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Where are all the dental assistants and hygienists?

Why practices are struggling to find talent

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Dr. Salierno

It’s always a challenge hiring great people. But something that all dental practices are asking right now is: Where are the dental assistants and hygienists?

According to the ADA, almost three quarters of dental practices that are hiring hygienists say that the process has been “extremely challenging.” More than half say the same for hiring dental assistants.

The problem is worse than ever before — and it’s only grown more challenging since the pandemic.

So, why is this problem happening? And, most importantly, how do dental practices solve it?

It’s incredibly difficult to hire these critical team members right now.

The market is still reeling from COVID-19. There was an estimated 8% reduction in the hygiene workforce due to the pandemic. That included people who said, “You know, I’m 60 years old, and I’m a hygienist trying to do my job in the middle of all this craziness. That’s it, I’m out.” Maybe these folks were burned out, or maybe they had a significant other who earned enough to keep things steady. Whatever the case may be, they retired early.

There was also a rise in dental assistants and hygienists working part time. There’s still data coming in on this piece, but for the same reasons people quit, others decided to shift to a part-time role.

This falloff in full-time employees caused a dramatic increase in wages because demand grew seemingly overnight. If a hygienist or dental assistant didn’t feel attached to their employer, they could take a position nearby for more money. A lot of practices tried to simply throw money at the problem, rather than taking a deeper look at how they operated.

I want to pause here to say that these developments were good for dental assistants and hygienists. 

And this is good for the dental community overall, because dental assistants and hygienists are so integral to providing oral health care. In some cases, these folks were being underpaid, and the sudden demand for their services helped correct the market. When they’re happy, we all win.

Also, it’s worth pointing out: Higher wages are a normal phenomenon whenever workers are in high demand. We’re absolutely seeing that now. Hygienists and dental assistants are specialized, licensed, highly skilled professionals. You can’t just pluck them out of thin air; they graduate from accredited programs. There’s a real limitation on the supply side.

But in the short term, these developments caused a lot of practices, big and small, to scramble. Some haven’t been able to pay the table stakes in this increasingly competitive game; they simply weren’t able to increase their wages and lost out on talent as a result. Here’s a big reason why: Reimbursement rates from third-party payers have not kept up with inflation — or have even decreased, in some cases. This is also a major reason why more than half of practices don’t offer benefits to their dental assistants and hygienists.

So, what is the solution?

First, and perhaps most obvious, is to compete on wages and benefits. But simply throwing money at the problem isn’t enough. You need to also add to your value proposition as an employer.

Make sure you’re a “best place to work.” Now, everyone says they want to have a great culture, but what do you actually do about it? Start with an employee NPS. Check in with the folks who work for you. Actually listen to their feedback and see how you can improve. Make sure you give them ways to grow.

There are plenty of really talented hygienists and dental assistants who have aspirations to do something else. Maybe they want to take on leadership, educational and managerial responsibilities. If you’re able to create that clear pathway that internally promotes, rather than just recruits from outside, that’s very attractive and goes well beyond wages and benefits.

Once you’re a “best place to work” — and understand why you are — make sure that your value proposition as an employer is clear. 

Then, increase the size of the recruitment funnel. There’s a lot of ways to do this. But one way that’s underutilized is peer-to-peer recruitment. Find brand ambassadors within your company who live your mission, vision and values, and are emblematic of the culture you’re creating. If they’re excited to be able to go and preach from the highest mountain top, then empower them to do so. We feature our evangelist team members in our social media posts and send them to community events. We let their personal brands shine. Their enthusiasm and their passion are arguably the most effective recruitment tool we have.

Next, you want to improve retention. So, in addition to providing clear career pathways for folks, you need a best-in-class onboarding program. Rather than just being shown where the cafeteria is, employees need to be truly welcomed into the culture. When onboarding is done right, it removes a lot of speed bumps that could lead to premature turnover. Set your people up for success.

Dental practices can take this as a challenge — and rise to the occasion.

Yes, the statistics are daunting. But health care business owners can take this as a challenge to evolve their value proposition. What does it mean to be an employee in your organization? If you’re just throwing money at the problem, you’ll attract mercenaries — not missionaries.

Raising wages is in many cases necessary, but that alone is a stopgap measure. It doesn’t lead to sustainable growth and creating a better environment for your employees.

And if you’re creating a better environment for your employees, your practice will be better for it.

This editorial, reprinted with permission, appeared Jan. 26 in Group Dentistry Now. Chris Salierno, D.D.S., is Tend’s Chief Dental Officer.


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