Dental leaders across the U.S. are voicing a mix of concern, adaptation and cautious optimism as staffing shortages continue to reshape practices, patient access and the future workforce.
Here’s what five dental leaders have told Becker’s recently about the state of staffing issues:
Dan Bishop, DDS, PhD. Dentist at Metroplex Endodontics and Microsurgery (Duncanville and Mansfield): It’s not just this year, but we have had issues hiring qualified assistants since Covid. I’m not sure why it started around that time, most likely a coincidence. We are short-staffed right now and have been for at least two years. We have found that our best new assistants are coming from dental assisting school. Just about every assistant we hire that boasts multiple years of experience, and any of those having a lead position, display little to no skills. Very disappointing.
We have not changed our schedule but must work short one to two assistants or front desk [employees] most days. Our schedule is usually not light so the assistants have to do more than what you would expect in a normal practice. We are very open with our assistants and praise them constantly about being effective and hardworking. It’s not fair to expect the assistants to work harder for no more pay. In a few cases they will receive a bonus from the DSO if we knock a month out of the park but those are very few and far between. The doctors will give bonuses out of our pockets for key anniversaries and Christmas with some minor help from the DSO. I think we maintain a very positive vibe in the office that is comfortable and safe. We also treat our assistants with a great deal of respect. This might seem minor, but from what we hear from assistants we hire, they are always surprised by how relaxed and efficient we are as a team. We always strive to keep a very high morale.
So, at this point, staff shortages have not had a profound effect on our practice, but our current staff must work harder than they should. In our case the staff shortages are affecting the staff more than the practice. They know we are aware of this, and are constantly trying to hire new, qualified staff. This is how we deal with staff shortages: We keep looking (there are a lot of imposters out there), praise for excellent work, support those who are slower to learn and reward all when we can. Right now, we are short one to two staff and have two getting ready to go on maternity leave. Now that will be interesting.
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.
Samson Liu, DDS. CEO of SOHDental (St. Louis): Overall, team shortages have been less of an issue for us this year versus previous years as a company. However, since we are a national group with practices located in nine states, certain geography does continue to be a challenge. For example, in the state of Hawaii, team shortages have been a bigger issue than provider shortages in the last couple of years. As a result, last year we developed company initiatives to address this very issue. We are in the process of evaluating and investing in technologies that will automate or simplify certain team responsibilities. We are also implementing a call center to streamline practice-patient communications. Lastly, we are in the midst of centralizing and optimizing our revenue cycle workflow. It is not a surprise that we are also diligently monitoring the development of AI technology and its impact on team shortages as well as other areas of opportunities.
Barry Lyon, DO, Dental Director of Main Street Children’s Dentistry and Orthodontics and the Chief Clinical Auditor for Dental Care Alliance: According to the American Dental Association’s 2024 Communications Trend Report, 60% of dentists who reported “major” career stress are considering early retirement or career changes. The profession may be challenged to maintain enough practicing dentists to meet patient demand.
According to the ADA, 33% of practicing dentists are over the age of 55 and nearing retirement, with retirement rates accelerating after the pandemic. In addition, dentists continue to grapple with difficulties recruiting and retaining dental personnel. Compounding the problem is 21% of practice managers plan to retire within six years, and 43% in the next 10 years, according to Dental Post’s 2024 Dental Salary Survey. Thirty percent of practice managers are 55+ years old. Thirty-two percent of billing specialists plan to retire within six years, and 47% in the next 10 years. Fifty-two percent of billing specialists are 55+ years old. Twenty-four percent of front-office associates/receptionists plan to retire within six years, and 41% in the next 10 years. Twenty-nine percent of front-office staff are 55+ years old. This retirement forecast of dental personnel may easily accelerate dentist retirement rates.
But wait, there’s more. Let’s not forget the effects tariffs may have on dental practices and the expected increased overhead costs. This may force those dentists on the retirement fence to decide it’s time to move on. Plus, if in fact prospective dental students are having difficulty obtaining federal loans for school, and this further impacts the availability of practicing dentists, then the shortage of dentists in the coming years may likely become an acute problem.
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.
