Cost Vs Reward

Viewed as an honorable and influential profession, dentists play an important role in the overall health of their patients. Despite a hefty price tag to obtain a dental school education, recent studies show that the career field proves a better investment than many other professional pathways. Additionally, with an increasing acknowledgement of the importance of oral health in relation to overall health, the public demand for dentists will continue to rise.

Choosing to become a dentist involves much more than satisfying educational requirements to earn an attractive salary. Prospective dental school students must weigh the pros and cons associated with the time commitment, work environment, potential work-related stress, and overall job satisfaction of the profession. Not everyone will encounter the exact same educational experience; therefore, the ROI (Return on Investment) for a dental degree will differ for every graduate. The following information highlights key points regarding the total cost versus the rewards related to pursuing a dental school education:

The total cost to pay for a dental school education varies for each student, as a number of factors come into play which can affect the overall debt owed after graduation, as well as the additional expenses paid while pursuing an advanced degree. For the most part, the tuition cost for four years of dental school in the U.S. ranges in price from $21,600 (in-state) and $64,800 (non-resident) for a public school in Texas to nearly $300,000 for the highest-priced private institutions. These figures do not include the associated school fees, which typically include lab dues, preclinical supplies, books, dental kits, scrubs, and the cost to take certain exams.

A new dentist’s overall ROI for a dental school education also increases and decreases regarding the outcome of the following variables:

• Starting tuition cost. Every dental school program has an initial dollar amount they charge a student to attend their institution. Generally, private institutions cost more than a public college.
• Location: There is a noticeable difference between the tuition paid by out-of-state applicants versus the in-state tuition that residents are charged, as shown above.
• Financial aid. A student may fund their dental education a varying combination of government school loans, parent contribution, as well as grants and scholarships, which do not have to be paid back. The majority of dental students rely on education loans to fund their studies (most frequently Unsubsidized Federal Stafford and Federal Grad PLUS Loans); all of which must be paid back with interest. Students who borrow the most money wind up paying more for their education in the long run, due to interest rates and repayment terms.
• Personal expenses. The amount of financial aid that a student receives is up to (but not exceeding) the total cost of dental school education each academic year. Students are also responsible for paying the expenses associated with the cost of living, such as food, transportation and rent.

“The hardships that most dental school graduates are likely to face may have to do with the enormous debt that can be brought on from a dental school degree,” says Dr. Kent Brady, DDS, who has 38 years of experience and runs Brady Dental Care along with his son, Corbin.

According to the American Dental Education Association, statistics for the Class of 2014 reveal varying levels of debt for graduates, such as:

• Approximately one out of five dental school grads reported either no debt or debt less than $100,000.
• Average debt for all dental school graduates who owed money was $247,227: public school graduates ($216,437) and private school graduates ($289,897).
• More than 30 percent of dental school graduates with student loans reported debt in excess of $300,000.

However, an advantage that comes with the dental profession is the ability for dentists to profit from their income stream after graduation faster than other colleagues pursuing a career in health care – which generally makes it easier to embrace a more aggressive repayment of student loans.

“A dental school degree is ultimately worth the cost…,” says Dr. Corbin Brady, DDS, “it provides and will pay back on the investment.”

An important concern for many future dentists is the time it takes to complete their education and training in order to earn the credentials of a dental professional or specialist. Students generally spend at least 8 years in school before becoming a dentist, earning either a D.D.S. (Doctor of Dental Surgery) or D.M.D. (Doctor of Dental Medicine). The typical graduate completes four years of undergraduate school and four years of dental school.

Although no internship or residency is required for dental school graduates entering the workforce as a general dentist, several states do require a post-doctoral residency lasting one year instead of a dentist taking a licensing examination.

Dentists who go on to specialize in a specific area of dental care receive 2-4 additional years of training in one of nine recognized advanced specialties, including Oral and Maxillofacial Surgery, Periodontics, Pediatric Dentistry, Prosthodontics, and Dental Public Health. Also, the U.S. Bureau of Labor Statistics states that dentists who wish to teach or conduct research on a full time basis usually spend an additional 2 to 5 years in advanced dental training as well.

In addition to high education costs and an extensive time commitment, future dental students and graduates typically encounter a range of hardships and obstacles that can make the dental profession a less-than-desirable career choice. A few examples include:

Increasing Competition for Dental School Entry: A growing number of people recognizing the benefits associated with the dental profession have led to a larger, more competitive applicant pool. The American Dental Association (ADA) noted the total pre-doctoral enrollment for the profession was at its highest level during the late 1970’s/early 1980’s – peaking with an enrollment of 22,842 students during the 1980-81 academic years.

Most recently, the 2013-2014 academic years culminated with 22,776 enrolled students, showing that recent trends are on the rise again. The last ten years have shown an average annual increase of 2.4% regarding first-year pre-doctoral enrollment.

Rigorous Curriculum: Dental school is a challenging four years of intense studies, and often involves class time and a workload that is at least two to three times greater than a standard semester of undergraduate school. Those who fall behind in their reading material and assignments find it extremely difficult to ‘catch up.’

“My friend counted up the tests and quizzes we had during our second year and here are the numbers: 84 tests, 140 quizzes,” a fourth-year dental student was quoted as saying on his website, HowtoBecomeaDentist.org.

It isn’t until the third year of dental school that students start to see a noticeable decrease in the amount of coursework. Although classroom instruction still takes place in endodontics, oral/maxillofacial surgery, orthodontics and with other more advanced classes, third year students spend the majority of their time in clinics working on patients.

“A strong desire to become a dentist is one of the most important qualities necessary to survive dental school,” Dr. Jerry Gordon wrote in a piece titled, “How Dental School Works.”

Pressure on New Graduates: New dentists often face a range of pressure that comes with having to pay off their student loans, as well as recoup the cost of establishing a private practice, which can easily surpass $250,000.

“Becoming a dentist is expensive,” says Edita Outericka, DMD, of Dynamic Dental in Mansfield, MA. “Once you graduate, you may want to start your own practice which is very expensive.”

To accelerate the repayment of loans, some dentists choose to work through their lunch period in order to accommodate additional patients and earn more money. Over the years, office overhead reaches a level that meets income, and often exceeds it in time. However, those who do not take the time to rest during the day, create an exhausting pattern. Economic pressure can also cause dentists to choose running their business and covering overhead expenses over taking time off.

Financial concerns are not the only issues that new dentists face.

“One of the hardships dental school graduates may have is trying to learn about being in a business,” says C. Brady.

Becoming a new dental business takes time, energy and research, as a dentist must hire and train staff; rent an office space; pay for dental equipment; market their services; and become established within the community.

Student Loan Interest: Because of the high cost of education, dentists who do not opt for an aggressive repayment plan wind up paying high interest costs. For example, the American Dental Education Association gave an example of a dental school graduate with a total student loan debt of $241,097 (Stafford and Grad PLUS loans with fixed interest rates of 6.21% and 7.21%, respectively). After earning a starting salary of $184,140, the dentist will have accumulated $140,995 in total interest costs over a standard 10-year repayment plan of paying $3,184 each month. While the dentist’s education roughly cost $241,097 to finance, he or she repays $382,092 in total because of the interest rates.

Dealing with Patient Anxiety: Since paying a visit to a dentist is not one of the most welcomed trips patients have to make, dental professionals must find ways to cope with the psychological stress associated with working on fearful and apprehensive patients. Evidence suggests that dentists experience an increased heart rate and high blood pressure in response to patients expressing fear and anxiousness.

A High Level of Patience Required: The dental profession involves performing redundant procedures and working in small spaces for extended periods of time; all of which requires a dentist to exercise an elevated level of patience. Oftentimes, dentists deal with fearful patients (especially children), and a professional must learn how to blend patience with compassion.

Working in Confined Spaces: Randy Lang, DDS, D.Ortho, points out in Stress In Dentistry — It Could Kill You! how dentists can suffer from working in tight spaces, which usually measure 7ft. by 9ft. and lack windows. While performing intricate procedures, dentists also operate in small, limited oral spaces. This type of work oftentimes leads to physical consequences for many dentists, including back problems, strain, circulatory disorders and fatigue.

Physical Stress: Ergonomic research and studies further suggest that the majority of work that a dentist performs often leads to musculoskeletal problems affecting their arms, neck, shoulders, and lower back. Many problems stem from the long work hours, working postures, and equipment design. Dentists have also reported to suffer from issues concerning their eyes and hands.

Dealing with Insurance Companies: “I truly enjoy dentistry, however I would take my education to the next level and I would become a specialist,” says Outericka. “Specialists have fewer difficulties dealing with insurance companies.”

According to the results of a survey featured on ‘The Wealthy Dentist,’ a resounding number of dental professionals see the need for sweeping changes regarding the way dentists are reimbursed for the services they provide, and the type of coverage given to patients. Respondents voiced opinions ranging from ‘dental insurance benefits no one but the insurance company’ to ‘they seem to want to talk the patients out of the best treatment and only provide them with ‘cost effective’ treatments that in the long term become more costly.’ The consensus felt that insurance should not dictate treatment, and that insurance companies often undervalue the work of dentists.

“Dealing with insurance companies is very difficult as most patients do not understand their insurance plan and insurance companies are difficult to deal with,” adds Outericka. “You will have to be prepared to understand and cope with all of the difficulties associated with dental insurance companies.”

Professional Stresses & Burnout: Dentists are at risk for experiencing work-related stress that can lead to anxiety, clinical depression, and burnout. Dentists suffering from burnout often encounter mental and emotional stresses that can cause them to view their work environment, staff and patients with varying levels of negativity, indifference and cynicism. Work-related stress comes in many different forms, including feeling the pressure to stay on schedule to internalizing the fear of a young patient.

From a simple filling to restoring a broken tooth, some dentists also feel the stressful effects of trying to achieve perfection in a line of work that renders their efforts imperfect over time.

Frustration with Compromise: A patient’s financial limitations and poor insurance plans can also cause a dentist to make compromises in regards to their recommended treatments. This can cause a dentist to become frustrated when he or she is unable to move forward with what they believe is an ideal solution.

According to the American Dental Association’s Health Policy Institute, the average net income in 2013 for a dentist in private practice was $180,950 for a general practitioner; and $283,900 for a specialist. With the majority of dentists establishing their own businesses, the average salary earned makes the profession one of the most lucrative career options in the United States. In addition to the attractive salary, further benefits associated with the dental profession include:

An Increased Need: As the population in the U.S. grows, so does the need for dental care. Additional factors also affect an increasing demand for more dental professionals, such as changes in health care laws and the anticipation of more openings left vacant from retirees. From 2012 to 2022, the Bureau of Labor Statistics projects the employment of dentists to rise 16 percent, which is a faster rate than the average of all other occupations in the United States.

A Rewarding Career: Dentists not only restore the oral health of their patients, but can literally transform their lives – from performing corrective procedures, improving a bite and filling in tooth gaps to alleviating pain with tooth fillings and extractions.

“It is extremely rewarding to be able to provide health care (that is not life threatening) to patients, especially those in pain or that require cosmetic dental work,” says Outericka.

Dentists are also in a unique position to make a difference in their overall community by offering their services to areas and populations who cannot afford to pay or lack access to dental care. Some dental professionals volunteer their time and skills to treat patients at public health clinics, while others travel abroad to teach preventive measures and provide care to those in dire need.

Wide-Ranging Career Options: “The largest reward associated with getting a dental school degree is the opportunity to practice in the kind of business you want, and the ability to focus in different areas of specialty,” says C. Brady.

Although 80 percent of dental school graduates establish a general dentistry private practice, the profession provides a wide range of career opportunities for dentists that include academic pursuits; working in a fast-paced hospital emergency room; assuming clinical positions around the world; conducting advanced research in a lab, providing consultation; and writing textbooks – all of which can be pursued at any stage of a dentist’s career.

“If I could do it all over, I would still become a dentist,” says C. Brady. “It’s been an enjoyable job, and there’s always something new to learn.”

Ability to Own a Business: “Another benefit is the ability to own your own office and dictate your hours,” says Outericka. “Being a practice owner allows you the control to develop your practice into what you want.”

Nearly 90 percent of all dentists deliver care through a private practice, where they enjoy varying levels of autonomy and schedule flexibility that comes with starting a dental business. And, the chance of maintaining a prosperous self-employed venture is quite high. One study showed that dental offices ranked third as the best category for start-up businesses most likely to thrive and survive.

A Good Track Record of Loan Repayment: Although the cost of a dental education is steep, statistics show that the overall profession represents a group of professionals demonstrating a pretty good reputation of successfully managing loan repayment.

Most dentists are paid enough to eliminate loan debt in less than 14 years. For example, ABC News ranked the dentist profession #11 out of 20 top jobs with the best return on investment, stating that it would take a graduate 13.75 years to repay $139,298 in debt, if they earned a median pay of $149,310, and devoted 10 percent of their salary ($14,931) as annual repayment.

Additionally, some dentists also have the option to eliminate debt faster by entering loan repayment programs which reduce their student loan debt in return for service to populations in need of dental professionals. There are also opportunities for dentists to conduct research and pursue academic dentistry, in exchange for lowered student loan debt.

Ranked #1 as Best Job by U.S. News & World Report: Last but not least, the dental profession earned the most coveted honor in the annual job rankings conducted by the U.S. News & World Report. Not only did the occupation rank number one as Best Job, but was also deemed #1 as Best Health Care Job and #2 as Best Paying Job.

The overall dental career field was noted for its attractive median salary; offering a satisfying work-life balance; and having a healthy projected job growth rate through the year 2022.

While the cost of education and rigorous curriculum associated with the dental profession can cause a great deal of stress for students, there are many ways that aspiring dentists can better prepare for some of the common hardships they may encounter before being able to reap the rewards. A few suggestions include:

Embrace Science and Math Coursework: Early planners, who build a solid foundation in science and math while in high school and undergraduate school not only become better-prepared college applicants, but also fulfill the prerequisites required by dental schools. Targeted coursework includes General Biology, General Chemistry, Organic Chemistry, General Physics and all associated labs. It’s highly suggested to especially aim for getting good grades in these courses. Calculus is another course to take; some dental schools require two semesters worth.

Actively Research Dental School & Career Possibilities: Those who seek out information and opportunities to interact with dental professionals gain valuable insight and networking experience. Attending ADEA-sponsored recruitment events is an ideal move for aspiring dentists. Additionally, the ADEA hosts a live recruitment fair in a different city around the country in March, as well as organizes an annual virtual recruitment fair. Here, students can pay a visit to online booths representing the majority of dental schools in the United States.

These virtual fairs also give students a chance to communicate with dental school faculty, administrators, and students during live chats.

“For students looking to pursue a career in dentistry, I’d suggest spending some time job shadowing, school may look very different than what you may actually experience in an office,” says C. Brady.

In addition to visiting dental offices and spending time with a dentist, K. Brady stresses the importance of making sure the profession is what a student really wants to pursue.

“Be absolutely sure it’s what you like — if not, it will be a job, not a career,” says K. Brady.

Participate in Summer Workshops: In the summertime, there are specific workshops that allow students a chance to enhance their knowledge and skills; introduce undergraduates to the profession; and prepare individuals for the Dental Admissions Test (DAT).

Purchase the ADEA Official Guide to Dental Schools: Released on an annual basis, the American Dental Education Association puts out an official guide that provides answers to practically every question related to dentistry and the admissions process of dental school. Students will find tips for writing a winning dental school application essay; guidelines on how to pay for dental school; descriptive profiles of dental schools in both the United States and Canada; and explanations of various loan repayment/service commitment programs.

Aim for Scholarships and Grants: Those who thoroughly research and apply for financial assistance that does not have to be paid back will experience less pressure to repay student loan debt upon graduation. There are also various scholarships given to students based upon merit, need, or both. Graduates also have the option to repay loans by making a service commitment through agencies, such as the National Health Service Corps [NHSC] and the military.

When asked if he would become a dentist again if given the choice, K. Brady answered, “After practicing for 38 years, if I can do it all over, there is nothing I would rather do… ”

“For me, [a dental school degree] was definitely worth the cost,” says K. Brady. “If health care is what one wants, dentistry is at the forefront.”

“The hours are good for raising a family, one gets to work with people, and the financial reward is good,” he adds.

“I do feel this degree is worth the cost,” says Outericka. “There will always be a need for dentists.”

Dentists enjoy a high level of job security. Outericka cites new research demonstrating the link between a patient’s poor oral health and their overall health as evidence for the profession’s positive positioning in the workforce.

“The field is somewhat shielded from the way the economy can affect other health care industries,” she adds. “You will always make a consistent income.”

The time commitment and overall cost of education are oftentimes the primary concerns that an aspiring dentist must address before deciding to apply to a dental school program. While paying for a dental education is a serious financial undertaking, the income that most dentists earn upon graduation is significant enough to make the management of loan repayment much easier to achieve. Graduates also have various programs available which help lessen the amount of student loan debt owed, such as taking a research position, teaching, or exchanging service in a designed region-in-need for reduced loan totals.

The trends and changes seen in today’s government healthcare policies have also increased the number of people with access to dental insurance, which means that more dentists are needed to meet the rising demand for oral health care services. Overall, the profession shows promising job growth rates and increased employment opportunities. The ability to start a private practice after graduation is another attractive benefit that most dentists enjoy.

However, dentists are at high risk for suffering a variety of stresses, and feeling overworked as a new graduate is common (especially with many attempting to pay down their student loan debt within a 10-13-year time period). Physically, the repetitive postures related to the profession can affect a dentist’s shoulders, back, spine, neck and hands over time. Dealing with fearful, anxious patients and insurance company frustrations can lead to mental and emotional stress. Due to dental insurance restrictions, the inability to treat patients using the most ideal course of action is another stress faced by dentists.

For the most part, the salary; high level of job flexibility and career mobility; loan repayment manageability; and increased need for dentists are leading factors which have led to the profession being considered one of the best career options in the United States. Ranked #1 by U.S. News & World Report in terms of overall job satisfaction, annual pay, and best health care profession, dentists tend to experience one of the best returns on investment for their education.