Developing proactive responses to staffing shortages is crucial for dentists, dental practices and DSOs to finding success.
The dental industry has faced staffing challenges for the past few years, in both the retention and recruitment aspects, as well as across almost every role, especially dental hygienists and assistants.
Francesca Pregano is the COO of Smile Makers Dental Center, a dental practice with six locations. She recently joined the Becker’s Dental + DSO Review to talk about how the organization is staying ahead of the curve when it comes to staffing.
Question: What are some of the biggest issues in the dental industry that you’ve been following in the first few months of 2025?
Francesca Pregano: One of the biggest issues, which is something that my team and I have been working on for a couple years now, is the shortage in the workforce, particularly among dental assistants, hygienists and administrative professionals. Not only is recruitment difficult, but long-term retention remains a huge concern. Data shows that nearly half of employees in these roles leave within the first two years, and given that there’s limited formal training for these support positions, it often takes just that long to fully onboard and develop these individuals. So at our organization, I’ve helped by taking a proactive approach. One of the most effective strategies was the expansion of a remote workforce. That workforce includes a call center, an RCM team that covers insurance verification, billing, account auditing, patient collection, a finance team and trained dentists to perform chart auditing and compliance. That shift really allowed us to tap into talent beyond our physical locations, not only to increase efficiency, but make the scalability of our operating systems possible.
Also, to combat this issue, we’ve really redefined our onboarding and development with structured programs and check-ins that focus on long term growth with our current employees. We set clear expectations from day one, and that alone has dramatically improved the engagement of the team members. We also have a career pathway that will define their skills from fundamental knowledge to technical skills, leadership, all the way to business growth. So those skills are mirrored to a pay tier, and we’re very open with the team members about their financial goals and the skills they need to achieve in order to receive their desired salary over time. That has made training a collaborative effort and also took away a lot of unnecessary expectations that were very hard to match. But really most importantly, we hire and lead based on our core values. We’re very protective of our team culture and the office atmosphere. And if anyone doesn’t align with the core values, we part ways pretty early on. It’s not always easy, but we found that standing by our principles has earned us a lot of trust within our team. And in the long run, investing in the right people costs a lot less than holding on to the wrong ones.