Addressing the Dental Hygienist Shortage

  • by Roger P. Levin, DDS
  • Aug 9, 2021
This article is a shortened version of content published in the latest issue of AGD Impact. Read the full article.

Dental hygiene is a major and critical part of the dental profession. Hygienists play various roles — expert clinicians, licensed professionals, practice producers and colleagues. Prior to the pandemic, many areas of the United States were struggling to hire hygienists for both full- and part-time positions. While inconvenient, I believe this prepandemic shortage would have organically resolved over time as dentists would have gradually accepted the increased compensation levels required to attract hygienists. 

However, once the pandemic arrived and practices shut down, more dental hygienists decided to exit the profession, at least temporarily. The American Dental Hygienists’ Association estimates as many as 1 in 12 hygienists left the profession due to various factors, including safety concerns about practicing hygiene in a pandemic. 

Managing Dental Hygiene 
As a dentist, I am well aware of the upheaval that occurs with the loss of a dental hygienist. Schedules are thrown into chaos, patient volume is completely realigned and dentists must perform hygiene services. Extended wait times lead to patient loss, and temporary (and unfamiliar) hygienists can decrease patient satisfaction. Dentists who are experiencing challenges finding and maintaining the necessary hygiene staffing level will benefit by considering the following recommendations. Practice owners who are fortunate enough to be fully staffed at this time should also pay close attention to these items should the need arise to rethink certain factors to retain their hygienists.

1. Review compensation 
When there is a shortage of any position in the labor market, compensation goes up. Newly hired hygienists are requesting levels of compensation that may be higher than many practices are currently paying. This may encourage some hygienists to switch practices to improve their financial situation. You may want to consider adjusting compensation for new and current hygienists. 

2. Give a longevity/retention bonus 
Dentists can offer hygienists bonuses at specified periods of time for remaining with the practice. This not only creates motivation and incentive, but it also can prevent a hygienist from leaving the practice for a slightly better compensation package. 

3. Review hygiene production 
One way to improve practice performance from a production and profitability standpoint is to identify all possible services that a dental hygienist can provide. These should include complete diagnoses on all patients for gingival or periodontal disease, selling home care products, identifying cosmetic services and implants, and keeping basic ancillary services (i.e., radiographs, fluoride, sealants or other basic services) up to date. 

4. Hire a hygiene assistant
If a practice has sufficient patient volume, it may want to consider hiring a part-time hygiene assistant. Assuming that there are two rooms available, the hygienist can alternate between rooms with the assistant and concentrate strictly on providing scaling and root planing and related patient services. 

5. Hire an associate 
Depending on the busyness of a practice, it may be prudent to hire an associate dentist with an understanding that they will also be providing basic hygiene services. 

6. Provide signing bonuses 
If a practice is seeking to hire a hygienist, it may consider a signing bonus. Like a scenario involving an athlete, a signing bonus may encourage the hygienist to quickly agree to join the practice. 

7. Advertise on multiple platforms 
There are numerous employment sites, both specific to dentistry and more general. No single platform is the answer. 

8. Consider employing a recruiting firm
Dental hygiene recruiting firms can be hit or miss. The downside is that the practice will have to pay a fee, which typically feels expensive to the dentist. Plus, there is no certainty that the recruited hygienist will work out. On the other hand, if you’re having no luck attracting a dental hygienist and losing production and profitability, this is an option that makes sense.

9. Interview properly 
Despite some practices being desperate to hire hygienists, it’s still important to follow a systematic interviewing process. Simply agreeing to hire someone because they’re available may quickly land the practice back in the same short-handed position. Practices have values, cultures and team camaraderie. 

10. Try “power hygiene days” 
One option for practices that are significantly backed up in hygiene and in danger of losing patients is power hygiene days. A power hygiene day is when the practice focuses the entire day on hygiene treatment. Doctors also perform hygiene checks throughout the day, and the practice may even bring in a temporary hygienist. 

Roger P. Levin, DDS, is the founder and CEO of Levin Group, a dental management consulting firm. To comment on this article, email