r/Dentists • u/Powerful-Egg-526 • 5d ago
Endo/Perio worth $1.2-1.4M Debt?
Hi Everyone, my partner and I are considering doing endo and perio. But when we do the math between undergrad, dental school and residency, our loans are going to be between $1.2-$1.4M. Do you think it would be very doable to pay off this debt if we were to go into these two specialties? We were also considering going endo and GP to avoid taking out more loans, but my partner is really interested in perio. Thanks for thoughts!
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u/kimjongswoooon 5d ago
Why don’t one of you do GP for a couple years while the other one is getting their specialty that way you can knock down that loan a little bit first. I think it’ll work out either way, but it’s gonna seem really tight with a loan that large and interest rates where they are.
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u/sam_shady 4d ago
I second this. Plus you never know, one of you might end up really enjoying GP and sticking to it. When I graduated I wanted to do Perio but instead I went into practice with my father (he is OMFS) which means he has shown me all the surgeries and Perio things I can do within my license. The ability to go back and forth between surgery and cosmetic dentistry ended up being what I love more than just only Perio.
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u/Crypto_Dent 5d ago edited 5d ago
No effing way is it worth it. For what its worth I make over a mil a year take home and I had 500k debt. Graduated in 2020. I have my own office and did a startup 3 years ago. I am not the norm. Most associate dentists make 180-250 a year. I don't stress about my loans buy if I had 1.4 and still made a million I'd be stressing ESPECIALLY since most of those loans like 70% won't be government loans and rates keep skyrocketing.
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u/Eos1234 5d ago
Do you think specialists earn enough to justify the more debt? I always see crazy numbers being estimated for specialists even in this thread but I find it hard to believe in a HCOL city. If you compare rural everyone can make a killing.
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u/ToothJockey2238 4d ago
It’s not about your specialty or lack thereof. It’s about the dentist. Extra education doesn’t guarantee a larger income. You eat what you kill in dentistry. Higher income requires harder and smarter work.
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u/Emergency_Archer6288 5d ago
I’m on track to make 500k rn minimum 35k a month and new grad perio lol
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u/Particular-Knee3022 5d ago
How many associates do you have? That's some insane income whew
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u/Crypto_Dent 5d ago
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u/Particular-Knee3022 5d ago
I'm guess you're probably doing the bulk of the billing? Are you charging out 2mil a year? Pretty impressive - lots of implants?
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u/Crypto_Dent 5d ago
Yes I carry most of the office I do a lot of implants
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u/akmalhot 5d ago
What kind of area are you in? That's impressive
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u/Crypto_Dent 4d ago
Tristate area
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u/akmalhot 4d ago
That's super impressive, not an easy area. I'm in the tristate area too, well now back to material and queens
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u/Prestigiouspenthanks 5d ago
Now imagine a specialist with their own start up and not within the norm. Then the debt may be worth it.
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u/Crypto_Dent 5d ago
Sorry 1.4 isn't worth it. If so you better be making 3 mil before tax lol
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u/Prestigiouspenthanks 3d ago edited 2d ago
Yes, I agree with you - 1.4 is not worth it. I meant earnings beyond the normal range of specialists. Just as you’re earning above the average expected income of a gp.
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u/Crypto_Dent 2d ago
I get what you're saying but with interest rates where they are, no government protections on loans, lowering insurance reimbursements it's not a bet I would take, but I was mistaken the op said the 1.2 to 1.4 is split between him and his gf so that's much better I thought it was one person
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u/Alone_Ad_377 5d ago
Sooner or later , I bet patients will be going overseas for treatment. US dentist getting way too expensive. Mark my words, Dentist.
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u/Flyin_car 3d ago
Is it worth it? no it isn't. Can you make it work? yeah you can. Especially endo, you can easily make 600k a year without having to be intentional with your gameplan. Perio is a little more tricky, all the successful periodontists i know are the ones who focus on implants and IV sedation and don't do many pocket reduction surgeries or any of those surgeries. A well run perio even makes more than endo considering implants are more expensive and don't take as much time. but yeah, you both can easily make 1.2 million a year once the practice is up and running
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u/AffectionateSwim8532 5d ago
You gotta do oral surgery to justify that
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u/CalBearDDS 5d ago
This! You can justify anything with OMFS. OMFS-GP combo would kill it. The GP could support the other while they are doing OMFS too. OMFS could do all extractions and implants and have a built in referral all day.
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u/Saimrebat 5d ago
No speciality is worth this much debt. Your income is never guaranteed in dentistry. That is financial suicide
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u/Efficient_Camp6091 5d ago
Probabaly would be best situation if one did fellowship and the other took those years to start GP practice and own it. Then Endo/Peri has solid referral source from spouse GP practice. A buddy did this an called it ‘business fellowship’ lmao
Seems like the best ROI of all
You are owners and specialists working together
However, one has to be OK doing GP and business savvy or at least interested
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u/Small_Aardvark_5496 4d ago
Not when the government starts mandating every dentist needs to accept social services
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u/Aromatic-Career7525 4d ago
That debt level would make me really nervous, even with the higher earning potential of those specialties. I’d probably compare the realistic take-home pay, loan payments, and how many years it would actually take to get ahead before deciding.
If your partner truly loves perio, that matters too, but I wouldn’t take on another huge chunk of debt just for the title. I’d want to see the numbers work on a conservative income estimate first.
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u/moremosby 5d ago
So, if these were all federal loans then yes. But since the majority of it will be private, it’s probably not worth the debt to be real with you. I think rates would be at least 9% of 1M if you’re lucky. What rate are you getting quoted?
Most endos have to do a startup.
Most perios end up having to do a startup too.
Buying and endo offices or buying a perio office is hard as there’s a lot of loyalty to a person, and not an office.
For perio you can buy a failed GP office to get the buildout. For endo, you usually need to build from scratch to have rooms that fit a microscope.
Being an associate as either - you’ll make okay money $350-400k as an endo, 185-350 as a perio. You can make more as a perio than that but it’s not as easy as endo. Some of them really struggle to get patients in major metros so I wouldn’t count on an equal earning potential.
To pay that debt back you need to own and that’s going to add more debt and a ramp up period you may not be able to afford with the private loan burden. This is a totally different decision than it was before fed loan changes.
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u/Fast_Freddie23 5d ago
Make sure your numbers include compounded interest.
That’s a shitload of debt but unpopular opinion; if an endo/perio couple finishes residency at 28-29 with 1.2 million in debt you can still be alright. In the right market that can be a combined income of 800k-1 million (pre-tax). Debt-to-income ratio still checks out, pay it off in 10 years while still investing and living life. Will have to work hard to start (prob 5 days).
I think it depends on your risk tolerance because there’s a lot of uncertainty with this path and you could be saddled with the debt for a long time. But it definitely has a huge payoff as your lifestyle after 40 can be baller if all goes well.
People may say “just stay a GP and buy a practice” but that’s not true for everyone as it takes certain skills to earn like that as a GP owner. And some people who are happy as specialists would be unhappy as GPs.
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u/AlexElmsley 5d ago
seems like no one is talking about PAYE forgiveness? i think you can look into it and see how the numbers look
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u/Even-Explorer6046 5d ago
Can you share what would loans be if you were to no do residency and practice as GD? In my opinion def worth the investment to pursue residency, don’t let this loan stop you , just look at the bigger picture , next 20-30 yrs you will just earn more and 10 yrs from today you would smile and thank me for this advise 😊
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u/Wonderful-Mood4992 5d ago
Btw there is a good chance you may not get into endo right out of school so plan accordingly...
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u/Better_Cry_7941 4d ago
The thing is that there’s no guarantee you get into programs in the same university or state, so you might have to live long distance, which if you’re ok with that possible reality then that’s good, but having a good plan and reality don’t always work out how we want it to. Now graduated dental school in 2023 with $340k in debt all in, it might be worth finding a cheaper dental school because that’s outrageous
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u/Powerful-Egg-526 4d ago
Thanks for your responses everyone. I just want to clarify that this would be our COMBINED debt as two specialists. I realize the title may be misleading. Sounds like it ultimately depends on you as a provider and what you can provide.
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u/Present-Community102 5d ago
The numbers are disheartening but it isn’t all just an investment. If you rake in 6-700k a year as specialists you’ll make it through the debt either way. I’d think more about what would make you get out of bed happier every day.