Dentistry is experiencing a staffing crisis at a level never before seen. We have lost many dental hygienists and other staff members from the workforce, and this dynamic is now beginning to have a significant impact on practice productivity, efficiency and, for some practices, office hour availability. This crisis is happening in many industries, as evidenced by countless articles and commentaries and the creation of new terms such as “The Great Resignation” and “quiet quitting.” 

I recently spoke to a dentist in the Southwest United States who had a stable team for the last five years. Within the last six months, she has lost more than 50% of her team. This is not an anomaly or unusual story. However, this story shows why you don’t want to wait until you face the urgent need of finding new team members. Your practice should be prepared to find new team members who appropriately fit your practice right now, whether you need new staff or not. 

Here are 10 steps that every practice can take (or be prepared to take) if it must identify new staff members. Each of these steps requires some level of thought and preparation, and I encourage all dentists to have these plans in place and ready to go. The reason that many practices ignore this advice is simply because it represents extra work during a time in which you may not need new staff. But when you do need new staff, being prepared can reduce stress because you’ll have the comfort of knowing that you already have an excellent plan in place for identifying the right new team member for your practice. 

These steps will be of immense help to any practice that is focused on hiring new members or building a culture of excellence and satisfaction for the current team.

1. Use online hiring sites. 
   There are many ads online for dental staffing positions. The key is to make your ad different. Instead of simply announcing the position with a few generalities, try to focus on what makes your practice a wonderful place to work. Talk about your practice mission, teamwork, fun office environment, advancement opportunities, and the chance to join a great team and contribute to the improvement of patients’ health.
   
   
2. Employ recruiting firms. 
   Recruiting firms can be beneficial, but you must also know that they are experiencing the same challenges from the staffing shortage and simply do not have as many people at various skill levels and quality to recommend. Keep in mind that you must still be diligent about properly interviewing candidates referred by an agency to make sure they are the right fit for your practice.
   
   
3. Offer staff referral bonuses. 
   Your staff may know other professionals who they feel would be excellent fits for the practice. Let them know that you would appreciate if they would refer any of their industry contacts and that, if you hire an individual based on their referral, they will receive a bonus if the individual stays for at least 90 days. The key is to make the bonus big enough to receive the right attention. We have been recommending $1,500 and have had success with this strategy.
   
   
4. Provide signing bonuses. 
   Until the pandemic, the dental industry never explored using signing bonuses. This was something you heard about for athletes being drafted. However, signing bonuses are becoming more popular in the business world and make sense when attempting to hire in a competitive market. Announce in your ad that there is a signing bonus, and include the amount. After hiring, the bonus should be paid out over six months.
   
   
5. Use expert trainers. 
   Letting new team members know or even announcing in your advertisement that you provide expert training in the practice can go a long way toward being a desirable place to work. Inevitably, whenever there is a workforce shortage, practices will be hiring less qualified individuals who have enormous potential. The key to accessing that potential is to make sure that there is training available to allow the new team member to grow more rapidly in skill and in the position. 
   
   
6. Assign a mentor. 
   When interviewing potential new team members, let them know that they will be assigned another team member as a mentor. The mentor should take the responsibility very seriously and understand that they should do anything they can to help the new hire. This will give new employees confidence that they will succeed in your office. 
   
   
7. Cross-train the team. 
   Cross-training is now essential for all major jobs and tasks in the practice. You don’t want to be in a position where you lose a key team member and no one else knows how to do that job. To avoid this, ensure at least two team members understand how to perform each major function so that the practice can continue to function efficiently in the event you must replace a team member. Furthermore, receiving training in new areas will be an attractive benefit for new hires. 
   
   
8. Develop a staff-level continuing education (CE) budget. 
   Another attractive benefit for potential new hires is annual CE. It will not only help to enhance a new employee’s skill set, but it will also be a source of motivation for them. Keep in mind that all selections for CE opportunities should be approved by the doctor or office manager.
   
   
9. Get extra part-time help. 
   There is an increasing number of people who want to work part time for numerous reasons, including daycare issues, caring for elderly parents and quality of life. This means that practices may need to employ more part-time individuals to be fully staffed and handle patient flow. Remember to treat part-timers the same way you treat full-timers and be sure that they are recipients of excellent communication, practice updates and invitations to practice meetings. You should do everything possible to build commitment with part-time people and let them know that the practice will view them as fully committed staff members. 
   
   
10. Hire for attitude; train for skill. 
    This is not a new concept, but it is a critical one. You should never hire people with bad attitudes. They will demoralize the rest of the team, cause customer service issues and contribute to a host of other problems. Make sure your interview process allows you to get a sense of the candidate’s personality and attitude. If you hire out of desperation and it doesn’t work out, you will have to do it all over again. Hiring a team member who has an excellent attitude but needs some extra training will be the better investment.

Summary 
The staffing crisis we are currently facing will be with us for a while. While it represents a legitimate problem, you should also view it as an opportunity. Practices will need to create new methodologies for training team members, building powerful cultures and recruiting the right employees. The above recommendations will help any practice be more successful in overcoming the challenges presented by the current workforce shortage facing our profession. 

Roger P. Levin, DDS, is the founder and CEO of Levin Group, a dental management consulting firm. To comment on this article, email impact@agd.org.

A Closer Look at the Dental Workforce Shortage 
What’s driving the shortage? 
More than half of dental hygienists who left employment early in the COVID-19 pandemic did not return to the workforce in 2021. The most common reasons cited — aside from “waiting until the COVID-19 pandemic is under control” — included concerns about workplace safety and insufficient childcare. Enrollment in dental hygiene and dental assisting programs also declined from pre-pandemic levels. Dental hygiene programs saw a 7% drop in enrollment and a 4% drop in graduates. However, data suggest both these rates are rebounding. The number of enrollees in dental assisting programs, as well as the number of programs themselves, appear to be on a downward trend. 

What’s the long-term outlook? 
The U.S. Bureau of Labor Statistics projects around 10% employment growth for both dental hygienists and assistants during the next eight years. Taking into account this growth, current demand for staff members and sluggish numbers training new workers, one can assume the workforce shortage will persist in the long term. 

Source: “Dental Workforce Shortages: Data to Navigate Today’s Labor Market.” American Dental Association Health Policy Institute, October 2022, ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/dental_workforce_shortages_labor_market.pdf. Accessed 7 Dec. 2022.

A Closer Look at Dental Assistants 
Satisfaction 

• 65% of dental assistants reported being satisfied or very satisfied with their jobs. 
• Although overall job satisfaction among dental assistants is relatively high, it has declined by about 20 percentage points since 2016. 

Career Commitment 

• Just over half (54%) of all dental assistants reported feeling valued by their employer. 
• About one in three (31%) often thought about leaving their current employer. 
• Nearly one in five (17%) changed jobs within the last year. 
• Certified Dental Assistants are more likely to view dental assisting as a career and more likely to stay with their current employer. 

Source: “2022 Dental Assistants Salary and Satisfaction Survey.” Dental Assisting National Board, danbsfprodassets.azureedge.net/assets/docs/default-source/marketing-and-surveys/danb-salary-survey.pdf?sfvrsn=bdcbe3ba_3. Accessed 13 Dec. 2022.

Dental Workforce Statistics 
Dental Hygienists 

• 2021 median pay: $77,810 per year/$37.41 per hour. 
• Job outlook: Employment of dental hygienists is projected to grow 9% from 2021 to 2031, faster than the average for all occupations. 
• About 16,300 openings for dental hygienists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire. 

Source: “Dental Hygienists.” U.S. Bureau of Labor Statistics, 8 Sept. 2022, bls.gov/ooh/healthcare/dental-hygienists.htm. Accessed 7 Dec. 2022. 

Dental Assistants 

• 2021 median pay: $38,660 per year/$18.59 per hour. 
• Job outlook: Employment of dental assistants is projected to grow 8% from 2021 to 2031, faster than the average for all occupations. 
• About 56,400 openings for dental assistants are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire. 

Source: “Dental Assistants.” U.S. Bureau of Labor Statistics, bls.gov/ooh/healthcare/dental-assistants.htm. Accessed 7 Dec. 2022.