Student loan-repayment options for dental residents

With the introduction of a dedicated refinancing program for dental residents, dentists in training now have more options for repaying their dental-school loans. It’s good to have options, but the landscape can be a little complicated to navigate. If you’re a dental resident, or are about to become one, there are some things you should know when deciding between private refinancing and a federal repayment plan.

Understanding REPAYE

DRBquiz1Before considering the new options available to dental residents, it’s important to understand the federal repayment plan that is still the best option for most dentists in training — REPAYE, the Revised Pay As You Earn plan.

The Department of Education introduced REPAYE at the end of 2015. It is an income-driven repayment plan that expands on its predecessors, Income-Based Repayment (IBR) and Pay As You Earn (PAYE). Similar to PAYE, REPAYE caps an individual’s monthly payments at 10 percent of discretionary income and offers loan forgiveness after several years of repayment.

Under IBR and PAYE, interest accrues at a relatively high rate — and for many dental residents, the forgiveness benefits go unrealized because of high post-residency incomes. This is why, pre-REPAYE, low-rate private refinancing seemed like the best option for dental residents who were not planning to pursue Public Service Loan Forgiveness (PSLF). Private refinancing allowed borrowers to obtain a lower rate on their loans and required low payments during training.

Under REPAYE, the government will forgive 50 percent of unpaid interest that accrues while in REPAYE. That means your effective interest rate is lowered — potentially to a point that could be lower than the rates offered by a private lender — while in residency.

REPAYE Benefits Borrowers With High Debt

One attractive benefit of REPAYE is that for borrowers whose payment is not covering all of their monthly accrued interest, the government will forgive 50 percent of the difference. For example, say a dental resident is accruing $1,000/month in interest and paying $200 based on 10 percent of their discretionary income. Under REPAYE, she would have $400 in interest forgiven every month ($800 in interest difference, multiplied by 50 percent).

The more you owe in federal loans, the more you stand to benefit from this new feature. For many residents, this interest subsidy will lower your effective interest rate from 7 percent to 4-5 percent during training. Let’s assume that a first-year resident earns $55,000, and owes $200,000 at a weighted average 7 percent interest rate. Using REPAYE during training yields an effective interest rate of 4.43 percent.

Go Federal For Loan Forgiveness

If you plan on pursuing loan forgiveness of any kind, then utilizing one of the income-based repayment options (IBR, PAYE, or REPAYE) is the clear-cut option. While PSLF comes with its own set of question marks—for example, potential legislative limitations — you need to enroll in one of these federal programs if your goal is to get your loans forgiven through non-profit employment.

You must also remain with the federal government if you plan on pursuing long-term loan forgiveness — no private lender would be willing to forgive your debt for any reason other than death or permanent disability. IBR allows for loan forgiveness to take place after 25 years of payments. PAYE forgives your remaining balance after 20 years of payments. REPAYE allows undergraduate borrowers to have loans forgiven after 20 years, while borrowers with post-graduate loans (like dentists) won’t see relief until they have made 25 years of payments.

Just remember that many dental residents are unlikely to receive loan forgiveness because high post-residency incomes mean their student debt is gone before they’re eligible for forgiveness. And keep in mind that forgiveness benefits are considered taxable events, which could lead to a large tax bill that’s due immediately in the year the loan is forgiven.

When Private Refinancing May Be Better

The majority of dental residents will want to use REPAYE during training to capture the interest subsidy and obtain a low effective rate, and then refinance through a private lender once they begin practicing. However, this strategy is not risk-free.

The most important thing to be aware of is that interest rates are not set in stone—they may go up while you’re in training. Rates on private refinancing are currently at very attractive levels. You may not be offered the same low rate from a private lender in the future that you could have locked in during residency. Secondly, while REPAYE’s interest forgiveness may offer the lowest effective rate during training, once training is complete, your rate will effectively return to the 6 percent – 7 percent that is written on your promissory notes.

Despite these risks, REPAYE is still the best option for many dental residents. However, certain groups are better off with private refinancing:

Borrowers with a working spouse

If your spouse earns a decent sized income, your monthly payment could very well be high enough that it is covering all of your accrued interest. In this case, you would see no subsidy, so you don’t stand to benefit from REPAYE.

Borrowers with lower debt

If you have relatively low debt ($60,000 or less), you likely aren’t accruing enough interest to benefit from the REPAYE subsidy.

Borrowers with private loans

Private loans are ineligible for federal repayment plans, so refinancing is most likely the way to go.

Borrowers who can’t afford to pay 10% of their household income

REPAYE will likely dictate monthly payments of $250 and up, based on your residency income — and potentially much higher if you have a working spouse. With private refinancing charging minimal monthly fees during training, it may be a good option if you need more money in your pocket while in residency.

Custom Refinancing Program

DRB is the only lender in the country with a dental-resident refinancing program. Regardless of how much you refinance, you’ll only pay $100/month during training. And if you’re an American Dental Association member, even better — the ADA negotiated a 0.25 percent reduction on refinance rates for its members, so whichever rate you qualify for, your rate will be 0.25 percent lower for the life of the loan as long as you are an ADA member.

Furthermore, interest does not capitalize while you’re in training, so you won’t accrue interest on interest. This help keeps the loan from significantly growing in balance while you make low payment during residency. Many residents also find it helpful to be able to combine their federal and private loans into one payment.

Factoring all the considerations into a repayment decision can get complicated, so we recommend working with an experienced professional before making a final decision. To learn more about our dental-resident refinancing program and discuss your repayment options, get in touch.

About DRB
DRB (Darien Rowayton Bank) is a national bank, marketplace lender, and one of the fastest lenders in industry history to reach $1 billion in student loan refinancings. FDIC insured and established in 2006, DRB Student Loan has helped thousands of professionals with graduate and undergraduate degrees across the country to refinance and consolidate federal and private student loans, saving these borrowers thousands of dollars each. Learn more at

The associateship interview: Come prepared with smart questions

New dentists have many professional options after graduating from dental school. One of these options is joining an existing office as an associate dentist.

InterviewAlthough it may seem like an ideal route for you, it may face some challenges if the future associate and the practice owner do not discuss — and put in writing — important hiring agreements such as compensation, benefits, laboratory expenses, supplies and future purchase terms, according to the Center for Professional Success.

During the interview process, both the owner and the potential associate should be prepared with a list of specific questions to discuss in a variety of areas, such as:

  • What is the practice vision? Does it align with what the new dentist wants?
  • How is the new dentist going to be mentored by the practice owner, not only in materials used or patient care decisions, but also in business management, staff relations and more?
  • How will the new dentist get assigned patients?
  • What is the future for the new dentist AFTER the associate period?
  • If the situation is one that the new dentist will eventually buy the practice from the owner, or become a co-owner, then he or she should ask to see the financial and tax information and the valuation report. This may even include preparing the papers needed to complete the transfer of ownership down the road. Going through this extra step during the interview process may help to eliminate hassles and misunderstandings in the future.

So You’re Getting a Root Canal

There’s a reason the root canal is often the go-to comparison of choice when people are discussing unpleasant experiences. It’s the most universally dreaded of all dental procedures, but that doesn’t downgrade its importance in the world of oral health.

We want to help prepare you for your root canal by explaining the basics for you beforehand and by giving you some pain management techniques (both during and after) your treatment.


In the simplest terms, a root canal is necessary when the pulp of the tooth (the innermost part of the tooth attached to the root) becomes infected. The infection can stem from a particularly large cavity or damage/trauma to the tooth. During the root canal procedure, the infected pulp is removed and replaced with filling material.

We won’t lie to you – it’s definitely not an easy procedure to sit through, but there are steps you can take to manage your discomfort.


It’s important to understand that the pain you feel is first and foremost caused by the infection in the tooth as opposed to the root canal treatment itself (which is primarily done to ease and eventually eliminate any pain).


You will be given a local anesthetic to numb the tooth and the surrounding area prior to the procedure and, if you’re still nervous that won’t be enough, there are always other options like nitrous oxide (also known as laughing gas). Your dentist can help calm you down before the procedure by going over exactly what they’ll be doing step by step (knowledge is power, after all). If you’re really nervous, try practicing some deep breathing exercises prior to the procedure to ensure your heart rate is steady and you’re as calm as possible.


Although the infected pulp has been removed, you will likely still feel some pain and discomfort after the procedure is over. While it’s true that the tooth will no longer feel any sensitivity to heat or cold, the surrounding area will need some time to recover from the procedure. Your dentist can prescribe you medicine to help your mouth heal from the resulting inflammation.


Remember that you will have to go back to the dentist for a follow up shortly after your procedure because the temporary filling in your tooth is just that – temporary – and will need to be replaced with a permanent filling or crown to ensure the canal of your tooth stays bacteria and infection free!


Be gentle on your teeth in the days after a root canal and try to stick to foods and drinks that won’t aggravate the area of the procedure. Your dentist will give you some specific tips when you’re leaving the office but the best way to avoid aggravating your tooth is to avoid very hot or very cold food and drink, to eat on the opposite side of the tooth that’s been treated, and to eat soft foods that don’t require much chewing.


Your mouth is going to be numb after the procedure so the chances of you accidentally injuring yourself without noticing are much higher (i.e. biting the inside of your cheek or burning your mouth because you can’t gauge the temperature of the food you’re eating).


Be careful, let your mouth heal, and if the pain is particularly intolerable, ask your dentist to recommend a pain reliever (oftentimes something as simple as Advil or Tylenol will do the trick but it’s good to know there are other options available to you should you need them).

Online Dental Information: Marvel or Myth?

No doubt we’ve all used or heard the phrase, “I read it on the internet.” But what this exactly means is unknown, not to mention risky. I’m certain that countless health care providers hear it all the time from their patients and clients. I gather information from the internet, too. Is an internet search a good thing or bad thing? It may be both. 
Naturally, being able to sort through the

Are you satisfied? – Practice setting and dentist job satisfaction

Are you satisfied with your current job situation? Are there certain aspects you wish were different? Maybe you are just starting your career, or looking for a change. It turns out the type of practice you work in may impact how you feel about your dental career.

Screen Shot 2016-11-02 at 10.10.46 AMIn an innovative, first-of-its-kind study, researchers from the University of Illinois at Chicago and the ADA Health Policy Institute (HPI) examined how dentists view different aspects of solo, small group, and large group practice. They found that:

  • Dentists working in small group settings reported the highest overall career satisfaction.
  • Dentists working in large group settings reported more satisfaction with income and benefits than dentists in solo practice, as well as less stress.
  • Dentists working in large group practices affiliated with dental management organizations were more satisfied with weekends off and fewer hours spent on non-clinical tasks.
  • Dentists working in dentist owned and operated practices were more satisfied with income and their overall feelings about dentistry.


Practice settings and dentists’ job satisfaction (August 2015 JADA)

Webinar: Dental Practice Settings and Job Satisfaction (55 min.)

The six CE topics new dentists want to explore

Want to learn from your peers?

Discover the top CE subjects they are searching for online. According to ADA CE Online, new dentists want to study topics that will advance their success in practice, improve patient care and deepen their knowledge of dental specialties.


Here are the six most popular terms your peers are searching for right now:

  • Infection Control & OSHA
  • Anesthesia & Sedation
  • Radiology
  • Oral Surgery
  • Practice Management
  • Implant Dentistry

If these topics interest you, don’t delay. Stay ahead of the curve by visiting to explore courses on each subject. Gain the support you need any time of day, from anywhere. Your practice and patients will thank you for it.

7 free (or almost free) things you can do that will make you a better dentist (and person)

7 free (or almost free) thing you can do that will make you a better dentist (and person)As dentists we’re constantly looking to make ourselves better. Whether it’s that new piece of equipment or a new procedure, we’re looking for constant improvement. Onward and upward!

These things usually cost a bunch, though. My ability to diagnose increases significantly with a cone beam CT in the office. For a mere $100k, I will be a diagnostic super hero. I get it. Getting better has a price, right? Well…not always. There are some really inexpensive things you can do to become a significantly better dentist.

  • read: Our ability to communicate is really important. As dentists. As parents. As humans. Much of our communication depends on language and our ability to use and understand language. With this in mind…when was the last time you took any kind of course in language arts? I know you’ve taken treatment planning courses, implant placement courses, veneer courses, business management courses and on. And on. I get it. Dentists don’t take courses in language. We’re just automatically great at it, right? Ummmm. No. This is why you should read. I personally have a hard time sitting down and reading books with my eyes. I’m more of a blog post reader or the occasional newspaper reader. Books are fantastic, though. I’m actually OK with comic books. Regular reading is kind of like a quick refresher course in using the language and it helps you use part of your brain that doesn’t necessarily get engaged with other kinds of media.
  • learn to meditate: I know what you’re thinking. “Meditating is for hippies. I’m not sitting cross legged and saying “om” to the universe. I’ve got things to do.” I thought this, too. For me, meditation has been a really healthy habit. I’m not perfect about making time for it, but I find my days get better when I do. All human beings are emotional creatures. You may not think of yourself as emotional, but remember being angry or stressed…that’s your emotions. Much of my stress and anxiety is linked to not recognizing my feelings. It sounds silly, but just recognizing that you’re feeling a certain way is enough to help move through it. Much of the time we’re too busy to think about the actual emotions we experience. Meditation and mindfulness is ALL about this. I’ve learned a lot from my friend Dr. Dawn Kulongowski and her private Facebook group for dentists. You should check it out.
  • listen to podcasts: Yes, this is self serving. But it isn’t wrong. I am a podcaster. I have two dental podcasts that you should be listening to. The Dental Hacks podcast is the show I’ve been doing with my friend Dr. Jason Lipscomb for 3 years. It’s fun, it’s informative and it’s free. The Alan Mead Experience is a new show that I started last month. It focuses on conversation and storytelling. I love them both. But if you don’t like those, there are 50+ podcasts about dentistry available on iTunes or most other podcast listening software. There’s something for everyone. Podcasts are great because they make time that’s often not productive (working out, driving to work, mowing the lawn) into a chance to learn and hear some different perspectives. Podcasts are awesome.
  • write: Many people that communicate very well through speech struggle with similar communication through writing. The spoken word is more comfortable for most people because the ear is more forgiving and so much of spoken communication is nonverbal through tone, expression and even hand gestures. Writing is harder. But it’s still really important. The good news…the writing muscle gets stronger with exercise. The more you write, the easier it will get and the better you’ll be at it. So spend some time writing. Write a letter to someone you haven’t talked with in awhile. When was the last time you got a letter from someone? It’s guaranteed to make someone’s day. Start a blog. Write a novel. Again…it doesn’t matter so much what you write as much as you give those muscles a little workout.
  • take photos: You’re thinking “that’s not free. You said the stuff was free!” True. You can spend a bunch of money on clinical photography set ups. But you don’t have to. If the Kois Center is recommending that you use a smartphone or tablet to take your intake images, that should be good enough for you! If you take photos (or even video) of your work, you will get better. End of story. There is nothing more frustrating (or educational) than taking photos of the perfect resin you just placed only to see some flash you missed or some anatomy that looks less than ideal that you just didn’t see clinically. Taking photos makes you better. Period.
  • take time off: I’m terrible at this. Seriously. Most of the time I take off from work involves dental CE. That’s pathetic. There’s something magical about having time away from the office and NOT doing dental stuff. I’m in the middle of a week off from work that has been incredibly energizing. I’m essentially doing work around my house and single parenting my children. Knowing that there is life outside of your dental office and that the whole world doesn’t end when you’re not in the office is valuable. It makes you better when you’re there and it helps make you realize that you’re human before you’re a dentist.
  • have lunch with local colleagues: I have a ton of dental colleagues. Many of them are from “away.” I interact with dentists across the country and across the world on a daily basis because of podcasting, blogging and social media. I’ve learned much of what I do in my office from people I’ve actually never met in person. However…there is something to having regular interaction with your local colleagues, too. I generally don’t think of local dentists as competition. It doesn’t serve me well and frankly, we compete against other things patients can spend money on (smartphones, lawn tractors) much more than other dentists. It’s really great to be able to communicate or commiserate with a real live person. Having local colleagues that you can lean on for second opinions and referrals is really important. Plus, it helps you realize that you’re doing OK, even though you aren’t posting all of your cases on Style Italiano or Tomorrow Tooth.

So there you have it. You don’t have to pay an arm and a leg to improve yourself or your dentistry. And a lot of these suggestions can help you be a better human being, too. Which is a pretty good side benefit, right?

If I missed any please or leave some suggestions in the comments section. If you found this helpful, please share it!

ADA-endorsed student loan program rebrands to Laurel Road

Darien Rowayton Bank — the student loan refinancing program endorsed by the ADA — announced June 15 that its online lending division inclusive of its student loan refinancing program is now officially called Laurel Road.

The rebrand includes a new logo, visual identity and website. Although the online lending division is rebranding under a new name, terms of ADA members’ loans will remain the same, and the lender of ADA members’ loans will continue to be DRB.

Borrowers will receive student loan statements from MOHELA, a student loan servicer, for Laurel Road starting June 15, and its new website,, is live. Completed student loan application and applications for new lending products can now be found on

According to letters the company sent to borrowers, the new name is more reflective of the company’s growing customer base, evolving product set and recent technology advancements.

“The name embodies both the journey (i.e. ‘Road’) it takes for our customers to achieve their life goals and the inherent satisfaction once those goals are earned,” according to a Laurel Road FAQ.

In 2015, the ADA announced the endorsement of DRB’s student loan refinancing program, which allowed ADA members an opportunity to refinance existing federal and private loans at a lower rate. As with other Laurel Road product offerings, ADA members receive an extra 0.25 percent discount on their student loan refinancing rate as long as they maintain their membership. As of December 2016, the typical ADA member saves nearly $33,000 over the life of their loan after refinancing with DRB.

In addition, the ADA announced earlier this year that students going into any one of the nine ADA-recognized specialties and general practice residencies are able to refinance their entire student loan portfolio as soon as they are matched to a residency program. For ADA members who qualify and regardless of how much is refinanced, their payment will be only $100 per month throughout training. Rates for the Resident Student Loan Refinancing program range from 4.48 percent to 6.95 percent, including an extra discount for those that set up autopay.

For more information on Laurel Road and student loan refinancing, visit For information on ADA debt resources, visit