As new dentists, we can all remember that gut-wrenching moment when we received an email from our loan servicer warning us that our payments would be due soon. Looking back at our time as dental students, we spent years learning the intricacies of prepping the most ideal class II restoration, administering anesthetic and memorizing mnemonics in order to pass our board exams. Seldom did we find ourselves calculating our net worth or determining which loan repayment method would work best for us. Realistically, when would we have had the time? This is something many of us must navigate on our own because there is no formal training in dental school.

Not long after graduating, many of us find ourselves wanting to get married, buy a house, buy a car, buy a practice, have children or start investing for retirement. Those first few years can feel like being stretched in so many different directions. Regardless of where life takes you, it’s important to have a plan early on. Time can work in our favor but can also work against us.

The ADA is advocating for dozens of student loan reforms that would help mitigate these financial burdens, and options are available now for new dentists seeking debt relief. It wasn’t until my grace period that I became overwhelmed with the thought of six-figure student loan debt. I started to do extensive research on different repayment plans and philosophies. Here is a summary of what I’ve learned through my loan repayment journey.

Repayment plans

Repayment plans can be oversimplified into the following three categories:

1. Fixed-payment repayment plans: Those with federal loans can take advantage of a fixed-payment repayment plan, such as the standard repayment plan, which divides your total loan debt over 10 years (120 equal payments). Because the monthly payments can be high, I don’t recommend standard repayment plans for those who have more than $200,000 in student loan debt.

2. Income-driven repayment plans: Those with federal loans can enroll in an income-driven repayment plan. The most recent is called the Saving on a Valuable Education plan, which replaced the Revised Pay As You Earn plan in 2023. This repayment plan calculates your monthly payments by taking 10% of your annual discretionary income and dividing it into 12 equal payments. This plan no longer requires you to include spousal income and takes your family size into account when determining your monthly payment. Any accrued interest that is not covered by your monthly payment is eliminated, which is a huge benefit. After 25 years on this repayment plan, the remaining balance of your loans will be forgiven; however, the amount forgiven qualifies as taxable income. This repayment option can benefit new grads right out of school because it offers the flexibility of low monthly payments when your income is inconsistent or lower than anticipated.

3. Private consolidation: You can also refinance your loans through a private loan servicer for a lower interest rate, but this typically requires the loans to be repaid over a shorter time frame, such as three to five years. Although federal repayment plans tend to have higher interest rates, they offer more flexibility in terms of when borrowers are unable to make payments or want to change repayment plans. It’s important to understand private loans are not eligible for federal loan repayment or public service loan forgiveness.

How to strategize

When choosing a federal repayment plan, there’s no need to stress. You can technically change your mind and switch between repayment plans (although this is not recommended because each time you reapply, your interest is compounded).

No matter how much student loan debt you have, many new dentists will benefit from enrolling in the income-driven repayment plan SAVE. The first few years of practicing dentistry are stressful enough, and no one wants to worry about having enough money to cover their loan payments. Income-driven repayment plans allow you to adjust or pause your payments when your income decreases or you become unemployed.

Many new dentists with the intention of going into practice ownership use SAVE to keep their loan repayment expenses low while their initial practice expenses are high. Dentists who practice part time or go out on extended leave also use this repayment method since it is directly correlated to their income.

Although the SAVE plan will forgive your total balance after 25 years, many dentists will benefit from paying off their loans before 25 years. This is why having a plan early on is so important.

The goal should be finding the balance among repaying your loans in a reasonable amount of time, minimizing the interest accruing and having the flexibility to spend money on other priorities.

Public Service Loan Forgiveness and loan repayment programs

There are ways to pay down your student loan debt using the Public Service Loan Forgiveness program and loan repayment programs.

The PSLF program requires you to be employed full time by a U.S. federal, state, local or tribal government or not-for-profit organization. You must have federal loans and you must be enrolled in an income-driven repayment plan, such as SAVE. The PSLF program will forgive your remaining loan balance after 120 qualifying monthly payments. Unlike the income-driven SAVE plan, the amount forgiven under PSLF is not taxable.

There are many different state and federal loan repayment programs in which dentists who work in government or not-for-profit organizations can participate. These programs include those sponsored by the National Health Service Corps and Indian Health Service and typically require a two- to three-year service commitment.

Although you can’t participate in more than one loan repayment program at the same time, what many dentists don’t know is that you can participate in both PSLF and a loan repayment program at the same time. Working for a community health center or university can keep monthly income-driven payments low. You can then use funds from a loan repayment program to make these monthly payments. You can also renew your loan repayment contracts until the total balance is paid in full or you complete 10 years of public service. Dentists who take advantage of these programs can have the majority of their student loans paid for this way.

For those in private practice who are enrolled in SAVE, loan repayment strategies require closer consideration. One must decide if participating for 25 years for the forgiveness is worth the corresponding taxes.

Real-life applications

To better conceptualize these loan repayment strategies, I like to use this example of identical quadruplets. Annie, Bonnie, Connie and Donnie graduated from the same dental school with $450,000 in student loan debt. These new dentists have a starting salary of $180,000 with an annual increase of 3% per year.

• Annie participates in the standard repayment plan at 5% interest. She pays $4,772 per month for 10 years. The total cost of the loan after 10 years would be $572,754.

• Bonnie participates in the SAVE plan at 5% interest. She pays $1,117-$2,140 per month for 25 years. The total cost of the loan after 25 years would be $409,223, with $449,686 forgiven. The amount forgiven is considered taxable income, so she would owe an additional $179,874 in taxes the year her loans were forgiven.

• Connie participates in the SAVE plan at 5% interest, but she works for a nonprofit organization and has enrolled in PSLF. She pays $1,117-$1,457 per month for 10 years. The total cost of her loan after 10 years would be $136,142, with $500,784 being forgiven tax free.

• Donnie participates in the SAVE plan at 5% interest, and she also works for a nonprofit organization. She has enrolled in PSLF and participates in the National Health Service Corps Loan Repayment Program. Her monthly payments are $1,117-$1,457 per month for 10 years. The total cost of her loan after 10 years would be $136,142, but since she used her NHSC disbursements to cover her monthly payments, she had no out-of-pocket expenses, and $500,784 will be forgiven tax free.

Words of encouragement

It’s important to remember that our student loan debt does not define us. I believe that being informed and aware of your financial situation can provide you with the tools to achieve your goals and live an intentional, meaningful life without crippling student loan debt.

This information is for educational purposes only and should not be considered financial advice. The examples were calculated using studentloanplanner.com.

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Six-year-old C.J. had a mouth filled with cavities. At school, he would hide his smile, keeping his mouth closed to avoid bullying. At home, he would only eat soft foods, fearful of the pain eating caused. His school nurse and pediatrician tried to get him to open his mouth, to see the severity of dental disease, but he would never open. He was terrified of extractions and any dental treatment at all.

In February 2023, that nervous 6-year-old walked through the doors to Meharry Medical College School of Dentistry, a participant in the ADA Foundation’s Give Kids A Smile program. He received an applause as he took X-rays, he danced in the halls as he entered the clinics, and he designed his very own sugar bug art. By the end of the day, with urgent treatment begun and a plan in place for comprehensive care, C.J. gave each of us a hug.

“When can I come back to the dentist?” he asked, his sick tooth packaged with care for the tooth fairy.

What is Give Kids A Smile?

Give Kids A Smile, the ADA Foundation’s signature access to care program, is a national program that began in 2003. The goal is to provide underserved children with free oral health care and help establish dental homes for children in need. According to the ADA Foundation, GKAS has grown to serve more than 300,000 children annually. GKAS events take place throughout the year, with the majority taking place in February during National Children’s Dental Health Month.

My experience with Give Kids A Smile

I began participating in GKAS as a dental student at Harvard School of Dental Medicine. With a passion for working with children and a focus on increasing access to care, I joined the planning committee for HSDM’s annual Give Kids A Smile event in 2016. The next year, I served as chair of this committee, helping the program grow in size and move toward interprofessional collaboration. We offered free dental care, physical exams and nutrition consults all in one building.

I knew instantly this was a program I would continue throughout my career, so I applied to attend the ADA Foundation GKAS Community Leadership Development Institute to become a national GKAS ambassador. In 2018, I flew to St. Louis, Missouri, where I took part in one of the largest GKAS events nationwide and learned directly from Jeff Dalin, D.D.S., co-founder of the St. Louis GKAS program. Upon returning to Boston, I used my knowledge to continue expanding Harvard’s GKAS event while also guiding others who wanted to start their own events.

Today, I am a board-certified pediatric dentist and interim pediatric dental residency program director at Meharry Medical College School of Dentistry. GKAS still remains the highlight of my year. Instead of doing the planning on my own, I work with a team of incredible young professionals, the aspiring pediatric dentists at Meharry. The students, including this year’s co-coordinators, Tamera Thomas and Joshua Delaney, share my vision of reaching increasing numbers of children in need. The program has grown on Meharry’s campus to treat nearly 200 children, and the entire school is involved (and decorated!). Last year, C.J. made a special impression on my heart, but there are so many children just like C.J. each year who are only able to see a dentist because of GKAS programs nationwide.

You can get involved, too

GKAS events can be large, like ours at Meharry and Harvard, or small, contained to a local dental office. Each event has a profound impact. Participation begins by registering your program on the national GKAS website, ADAFoundation.org/GKAS, where you can sign up to request free education and prevention materials from the program sponsors, Henry Schein and Colgate. You then recruit volunteers, publicize a free dental care day or work with a school to bring children to your office, and do what dentists do best: examine, clean and treat teeth.

If I think back on my dental career thus far, one event each year stands out from all the rest: Give Kids A Smile. The name captures every bit of this program. By making the dental setting fun and affordable, with the support of the ADA Foundation and many sponsors, we truly have the potential to gift children healthy smiles that were never before possible. We can truly make an impact.

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Golf is a sport that demands not only physical skill but also mental fortitude and concentration. Mastering the mental aspect of the game is crucial for golfers aiming to perform at their best. Techniques that enhance focus, confidence, and mental resilience can significantly impact a golfer’s performance on the course. Here are some strategies to strengthen the mental game of golf:

1. Practice Visualization: Visualization involves mentally rehearsing shots before executing them physically. Please close your eyes and imagine the perfect swing, visualize the ball’s trajectory, and picture the shot landing exactly where you intend it. Visualization helps build confidence and prepare the mind for successful execution.
2. Develop a Pre-shot Routine: Establishing a consistent pre-shot routine helps create a sense of familiarity and confidence before each shot. This routine could include visualizing the shot, deep breathing to relax, aligning the body, and focusing on a specific target. A consistent routine aids in calming nerves and maintaining focus.
3. Stay Present and Focus on the Process: Avoid dwelling on previous shots or anticipating future ones. Stay present and focus on the process rather than the outcome. Concentrate on each shot individually, regardless of previous successes or failures, allowing for better decision-making and execution.
4. Positive Self-talk and Confidence Building: Maintain a positive mindset using affirmations and positive self-talk. Replace negative thoughts with constructive, encouraging statements. Building confidence in your abilities is crucial for executing shots effectively under pressure.
5. Embrace Resilience and Manage Expectations: Golf has inevitable ups and downs. Embrace resilience by accepting that mistakes happen and focusing on the next shot. Manage expectations and understand that even professional golfers encounter challenges on the course.
6. Utilize Breathing and Relaxation Techniques: Incorporate breathing exercises and relaxation techniques to manage stress and anxiety. Deep breathing helps calm the nervous system, reducing tension and promoting focus and clarity.
7. Learn from Setbacks and Stay Composed: Adversity is a part of the game. View it as a learning opportunity instead of becoming frustrated after a bad shot. Stay composed, maintain your composure, and focus on the next shot with a clear mind.
8. Trust Your Skills and Commit to Shots: Believe in your abilities and commit fully to each shot. Doubts can hinder execution, so trust your skills and swing confidently without hesitation.

Enhancing the mental game of golf requires practice and patience. By incorporating these cognitive techniques into your routine, you can develop a resilient and focused mindset that positively influences your performance on the course. A solid mental game improves your golf and provides an enjoyable and rewarding greens experience.

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A vibrant smile is often considered a reflection of good oral health. Maintaining proper oral hygiene not only contributes to a sparkling smile but also plays a pivotal role in preventing various dental issues. Whether you aim to enhance your dental routine or seek ways to achieve a brighter smile, here’s the ultimate guide to impeccable oral hygiene.

Brushing Techniques: Brushing your teeth is the cornerstone of oral hygiene. Use a soft-bristled toothbrush and fluoride toothpaste, brushing at least twice daily for two minutes each time. Ensure gentle, circular motions to clean all tooth surfaces, including the front, back, and chewing surfaces. Remember to brush your tongue to eliminate bacteria that cause bad breath.

Flossing: Flossing is as crucial as brushing and should ideally be done at least once daily. It helps remove plaque and food particles from areas your toothbrush can’t reach, such as between teeth and the gumline. Proper flossing involves gently gliding between teeth and curving it around each tooth in a C shape.

Use Mouthwash: Incorporate an antimicrobial mouthwash into your routine to kill bacteria and freshen your breath. Opt for an alcohol-free mouthwash to avoid drying out your mouth and causing irritation.

Regular Dental Check-ups: Schedule regular visits to your dentist for professional cleanings and check-ups. Dentists can detect early signs of dental issues and guide on maintaining optimal oral health.

Healthy Diet Choices: What you eat significantly impacts your oral health. Limit sugary and acidic foods and beverages that can erode tooth enamel. Instead, consume a balanced diet of fruits, vegetables, lean proteins, and calcium-rich foods to support healthy teeth and gums.

Quit Smoking: Smoking and tobacco use not only stain teeth but also increase the risk of gum disease, tooth loss, and oral cancer. Consider quitting smoking to improve your oral health and overall well-being.

Protect Your Teeth: Wear a mouthguard to prevent dental injuries during sports activities. Also, avoid using teeth as tools to open bottles or packages, which can cause chips, fractures, or other damage.

Stay Hydrated: Drinking plenty of water helps wash away food particles and bacteria, stimulates saliva production (which aids in protecting teeth against decay), and keeps your mouth hydrated.

Integrating these tips into your daily routine will pave the way for a brighter, healthier smile. Consistent and thorough oral hygiene and professional dental care are the keys to optimal dental health and achieving your desired dazzling smile.

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