Dr. Darshan Parikh: Dentistry is a profession where learning never truly stops. Regardless of which area you choose to specialise or sub-specialise in, you will continue to evolve over five, ten, or even twenty years. The learning curve is always present; how steep it becomes depends entirely on how much effort and responsibility you are willing to take on.

Implant dentistry stands out because it feels more surgical than most other branches, keeping aside oral surgery and periodontics. For many dentists, it is the first time they are directly dealing with bone, blood, flap reflection, and suturing. That surgical exposure makes implantology both exciting and intimidating. It is also one of the reasons many young dentists are drawn to it. Another factor that attracts dentists to implants is the financial aspect. Compared to routine procedures like fillings, root canals, or crowns, implant dentistry involves higher treatment values. The moment you start doing implants, you're talking in bigger figures, like 20k or 50k, which are not figures that as dentists we are used to really talking about. Later when you start doing full mouths, you talk about even larger numbers - 1 lakh, 2 lakhs, whatever it might be. This naturally changes how dentists perceive responsibility, risk, and outcomes involved with implant therapy.

However, when you actually start practicing implants, the biggest challenge is not theory or planning, it is working on a real patient. Knowing protocols and executing them on another human being are two very different things. Managing tissue gently, raising a flap properly, suturing well, ensuring patient comfort, and delivering predictable outcomes all at once can be overwhelming initially. So, from a philosophical standpoint, to ensure overall comfort for the patient was the biggest challenge for me. You want to do the best that you can for them, right? Because they've come to you with that trust.

For general dentists, soft tissue handling and surgical confidence can be challenging early on. For oral surgeons or periodontists, prosthetic rehabilitation often becomes the bigger learning curve. This is why I believe general dentists are well-positioned to become implantologists, as implant dentistry requires a balanced understanding of both the surgical and prosthetic phases.

Dr. Darshan Parikh: What you’re describing is very real, and I encounter this sentiment frequently, especially through conversations on professional platforms. I have been on LinkedIn for a little more than a year now, primarily with this point of reaching out to people, because I want to raise awareness about the programs that I conduct. And what you're saying is absolutely true. The young pass-outs are actively looking for alternative options, and they don't want to go deep into clinical dentistry. It's a little surprising. As a dentist myself, it is genuinely disheartening, too, to see colleagues feel so discouraged early in their careers.

That said, dentistry as a profession is far from dying. We are a country of over a billion people, each with multiple teeth (20 deciduous teeth and 30 permanent teeth) that will require care over a lifetime. The demand for dentistry is enormous. The challenge is not the lack of patients, but how and where dentists choose to practice.

The financial burden of dental education has increased significantly, especially due to the mushrooming of private colleges. I don’t have exact figures, but undergraduate education today probably costs anywhere between ₹20–30 lakhs. I recently overheard a discussion where postgraduate fees in private institutions were around ₹15–20 lakhs per year. If someone completes both undergraduate and postgraduate education through paid seats, the total expense easily reaches close to ₹1 crore over 8–9 years. This does not even include additional costs like books or materials. Then comes setting up a clinic. Whether you rent or buy a space, real estate is expensive. Equipment is also not cheap. You may start with more basic setups like a chair and economical materials, but dentistry today has evolved, from RVGs to intraoral scanners and other advanced technologies, all of which are big-ticket investments. Setting up a practice can require anywhere from ₹20 lakhs to another ₹1 crore. Naturally, this means dentists need to earn enough to sustain that investment. If access to that kind of capital is not available, most graduates opt for jobs.

The challenge with working under someone is that clinics themselves often operate on limited margins. For example, if someone works with me in my clinic, which is a relatively small practice, I realistically cannot afford to pay more than ₹30,000, ₹40,000, or ₹50,000 per month. Even that is a reasonable salary in many cases, because the clinic itself may not be generating very high revenue. One major issue is that, as a profession, dentistry has historically undervalued its services by keeping treatment charges low.

For younger dentists, one important suggestion would be to consider Tier 2 cities or smaller towns, perhaps even locations an hour away from major metros like Delhi or Mumbai. Overall, our country has become economically stronger. It’s not that people cannot afford treatment - they may not pay ₹40,000, but many can afford ₹20,000. It is largely a question of scale.

I used to work in an NGO hospital until COVID, where I would go just two days a month. In those two days, I often saw more patients than I did in my private clinic over the entire month. It was an NGO setup, so treatment was free or very low-cost, but the patient volume was enormous. This shows that the demand exists, you just need to decide where you want to position yourself within that spectrum.

Even in cities, there is enough work, though big cities do present challenges due to high real estate and operational costs. Exploring parallel or allied fields is also reasonable, as long as the work is personally satisfying. The difficulty arises when dentists compare themselves to peers from other professions, like engineering, who may be earning significantly more at 25 or 28 years of age. That is a broader drawback of medicine and dentistry that we start earning later.

I believe professional bodies have started addressing this issue by introducing minimum rate lists in certain regions. I know Jaipur has one, and I recently saw something similar from Visakhapatnam. These lists recommend minimum charges—for example, a root canal should not be charged below ₹5,000. If you want to charge ₹7,000, ₹8,000, or ₹10,000, that is your decision, but there should be a baseline.

As a profession, we need to collectively adopt such minimum standards so that dentists can make a reasonable living. Dentistry and medicine offer not just financial stability, but also immense personal satisfaction like relieving pain, restoring smiles, and improving quality of life. From an institutional and policy perspective, this is something that needs structured attention.

Moreover, even at an individual level, young dentists should avoid under-selling themselves. Just because you are starting out does not mean you should offer a filling for ₹200 or allow patients to bargain simply because of your age. Maintaining basic pricing standards is essential, for the profession and for yourself.

Dr. Darshan Parikh: Yes, that’s a very valid question. Because I trained at Nair, which is a government institution, I clearly remember that during internship we were paid ₹1,700. At that time, around 2004, it actually felt like a big amount. Today, of course, that barely covers a movie ticket and popcorn. Internship involved a lot of work, and after four years of dentistry, most of us just wanted a routine, like going to college from 9 to 5 and being done. Toward the end, people became more focused on postgraduate entrance exams. In my case, I had started preparing for the US national boards, so things became more serious. Alongside that, I also did some part-time work in a private clinic toward the end of internship. After completing my internship, I worked in that clinic in Mumbai for about six months. I remember being offered around ₹3,000 per session. Then I moved back to Pune, my hometown, where I worked part-time in another clinic as a locum. If the doctors, husband-wife, were traveling, I would manage the clinic for half a day, doing scalings, fillings, and general procedures. There, I was paid ₹5,000 for half a day. At another clinic, where I knew the doctor personally, the arrangement was different. He had reasonably good practice and told me to handle new patients or patients who were not his regulars. Whatever the billing was, the lab cost would be deducted, and I would keep a percentage, around 30%. With that setup, I would make another ₹4,000 to ₹5,000. So, within a span of about two years, I went from earning ₹1,700 as an intern, to ₹3,000, then ₹5,000, and then variable earnings on a percentage basis. Essentially, my earning potential was almost doubling every six months. I did this for roughly two years, after which I felt it was time to start my own practice.

At that stage, I was comfortable because I was living with my parents and didn’t have major expenses. If I translate that phase into today’s terms, I would say it is equivalent to earning around ₹20,000 to ₹30,000 a month. If your expenses are low, say, you share rent with two or three people, ₹20,000 to ₹30,000 is a reasonable amount early on. It gives you dignity, a sense that you are being paid fairly, and, most importantly, you are learning under someone else’s responsibility. At that pay level, I would suggest staying anywhere between six months to a maximum of two to three years. Beyond that, unless your income increases significantly or your skill set is clearly expanding, you are not really growing, neither financially nor professionally. If your income crosses ₹50,000, then the decision depends on how much work you are doing and what you are gaining from it. In the Indian context, for a fresh undergraduate aged 23–24, this is a reasonable starting point. As you approach your 30s, life circumstances change. Marriage, family responsibilities, and long-term planning come into the picture. At that stage, especially in urban areas, you should ideally be earning at least ₹1 lakh per month. That should be the target.

When I started my own clinic, our initial collections were around ₹10,000 to ₹15,000 per month for the first few months. Gradually, that moved to ₹20,000–₹30,000, and as we started doing more complex procedures like bridges, it increased further. For the first one to two years, we were probably in the ₹30,000 to ₹50,000 range. At that point, the benchmark becomes crossing ₹1 lakh, and once you do, it becomes much easier to sustain and grow.

Anything above ₹1 lakh is a good income. If you own your clinic space, ideally your income should be at least 50% higher, somewhere around ₹1.5 to ₹2 lakhs once you are in your 30s and have a family. That accounts for savings, retirement, and other long-term responsibilities. Beyond that, there is really no upper limit. There are dentists earning ₹2–3 lakhs a month, and some earning ₹8–10 lakhs or even more.

If you are starting your own clinic, I would say give it at least two to five years. That initial phase, when you sit in the clinic and patients don’t come, is genuinely painful. Today, social media adds another layer. People spend ₹20,000–₹30,000 on social media managers to make reels and posts. While marketing has its place, it is important to remember that this is not dentistry itself. My advice would be to focus on dentistry for those two to five years and honestly assess how it is going. If it still does not work out, then you can think of alternatives, sometimes people joke that opening a chai-samosa shop might give similar returns.

A lot, also, depends on your teachers and mentors. If you had good teachers, you tend to love the subject more. And from a purely financial or parental perspective, dentistry is a significant investment. If someone invests ₹2 crores, even a simple 10% return gives ₹20 lakhs a year. If that kind of investment has gone into your education, that should be your benchmark over time.

One unfortunate reality is that dentistry does not teach us business, finance, or numbers. These are conversations that absolutely need to happen, and they are long overdue.

Dr. Darshan Parikh: But again, we are living in a time where money is the primary currency. Maybe a hundred years ago, things were different. If I treated someone, they could give me rice or grain in return, and that worked because it sustained the family. That kind of exchange made sense in that context.

We have clearly moved away from those times. Today, everything, from education to healthcare to daily living, operates within a monetary framework. So yes, money is important. It is not about being greedy or unethical; it is about survival, sustainability, and being able to function in the system we live in now.