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The cost to do dentistry well

I’ve always heard that the dental profession is a tight-knit community of like-minded individuals, here to service patients with the best care possible. Since entering the world of private practice general dentistry in 2018, this has largely proven to be true. I’ve had excellent mentors, and I’ve been fortunate to find some success as a young associate in a private practice.

Photo of Dr. Fisher

Dr. Fisher

But I’ve also come to see that there is a disparity in the way my peers and I will have to continue to gain clinical skills compared to those who opened their practices in the golden age of dentistry.

According to the American Dental Education Association, graduates in 2019 owe, on average, nearly $300,000 to their student loan lenders. Thirty-nine percent of graduates in debt claim they owe more than $300,000. Additionally, large dental offices continue to gain traction (and for what it’s worth, likely aren’t going anywhere) especially amongst young professionals who don’t want to incur more debt. In a post-COVID-19 world, it feels that more and more young dentists will be accepting or remaining in positions as associate dentists to avoid a lot of the small business concerns that have come to light recently.

What I see, personally, is the challenge of balancing my desire to accumulate clinical skills and continuing education with an ability to afford it. As most clinicians have, I’ve taken a great deal of continuing education in my furlough from clinical dentistry. Most have been free, and many have been very informative. A number of them have been sponsored by companies promoting their products, which I would be interested in working with, but as an associate I can’t manage to pay out of pocket for, nor do I expect my owner to be interested in as we struggle to recover from our nearly two-month hiatus.

One well known aligner company has cancelled all their in-person onboarding classes but offers an online version. The online course is 45 minutes (three sessions of 15 minutes) and costs $995.

Many companies have done a great job accommodating dentists in this time of need. One prestigious dental higher education facility recently offered a virtual, two-day webinar for their level 1 foundational course for $200, less than one-eighth of the normal cost. The course was excellent, and I applaud the facility for recognizing the potential need and changing their fee structure to accommodate people. However, the next course is $5,395, so even with a payment plan, this is something that will need to be budgeted for over the course of the next few years for so many dentists with families, mortgages, student loans, and car payments.

It would be naïve of me to make all of these claims without also acknowledging that these companies are businesses, and everything can’t be free. They have an obligation to pay their staff and if you’re purchasing a product, you’re purchasing the time, the materials, and the expertise the same way we expect our patients to purchase our dentistry. Additionally, being an associate comes with the relief of not paying staff, rent, or for materials.

My concern, however, is that our inability to partake in continuing education or to purchase new products, which allow for more procedures to be completed in the office and better tolerability, may ultimately result in a complacency and a continuation of the status quo in our dental offices.

As dental benefit plans continue to limit what patients are willing to pay for, I believe, so too will the price of dental products and continuing education limit what we as young clinicians can provide to our patients. I hope that our community realizes the significant changes that have occurred in the dental landscape, and can discuss new ways to reach young dentists in meaningful ways without breaking their bank.

Dr. Alex Fisher is a New Dentist Now guest blogger who graduated from Rutgers School of Dental Medicine in 2017. He is an associate general dentist, and the sole clinical provider, in a private practice in Montclair, New Jersey. He is an active ADA, AGD, and AACD member, and continues his learning with preeminent higher dental education programs. When not practicing dentistry, he enjoys taking on home improvement projects for which he has neither the skillset nor temperament, going on long strolls with his wife, Chelsea, and their dog, Mack, and purchasing T-shirts at breweries across the U.S.

Editor’s note: The ADA provides continuing education opportunities that impact on dentists’ ability to treat patients, grow their practice, and meet state licensure requirements. These include live and online courses, many of which are available for free for ADA members. For more information, visit ADA.org/ce.

6 comments

  • Dr. Fisher,

    This is probably the best post I’ve seen on this blog. Thanks for not sugarcoating nor politicizing the current situation.

    Private practice dentists are business owners, too. Covid 19 and its after effects are major threats to every small business in America.

  • really explained well current situation due to covid 19 and its relation with our finances…

    hope to see more blogs soon …

  • I am a self-confessed CE junkie. To continue to grow in knowledge and confidence in the practice of dentistry, CE is essential. There is so much to choose from, and as mentioned in the excellent article, many are promoting products. Historically, our major, and even local meetings would not exist without sponsorship. We all have to pick and choose what products to use to provide the care that we aspire to. Find a local study club to develop mentors and lifelong friends on the same path. Most study clubs provide free, or inexpensive CE. You get to meet the representative of the company trying to sell you their materials. Become a ‘brain picker’. Knowledge is out there for those willing to look for it! My favorite acronym is ASK–AlwaysSeekingKnowledge. Maintain membership in both the AGD and the ADA. Become active in both organizations, as organized dentistry is the best way for the young dentist and for the profession to continue to grow.

  • Well I empathize with the financial challenges of attending quality CE for our younger colleagues, be careful about the assertion that dental benefit plans limit what patients want for themselves. Many dentists can attest to the fact that given the right plan at the right time for the right patient, many will choose well beyond what their insurance pays for. Our role is to help them want what they need, and the more advanced training we have, the more we can help them see a preferred dental future.

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