Finding Your Way As a New Dentist

  • by AGD Staff
  • May 15, 2023
With many dental schools graduating in May, a new generation of dentists is entering the workforce. With this in mind, AGD Impact consulted four experts to provide advice for these new dentists. They lent their expertise on key aspects of beginning practice — finding a job, addressing student debt, obtaining insurance and licensure, and planning a career.

What’s Your Dream Job?
By Amrita Rohit Patel, DDS, FPFA, FICD

Congratulations, graduates! Welcome to the best profession in the world. The four years of hard work that you put into obtaining your doctorate were likely full of ups and downs, but you’ve made it. Now, it’s time to go out and find your path in dentistry. There are numerous options available: private practice associateships, larger group practices, academia, public health and military dentistry. You might even want to put yourself on the track to practice ownership in the next few years. This can all seem overwhelming at first, but it is a road that can be navigated with some guidance from those who have been there before you. 

The first and most important question to answer is: Where are you going? I mean this in a literal and figurative sense. Where do you want to be geographically? Where would you like to raise a family? Do you have existing obligations that are drawing you to a certain area of the country? Does being an associate for most of your career interest you, or would you like to get more involved with the business of dentistry? These are all legitimate and often difficult-toanswer questions. In my experience, it is crucial to have a plan before setting out on your journey to find an ideal work environment. 

The best place to start having these conversations is often with your dental school faculty prior to graduation and also with your local component dental societies. You will meet leaders in dentistry in your area that might end up being your connections to employment opportunities. You will also get to network with other recent graduates at membership and mentoring events that these organizations host. If you are doing a postgraduate training program, your attendings are also wonderful resources for employment options. Many of them are likely looking for associates to mentor and potentially onboard as partners in the future. Many retiring dentists do not work with brokers or sales representatives when they are ready to sell their practices; instead, they rely on word of mouth. This is a great opportunity for newer graduates to find ideal positions that are sometimes not listed on job websites. If you are interested in practice ownership and learning about the business of dentistry, look for jobs that advertise a partnership or owner track. These will be the right fit for you. 

As you go through the interview process, make sure to ask about scheduling of patients, treatment planning philosophies and any technology that the office uses. You probably learned about a lot of new technology in school and even in your training, and now you get to use what you learned to help patients. The flow of a schedule is an important part of every working day, and some offices allow associates to allot their own amounts of time per procedure. Other offices may create your schedule for you. Remember that, as you grow, learn and continue to practice, your skills and working speed will increase. Don’t get discouraged if appointments seem to take longer in the beginning. Showing an interest in learning to do better can go a long way toward working better with your team. 

What happens after you’ve found your dream job? The first piece of advice I give to all new graduates is to hire an expert — an attorney who deals with contracts — to review the employment contract. Make sure that a contract exists between you and your employer. Handshake deals are red flags and should be avoided. A solid contract, with expectations and requirements clearly laid out, is the way to make sure all parties involved are on the same page. It should describe in detail your expected compensation. There are different methods to calculate this. The most common I have seen is paying a base salary per day and then a percentage of production or collection after a few months. For offices that are in-network with dental insurances, this initial period is generally used to credential you and get you signed up with these plans. 

Other considerations that should be included in your contract are the licenses and documents that you need to keep up to date (malpractice insurance, Drug Enforcement Administration registration and any state continuing education requirements), your daily schedule, and the types of procedures that you are expected to perform. You may also be offered a continuing education stipend in addition to your compensation. This shows that the practice is invested in your clinical growth and is an important point to consider when interviewing. 

Clear communication from the start is how you avoid conflicts and make the transition process a smooth one, no matter where you end up. Make sure to communicate any questions or concerns prior to signing your contract with your future employer. Communicate with your local dental societies to network with other doctors who are in the same position (and use these networking opportunities to find a mentor!). Lastly, remember that these important interviewing and communication skills are the building blocks to continued success in your professional life, whether you choose to be an associate indefinitely or put yourself on the path to ownership. As a doctor and a leader, empowering your team to achieve your goals is the way that successful positive growth can continue. 

Amrita Rohit Patel, DDS, FPFA, FICD, is in private practice with her father, endodontist Rohit Z. Patel, DDS, PC, in Westchester County, New York. She is the AGD Impact Leadership columnist.

9 Steps to Tackle Student Loan Debt 
By Roger P. Levin, DDS

Student loans can be overwhelming and affect people differently depending on how the debt is managed. Student loans can affect the trajectories of income, savings and lifestyle. Understanding the available options and best strategies to manage student loans can make a significant difference in the personal and professional satisfaction of dentists. 

Here are nine steps to successfully navigate the repayment phase of the student loan maze: 

1. Always be aware of how much you owe. I am surprised when I ask dentists their student loan balance and they do not have an answer. It is as if they have shifted into autopilot mode and are paying bills without considering how long they will have to pay (i.e., the term of the loan), when the loan will be fully repaid (also known as retired) and how much is still due (the outstanding balance). Only by understanding your total debt will you be able to make other critical decisions about not only your career path, lifestyle and savings, but also options in managing your student loans. 

2. Understand your payment obligations. As you determine the amount of debt remaining, you should also understand the terms of the loan. For example, loans can have different interest rates during different periods as well as different repayment rules. This is critical to understand as you look at options so as to avoid extra penalties, such as interest, fees, etc. The terms of your loan should be clearly spelled out by the lending institution in your loan document(s), and you should be able to easily access this information. 

3. Know your grace period (especially for younger dentists). Not all loans need to be paid back immediately. You should take advantage of any allowable grace periods to reduce pressure and establish a more stable financial position. Student loans typically have a six- to nine-month grace period after you graduate before you must begin repaying your loan. And there are sometimes other grace periods, such as during the recent pandemic or other emergency or hardship situations. 

4. Consider loan consolidation. Frequently, you can consolidate multiple loans, extend payment terms and lower payments. Lower payments will reduce pressure and allow dentists the opportunity to build up higher income from practicing dentistry. A highly efficient, high-production practice is important for every dentist, but it is particularly helpful in providing the resources to pay back student loans. Be careful to evaluate the new interest rate on a consolidated loan. Consolidation is typically done to reduce payments, but it sometimes comes with a higher interest rate. Depending on your situation, that scenario may be desirable; don’t let it catch you off guard. 

5. Always pay off higher interest-rate loans first. You should check with your accountant on any of these recommendations, but it generally makes sense to reduce the most expensive loans as quickly as possible. As these loans are retired, your ability to then pay the next lower interest rate loans becomes easier. 

6. Don’t fall into the trap of making interest-only payments. It may be appealing to make lower payments, but, by doing so, you may find yourself in a trap where you are paying off loans for many more years. Always try to pay something toward the principle with every payment. Interest will continue to accrue on the principle, and, if you do not reduce it, the loan could actually continue to grow. 

7. Check to see if there are any mechanisms to receive discounts on the loans. For example, sometimes discounts are offered if you authorize payments to be automatically deducted from one of your accounts. Any opportunity to achieve discounts on loans should be considered, as those will reduce the overall loan burden. 

8. Periodically evaluate other plans and options directly with your lender. For example, your lender may offer you the opportunity to change your repayment requirements, which may be beneficial. Although it is beyond the scope of this article to evaluate all the possible different options you may encounter, your accountant will be able to look at these with you and make recommendations. Keep in mind that, regardless of the accountant’s recommendations, you must be comfortable and confident that moving into a new type of repayment plan is in your best interest. 

9. Establish a personal budget. Very few dentists have budgets for their personal lives, and this is a bit of a mistake. If you have debt, you want to know what your monthly expenses will be (including student loan debt) compared to your monthly income. This will make it easier to evaluate personal purchases, such as a new car or house, and what level of purchases you may or may not want to make. 

There are numerous acceptable strategies for repaying student loans. In general, I lean toward those that eliminate debt as early and quickly as possible. While there may be budgetary or tax reasons to extend your payments, debt is debt, and, in observing thousands of dental practices, I see the best results for long-term practice success when the doctor focuses on retiring debt and then shifts to maximizing savings. The longer the debt is present, the less likely dentists seem to properly take advantage of retirement funding at the highest level. 

The ability to save money and realize the tax advantages that are available in the United States for retirement savings plans allow dentists the opportunity to retire comfortably. Too many dentists today are waiting until their student loans are paid off to explore contributing to retirement plans. They seem to believe that they have many years to address this issue. Unfortunately, that period of “many years” becomes shorter and shorter. According to Levin Group data, the average retirement age of a dentist is now 72 and rising. Given the increase in the average retirement age of dentists, partly due to additional debt like student loans, it makes sense to take advantage of the best strategies that allow retirement funding and compound interest to be allies in the accumulation of a higher net worth. 


It is important to remember that improving practice performance to increase production and individual compensation is one of the primary mechanisms available to dentists to create funds to repay student loan debt. It is not the only solution, but a higher income makes it easier to repay debt, leaving more money to fund your lifestyle and your retirement savings. 

Remember that student loan debt is good because loans have allowed many dentists to enter the profession when they may not have had any other way to do so. But you owe it to yourself to evaluate your financial position on a regular basis and take advantage of the best opportunities to create a solid financial future that allows you to leverage all the time and effort you have spent on your education to ultimately help the patients you serve and live the life you deserve. 

Roger P. Levin, DDS, is the founder and CEO of Levin Group, a dental management consulting firm. He is the AGD Impact Practice Management columnist.

Insurance Primer for New Graduates: Keeping It Legal 
By Richard C. Engar, DDS, FAGD

New graduates face several necessary decisions as far as practice protocols, licensing and more. Whether you are working for a large group practice or as an associate, decisions about insurance and licensing issues have to be made. Rarely does a new dentist open a private practice from scratch in this day and age, with school expenses such as loan payments due, but there are some things that the new dentist must face in the future that require decisions. 

This section provides the basics on necessary coverage with regard to insurance and licensing. It will also cover a few other matters that new graduates must understand as far as state or provincial practice act provisions. 

Personal Insurance Requirements 

1. Malpractice insurance.
All dentists must carry professional liability (malpractice) insurance. With very few exceptions, these policies are written on individual bases, and everyone in a group practice must hold their own policy. There are two basic types of policy. One is called “occurrence form,” which means that coverage has to be in place at the time the claimed event took place, but coverage does not have to be in place at the time the claim is made by the patient if the dentist leaves the practice, for example. This coverage is more expensive, however. The other type of policy is called “claims made form,” which means that coverage must be in place at the time the claimed event took place and at the time the claim is made by the patient, even if the dentist has left the practice. Therefore, you have to purchase extended reporting, or “tail coverage,” to ensure that you will be covered if you cancel the policy. Policy limits are customarily $1 million per claim, but the limit may need to be more depending on the litigious climate in the state or province where you practice. 

2. Personal liability umbrella coverage. This coverage may be obtained through your homeowners insurance company, but it usually has policy limits of $1 million per claim. This coverage is good if you have teenage drivers or a swimming pool or other more risky aspects of your life that could create financial hardship without this coverage being in place. 

3. Life insurance. This may be required if you have student loans, and the loan issuer may require you to list it as a beneficiary in the policy. 

Business Insurance and License Requirements 

These may not be directly applicable initially, but, if you get to the point where you become a part owner of a practice, these are essential. If you are an associate, you should still ensure that the practice has these insurance coverages in place: 

1. Business owner’s coverage. This covers the equipment, premises liability (in case a person falls down in the waiting room and gets injured) and the building (if owned by the dentist). 

2. Workers’ compensation insurance. This must be in place to cover employee injuries, the most common in dentistry being a needle stick. 

3. Employment practices liability insurance. This takes care of harassment claims and other disgruntled employee allegations. 

4. Business license. Some states, provinces, counties or cities require a business license. These are renewable on an annual basis, but requirements vary depending on the location. 

Practice License Requirements 

1. State or province licensure for dentistry. You must have your own personal license to practice in any U.S. state or Canadian province. You must follow the regional testing requirement for the particular state or province in which you wish to practice. Rarely, an individual state or province may conduct its own licensing examination, and the key to applicability in any other area is equivalency of the state or provincial test to the applicable regional examination requirements. 

2. State or province licensure for prescriptions. Requirements for the license to prescribe generally fall under the same rules as dental licensure.

3. Drug Enforcement Administration number to prescribe controlled substances in the United States. This is a separate license from the state license and must be renewed on a specified periodic basis. 

4. Sedation level requirements. How sedation modalities are licensed is dependent on state or provincial practice acts and rules. The American Dental Association classifies sedation by levels, but some jurisdictions classify licensure by modes, i.e., nitrous oxide, oral sedation and intravenous sedation. Some jurisdictions require a certificate or letter from the graduate’s dental school or residency program outlining the level of sedation training achieved. 

Protocols for Procedures Relatively New to Dentistry 

This section has to do with verifying the legalities of practice in your location and knowledge of the various protocols for unusual situations: 

1. Botox and dermal fillers for cosmetic treatment. You must review the practice act in your state or province to see if general dentists are allowed to perform cosmetic procedures involving injections or other methods. 

2. Expanded duties of hygienists and dental assistants vary among states and provinces. You need to know what specific procedures, such as injections or restorative material placement, that auxiliary personnel are allowed to perform in your practice location. 

3. Laws requiring interpreters for deaf patients and governing service animals in dental facilities, etc. You must be aware of these accessibility protocols as well as new situations that will occur in the future. 

In summary, these basic suggestions should help new dentists stay on the right track and avoid getting themselves into unpleasant situations, as ignorance is not always bliss! 

Richard C. Engar, DDS, FAGD, is retired CEO of Professional Insurance Exchange Mutual Inc., a Utah-based professional liability insurance carrier created by Utah dentists in 1978. He is also retired from the faculty of the University of Utah School of Dentistry and is the former AGD Impact Risk Management columnist.

Planning the Path Ahead 
By Gerard Scannell, DDS

As new dentists, much of our focus is on improving upon what we just learned in dental school. That can include increasing our speed and efficiency of procedures, developing comprehensive treatment plans, or simply being better leaders of our teams. However, making progress on our foundation in the short term should be balanced with planning our career path for the future. If we don’t plan who we want to become and what successes we want to achieve, there’s a good chance we won’t accomplish these goals. We also can’t reach those goals by ourselves and often need to use resources to streamline the process. 

We first need to define what success means to us, whether it’s in our professional or personal lives. Many people think of success in terms of money, but I suggest that mindset be expanded to health and happiness. Identify what goals will accomplish the successes you’re striving for. One of the most proven resources for this is making your goals SMART, which stands for specific, measurable, achievable, relevant and time-bound. There are countless prompts online to help you make SMART goals. Apply this principle to any goal when planning the path of your career. 

Working on our professional goals can often both help and hinder accomplishing the goals of our personal lives, so find the right balance that fits the lifestyle you want. I’ve written about being a lifelong student, and I truly believe continuous learning will make for a successful career. One of the best resources for this is continuing education. That can include in-person courses, webinars or self-instruction tests in dental publications you receive in the mail or online (like this one!). And don’t just complete them for the credit. Take the time to learn and understand the material. Your effort will benefit you, your patients and everyone else around you. Another great resource is a dentistry-related podcast. I often listen to them during my commute to work. The AGD Podcast has almost 100 episodes that cover a wide range of dental topics and is accessible on the streaming platform SoundCloud. 

Networking can be another great tool to create a successful career. By building relationships with other dentists, specialists and suppliers in your community, you can expand your professional network and referral base, which can contribute to your success. Opportunities to network are all around. Annual meetings, study clubs and fundraisers are good events to start with. Every month, a local dental society hosts a happy hour for new dentists. Both general dentists and specialists attend, and the connections I’ve made have enhanced the referrals I’ve received from those specialists. 

As dentists, we make a good living doing what we enjoy. Financial success can help us achieve other aspects of success in our careers, whether that’s further investing in your practice and team, taking a high-level training course to enhance your skills, or even paying off your student debt. A good financial adviser and accountant can make a positive difference in the success of your career. Choosing one can be tough, and asking your colleagues and mentors for recommendations is a great place to start. A few books that have been recommended to me to help achieve financial success as a healthcare provider are “The White Coat Investor” by James M. Dahle, MD; “The Financial Survival Guide for Dentists” by Sam S. Shamardi, DMD; and “The Resourceful Dentist” by Chad Olivier, CFP. 

Defining the time frame in which you want to achieve each step in your career is critical. Choosing an estimated age for retirement, if you’d like, can be a good bookend for creating the timeline of your career. Then add what your accomplishments will be along the way and when those should happen to ensure the success you’ve defined. To help define your timeline, keep in mind this quote often credited to Bill Gates: “People overestimate what they can do in one year and underestimate what they can do in 10 years.” The most valuable nonrenewable resource we have is time, so use it wisely. 

It’s important for us to regularly review our career goals. We are in an ever-evolving profession, and our career path should be flexible with the changing times. There is no one sure path to success. Everyone is on their own journey, and everyone has a different trajectory. Make it your own, and make it count. 

Gerard Scannell, DDS, is a general dentist practicing in his hometown of St. Petersburg, Florida. He is the AGD Impact Communications columnist. To comment on this article, email