Factors that 6 dentists see keeping dental hygienists, assistants away from the field

Six dentists recently connected with Becker's to discuss the reasons that dental hygienists and assistants are staying away from the industry, creating high demand and short supply.

Note: Responses are lightly edited for length and clarity.

Question: What factors do you think/have seen are keeping dental hygienists and/or dental assistants away from dental practices and the dental industry?

Bradley Dunn, DMD. Owner of Dynamic Dental Group PC (Vandalia, Ill.): I think one of the largest factors limiting individuals from becoming dental assistants and dental hygienists is the lack of career advancement possibilities. Aside from becoming team leaders in their particular practices, the only easily identifiable options are either a supervisory or training role for a large group practice or becoming an instructor for their chosen profession.

David Keller, DDS. Owner of Granite Dental (Vancouver, Wash.): The bottom line is that dentistry is demanding and becoming more so: physically, emotionally, and intellectually. Many hygienists and dental assistants took a break during COVID and realized that they were happier and/or healthier taking a break from the profession. This isn't that unusual. The same sorts of trends occur in medicine, but generally, instead of leaving the profession as we see in dentistry, non-doctor clinical and administrative staff migrate from location to location when they get to the point they need a break. The medical employment model offers far more freedom to change jobs when stressors become overwhelming. Unfortunately, with the bulk of dental employment opportunities found in small private practices, it can be easier to walk away completely than to move from one office to another, especially in smaller population centers where supply is less than demand. Furthermore, as private practice profits decline, and insurance reimbursements continue to plummet, there is less capital available to offer benefits packages similar to other areas of medicine. These dual stressors may cause many to change careers earlier than what I believe historical data would demonstrate.

Brion Long, DMD. Dentist of SmileWorks Children's Dentistry and Orthodontics (Tallahassee, Fla.): There are several factors that have been observed as potential barriers keeping dental hygienists and dental assistants away from dental practices and the broader industry. Firstly, economic considerations play a significant role. Dental hygienists and assistants, especially those just starting out, might find the compensation offered by some practices insufficient, particularly when weighed against the cost of education and the physical demands of the job. Secondly, the physical toll and ergonomics of the profession can deter potential candidates. Many dental professionals suffer from musculoskeletal issues due to the repetitive nature of their work and the awkward positions they must often maintain. Finally, the risk of exposure to various infectious agents, including but not limited to COVID-19, can be a discouraging factor, as dental workers operate in close proximity to patients' mouths, making them vulnerable to potential infections despite the precautions in place.

Barry Lyon, DDS. Chief Dental Officer of Orthodontics and Pediatric Dentistry Division of Dental Care Alliance (Sarasota, Fla.): There are a number of factors keeping dental hygienists and dental assistants away from dental practices. Dental assistants and hygienists are aware they are in high demand, understand that dental practices cannot survive without them and know dentists are offering greater compensation than ever before. Some dental assistants and hygienists leave a practice because another dentist will pay more and provide better benefits.  However, for most dental assistants and hygienists, it is not necessarily the money that drives them to leave. A lack of appreciation is also a most common reason why dental assistants have left their current practices. Finally, because so many dental assistants and hygienists were furloughed or laid off during the pandemic, a number elected to retire. 

Michael Perpich, DDS. Dentist at Northland Smiles (Deerwood, Minn.): I think the biggest factor keeping dental assistants and hygienists from the dental industry is the COVID-19 pandemic. Some staff chose to retire early because of safety concerns with aerosols and new enhanced infections control measures. Staff entering the dental industry has declined as well as the cost and length of the dental hygiene programs are too great. Our industry is getting affected on both ends or the workforce.

Charles Schlesinger, DDS. COO of Comfortable Dentistry 4U (Albuquerque, N.M.): They are staying away for two reasons. The first, I think, is decreasing as time goes on, but is due to the latent fear of something like COVID happening again. The second is other opportunities. When they can get a job for Amazon at $21/hr to start with a signing bonus, insurance, etc., it is an easier way to go with less risk of health issues. 

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