By: Paula Cohen (

It is no secret that debt amongst dental students has been rising at an alarming rate for the past 20 years. Last year, ADEA reported that there has been a 192% increase since 1990 in average debt for public dental schools, when dollars were adjusted for inflation. When you factor in all dental schools, there was a whopping $19,094 difference in the average debt just between 2012 and 2013. With the loss of subsidized graduate student loans from the Budget Control Act of 2011, we also face the question of how much more we’ll end up paying back than what we initially borrowed, due to accruing interest rates while in school and afterward. Despite the anxiety many students feel about the debt burden they will inevitably face upon graduation, it seems like there are few alternative options for us.

In 2006, there was a four part study published in the Journal of the Canadian Dental Association that addressed dental school debt on a global level. It was interesting to see that despite obvious differences between Canada and the United States, both countries are facing the same rising debt issues. The authors concluded that a primary driving factor behind this issue was a lack of action and support from our respective governments. This is further supported in an extensive report published by the Health Resources and Services Administration on the impacts of financing a dental education. Even the University of Florida’s own President, Bernie Machen, recognized the importance of government subsidies in dental education. In the May 1998 edition of the Journal of Dental Education, Dr. Machen published a report on the implications of funding changes by the government. He had high hopes that we would “continue to get a significant amount of dollars from the government.” Unfortunately this would be disproven, as the average state subsidies of dental education have dropped from 60% in 1990 to 20% in 2009.

The consequence of increased debt does not just affect the student’s either. ADEA has compiled years of data that shows that recent dental graduates are less inclined to practice in public health clinics or accept public programs like Medicaid, than they were five years before. This suggests that an increased debt burden can translate to decreased access to healthcare for the populations most in need.

There are two primary ways that legislation has tried to ease the debt burden of graduating dental students.

First, many of us are lobbying for the option to refinance federal loans through the government. Currently, if your credit score has improved since starting school, and you are willing to pay a private loan company, you can refinance by effectively taking out another loan through that company at a lower interest rate than your initial student loans. However, by being able to refinance through the federal government, you’d be able to cut out this middle man. There are two sister bills in the House (H.R.4622) and Senate (S.1066) that would allow us to refinance at 4.0%. This could potentially save every student more than $10,000 over the life of the loan.

There are also lobbying efforts for increased tax deductions for student loan interest. Presently, the maximum deduction is $2,500 for individuals. H.R.1527 would increase this to $5,000 for individuals and $10,000 for joint returns. It would also repeal the adjusted gross income limitations that prevent most dentists from qualifying for this deduction right now.

In addition to these long-standing platforms, Representative Thomas Petri (R-WI) has also introduced an innovative loan called the Income Dependent Education Assistance Loan program (IDEA). If enacted, this would cap our interest accrual at 50% of the IDEA principal, and allow us to make repayments via wage-withholding that is set based on our income, with the option to pay more.

So What Can We Do?

1)     Partner with organized dentistry.

Many organizations such as ASDA, ADA, AGD, and state dental associations, dedicate a lot of time and resources toward lobbying for student interests, especially debt burden. They have events dedicated to educating governmental representatives on the issues, and encourage their student members to participate. By partnering with an organization, you not only get the opportunity to have your voice heard, but you have the support of well-established and respectable dentists.

2)     Write to your representatives.

ASDA’s Engage website allows anyone to easily Take Action by submitting emails to their representatives with just a few clicks. They include pre-written templates explaining the reason for support or opposition that you can customize or use as is. If you have more time, or feel very passionately about a specific piece of legislation, you can also contact your representatives directly.

3)     Stay updated and educated.

We all know our schedules can be hectic, and it can be discouraging when change occurs so slowly, but by committing a few minutes every month to stay on top of the issues that you’re interested in, you make a vital contribution to the advocacy of our profession.