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The slow decay of dentistry

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8 hours ago, Negura Bunget said:

Right. And the number of botched, half-drilled, impacted thirds I have seen infuriate the majority of the OMFS residents out there that end up seeing them in clinic to fix someone else's mess. It happens alot.  

I'm biased, but I really have a hard time seeing how OMFS is really affected. T+T are important to private practice OMFS, no doubt, but it's a tiny part of the OMFS scope. Sure orthognathics, trauma, deep neck I&Ds, H&N path may not be as luctrative, but to say that OMFS will be "hardest hit" because some GPs are extracting 3rd molars is ridiculous. The moment most GPs see a "medcially complex" pt that needs some form of an extraction, OMFS is consulted, and rightfully so. OMFS has exhasutive training in general anesthesia (300+ general anestheisa cases) and IV sedation (300+ cases). If things go wrong, is the GP going to be confident to intubate, bag, and adminstered the right meds? Sure the GP has the certificate to administer sedation in the clinic, but are they prepared for the worst?  

For the sake of your pateints, if you are remotly unsure if you can handle it, refer to someone that has the expeince rather than botching it. 

i don't think oral surgery will be 'hit the hardest', but i do think that specialties in dent may have a hard(er) time finding patients in the future. You can blame Continuing Education courses for generalists, the perception of different costs in going to a GP vs a specialist for a procedure, etc... but in the end, i think it's all about what services patients can get for the dollar they're willing to pay.

imo dent is a pretty specialized field (even if you look at a GP) and the general public knowledge of oral healthcare isn't really all that in-depth. at the same time, i think the average North American patient has a feeling that a lot of dentists overcharge (blame the CBC news video if you've seen it). So when they see the higher price tag in going to a specialist vs going to a GP who can (or claims to be able to) do the similar procedure for a lower price, AND coupled with a lack of general dent knowledge, they might be more inclined to see the GP instead.

don't get me wrong though, i have so much respect for students who specialize in any type of surgery. it's definitely a grueling process, but a rewarding one if you enjoy that type of invasive work.

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On 11/27/2018 at 3:35 PM, Negura Bunget said:

Right. And the number of botched, half-drilled, impacted thirds I have seen infuriate the majority of the OMFS residents out there that end up seeing them in clinic to fix someone else's mess. It happens alot.  

I'm biased, but I really have a hard time seeing how OMFS is really affected. T+T are important to private practice OMFS, no doubt, but it's a tiny part of the OMFS scope. Sure orthognathics, trauma, deep neck I&Ds, H&N path may not be as luctrative, but to say that OMFS will be "hardest hit" because some GPs are extracting 3rd molars is ridiculous. The moment most GPs see a "medcially complex" pt that needs some form of an extraction, OMFS is consulted, and rightfully so. OMFS has exhasutive training in general anesthesia (300+ general anestheisa cases) and IV sedation (300+ cases). If things go wrong, is the GP going to be confident to intubate, bag, and adminstered the right meds? Sure the GP has the certificate to administer sedation in the clinic, but are they prepared for the worst?  

For the sake of your pateints, if you are remotly unsure if you can handle it, refer to someone that has the expeince rather than botching it. 

I definitely agree. OMFS will not be hit the hardest and it's a very rewarding career if one enjoys this type of work. I know plenty of oral surgeons living a very luxurious life in the states, can't go wrong with specializing in this field

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My honest opinion from the get-go is that dentistry is too fragmented a field as it is. General dental education is pretty piss-poor and the walls between fields of dentistry are artificial at best; partially a product of educational institutions grubbing at money, partially a product of inflated egos that must be maintained. This creates in-fighting, people stepping on each other's toes, etc. We work in a relatively small area of the body; why there are 7 or 8 or whatever specialties amongst us boggles my mind. 

While sometimes I take solace in the fact that because of this I have the ability to refer away patients that I'm unsure of my capability to give good care for, I also have to deal with the fact that sometimes there are expectations that we all 'stay in lane.' 

I think a better solution, to be frank, is to improve education (lengthen it, even), make dentistry more of a "oral/maxillofacial disease" type medical specialty. I know that raises about a thousand questions about how things should be structured, who pays for it, how on earth it gets lumped in with medicine, taxation, regulation, licensing, etc. But at the end of the day, when i really think about it, I'm very confused why dentistry isn't simply a medical field. 

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1 hour ago, cleanup said:

My honest opinion from the get-go is that dentistry is too fragmented a field as it is. General dental education is pretty piss-poor and the walls between fields of dentistry are artificial at best; partially a product of educational institutions grubbing at money, partially a product of inflated egos that must be maintained. This creates in-fighting, people stepping on each other's toes, etc. We work in a relatively small area of the body; why there are 7 or 8 or whatever specialties amongst us boggles my mind. 

While sometimes I take solace in the fact that because of this I have the ability to refer away patients that I'm unsure of my capability to give good care for, I also have to deal with the fact that sometimes there are expectations that we all 'stay in lane.' 

I think a better solution, to be frank, is to improve education (lengthen it, even), make dentistry more of a "oral/maxillofacial disease" type medical specialty. I know that raises about a thousand questions about how things should be structured, who pays for it, how on earth it gets lumped in with medicine, taxation, regulation, licensing, etc. But at the end of the day, when i really think about it, I'm very confused why dentistry isn't simply a medical field. 

Strongly agree with this post, especially the bolded parts. 

It's unfortunate that it's probably too late for countries like Canada and the US provide dental care at a national level, like NHS in UK. 

Personally, I'd be okay having our salaries decreased if it means more people can have access to dental care. To my knowledge, average dentists earn £40k-£80, and specialists can earn up to £100k, which turns out to be around $70k-$135k for general dentists and ~$170k for specialists. 

I feel the whole profession is built on sand and it's due for some sort of a crash within the next few decades or so.

It will start with the saturation and subsequently corporations leveraging the decreased patient:dentist ratio along with the perpetually increasing tuition to make dental care into a product as opposed to a service.

Once that is achieved, it will see a similar fate as pharmacy. 

(See: Dentistry in the USA) 

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I'd argue that if dentistry were a medical field in North America salaries would actually greatly stabilize. They would normalize in the middle somewhere. There wouldn't be many dentists doing 7 figures a year but there would be a higher average earnings that would likely rival the grand majority of medical specialties. All of which earn more than their counterparts in the UK for the most part.

Healthcare expenditures & taxes would rise in a commensurate manner however.

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4 minutes ago, Stethescope said:

Strongly agree with this post, especially the bolded parts. 

It's unfortunate that it's probably too late for countries like Canada and the US provide dental care at a national level, like NHS in UK. 

Personally, I'd be okay having our salaries decreased if it means more people can have access to dental care. To my knowledge, average dentists earn £40k-£80, and specialists can earn up to £100k, which turns out to be around $70k-$135k for general dentists and ~$170k for specialists. 

I feel the whole profession is built on sand and it's due for some sort of a crash within the next few decades or so.

It will start with the saturation and subsequently corporations leveraging the decreased patient:dentist ratio along with the perpetually increasing tuition to make dental care into a product as opposed to a service.

Once that is achieved, it will see a similar fate as pharmacy. 

(See: Dentistry in the USA) 

I remember my brother telling me about his ethics professor polling the class about whether students would drop out of dental school if the average General Dentist salary was 80-100K. The stat was 70/30 in favor of leaving for something else, with the primary reason being other careers requiring less debt and less strain on the body while making 6 figures. As depressing as this thread is, people need to know that you can enjoy this career, work 3-4 days a week and make 6 figures doing it. Are the vast majority going to pull 250-300K 5 years out of school? Probably not but you definitely could. I know many grads who make a killing from dentistry but they did move to rural locations and/or the US. I still stand by the opinion that dentistry won't be overly saturated and that there wont be some sort of "crash" in the future. It's still a great career, pays well and a respected profession. Pharmacy I feel went down a different path to its doom and I don't see dentistry going down that road.

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On 12/3/2018 at 5:01 PM, Stethescope said:

 

Personally, I'd be okay having our salaries decreased if it means more people can have access to dental care. To my knowledge, average dentists earn £40k-£80, and specialists can earn up to £100k, which turns out to be around $70k-$135k for general dentists and ~$170k for specialists. 

 

In theory I agree.. but the countless number of UK dentists that I have met and worked with in Australia have indicated to me that being an NHS dentist was much more difficult than being a dentist in private practice in Australia (which is essentially the same as it is in Canada).  Their main complaints were being limited to specific treatment options they could offer, short appointment times, and being overbooked/overworked.

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This thread has some interesting discussion topics. Just to put things in perspective, I graduated about 3 years ago. What I have learned this past little while is that managing early burn out is a challenge. I would be more concerned about establishing a balance between work and life than anything else. Income comes with - God's will and-the decisions you make to improve your skillset, going into ownership, working longer days etc. What's more important than anything else is to find the right balance between your career and life. It's not too difficult to earn a good income but if it comes at the cost of sacrificing your health, physical and emotional, then you are not doing justice to yourself or the profession. 

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On 12/7/2018 at 12:35 AM, human instinct said:

This thread has some interesting discussion topics. Just to put things in perspective, I graduated about 3 years ago. What I have learned this past little while is that managing early burn out is a challenge. I would be more concerned about establishing a balance between work and life than anything else. Income comes with - God's will and-the decisions you make to improve your skillset, going into ownership, working longer days etc. What's more important than anything else is to find the right balance between your career and life. It's not too difficult to earn a good income but if it comes at the cost of sacrificing your health, physical and emotional, then you are not doing justice to yourself or the profession. 

I'm starting to hit both my stride and my 'burnout' wall right now. It's strange how it works. I feel more competent and comfortable than ever before, but I also feel tired and overworked and like too much of my life is devoted to dentistry. 

Luckily, hitting my stride is giving me some opportunities to scale back on work and bring some balance back to life, even if that means income taking a hit and swallowing my pride a bit. In the end, there are far, far  more important things than work.

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Internationally trained dentists certified almost equal Canadian graduates in 2018

491 Canadian graduates 

320 Internationally trained dentists

 

The number of new dentists has nearly doubled in 8 years

Total certified in 2010:  664

Total certified in 2018: 1143

 

Dentistry in Canada will change immensely. Migration to the US seems like a more viable option each year.

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50 minutes ago, Everclear said:

 

Internationally trained dentists certified almost equal Canadian graduates in 2018

491 Canadian graduates 

320 Internationally trained dentists

 

The number of new dentists has nearly doubled in 8 years

Total certified in 2010:  664

Total certified in 2018: 1143

 

Dentistry in Canada will change immensely. Migration to the US seems like a more viable option each year.

What makes up the differential between 491+320 = 811 and 1143?

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9 minutes ago, cleanup said:

What makes up the differential between 491+320 = 811 and 1143?

Graduates of accredited degree programs and US+Aus+NZ+Ireland dentists. I don’t think the increase in the latter catageory is an issue because a good portion of those dentists take the NDEB as a backup. A large portion do just stay in the US.

 

Source: https://ndeb-bned.ca/en/dental-programs/historical-pass-rates

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As a predent, how will this affect my ability to repay my $600,000 loan from NYU? /S :mad:

Interesting also - we are now licensing more foreign-trained dentists than domestic-trained for probably the first time ever.

 

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7 hours ago, Ostracized said:

As a predent, how will this affect my ability to repay my $600,000 loan from NYU? /S :mad:

Interesting also - we are now licensing more foreign-trained dentists than domestic-trained for probably the first time ever.

 

 

Why was this decision made to put a nail in the coffin of Canadian dentistry? It’s perplexing- no other primary care profession allows graduates from non-accredited schools to practice their craft without at least some training in Canada. Not medicine, not pharmacy, not vets, not optometry, not chiropractors, not physiotherapists, not lawyers.

A slap in the face is that none of this reciprocal, unlike the US or Australia where Canadians can practice there.

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1 hour ago, Chaxon said:

It’s still a good profession. Just not the golden age for dentists anymore lmao.

The grass is always greener, none of the health care professions are as good as they used to be.

It all depends on priorities and wants/needs. Dentistry is still a great profession.  There are many non-profession factors that make pharmacy, dentistry, medicine etc "worse" than before, and some that make it better depending on perspectives.

Long gone are the days of just opening up your own dental clinic or family medicine practice 1-2 years out from graduation. skyrocketing city commercial rentals etc have made it unrealistic. 

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22 hours ago, Bentist said:

100K plus for those who go outside of Canada XD

 

On 6/2/2019 at 8:51 AM, #YOLO said:

fr 40K a year for that shit smh

You guys are both hilarious. Shoulda been comedians

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On 6/2/2019 at 7:51 AM, #YOLO said:

fr 40K a year for that shit smh

 

On 6/2/2019 at 9:35 AM, cleanup said:

It was around 38-40k when I was in school. I believe it varies from 45-50  per year now.

 

On 6/2/2019 at 10:03 AM, Bentist said:

100K plus for those who go outside of Canada XD

Just because it's a slow day at work with some cancellations I did some fun calculations:

 

UBC dental tuition is more like >60k per year. That's not including living costs.

Just dental school tuition alone is ~250k. Let's say you live extremely frugally and can live off 20k a year. That's another 80k which makes it 330k.
Don't forget you are accruing interest in the LOC for all of those 4 years which adds another ~25k and now you're looking at 355k of debt.
Average undergrad comes out with ~28k debt which makes the final total for a UBC grad.....383k. 

Let's say you went to any other school other than UBC and dental school is ~40k/yr. Then your total debt is ~286k

If you went to dental school in the states with tuition 100k/yr then your total debt is ~544k. And that's a VERY conservative estimate for some schools where you are living in high cost of living areas. 

 

Assuming you're going to be paying it off over 10 years, here are the monthly repayment amounts:

non UBC Canadian grad: $2855

UBC grad: $3823

International grad: $5430

 

That's still pretty manageable for the domestic grads. Sure, you won't be living a life of luxury, but still you're above average in terms of income compared to the general population even after taking into account the loan payments.

If you can make 150k as an associate, that's ~100k after tax, which leaves with with $4500-5500 a month to spend after paying your LOC. That's equivalent to a salary of 72k-90k

Once your debt is paid off when you're in your mid 30s then you have a lot more cash flow. Still, probably not gonna afford a detached house in places like Toronto or Van though.

For the international grad, after loan payments you're only left with $2900 a month which is equivalent to a 44k salary. Not a very satisfying income after 8 years of further education after HS. 

 

 

 

 

 

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