Is Dental School Still Worth it?
What You Deserve To Know Before You Apply. A Look From a Dentist who Graduated in 2017
By Dr. Peter Bonifatto
Dentistry has always been sold as the perfect middle-class ascension story.
If you grew up middle class, dentistry probably looked like one of the safest paths out. Six figures. Job security. A respected title. When I was in college, I typed “dentist salary” into Google and saw numbers that looked life changing. I thought I was choosing a career that would lift me into a completely different financial reality.
I became a dentist. I graduated in 2017. I have lived this career through school debt, corporate dentistry, private practice, and the financial trends that now define the profession. I wish someone had told me the truth earlier. Dentistry is not the career older generations describe, and if you are about to take out hundreds of thousands of dollars to join this field, you deserve a clear picture of what the job looks like today.
This is information I wish I had when I was eighteen.
The cost of becoming a dentist has skyrocketed
The average dental student now graduates with more than $300,000 of debt according to the ADA Health Policy Institute. Many cross $500,000 once interest and living expenses are added. Tuition has increased at a rate that completely outpaces dentist income.
I personally graduated with $425,000 in student loans even though I had no undergraduate debt. On an income-driven repayment plan, my monthly payment is around $1,200, but the interest grows faster than the balance goes down. These loans can follow you for decades and shape every financial decision you make. Housing. Family planning. Saving. Investing. Everything.
Older dentists did not face this. They entered the profession when tuition was lower, ownership was immediate, and income stretched much further.
Margins are tightening and overhead keeps rising
The average general dentist produces around $940,000 a year and takes home roughly $200,000 after overhead. Staff costs, supplies, rent, equipment, software, and taxes have all climbed sharply since the pandemic. Insurance reimbursement has not kept up.
According to the ADA, dentist net income has dropped by about 8 to 12 percent since 2005 after adjusting for inflation. Some analyses estimate that general dentists effectively earn 20 to 25 percent less than they did in 2019 because costs surged and reimbursement stayed flat.
This is why so many dentists feel like they are doing more work for less money. Because they are.
Understanding dental insurance is essential
Nearly three out of four dentists participate in PPO insurance. Only about 20 to 25 percent are out of network or fee for service. Insurance maximums have stayed around $1,500 since the 1980s. They have not moved with inflation and are unlikely to.
If you are new to this, here is the simple explanation. Insurance companies decide what your work is worth. You do not. You can raise your fees, but they will pay the same amount they have always paid. Everything around you gets more expensive but your reimbursement does not. This creates a long-term squeeze on profit that compounds every year you practice.
Dentistry is one of the only businesses where the business owner has almost no control over pricing.
The part no one teaches students: what a good business actually looks like
Before anyone signs for dental school loans, they should understand the basics of how wealth is actually created. Most of us never learned this. We just heard “six figures” and believed that income equals financial freedom.
A healthy business usually has three characteristics. It does not depend on the owner’s physical labor. It can grow without the owner working more hours. And it has the power to set its own prices.
Dentistry has none of these.
If you stop working, revenue stops. If you want to make more, you work more. If insurance decides what a procedure is worth, that is the price. Dentistry is stable, respectable, and meaningful, but it does not create wealth the way scalable businesses can. People in tech, media, real estate, and ownership-based fields have leverage. Clinical work does not.
Knowing this early does not make dentistry bad. It just gives you realistic expectations.
If this part feels new, you’re not alone
Most of us never learned real financial literacy. I didn’t either. Everything I know came from mistakes, loans, and teaching myself how money actually works. I’m putting together a follow-up piece with the books that helped, the ideas that changed how I think about income, and the things I wish someone told me before I chose this career.
If you want it when it drops, subscribe to my Substack below.
The key-man problem matters more than people admit
A dental practice depends almost completely on the owner being physically present. If you take a sick day, revenue drops. If you take a vacation, the office feels it. If you cut back your schedule, your income drops immediately.
A lot of students say they will buy multiple practices and eventually step away from clinical work. The data tells a different story. Only about ten percent of dentists work in multi-location settings. Even fewer actually own multiple offices. Almost none step out of the chair completely. Patient loyalty is tied to the owner, not the associate. Turnover is common. Running multiple practices is a job in itself.
There is nothing wrong with being hands-on. Just understand that dentistry is a key-man business and the key is you.
Dentistry is a middle-class career, not a path to extreme wealth
Dentistry pays well. It offers stability. It gives you clinically meaningful work. But it is a middle-class career. You can live comfortably, and you can build a respectable life. What you cannot do on income alone is join the one percent, buy multiple properties with ease, or accumulate wealth at the level those salary charts imply.
A middle-class kid looks at $150,000 to $300,000 and thinks that means being rich. It does not. After taxes, loans, mortgage, childcare, CE, insurance, and inflation, most dentists live solidly middle class. There is nothing wrong with that. But it is not the fantasy many people imagine when they click on salary websites.
Real wealth comes from ownership, leverage, and scalable income. Dentistry gives you none of that automatically.
So is becoming a dentist worth it?
It depends on what you want. If you want a stable, hands-on career that helps people directly, dentistry is still a strong option. If you want a path to wealth that scales beyond your physical labor, you need additional skills and additional income streams. Dentistry alone will not get you there.
I am not walking away from dentistry. I am walking away from the old blueprint. And if you are choosing this career today, you deserve to see the blueprint clearly before you borrow a single dollar.
My choice
After weighing the clinical demands, the overhead treadmill, the debt load, the reimbursement environment, and the reality that ownership keeps getting pushed further and further out, I had to be honest with myself. I wasn’t chasing the traditional dentistry path anymore. I was chasing autonomy.
So I started building the things dentistry couldn’t give me. I built a whitening brand. I learned e-commerce. I learned marketing. I built content. I learned how businesses actually grow. I discovered that I’m more energized building systems, product strategy, and customer experience than drilling teeth for ten hours a day.
I’m choosing a career where the ceiling isn’t determined by my physical stamina or an insurance fee schedule. A career where creativity matters. Where leverage exists. Where I can build something once and let it scale. Where I’m not the bottleneck.
I’m not walking away from dentistry as a clinician. I’m walking toward the version of my career that lets me use more of my brain and less of my body. I’m walking toward ownership that is not chained to a chair or dictated by third-party payers. I’m walking toward a blueprint I designed myself.
If you’re early in your career, you deserve that same clarity. You deserve to know all your options. Not just the ones older generations repeat out of habit, but the ones that actually exist today.
If you found this helpful, share it with someone considering dentistry.
Copy the link.
Drop it in a group chat.
Send it to a pre-dental friend.
This is information people rarely get before signing for six-figure loans.
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Sources
ADA Health Policy Institute: https://www.ada.org/resources/research/health-policy-institute
Dentist Income Data (ADA): https://www.ada.org/resources/research/health-policy-institute/dentist-income
Dental Education and Student Debt: https://www.ada.org/resources/research/health-policy-institute/dental-education
ADEA Dental School Costs: https://www.adea.org/data/seniors
Survey of Dental Practice: https://www.ada.org/resources/research/health-policy-institute/survey-of-dental-practice
NADP Dental Benefits Report: https://www.nadp.org
Dental Economics Industry Reports: https://www.dentaleconomics.com
DSO Trends (ADA): https://www.ada.org/resources/research/health-policy-institute/dental-service-organizations
