Navigating the dental hygienist shortage and the booming temp economy

Having lived on both the Texas and Florida coasts, I’ve seen my share of hurricane force winds. If you’ve ever seen a huge oak tree that seems immovable shaken violently by strong gusts, you know that its branches land in odd places.

To me, the dental field used to be like that unmoving oak, and the pandemic, the strong gust. Things landed in odd places. Many of us are still wondering what happened, and the answer depends on where you landed.

The most impactful change has been the complete reversal of a once-saturated hygiene employment market. Today, there’s an official shortage of working dental hygienists in the US. It’s so widespread that news of the shortage has been covered by such media outlets as NPR, USA Today, and US News and World Report.¹

In 2019, hygiene openings attracted dozens of qualified applicants. In the decade before the pandemic, social media was full of new hygienists warning those pursuing the profession to change course, as there were no quality positions to be had. Now, it’s a hygienists’ market.

The tables have turned

For hygienists still working, many are realizing pay increases, benefits, work/life balance, and multiple employer options. Those are undeniable positives, and it stands to reason that these happier hygienists will provide even better patient care due to their increased career satisfaction. 

But what about those who left? 

Dental professionals, more than most health-care workers, literally came face-to-face with COVID-19 most days. Despite the safety of enhanced PPE, some hygienists powered down their ultrasonic units and headed for the hills. Many found the distancing, testing, vaccine requirements, and extra PPE too cumbersome to be worth the hassle.² 

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Some wanted to eliminate the commute and found remote careers. Those contemplating retirement reasoned this was the ideal time. For others, school and childcare closures forced them to stay home. Some decided that spending more time with their families was more meaningful than working outside the home.³

Enter temping

Hygiene temping—which for a long time was (unfairly) viewed as being primarily for the unemployable or semiretired—became the new black. There are many benefits to temping, and online dental temp matching apps allow hygienists to book themselves for when, where, and how much pay.⁴

It doesn’t hurt that many platforms provide same-day pay at wages higher than market. A few offer vacation and medical benefits to those who work a minimum number of days per month. It can be challenging for permanent employers to compete (although they may not have to forever). But short-term stints over the long haul can take a toll on a provider, just as it can for anyone who substitutes in a job that isn’t “theirs.”

Managing the unknowns

When temping for the first time in a practice, the unknowns can be stressful and lead to an exhausting workweek. These include making a great impression in an unfamiliar environment, untried software/technology and documentation protocols, and shorter or longer appointment times than the temp is accustomed to. Thousands of temps find ways to work around these challenges every day. But is it sustainable at current levels?

Patient perception and revenue suffer when a practice frequently uses temps. Most temps just try to get through the day, not learn the nuances of the practices’ perio program. It’s not that temps don’t want to do the right thing for patients. But the constraints on time and training, along with unfamiliar technology, can make comprehensive and confident hygiene care difficult. 

If the temp is unfamiliar with the software, comprehensive charting is compromised. If they’re not aware of the practice’s assessment protocols, patients may not be getting periodontal, oral cancer, or caries risk screenings. 

A common complaint practice leaders have about temps is that they work too fast or too slow. But it can be difficult to achieve cadence in a brief time, in new surroundings. Most teams need weeks together to all dance to the same beat. If a practice relies on new faces frequently, patient retention and revenue will suffer.

Getting permanent help back

So how can a practice minimize the use of temps? By attracting and retaining permanent hygienists. To do that, some practices will need to get out of their comfort zones. This can mean minor tweaking or require a major cultural overhaul.

Gimmicky perks and short-term incentives are not effective over the long term. A sign-on bonus may grab attention, but it’s meaningless if the hygienist’s promised work/life balance doesn’t materialize. When someone is looking for a permanent position, they’re looking for a home—and a person won’t stay long in a home where they aren’t comfortable. 

Can you offer any benefits that provide financial protection, such as medical, life, and disability insurance? Will hygienists have pay protection from lost workdays when they’re ill or injured? What about a 401(K) and retirement? These cushions set you apart from the temp agencies.

Hygienists don’t want unrealistic and ever-shifting performance standards. Performance expectations should be written, clear, and change only when warranted. Hygienists should trust their peers and superiors and be able to safely make mistakes as they learn. Finally, hygienists need effective instruments and equipment.

Have you ever considered purchasing a home, but realized it needed too much work to make it worth the investment? The same happens when hygienists turn down generous job offers. Some practices have issues that aren’t worth the hassle, particularly if a turnkey employment home can be easily found down the street.

Eventually, many hygienists will want to settle down in one place. They will be looking for their work home. Will hygienists want to call your practice home for the long haul? If so, you will be well positioned to convince your ideal hygienist that they should choose your practice. Only then will your use of temporary hygienists be at the level it should be. 

References

1. A dental hygienist shortage has dentist offices struggling to schedule patients. All things considered (NPR). https://www.npr.org/2022/09/12/1122482181/a-dental-hygienist-shortage-has-dentist-offices-struggling-to-schedule-patients

2. Edwards K. Dentistry’s job market: Hey, Doctor! Where did all the hygienists go? Today’s RDH. https://www.todaysrdh.com/dentistrys-job-market-hey-doctor-where-did-all-the-hygienists-go/

3. Pandemic bit into supply of dental hygienists. US News & World report. https://www.usnews.com/news/health-news/articles/2022-02-24/pandemic-bit-into-supply-of-dental-hygienists
4. Employment patterns information. February 2021. https://www.adha.org