There are limited opportunities for dental education in the United States with only 4,440 graduating in 2003, down from 5,750 in 1982. There is little or no movement on the part of the American Dental Association, the ADA, or the states to expand dental education. Due to the hands-on training required, dental education is expensive and is not subsidized by the federal government.[26][27] The average dental student graduates with over $200,000 in debt.