The AAO continues to actively engage policymakers and stakeholders at the federal and state levels to address the growing impact of educational debt on future orthodontists and the specialty’s workforce. The cost of dental and orthodontic education continues to rise, and new federal student loan restrictions taking effect July 1, 2026, can make specialty training more difficult to finance for future orthodontists. Significant changes to federal student loan programs, including new borrowing caps and the elimination of Grad PLUS loans for new borrowers, could increase reliance on private lending and can potentially create new financial barriers for students pursuing orthodontic specialty training. 

The following update from Cozen O’Connor Public Strategies outlines recent changes to federal student loan programs resulting from the One Big Beautiful Bill Act, signed into law in July 2025, and subsequent actions taken by the U.S. Department of Education to implement those changes. Many of the new provisions are scheduled to take effect beginning July 1, 2026. 

What Is Changing? 

The final rule includes four major changes to federal student lending: 

  • The phasing out and elimination of the Grad PLUS loan program; 
  • The establishment of annual and aggregate loan limits for graduate and professional students; 
  • The allowance of institutions to establish their own programmatic loan caps that are meant to match the “true value of their academic programs”; and 
  • The simplification of student loan repayment plans with creation of new Tiered Standard plan and income-driven repayment plan to eliminate negative amortization. 

For orthodontic residents beginning their program on or after July 1, and for future orthodontic residents, the most significant change is the establishment of new borrowing caps. 

Under the new rules: 

  • A borrower pursuing a professional degree (which includes a D.D.S. and D.M.D.) faces a $50,000 annual borrowing limit for federal student loans and a $200,000 lifetime limit. 
  • A borrower pursuing a graduate degree (which includes a M.S.) faces a $20,500 annual borrowing limit for federal student loans and a $100,000 lifetime limit. 
  • A borrower is subject to an overall $257,500 lifetime limit for student loans across graduate and professional schools. 

As a result, many future orthodontists may need to rely more heavily on private financing to cover educational expenses. 

Below are some hypothetical examples of how the final rule might impact orthodontists. 

  • Orthodontic Resident A attends a 4-year state dental school with annual tuition of $40,000 and then attends a 2-year orthodontic residency program with annual tuition of $60,000. The Department of Education’s professional school loan limit would not impact Orthodontic Resident A as it applies to their dental school student loans, as those loans would fall under the annual and aggregate limits for professional school. However, Orthodontic Resident A could only take out $41,000 in federal student loans for their orthodontic residency program based on the graduate degree annual cap ($20,500 per year). Orthodontic Resident A could therefore obtain $201,000 in federal student loans ($160,000 for dental school and $41,000 for graduate school) and would need to obtain $79,000 in additional student loans from a private lender. 
  • Orthodontic Resident B attends a 4-year private dental school with annual tuition of $70,000 and then attends a 3-year orthodontic residency program with annual tuition of $10,000. Under the Department of Education’s rules, Orthodontic Resident B could only borrow $200,000 in federal student loans for their dental school. However, Orthodontic Resident B could borrow $10,000 annually for their graduate degree as this figure falls below the Department of Education’s graduate degree loan limits. Orthodontic Resident B would therefore receive $230,000 in federal student loans ($200,000 for dental school and $30,000 for graduate school) and would require $80,000 in additional student loans from a private lender. 
  • Orthodontic Resident C attends a 4-year dental school with annual tuition of $50,000 and then attends a 4-year residency program with annual tuition of $20,000. Orthodontic Resident C would perfectly exhaust their professional degree federal student loan limit of $200,000. While Orthodontic Resident C’s graduate degree costs less than $20,500 per year, the cost of the four-year program graduate program plus the four-year dental school ($280,000) would cause Orthodontic Resident C to exceed the $257,500 lifetime loan limit under the Department of Education’s loan rules. Thus, Orthodontic Resident C could therefore obtain $257,500 in federal student loans and would require $22,500 in additional student loans from a private lender. 

Grad PLUS Elimination and Borrowing Caps 

Another significant component of the rule is the phase-out of the Grad PLUS loan program. 

Historically, Grad PLUS loans have allowed graduate and professional students to borrow up to the full cost of attendance, helping cover tuition, living expenses, and other educational costs not met through other federal loan programs. 

Under the new rules, current borrowers may qualify for limited transition protections if they remain continuously enrolled. However, future students will face the new borrowing limits outlined above, increasing the likelihood that many will need to seek private financing to bridge funding gaps. 

Legal and Legislative Challenges Continue 

The regulations have already faced legal and legislative challenges. 

On May 19th, 25 states and the District of Columbia filed a lawsuit against the U.S. Department of Education challenging the rule. The lawsuit claims that ⁠the rule unlawfully narrowed who counted as professional students, violated the Administrative Procedures Act, and unlawfully strips grandfathered students of protections if they transfer schools or temporarily withdraw and subsequently reenroll in educational programs. The lawsuit remains pending as of June 2026. 

Separately, on June 4th, several Democratic Members of the U.S. House of Representatives and the U.S. Senate introduced a Congressional Review Act (CRA) resolution of disapproval (H.J. Res. 189) to repeal the rule. Under the CRA, Congress can introduce a resolution of disapproval within a set period to overturn recently issued rules or guidance from the Executive Branch. The CRA resolution of disapproval must receive a simple majority vote in both the House and Senate and be signed by the President for the rule to go into effect. Given that Republicans control the Presidency and both chambers of Congress, this CRA resolution of disapproval has a very low likelihood of being successful. 

The AAO will continue monitoring these developments and evaluating their potential impact on orthodontic education and the profession. 

Why This Matters to Orthodontics 

The average orthodontic resident graduates with $567,000 in federal student loan debt. AAO has long recognized that rising educational debt can influence career decisions, practice ownership opportunities, and access to specialty education. New federal borrowing limits may create additional financial barriers for students considering orthodontics and could disproportionately affect those from backgrounds traditionally underrepresented in the profession. 

While the exact impact will vary based on tuition costs, program length, and individual circumstances, many future orthodontists may find that federal loans no longer cover the full cost of their education, particularly when combined with existing undergraduate and dental school debt. 

These changes could also influence the broader orthodontic workforce pipeline. Limiting access to affordable financing may discourage qualified students from pursuing specialty training or create additional financial pressures that affect career choices after graduation. Increased debt burdens can delay practice ownership, influence employment decisions, and ultimately affect access to orthodontic care in communities across the country. 

AAO Advocacy on Student Debt at the Federal Level 

Addressing student loan debt remains a top AAO advocacy priority. The AAO has long supported the bipartisan Resident Education Deferred Interest (REDI) Act, reintroduced in 2025 by Congressman Brian Babin, DDS, and Senator Jacky Rosen. The legislation would allow medical and dental residents to defer federal student loan payments without interest accruing during training, helping prevent loan balances from growing substantially before practitioners enter the workforce. 

The AAO also continues to work alongside organized dentistry and higher education partners to educate policymakers on the impact of student loan policies on the future dental and orthodontic workforce. At the 2026 AAO Professional Advocacy Conference, AAO members, including more than 40 current orthodontic residents, met with over 60 Congressional offices to discuss rising educational debt, the elimination of Graduate PLUS loans, new federal borrowing caps, and increased reliance on private lending. The AAO also welcomed Assistant Secretary for Postsecondary Education at the U.S. Department of Education David Barker, to the Conference, providing an opportunity to strengthen relationships and share perspectives directly on this issue. 

Additionally, the AAO supported comments to the U.S. Department of Education urging a delayed implementation of the new loan limits to minimize disruption for students, institutions, and the healthcare workforce pipeline. 

State-Based Solutions 

Florida Loan Repayment Program Offers a Potential Solution  
In Florida, AAO advocacy helped secure $6 million last year in the state budget for the dental student loan repayment program. The FRAME program provides up to $250,000 in loan repayment for orthodontists practicing in medically underserved areas and supports access to care for patients across the state. The AAO also supported inclusion of an additional $6 million for this program in Florida’s FY2026–27 budget to help support orthodontists and their student loan repayment options. The Florida Legislature approved this funding, and as of June 24, 2026, the budget is awaiting approval by Governor Ron DeSantis before becoming law. 

If the budget is signed into law with the additional $6 million in funding for the dental student loan repayment program, eligible orthodontists in Florida will continue to have uninterrupted access to this reimbursement opportunity, provided they are approved for participation and satisfy all program requirements.  

More details can be found at the following website, and orthodontists are eligible: AAO supported Florida Dental Student Loan Repayment Program   

Maryland Loan Repayment Opportunity  
In Maryland, applications are currently being accepted for the Maryland Dent-Care Loan Assistance Repayment Program, which provides loan repayment support for dentists, including orthodontists, who serve Medicaid populations in eligible practice settings.   

Applications are due by July 31, 2026. More details can be found here: Orthodontist Medicaid providers can access student loan repayment support in Maryland.  

Member Resources 

To help members navigate these changes, the AAO maintains a student loan debt resource center featuring federal and state program information, repayment resources, and advocacy updates. Visit AAOinfo.org/StudentDebt to learn more. 

Advocacy Matters 

Without thoughtful policy solutions, new federal borrowing caps may reduce access to orthodontic specialty training, limit workforce opportunities, and disproportionately impact residents who rely most on student loans. Orthodontists are small business owners, healthcare providers, and essential contributors to their communities. Ensuring access to education and sustainable financing pathways is critical to the future of the specialty and to patient access to high-quality care. 

“The AAO is actively engaging with lawmakers at both the federal and state levels to pursue meaningful solutions to the student loan debt challenges facing our members and future orthodontists,” said Nathan Mick, AAO Vice President of Advocacy. “The AAO will continue to advocate for policies and holistic student loan debt solutions that reflect the realities of healthcare training, support access to education, and strengthen the orthodontic workforce.”