Contemporary Orthodontics & Dentofacial Orthopedics
James
R. Waters,
DDS, MSD , PA
Board Certified Treatment for Children, Teens and
Adults
Comparing the cost of Dentistry to
Braces
I have been practicing dentistry for 19 years, first as a
hospital dentist, then in private practice as a dentist and finally as a
specialist in Orthodontics. During that
time, I have seen what the public sees; ever increasing dental costs for
fillings and crowns in particular. But
has the cost of braces also kept in pace with these increases? Have you ever
wondered how much the costs have increased and why?
When I first started as a dentist, there was no digital
radiography available, no laser scanners and limited computer technology in the
dental office. I remember having a IBM
386 computer for keeping track of the schedule and for minor billing/insurance
submission. Beyond that minor addition,
we were essentially unchanged from practices 20 years earlier. White fillings were becoming popular but
silver fillings were the over-whelming standard. Crowns were charged at $400 in my private
practice and fillings were @$100 to $200 for larger silver fillings and $150 o
$250 for white fillings. Braces at the
local orthodontist were a standard $4100 for adolescents. This was 20 years ago; so what does dentistry
look like and cost now?
As more and more digital devices entered our field, costs
began to rise; X-Ray machines were no longer $20,000 as the new digital
versions were $60,000 to $80,000.
Software became available to assist us but a revolving cost for updates,
usually $15,000 to $20,000 for setup followed by a forever yearly cost of $3000
for updates and support. Computers had
to be replaced and set back up every 3 to 5 years at additional expense of
$1000 per device and the network technology evolved adding costs regularly. Over the last 20 years, property values and
taxes have also risen significantly (my building is now valued for taxes at120%
of the value just 10 years ago) making rent a more significant portion of a
dentist’s overhead and taxes a larger burden.
Many offices have had to spread out to gain more market share due to
competition in popular regions (I have two locations) essentially doubling
costs. Education costs are extremely
burdensome with dentists today entering practice routinely with $200,000+ in
student debt and specialists even more due to additional years of
training. Making this worse, only a
small portion could be paid with federally subsidized deferred interest
(Stafford loans); the majority of the professional loans accrued a higher
interest (I have some still at 6%) sometimes for up to 10 years while the
doctor is training in school which added to the payback. When I refinanced a building roughly 12 years
into paying back my loans, I learned I had only just reached the principal
payback and still owed over $150,000!
Today, nearly 20 years into practice, I still pay $3500/mo for student
loans.
So what does this mean for today’s dentists? It means overhead in the typical but modern
general dental office has risen from 55% to 75% or more. This means a general dentist today must
collect $1 million dollars (which would have been unheard of 20 years ago) to
earn $250,000 salary. From that salary,
the dentist will first be taxed 40% federal taxes plus any state taxes and
property taxes (figure an average of an additional 10% even though my property
tax alone is twice that in Texas since I own the buildings).
This all leaves the modern dentist with roughly $125,000 net
salary to pay $3500/mo in student loans, maybe another $3500/mo for a home
mortgage, at least $1000/mo for health insurance and another $500/mo for
home/vehicle insurance and the rest for general living expenses. If you are adding this up, you will see that
after producing $1 million dollars over the year (a decent number for a
successful practice today), your dentist gets to save less than $23,000/yr. to
pay for food, clothing, childcare, retirement, college, etc.
So how much are crowns now v. the $400 20 years ago? The average is probably somewhere around
$1000 up to $1200 (certainly more complex crowns for implants or other factors
can even drive this up). In contrast,
your Orthodontist has similar costs with similar overhead but due to wire
technologies allowing more time between appointments allowing more patients to
be treated, costs have remained relatively stable. Today braces for your typical adolescent will
run @$5800 v. the $4100 routinely charged 20 years ago making for an excellent
value though I admit the prices are going up due to a much heavier tax burden
and overhead.
So when you see your bill next time at the dentist or you
get that “sticker shock” at your local orthodontic office, you will be better
informed about the whole picture and just maybe you will not be too hard on
them!
If you have questions or comments concerning this or any
orthodontic question, please feel free to make a complimentary new-patient
appointment at either my Steiner Ranch location or my North-central Austin
location on West 35th street and MoPac.
Dr. James R. Waters is
a 1996 graduate from UTHSC Dental School in San Antonio, 1997 graduate of
Advanced Dentistry from the UNMC in Nebraska and the 2001 Valedictorian
graduate from the prestigious Saint Louis University Orthodontic Program
receiving the J.P. Marshall award for clinical excellence in 2001. He holds a Bachelor’s Degree in Science,
Doctorate in Dental Surgery, a post-doctorate certificate in Advanced
Dentistry, post-doctorate Degree in Orthodontics & Dentofacial Orthopedics
and a Master of Science Degree in Orthodontics.
Dr. Waters and his wife of 19 years live in Austin, TX with their 4
children where he has a thriving, multi-faceted Specialist practice with
locations in Steiner Ranch and North-Central Austin. You can learn more about Dr. Waters at
BracesAustin.com.
Central Austin
1814 W. 35th
Street
Austin, TX 78703
(512) 451-6457
Steiner Ranch
4302 N. Quinlan Park
Austin, TX 78732
(512) 266-8585
Bracesaustin.com
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