldn’t pay off his student loans with his 180-200k/year income. Used most of his income on nice cars and renting nice pads. He went back to school and specialize in endo at a Midwest program - which definitely hurt his lifestyle from a dentist with an income to a student life again. His endo debt was about 250k, so now he has about 400k in student debt total. He started work as an endodontist 6 months ago and he expects to make about 300-350k his first year, hopes to make 400k second year and probably thinks he will peak at 450k/yr for the following years with his ideal work-life balance. He’s focusing on paying off all his student loans next 2-3 years. He complains about the learning curve and picking up his speeds as a new endodontist now, it can be rough some days at work - he gets a lot difficult cases (calcified canals, etc), as general dentists keep all the easy cases to themselves. He doesn’t own a home yet, he thinks there is a big housing bubble - waiting until prices come down, which maybe few more years. He’s 38 now.

Bottom line, specializing is very hard and comes with additional debt. Both of my friends would have bigger student debt if they were applying to DS and specialty programs today. In fact, the Ortho friend would be looking at 800k-1M total if he applied today as a pre-dent. While the endo friend would be looking at maybe 600k+. I don’t think either of them would rush to specialize if the debt was that high, then again, no practicing dentist could imagine paying more student loans out of their personal finances. Me personally, anything north of $500k is wild and very risky. The world has also changed; we are in a high inflation economy, everything costs more, so imagine taking out a ridiculously high student loans in an environment where dental insurances are not increasing reimbursements, which all adds up to lower net/take home for the average specialist. Not to say the average specialist will not make a good income, but when you combine bigger student debt + higher inflation = the purchase power of any income declines. The specialist $400k income will be worth 5-10% LESS every year in that equation. So do your maths before you make the decision.

 

[2TH MVR]

Practicing dentist here. Since this is all hypothetical, let me respond with some real world perspective. To answer “how much loan is too high?” question, the answer would be “it depends”... you may also have to consider being an average specialist in that context. Let me give you couple of examples of specialist friends I know;

Friend 1: Graduated with me from the same class in 2010. He did 3 years ortho residency in Colorado directly after dental school. Graduated with a total 600k in student loans. He opened a practice about 5 years ago, paid all off his student loans, owns a home, and makes a decent income about 300-400k/yr. The last 12 months was rough for him; staff quitting for better pay somewhere else (he was paying his financial coordinator 75k/yr, she left him for a better pay, most of his assistants left too for the same reason), he constantly complains about how traditional ortho is still good but some patients are shifting to aligners and treatments in his office slowly moved away from traditional braces. He complains about stagnant dental insurance reimbursements relative to high inflation and the increasing overhead (specially payroll), etc. He doesn’t think ortho was truly worth it from today’s perspective, and if he had known what he knows now, he would pick a different career (maybe in tech?) and make as much money with far less headaches that owning a dental office headaches. He’s 41 now.

Friend 2: Graduated from DS in 2013 with about 250k. Worked about 5 years as a general dentist and couldn’t pay off his student loans with his 180-200k/year income. Used most of his income on nice cars and renting nice pads. He went back to school and specialize in endo at a Midwest program - which definitely hurt his lifestyle from a dentist with an income to a student life again. His endo debt was about 250k, so now he has about 400k in student debt total. He started work as an endodontist 6 months ago and he expects to make about 300-350k his first year, hopes to make 400k second year and probably thinks he will peak at 450k/yr for the following years with his ideal work-life balance. He’s focusing on paying off all his student loans next 2-3 years. He complains about the learning curve and picking up his speeds as a new endodontist now, it can be rough some days at work - he gets a lot difficult cases (calcified canals, etc), as general dentists keep all the easy cases to themselves. He doesn’t own a home yet, he thinks there is a big housing bubble - waiting until prices come down, which maybe few more years. He’s 38 now.

Bottom line, specializing is very hard and comes with additional debt. Both of my friends would have bigger student debt if they were applying to DS and specialty programs today. In fact, the Ortho friend would be looking at 800k-1M total if he applied today as a pre-dent. While the endo friend would be looking at maybe 600k+. I don’t think either of them would rush to specialize if the debt was that high, then again, no practicing dentist could imagine paying more student loans out of their personal finances. Me personally, anything north of $500k is wild and very risky. The world has also changed; we are in a high inflation economy, everything costs more, so imagine taking out a ridiculously high student loans in an environment where dental insurances are not increasing reimbursements, which all adds up to lower net/take home for the average specialist. Not to say the average specialist will not make a good income, but when you combine bigger student debt + higher inflation = the purchase power of any income declines. The specialist $400k income will be worth 5-10% LESS every year in that equation. So do your maths before you make the decision.

Hey. Welcome back.
Jeez. Your dental friends like to complain alot lol. Probably the reason I don't hang out with dentists. They're too depressing and all they talk about is dentistry .

 

[D1Bound]

Hey. Welcome back.
Jeez. Your dental friends like to complain alot lol. Probably the reason I don't hang out with dentists. They're too depressing and all they talk about is dentistry .

All I know is if I'm clearing multiple hundred thousand dollars a year working in the air conditioning no way I'm going to complain when so many Americans make fifty to sixty thousand and that's all they'll ever make

 

[Anonamoose]

All I know is if I'm clearing multiple hundred thousand dollars a year working in the air conditioning no way I'm going to complain when so many Americans make fifty to sixty thousand and that's all they'll ever make

I think about this often. It is important to have perspective when considering lifestyle and the relativity of "hard" work. It may be stressful and require a great deal of time and dedication to become a dentist/doctor/PA, etc, but I refuse to believe that this process is any "harder" than working multiple back-breaking minimum wage jobs, which for many people is the end of the line in terms of career advancement. This is especially important to remember when users on this site complain about wages shrinking and yet still expect to work 4-days a week, all while affording a three car garage and a second home.

 

[D1Bound]

I think about this often. It is important to have perspective when considering lifestyle and the relativity of "hard" work. It may be stressful and require a great deal of time and dedication to become a dentist/doctor/PA, etc, but I refuse to believe that this process is any "harder" than working multiple back-breaking minimum wage jobs, which for many people is the end of the line in terms of career advancement. This is especially important to remember when users on this site complain about wages shrinking and yet still expect to work 4-days a week, all while affording a three car garage and a second home.

Perspective is huge. I think people who didn't grow up with big money that become dentists appreciate it a hell of a lot more. The ability to take a single vacation and not have to watch expenses too closely is what goes through my mind.

 

[Cold Front]

Hey. Welcome back.
Jeez. Your dental friends like to complain alot lol. Probably the reason I don't hang out with dentists. They're too depressing and all they talk about is dentistry .

Thanks! Good to see you‘re still hanging out on SDN! lol

Yes, we dentists love to complain. It’s definitely an occupational hazard. lol

 

[DDS9994]

Perspective is huge. I think people who didn't grow up with big money that become dentists appreciate it a hell of a lot more. The ability to take a single vacation and not have to watch expenses too closely is what goes through my mind.

You are absolutely right perspective is huge. My parents are from the poorest country in the Western hemisphere on par with subsaharan Africa in terms of standard of living. Dad was a kid on his own by the age of 17 no education living in a poor country during the depression of the 1930s in a country far poorer than the US. Same with mom. Both came to this country in the late 60s as grown up s and had to start over. We grew up with little money, in a 900 sq ft home, dad was a janitor in the hospital and mom did, college was on my dime, worked for 6 years before DS as research tech and a side job on the weekends. I said the same thing If I make hundreds of thousands I wont complain about anything, lol. Well let me tell you I do complain and feel stressed out sometimes. You are running a small business dealing with alot of headaches all the time. Between skyrocketing cost of supplies, staff wages going up if you can find staff, and the insurance industry cutting your fees, I got my letter last month that Cigna was going to be cuttitng fees across the board around 20%! and there are others doing the same. At this point I am going OON with alot of insurances, so thats gonna cost me in the short run as I am sure I will lose pts, but I am ok with that as I have very little debt and my financial house is in order, now if I had a very large practice note, house note, and DS nut to crack, I would never think of doing it. Also I think there are alot of docs who do 4 days a week cause they can, but there are alot of do 4 days because it cuts down on OH and staffing issues, for me in the midwest most docs I know seem to be more 5 days a week and many doing every other saturday as well.

 

[D1Bound]

You are absolutely right perspective is huge. My parents are from the poorest country in the Western hemisphere on par with subsaharan Africa in terms of standard of living. Dad was a kid on his own by the age of 17 no education living in a poor country during the depression of the 1930s in a country far poorer than the US. Same with mom. Both came to this country in the late 60s as grown up s and had to start over. We grew up with little money, in a 900 sq ft home, dad was a janitor in the hospital and mom did, college was on my dime, worked for 6 years before DS as research tech and a side job on the weekends. I said the same thing If I make hundreds of thousands I wont complain about anything, lol. Well let me tell you I do complain and feel stressed out sometimes. You are running a small business dealing with alot of headaches all the time. Between skyrocketing cost of supplies, staff wages going up if you can find staff, and the insurance industry cutting your fees, I got my letter last month that Cigna was going to be cuttitng fees across the board around 20%! and there are others doing the same. At this point I am going OON with alot of insurances, so thats gonna cost me in the short run as I am sure I will lose pts, but I am ok with that as I have very little debt and my financial house is in order, now if I had a very large practice note, house note, and DS nut to crack, I would never think of doing it. Also I think there are alot of docs who do 4 days a week cause they can, but there are alot of do 4 days because it cuts down on OH and staffing issues, for me in the midwest most docs I know seem to be more 5 days a week and many doing every other saturday as well.

Insurance companies must understand that dentists won't participate if they refuse to pay. Dental insurance will be basically useless. That cycle is not sustainable

 

[PerioDont]

This topic has been discussed to no end on here, and for good reason too. I know debt is a huge factor when looking at dental schools. However, I want to know how much debt is too much for a specialist? Mainly referring to omfs/perio/endo . I want to point out that I’m not in dental school yet, but I have been accepted to a few schools and I just want to know at what loan amount is it no longer worth it for a person to pursue a specialty like omfs. This is all hypothetical. So before I get crucified for talking about being an oral surgeon before dental school, I’m purely asking about this out of curiosity. Thanks all, I appreciate all of the awesome feedback and free advice I see on here.

I'm going to say 500kish would be a limit for dental school + residency...which is very difficult to stay under honestly.

That being said, I agree with above posters, go to dental school for becoming a GP and consider the value for that.

I will also say being a specialist is awesome. I love it WAY more than being a GP (though I never practiced as a GP, went straight through d school to residency.)

You can also do exceptionally well as a specialist. With some hard work and traveling and networking, from the people I know, I don't think it is difficult to do at least 3-400k/yr as an endo/perio/OMFS. And you can definitely double that amount as a smart practice owner.

While residency can be a hard pill to swallow putting in more years, my personal opinion is that practicing as a specialist is way easier than being a GP.

Your patients are already primed to have tx done, and most are more accepting of bigger tx plans from a specialist. You only do a limited amount of things and you generally charge more for each procedure for 'specialist' fees.

Just my two cents as a specialty resident who has not practiced in the field yet

 

[D1Bound]

I'm going to say 500kish would be a limit for dental school + residency...which is very difficult to stay under honestly.

That being said, I agree with above posters, go to dental school for becoming a GP and consider the value for that.

I will also say being a specialist is awesome. I love it WAY more than being a GP (though I never practiced as a GP, went straight through d school to residency.)

You can also do exceptionally well as a specialist. With some hard work and traveling and networking, from the people I know, I don't think it is difficult to do at least 3-400k/yr as an endo/perio/OMFS. And you can definitely double that amount as a smart practice owner.

While residency can be a hard pill to swallow putting in more years, my personal opinion is that practicing as a specialist is way easier than being a GP.

Your patients are already primed to have tx done, and most are more accepting of bigger tx plans from a specialist. You only do a limited amount of things and you generally charge more for each procedure for 'specialist' fees.

Just my two cents as a specialty resident who has not practiced in the field yet

400k for OMFS and endo is light work

 

[DDS9994]

I'm going to say 500kish would be a limit for dental school + residency...which is very difficult to stay under honestly.

That being said, I agree with above posters, go to dental school for becoming a GP and consider the value for that.

I will also say being a specialist is awesome. I love it WAY more than being a GP (though I never practiced as a GP, went straight through d school to residency.)

You can also do exceptionally well as a specialist. With some hard work and traveling and networking, from the people I know, I don't think it is difficult to do at least 3-400k/yr as an endo/perio/OMFS. And you can definitely double that amount as a smart practice owner.

While residency can be a hard pill to swallow putting in more years, my personal opinion is that practicing as a specialist is way easier than being a GP.

Your patients are already primed to have tx done, and most are more accepting of bigger tx plans from a specialist. You only do a limited amount of things and you generally charge more for each procedure for 'specialist' fees.

Just my two cents as a specialty resident who has not practiced in the field yet

Of course its great being a specialist, we GP spend all the money on recruiting pts into the practice, we cultivate them and convince them over time to get that implant or whatever and by the time they go to the specialist they are practically sold on the procedure, we basically tell them how wonderful Dr. X is at wisdom teeth and if I were my granny thats who I would send them too, and in return we get a fruit basket, whats not to love. ( kidding)

 

[PerioDont]

Of course its great being a specialist, we GP spend all the money on recruiting pts into the practice, we cultivate them and convince them over time to get that implant or whatever and by the time they go to the specialist they are practically sold on the procedure, we basically tell them how wonderful Dr. X is at wisdom teeth and if I were my granny thats who I would send them too, and in return we get a fruit basket, whats not to love. ( kidding)

We appreciate you!!

plus it eliminates all those unproductive conversations convincing people they have a problem from my schedule