Dental and Medical Counsel Blog

You’ve Just Graduated Dental School, Now What?

August 5, 2021
buying a dental practice

The first days after you graduate from dental school are often overwhelming. After the celebrations are over, your professional career looms ahead of you. Choosing the right path is complex and often difficult. This guide will help you discover the various options, weigh the pros and cons of each one, and choose a career path that is the perfect fit for your interests and goals.

First Steps First

Now that you are done with dental school, you need to start preparing yourself for professional life. This isn’t as easy as you might think, because up until this point your focus has been entirely on your education. Here are some first steps you need to take:

  • Learn time management – If you haven’t already done so, now is the time to learn to manage your time. When you start working, you may be in the office 8 to 10 hours a day. Make sure you can manage your time both in and out of work.
  • Build a balance – It’s easy to become so focused on your professional life that you lose track of your personal life. Build a work-life balance early, so you can enjoy your profession and avoid burnout. Make sure you take care of your physical and emotional health.
  • Network – Even before you have a job, and after you land one, keep your professional network strong.
  • Learn to manage your money – Owning a dental practice means owning a small business, and you are going to need good money management skills if you plan on becoming a practice owner. Start learning how to manage your income now, so you are in the best position to get a loan.
  • Continue your education – Dental practice is a life-long endeavor. Upon graduating, continue to stay abreast with continuing education courses and build new skills as you develop in your profession.
  • Start saving now – Start a savings account, and pay yourself a little every time you are paid. As soon as possible, start a retirement savings plan as well.
  • Find a mentor – Is there a dental practitioner you look up to? Try to build a relationship with them that can serve you well in the future.
  • Write down your plan – Once you know where you want to go with your profession, write down your plan.
  • Build support – Build a team of support around you, both in the office and in your home life, so you can set the stage for success.

Dealing with Debt

Most dental school graduates have some student debt. One of the steps to take in these first days is determining how you will manage that debt.

One option is to pursue a practice-based or residency-based repayment strategy. If you enter practice immediately or shortly after graduation, you can start your repayment strategy right away. If you are aggressive, you can repay the loan in 10 years or less.

If you are entering a school-based residency program, you may not have the funds to start repaying your debt. You can postpone your debt using an In-School Deferment. This deferment is available to anyone who is enrolled at least half-time in school, including a residency program. During the deferment, you will not accrue new interest on the loan.

If you are entering a hospital-based advanced dental education residency program, you may apply for Mandatory Internship Residency Forbearance. This also pushes off your repayment, but it does allow interest to start to accrue.

Once you start repaying your debt, consider whether you are focusing on a time-driven or income-driven strategy. Time-driven strategies space out payments over either 10 or 25 years. Your monthly income stays the same, regardless of income. You will be debt-free at the end of the term. Income-driven repayment has a payment based on a percentage of your income, also figuring in family size. If your time-driven repayment is too costly for your budget, and you are in a residency program but still want to start paying, this can be a good option. With this plan, your payments will change each year based on your income and family size.

Consider an Advanced Degree

One option to consider after finishing dental school is to pursue an advanced education. This will open the door to a career in a particular dental specialty. These are often roles with less competition and more potential income. There are several you can consider, including these:

  • Dental Anesthesiology – A dental anesthesiologist provides patients with anesthesia care when they visit the dentist. This can include care during surgical procedures as well as anesthesia care
  • Dental Public Health – A career in dental public health focuses on developing policies and programs that help the dental health of your community. In this role, you may not work in a dental office, but you will use your dental knowledge and training to impact public health policies.
  • Endodontics – Endodontists perform root canals and help people retain their natural teeth when they face oral diseases and infections. They can repair teeth or perform root surgery or pulp therapy.
  • Oral and Maxillofacial Pathology – Oral and maxillofacial pathology specialists identify and manage diseases of the mouth or jaw by looking at imaging, biochemical levels, and microscopic exams.
  • Oral and Maxillofacial Radiology – This field is surrounded by technology, and radiologists need to be able to use and interpret digital images, computer tomography, and magnetic resonance imaging scans.
  • Oral and Maxillofacial Surgery – This surgical specialty helps improve patients’ lives by repairing cleft lip and palate problems, facial injuries, and oral cancers. These surgeons also install dental implants and may perform cosmetic dentistry.
  • Oral Medicine – This new specialty teaches dentists how to manage the dental health of medically complex patients who may have conditions that affect the oral and maxillofacial regions.
  • Orofacial Pain – This is another new specialty designed specifically to diagnose and manage pain disorders of the jaw, mouth, face, head, and neck.
  • Orthodontics and Dentofacial Orthopedics – Orthodontists and orthopedic dentists help align the teeth and jaw to prevent problems and improve the look of someone’s smile.
  • Periodontics – Periodontists treat gum disease and other diseases that affect the tissues of the mouth. This can help eliminate the risk of tooth loss.
  • Pediatric Dentistry – Pediatric dentists set the stage for good oral health by working with children to establish good oral health habits and protect young patients from cavities and dental caries.
  • Prosthodontics – In this final specialty, you will learn how to use implants and other prosthetics to replace missing or broken natural teeth.

With an advanced degree in one of these fields, you open the door to a more lucrative and in-demand career.

Dental School or Hospital-Based Training

If you decide to go back to school for advanced dental education, you have two options. You can pursue this training in a dental school, or you can pursue it at a hospital. Sometimes your specialty will determine which choice is right, but sometimes you have the freedom to make a choice. Take a look at these programs to see which would fit your goals and timeline best.

Starting Your Career Now

Perhaps the idea of going to school longer is not appealing to you. If you are leaning toward starting your practice now, you need to consider what practice option you wish to pursue.

Associateship Opportunities

Getting started as a new dentist can be challenging, associateship propensities can help. If you have good references and a strong resume and can find a dentist with a similar philosophy to yours, you may be able to get an associateship position.

In an associateship, you work as an employee of the group practice or lead dentist. This can help you build a reputation in your area and may even allow you to buy the practice when your lead dentist is ready to retire.

Associate in a Group Practice or DSO

If you do not want to shoulder the burden of setting up your own practice, you can work in a group as an associate. A group practice or dental service organization connects a team of dental providers under one roof. Joining an established practice does eliminate some freedoms of practicing on your own, but you benefit from working in a place that already has a base of patients to tap.

When joining a large group practice, you have three basic options. Some groups operate on a geographic model. They have multiple locations within one geographic area. You may be part owner of your location or the only dentist in your location, but you still report to the main organization.

Group Practice Organizations, or GPOs, function on a franchise structure. They have offices or branch locations throughout the country, and each location has one or two dentists who may be owners or employees. This type of structure benefits from the established brand of the GPO, which can draw patients.

Finally, a Dental Services Organization, or DSO, helps a new dentist get established by creating a relationship with an existing, successful practice. It is possible for a dentist to take a path toward ownership after building a patient base with this structure. The DSO helps with marketing, human resources, and other elements of building a practice. DSO agreements are unique from other types of practices, so read them carefully before signing.

Getting started in a group practice can help you establish yourself in your area before launching your own practice, but be sure to read your contract carefully to see if it contains a non-compete clause. Only join a group practice if you can do so while protecting your ability to practice how you want later. Also, consider whether the contract treats you like an employee of the practice or a self-employed dentist who happens to work for the practice on a contract basis.

Private Practice

One option for a new dentist is to start a private practice as a dentist. This can be a more challenging route to take because you must not only find patients and start treating them on your own, but you also must start the business side of your practice from the ground up, including building or buying a location, hiring your team, and setting up your facility to make patients comfortable. While this sounds like a lot of work, and it is, it is the route many dentists take.

Another option is to purchase an existing dental practice with its own team members, patients, and processes. Though you can implement your own changes, it is recommended that you try to keep the existing team members to smooth the transition process. We advise you do your own due diligence when considering practices to buy so you don't inherit any problems later on.

A 2019 survey of dentists from the American Dental Association found that 50.3% of practitioners worked in solo practice. Though this number has steadily declined over the past decade, solo practice is still the most popular option. There are many perks to owning your own dental practice that are worth considering.

Academic Dentistry

One career path to consider is a career in dental education. Rather than practicing on patients, you can deliver your dental knowledge to new dentists in a dental school. This path does require you to practice for a while to gain experience, but it can be an end goal of your career after dental school.

Public Health Care Policy Expert

Perhaps you find after dental school that your passion is for dentistry as a whole, not necessarily for practicing on individual patients. If so, then a career in public policy can be a good fit. You can work in the government or on a university level to influence the policies that affect dental care in the country or in your state.

Federal Dentistry Opportunities

The U.S. Public Health Service, the different branches of the military, and the Department of Veterans Affairs all hire dentists. In fact, these organizations have over 5,000 dentists in their employment, according to the ADA. When you work as a dentist for the federal government, you have a base salary, benefits, and competitive compensation, and do not have to shoulder the responsibilities of owning your own practice.

Another federal option is working in a Federally Qualified Health Center. These centers serve low-income populations and are paid through federal or state insurance programs. You can work full-time at an FQHC, or you can do part-time work to give back to your community and earn loan repayment for your school debt.

Taking Time Off After Dental School

The third option after dental school is to take some time off before jumping into your practice. Dental school is no small commitment, and you may need time to refresh your mind and spirit before you start your career. Find a job in another field, and be willing to give yourself a mental and emotional break before you start working in dentistry. This can also help you determine your long-term goals for your dental career, and the break will give you the chance to evaluate your contracts and employment options more thoroughly.

Questions to Ask When Making the Choice

With so many options before you, the choices can feel a bit overwhelming. Before you decide a route to take, do some soul-searching and ask yourself some key questions. Some questions to include are:

Do you need scheduling flexibility?

One of the perks of working for yourself as a solo practitioner is the scheduling flexibility you get. You aren’t on anyone else’s schedule. On the flip side, this option can leave you with long hours in order to see enough patients to pay your bills.

Do you want a long-term or short-term arrangement?

If your future is somewhat up in the air, a short-term arrangement in a group or private practice may be a better fit than a long-term commitment. On the other hand, if you are looking for stability and do not need to have options to make a change at a later date, then a long-term agreement is a good choice.

Will you have financial obligations to consider?

Most dental students graduate with school loans. Do you have the obligation to repay those, or will you have a loan forgiveness option to pursue? Choosing a career path that will help you meet your financial obligations is important. Working in the public health sector or in a large practice may open the door to programs that help with loan repayment and forgiveness.

Do you desire your own patient base?

Some dentists want the ability to build relationships with their patients over the years, while others do not find this to be a priority. If you want your own patient base, you will need to have the option to work in solo practice in some form.

Do you want to push for ownership?

Does owning your own dental practice appeal to you, or do you feel content to work for an organization throughout your career? This is a highly personal decision, but it is a question worth asking as you consider your post-schooling options.

Do you prefer a small setting or a large one?

Do you picture yourself in a large organization or a small, intimate setting? This is another highly personal question, but one that will direct your choices for employment.

Does the thought of owning and running a small business appeal to you?

There are many aspects of owning your own practice that goes beyond working with patients. Make sure these are something that makes you excited about your future, not frustrated or stressed. Paperwork, bookkeeping, filing, marketing, and even doing your taxes are all tasks you need to handle as a small business owner.

Do you want to buy a practice or build from scratch?

If you are wanting to into business for yourself, consider whether you want to buy a practice or build one from scratch. Both have benefits and drawbacks, so this is another decision that is highly personal.

Are you a leader?

To own a dental practice, you must be a strong leader. You will have staff that works under you, and you must be able to lead them efficiently. On the other hand, if you work better as a member of a team, you may feel more comfortable working in a large practice as an associate.

Finding a Job

After you decide the route you want to take after dental school, it’s time to start looking for a job or opening your practice. There are many perks to choosing employment first. Working for someone else gives you the chance to establish your skills as a dentist. It can also provide you with clinical experience while getting paid, and it brings no financial risk. Should you decide to change geographic location, you don’t have to sell your practice first. Some opportunities with low-income patients or federal government programs even offer loan forgiveness options.

However, to take advantage of these perks, you need to first find a job. This can be the most challenging part of the process, but there are things you can do to make it easier.


First, build a professional network with other dentists and medical professionals in the area where you wish to work. If an associateship is what you’re considering, this can help you find dentists to partner with. If not, then this can help you build a good reputation in your area.

Use Your State Dental Association

Find your state’s dental association or society and become a member. Many open positions for dentists are posted through these groups. Attend meeting for these groups, if possible, to learn about openings and opportunities before they are public.

Reach Out to Your Dental School

Many dental schools have placement assistance programs. If you are going to stay in the state where you studied, this can be a good resource to tap. If not, ask your school’s placement program to introduce you to a school in the state where you want to practice and provide a recommendation for their placement program.

Take Your Time – The Future Awaits!

After graduation when people are asking you about your future plans, you may feel pressured to make a fast decision. While it is important to start earning income and putting your education to use, don’t allow yourself to give in to feelings of pressure. You have time to evaluate your options and make a solid plan. By giving yourself time to think through your choices, you can choose the career path or educational path that helps you reach your goals, both personally and professionally. For more help in determining your dental career path, download our Dental Practice Ownership: How to Create the Dental Career of Your Dreams eBook today.

For further assistance discussing your goals, contact Dental & Medical Counsel for a complimentary consultation with dental attorney Ali Oromchian.

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