Staffing shortages have become one of the greatest challenges facing the dental industry, and there currently seems to be no end in sight.
Dental practices have consistently found dental assistants and hygienists two of the most challenging roles to recruit for, a problem exacerbated by the COVID-19 pandemic.
In the American Dental Association’s most recent “Economic Outlook and Emerging Issues in Dentistry” poll for the second quarter of 2025, only between 37%-39% of dentists reported recruiting dental assistants and hygienists. When asked how challenging it has been to recruit dental assistants and hygienists over the last 3 months, 38.3% indicated it was “extremely challenging” to recruit dental assistants, while 74.1% said it was “extremely challenging” to recruit hygienists.
These shortages have led to a domino effect in the industry, including dentists having to perform more hygiene services, practice closures and long appointment wait times. Although legislators and providers are coming up with new solutions to alleviate shortages, such as licensure compacts, new programs and increased funding, it may still be several more years until we see any effects.
Becker’s recently connected with a dentist and a CEO to explore the long-term consequences of workforce shortages.
Editor’s note: These responses were lightly edited for clarity and length.
Krista Kappus, DDS. Dentist at Fitch Mountain Dental (Healdsburg, Calif.): If the dental workforce shortages persist, I believe the long-term effects will be largely driven by a basic issue of supply and demand. When there aren’t enough qualified team members available, the existing workforce can — and understandably will — demand higher wages. For example, the average hygienist salary has increased by 21% in recent years, while costs across the board — materials, equipment, rent — have also climbed significantly. Meanwhile, insurance reimbursements have remained largely stagnant, creating a widening gap between overhead and revenue.
This economic pressure is forcing many practices to reconsider their participation with lower-paying insurance plans, which will inevitably lead to reduced access to care for insured patients. Over time, I’m concerned we’ll see a tiered dental landscape: lower-cost, insurance-based offices may become increasingly difficult to find, while cash-based or boutique-style practices become more common. This shift could severely limit access to preventive and routine care for a large portion of the population.
There are potential solutions worth exploring, particularly in how we educate and license dental professionals. While some states have taken steps by allowing expanded function dental assistants, their scope is still limited — especially when it comes to routine prophylaxis patients. Broadening the scope of well-trained auxiliary staff could help reduce bottlenecks, lower costs and increase access to care, while also allowing dentists and hygienists to work more efficiently within their highest skill levels.
Thomas von Sydow. CEO of Cornerstone Dental Specialties (Irvine, Calif.): Unfortunately, I do think this problem will persist. Dental assistants and hygienists have always had turnover issues. The DSO sector has the most issues with that. I don’t think it’s a pay issue. DSOs pay well. I believe it’s the “local” feel of private general practices and specialty offices, as well as, more flexible time off. There is nothing as valuable in a practice as tenured staff. While I don’t believe the quality will be less, the patient wait times, their dislike of change, seeing new faces, etc. could impact their loyalty. Lastly, I believe dentistry needs to follow the healthcare sector and get staff to work at their highest level of certification/licensure. We know mental stimulation increases engagement. This also necessitates expanding training and looking at ways to increase scopes of responsibility. We need more expanded functions.
