As tuition continues to rise at the nation's dental schools, the former president of the nation's largest dental student organization worries it could soon cause would-be dentists to choose another field or opt against specialization.
The numbers are sobering.
In 2015 the average dental school graduate carried student loan debt totaling $255,567, according to the American Dental Education Association’s Snapshot of Dental Education 2015-16. That’s an increase of more than $8,000 from the year before.
Christian Piers is no stranger to those numbers. Piers is a recent graduate from the University of Colorado School of Dental Medicine, and served as American Student Dental Association’s national president for the past year. He saw annual tuition and fees “slowly creep up” from approximately $61,371 at the start of his four-year stint to nearly $67,514 by the time he graduated.
“I had the fortune to have a lot of scholarships as an undergrad that really covered most of my education, so I thought there has to be some sort of merit-based scholarship system for dental school,” Piers reasoned. “And it turns out those are extraordinarily rare.”
When Piers decided to attend dental school he found himself in a unique situation. He was living in Hawaii, and since the state does not have a dental school, an exchange program pays the difference between in-state and out-of-state tuition costs for any resident to attend a dental school on the mainland. The caveat is you must have lived in Hawaii for five years to be eligible for the program. Piers fell short of the criteria.
“Private and public schools were all going to be quite expensive for me,” he says. “Even state-funded universities can be up to twice as much for out-of-state residents. It has been a journey fraught with a lot of financial worry.”
But that hasn’t dampened Piers’ passion for a career in dentistry and, more specifically, orthodontics (which means he’s bucking a trend that has seen more dental school graduates forgo specializing due to concerns over increasing debt).
“Plenty of my classmates who became interested maybe a little later in the process in specializing, ended up dismissing the prospect outright simply because of cost,” he says.
But Piers, with an uncle and a cousin who are both orthodontists and a determination prior to entering dental school to pursue that specialty, was undeterred.
“I was really passionate about orthodontics, and I think that has let me be willing to take on any kind of financial burden that goes with it,” says Piers, whose wife has been the family’s single earner throughout dental school. “But it doesn’t make it any less scary.”
Work to Do
Piers says that one of the best things the ASDA does for dental students with regard to helping them deal with student debt is encouraging congress and state legislatures to introduce and pass measures to alleviate the burden. For example, on April 12, 58 of ASDA’s chapters scheduled more than 300 appointments with lawmakers and their staff to lobby specifically on behalf of dental loan refinancing and student loan reform.
“That’s an annual thing we do,” he explains. “Because ASDA represents 22,000 members, and basically 90% of dental students, we can really actively channel the voice of dental students through those meetings.”
There’s also assistance from the American Dental Association, which in September 2015 announced an exclusive student loan-refinancing program with Darien Rowayton Bank, more commonly known as DRB. The program allows ADA members an opportunity to refinance existing federal and private student loans at a lower rate that, according to the ADA, could save members tens of thousands of dollars on average.
All of those initiatives are helpful, Piers acknowledges. But he reminds that tuition rates continue to soar, rising exponentially every year.
“The concern is that without addressing that base problem, are we just applying band aids and allowing the problem to continue to grow?”
Piers says one of the plusses of specializing is the increased earning potential it affords. He’s hoping to buy into a practice as soon as possible following residency so he can use that additional earnings potential to pay down his debt.
“Whether or not the market and lenders allow me to do so remains to be seen,” he admits.
Still, the ADEA reports that the number of dental school applicants in 2010 was 12,001, an increase of 55% from the 7,700 who applied a decade earlier. Is the field still attractive despite rising tuition costs?
Perhaps, but Piers says the important question to ask is, at what point does the cost of dental school begin to turn away those bright young minds?
“I think a lot of students who are pre-health and traditionally may have gone on to become physicians are wary of a lot of changes in the healthcare system, so they turn to dentistry as kind of a safe alternative,” Piers says. “I feel like we’re getting these amazing applicants right now, and it’s just a question of how long those very smart students are going to consider the risk-reward of taking on $256,000 of debt a good idea.”