Should you refinance your dental school loans?

Refinancing replaces your federal loans with one private loan at a new rate. For the right dentist it saves tens of thousands of dollars. For the wrong one it throws away six-figure forgiveness.

Lenders only tell you the first half. This page covers both.

What you give up when you refinance

Refinancing turns federal loans into private ones. For those loans you lose access to RAP, PSLF, federal forgiveness, and federal forbearance and deferment. You can’t undo it later.

The CFPB also warns you may lose federal death and permanent disability discharge. Federal loans are discharged when the borrower dies, once proof of death reaches the servicer. Private lenders set their own rules, and “many but not all” offer a discharge, per the CFPB.

That’s the price. The question is whether the rate savings are worth it for you.

The federal side in numbers (as of September 2026)

New graduate and professional Direct Unsubsidized loans for 2026–27 carry an 8.07% fixed rate (FSA). At $300,000, interest alone runs about $2,020 a month.

If any of your loans was first disbursed on or after July 1, 2026, you repay under RAP or the Tiered Standard plan (Federal Student Aid). Older borrowers can still use IBR, and PAYE and ICR end no later than July 1, 2028.

• RAP charges 1% to 10% of your total AGI (10% above $100,000), divided by 12, minus $50 per dependent. Unpaid interest is waived each month. Whatever’s left after 30 years is forgiven, and that forgiveness is taxable again from 2026.
• Tiered Standard is a fixed payment. At $100,000 or more the term is 25 years. On $300,000 at 8.07%, that’s about $2,330 a month and $699,000 in total.
• PSLF forgives the rest, tax-free, after 120 qualifying payments while you work full time for a government or 501(c)(3) employer. RAP payments count.

Who should usually refinance

Refinancing tends to make sense if all of these are true:

1. You work in private practice with no plan to move to an FQHC, the VA, the military or public health.
2. Your income is high relative to your balance. An associate earning $180,000 with $300,000 of debt usually pays the loan off in full under RAP anyway.
3. You have an emergency fund and stable production, so you won’t need federal forbearance.
4. You’ll pick a fixed rate, or you can absorb a payment jump on a variable one.

If that’s you, the only real question is rate. Every point off 8.07% on $300,000 saves roughly $18,000 to $19,000 over 10 years.

Who usually shouldn’t refinance

• Anyone pursuing PSLF. An FQHC dentist on RAP can pay less than half the balance and have the rest forgiven tax-free. See Refinance vs PSLF vs RAP.
• Big balance, modest income. If you owe $500,000 and earn $120,000, RAP forgiveness can beat any private loan, even after the tax.
• Residents. RAP waives unpaid interest while your stipend is low. Most resident refinance loans let it build up instead. See Refinancing during residency.
• New owners or anyone with shaky income. A private loan’s payment doesn’t drop when collections do.

The full list is on When refinancing your dental loans is a mistake.

The math: an associate at $180,000

Take a typical associate: $300,000 at 8.07%, $180,000 income, single, no dependents.

Option 1: stay federal on RAP. The payment is 10% of $180,000 divided by 12, or $1,500 a month. That’s less than the $2,020 of monthly interest, so RAP waives the gap and the balance still drops about $50 a month.

With 3% raises each year, the payment passes the interest after about 10 years. The loan is paid off just short of 30 years, for about $835,000 in total. With flat income, you’d pay about $540,000 and have about $282,000 forgiven. At a 24% to 35% tax rate, that forgiveness brings a tax bill of roughly $68,000 to $99,000.

Option 2: pay the federal loan off in 10 years. About $3,650 a month and $438,000 in total at 8.07%.

Option 3: refinance. Example: $300,000 at 6.0% fixed APR over 10 years is about $3,330 a month and $400,000 in total. Not an offer; your rate depends on credit, income and term.

Path	Monthly payment	Total paid
RAP, 3% raises	$1,500 rising to about $3,500	about $835,000
RAP, flat income, then forgiveness	$1,500	about $540,000 plus a $68,000–$99,000 tax bill
Federal, paid off in 10 years at 8.07%	about $3,650	about $438,000
Refinance example, 6.0% fixed APR, 10 years	about $3,330	about $400,000

Totals are in raw dollars, not adjusted for inflation. The refinance vs forgiveness tool compares in today’s dollars and taxes forgiveness at 35% by default, so its figures differ, though for this dentist it lands on the same answer.

Refinancing wins here by about $38,000 against a 10-year federal payoff. It wins by far more against RAP. That’s the case lenders advertise, and for this dentist it’s real.

The math flips at a nonprofit clinic

Change one fact: the same dentist works full time at an FQHC for $150,000.

On RAP with 3% raises, payments start near $1,250 a month. After 120 payments you’d have paid about $172,000. The remaining roughly $294,000 is forgiven, tax-free under PSLF.

That’s about $228,000 less than the refinance example. No lender rate closes that gap. One caution: a 2025 rule on which employers qualify was vacated and is on appeal at the First Circuit, as of September 2026. Confirm your employer with the PSLF Help Tool.

What to do next

1. Check your employer. If there’s any chance you’ll work for a PSLF-qualifying employer, stop here and read PSLF for dentists.
2. Run your numbers. Put your balance, rate and income into the refinance vs forgiveness tool.
3. Build your cushion first. Three to six months of expenses in cash stands in for the federal forbearance you’d give up.
4. Compare with soft pulls. Check rates with several lenders or a marketplace. See the rate guide and how we compare lenders.
5. Pick fixed unless you’ll pay it off fast. A variable rate can rise above the fixed rate you gave up, the CFPB warns.