Financial Aid for Dental Students: Implications of Recent Legislation

In July 2025, Congress enacted major reforms to higher education funding by passing the One Big Beautiful Bill Act (OBBBA), overhauling federal student loan programs, setting limits on federal borrowing, and abruptly ending the Graduate PLUS loan program. These changes may significantly impact access to dental education—especially for students from low-income or underserved backgrounds—and further worsen the ongoing shortage of oral health clinicians in rural and underserved areas,^1-4 whose populations already face challenges to receiving adequate oral healthcare.

The OBBBA ends the federal Graduate PLUS loan program starting July 1, 2026, for all new borrowers. Graduate PLUS loans have historically allowed dental students to borrow up to the full cost of attendance, including tuition and living expenses, often exceeding $350,000 during a four-year dental program. For current borrowers, eligibility for PLUS loans may be extended for up to three additional years or until they complete their degree, whichever comes first. However, this legacy provision will soon expire.¹

The new law caps annual federal borrowing at $50,000 for professional students (such as dental, medical, and law students), with a total lifetime limit of $200,000 specifically for graduate or professional education (excluding undergraduate debt; the total aggregate available to borrow over the lifetime of a student is $257,000).^1,2,4 Once students reach this limit, they cannot access additional federal loans—they can only turn to private lenders, whose terms are usually less favorable and harder to access, especially for individuals with limited credit histories or guarantors.

Current and Prior Financial Aid for Dental Students

Until now, dental students have relied on a patchwork of federal financial aid, including: direct unsubsidized loans, capped at $20,500 per year; Graduate PLUS loans, which fill the gap between unsubsidized loans and the actual cost of attendance; grants and scholarships, which while available have been limited and highly competitive; and service-based scholarships and loan repayment programs, like the National Health Service Corps (NHSC) or Armed Forces health professions scholarships, which are targeted to promoting service to selected populations or in underserved areas.^5-8

In 2023, the average debt at graduation for new dentists stood at $296,500, with about one-third of dental graduates carrying debts exceeding $300,000.^9,10 Tuition and fees have risen dramatically—first-year dental school tuition now regularly surpasses $60,000 at public institutions and $85,000 at private ones, not including living costs, instruments, or fees.¹¹ Given these realities, nearly all dental students have needed federal loans, particularly Graduate PLUS, to close the gap between subsidized loan limits and the actual cost of attendance.

Impact of the New Model

The OBBBA creates a number of challenges for future dental students. First, they will find it impossible to finance the full cost of dental school solely with federal loans. With four years of dental school tuition, fees, and living expenses commonly exceeding $350,000, the new $200,000 aggregate federal cap can fall far short. Second, families without generational wealth or high credit scores may struggle to secure private loans, which come with higher interest rates and fewer consumer protections than federal loans.² Third, gift assistance (eg, grants and scholarships) will remain essential, but it is limited and unable to cover the massive gap for most students.^5,6 Lastly, dental workforce shortages will exacerbate oral health disparities for populations across the lifespan.

Possible implications for students from backgrounds with limited financial resources also loom. For example, those with the least disposable financial resources—often first-generation college graduates, underrepresented groups, and applicants from rural or urban areas with limited access to dental care—could be pushed out of the dental profession entirely due to financial barriers. The Health Resources & Services Administration and other scholarship programs targeted at such students exist but are far too limited in scope to address the needs of every affected student.^7,8 Also, students whose career goals are to serve underserved or rural communities may find the risk of high-cost, high-interest private debt unsustainable without the repayment flexibility and service-oriented forgiveness options (such as Public Service Loan Forgiveness or NHSC) previously available.^2,12

Broader Effect on Dental Care Access

The United States already faces a severe shortage of dental providers in rural areas and communities with few or no dentists. In 2020, nearly 70% of the country’s dental health professional shortage areas were in rural or partially rural locations, having an impact on more than 30 million people.^13,14 Per the American Dental Association Health Policy Institute in 2025,¹³ rural counties have only 32.7 dentists per 100,000 residents, compared to 64.7 dentists per 100,000 in urban counties. Many rural dentists are nearing retirement, threatening to worsen the shortfall in the coming years.^14,15

Restricting federal borrowing will likely worsen these shortages by impacting students from rural and underrepresented backgrounds—students who are most likely to return to practice in these communities—presenting even higher barriers to entry. These communities disproportionately experience the burden of limited access to dental care and related poor oral health. Facing larger private loan balances and less favorable terms, new graduates may be less likely to practice in rural communities or safety net clinics and instead seek higher-paying jobs in affluent or urban markets.^9,10,12 Programs designed to attract dental graduates to communities with limited access to dental care via loan repayment or forgiveness lose effectiveness if a student’s primary debt is private and not eligible for federal forgiveness or repayment assistance.

Widening the Gap?

The new federal financial aid model, by sharply capping graduate and professional student borrowing and eliminating Graduate PLUS loans, risks transforming dentistry into a profession for the affluent—accessible primarily to those who can pay six-figure tuition upfront or secure private loans on their own. Aspiring dentists from low-income, rural, and underrepresented backgrounds may be prohibited from applying to dental school by the financial burden placed on dental students. This can further widen gaps in access to higher education and oral healthcare among the dental workforce and communities with the greatest need for oral health professionals, worsening health disparities in America.¹⁶ This will have a negative impact for both the dental profession and the oral health of the communities it serves. The reduction in federal financial aid for professional students sets the stage for even greater shortages of dentists in rural and underserved areas, already most in need of access to oral healthcare.^1,3,10-14

ABOUT THE AUTHORS

Fotinos S. Panagakos, DMD, PhD
Founding Dean and Professor, School of Dental Medicine, Pacific Northwest University of Health Sciences, Yakima, Washington

Nader A. Nadershahi, DDS, MBA, EdD
Senior Vice President, Education and Professional Affairs, American Dental Association, Chicago, Illinois

Cherae M. Farmer, DDS, MSPH, MBA
Dean, School of Dentistry, Meharry Medical College, Nashville, Tennessee

Linda C. Niessen, DMD, MPH, MPP
Founding Dean, Professor, and Vice Provost for Oral Health Affairs, College of Dental Medicine, Kansas City University, Joplin, Missouri