The dental assistant shortage may get worse. Here’s how practices can prepare.

The shortage of hygienists and dental assistants may get worse before it gets better.

In October, the ADA published robust research that found these shortages may worsen over the next few years. I’ve previously discussed the shortage of hygienists and dental assistants, but this new paper warrants its own post. There are alarms going off, and the dental industry needs to plan accordingly.

Some of this new data reiterates things I've already discussed. But there are new numbers that are important to hear.

A third of dental assistants and hygienists say they’re going to retire in the next five years.

There’s an “outflow” and “inflow” problem that’s about to get worse. According to the ADA’s new research, 33.7% of dental assistants and 31.4% of hygienists surveyed expect to retire within the next five years.?

There’s a major outflow problem, and the anticipated inflow won’t solve it. COVID adversely affected enrollment in hygiene programs, although that trend is showing signs of normalizing. However, enrollment in dental assisting programs shows a larger downtrend since 2015. These programs were adversely impacted by COVID, too, but there was a problem even before the pandemic.?

The challenge with hygienists is that there’s a two-year runway for them to graduate. Even if we waved a magic wand and hygiene schools were fully enrolled across the nation, there’s still going to be a two year wait until it affects the labor market.?

The good news with dental assisting programs is that there’s a shorter runway. States have different assisting levels that may require more training, but it typically takes less than a year to be an entry level assistant. In some states, it only takes a handful of weeks to become a licensed dental assistant.?

The problem is: Where’s that magic wand? We’re still seeing a downtrend in enrollment.?

Is it a wage issue? Or does dental assisting have a PR problem?

Why are people not going into dental assisting? That’s tough data to get, but we can ask some other questions in the interim. A principal one is: What other healthcare professions are people going into instead of dental assisting? We could examine those other professions and find useful information. We need to make sure dentistry is operating from an even playing field.

Another (larger, and more vague) question to contemplate is: Does dental assisting have a PR problem? Is there something about this very noble career that’s deterring people? We would need to survey this out.

Armed with that data, we could make changes on a macro level by teaming up with the ADAA (American Dental Assistants Association).?

There are things individual practices can do to make sure they’re prepared.

As I’ve mentioned previously, small practices and group practices need to make sure they’re an outstanding place to work if they want to attract hygienists and dental assistants in a shallow labor market.

According to the data from the ADA, the top three reasons for dissatisfaction at work for dental assistants were: insufficient pay, being overworked, and workplace culture.

If you want to be competitive in this marketplace, you need to know what the local rate is and meet it. Offer paid time off — and health insurance if you can. Most dental practices are not offering health benefits, and that's something to consider if you really want to stand out.?

Add to your value proposition as an employer. Build a great culture, starting with an employee survey. Check in with your employees, actually listen to their feedback, and act on it in areas you can improve.?

Career pathing for dental assistants is really overlooked. In many states, there's different levels of dental assisting. Paying for dental assistants to get to that next level, where they can increase their scope of practice, is tremendously attractive. And creating a clear pathway that internally promotes (rather than always recruiting from outside) goes beyond wages and benefits.?

This varies state by state, but there are aspirational opportunities where an assistant can take more ownership of patient outcomes, such as tooth whitening or digital scanning. They can design restorations with CAD/CAM. These are exciting opportunities. If they're not only offered but also publicly communicated to the community at large, then the potential applicant pool will view your product.

These are the strategies we use at Tend to attract and keep employees. We’re competitive with wages and offer benefits, like health, paid time off, and 401k. We use employee feedback to constantly strengthen our culture. And we offer clear paths for internal promotion to new leadership positions.

While there remain some big questions about the shortage of hygienists and dental assistants, change can begin at the individual practice level.?

The practices that get it right — and create great places to work — will adapt, even in a tight labor market.?