The Dental Hygienist Shortage: Impact and Solutions
Written by Dr. Adrienne Hedrick
Have you recently called a dentist’s office to schedule an appointment but couldn’t get one as soon as you would have liked? If so, the reason may be because of a hygienist shortage, and it’s not just happening here in Longmont but across the nation. Read on to find out how this shortage is affecting us and our patients and is another reason why we’re going out of network with all insurance companies, including Delta Dental.
The Reason for the Hygienist Shortage
The reason is a classic example of supply and demand: There is a high demand for quality hygienists at dental practices, but there are a limited number of hygienist schools across the country, and they haven’t been able to produce enough graduates to meet that demand. According to a 2022 American Dental Association study, there is an 11% decrease in practice capacity because of staffing shortages.¹
Other Contributing Factors for the Shortage
The Changing Demographics of Baby Boomers
According to the CDC, 68% of adults age 65 or older have gum disease.² This sizable generation means that more people than ever have periodontal disease and need to see a dentist more frequently than the average patient, which only increases the demand for hygienists.
The COVID-19 Pandemic
This caused many hygienists to since leave the profession and many full-time hygienists to transition to temp for more flexibility and the ability to work fewer hours. A published study from The Journal of Dental Hygiene in 2022 showed that 4.9% of respondents had not returned to work by 2021; although this rebounded from the previous year’s high of 7.9%, 1.6% of study participants said they no longer intended to work as dental hygienists.³
It’s Difficult to Pay the Fair Market Rate for Dental Hygienists
That’s because benefit payouts by insurance companies have remained the same since the 1980s, not even increasing to keep up with inflation.
How the Hygienist Shortage Is Impacting Dental Practices
It’s Time-Consuming to Hire Hygienists
Before the COVID pandemic, dental practices would post an online ad for a hygienist and typically receive several applications within the first few days and expect to hire within a few weeks. Now, with the high number of practices with open positions and not enough hygienists to fill them, we’re fortunate if we receive one application within the first few months. Longmont Dental Loft once posted a job and received just one application within the first three months.
There Are Many Dental Practices with Job Openings for Dental Hygienists
At the time of this blog’s post, there are 14 job postings on Indeed for dental hygienists in Longmont alone.
Lack of Consistent Care
During normal times, dental practices generally use temps only when their full-time hygienists are sick or on vacation. However, the shortage is now forcing practices to use temps longer-term, which we at Longmont Dental Loft have also done over the past few years. Although temps are skilled professionals and perform good work, relying on them does not reflect the consistent care we want to provide.
We Sometimes Have to Turn Away New Patients
Although we still see new patients, the shortage means we can’t see as many as we would like to.
Long Wait Times for Cleanings
At some dental practices, patients may have to wait longer than the usual six months for a cleaning. In extreme cases, some dentists clean their patients’ teeth instead, which means they can see fewer patients for surgeries and other procedures that only a dentist can perform.
A Nationwide Issue
It’s important to stress that this shortage is a national problem and not only affecting Colorado, and the same 2022 ADA study mentioned above also cited that 90% of dentists surveyed reported that recruiting hygienists has been “extremely” or “very” challenging.
Dr. Brandon McKee, DDS at Park City Dental Associates in Park City, Utah, is just one of many dentists across the country experiencing the dental hygiene shortage firsthand. “We still refuse to decrease patient care, but it’s difficult to meet our maximum volume with staff shortages,” said Dr. McKee.
Dr. McKee’s office also has an opening for a hygienist position, which hasn’t been easy to fill and is straining his practice financially. “We’re currently throwing whatever money [we have] to get a new one. We’re also going through a temp agency. That’s not very promising either. We pay travel time, hourly [wages], and fuel.”
How the Shortage Impacts You, the Patient
You May Have to Shop Around for a While for a New Dentist
- Gone are the days when you could make an appointment as a new patient with a dentist and get one right away. Nowadays, you may be told that a particular dentist isn’t even seeing any new patients at the moment. Longmont Dental Loft has had to turn away many people wanting to become patients because it’s impossible to see everyone in the current environment.
Longer Wait Times for Even the Most Basic Care
If you want to make an appointment right away or at least in the month you call, you may have to wait another month or two before your dentist can see you.
Your Medical History Determines Your Cleaning Schedule
Typically, patients receive a dental cleaning every six months, but the hygienist shortage may mean you’ll have to wait a little longer. On the other hand, patients with periodontal disease will likely continue to be seen more frequently (about every three months).
Our concern is that if the hygienist shortage continues or worsens, quality care across all dental practices will also deteriorate as patients won’t receive proper treatment. We go into more detail about this in our post on the decline of dental insurance. The biggest downside is that it would cause oral diseases to progress, and we’ll see an overall decline in dental health.
Solutions
Unfortunately, there are no quick fixes for such a large shortage, and there’s not going to be a sudden decrease in demand for hygienists. If anything, there is more demand now than ever and will continue to be as baby boomers require more dental care as they age.
However, there are two crucial steps our industry can take to address the problem:
Increase the Number of Dental Hygienist Graduates
As noted by the Colorado Sun,⁴ some new grants in Colorado aim to double the number of graduates with dental hygienist degrees in the state by 2025.
Go Out of Network
This enables dental practices to pay dental hygienists their worth. Doing so also has the potential for a triple impact, as it may encourage:
- Current hygienists to stay in the profession full time
- Hygienists who left during COVID to return to the workforce
- Part-time hygienists to return to full-time work
Increasing pay would also give dental practices more funds to supply hygienists with continuing education and costly state-of-the-art technology like soft tissue lasers.
We also believe that freedom from the control of the insurance companies is the best way to maintain a standard of care. We can’t emphasize enough that in-network providers must abide by antiquated insurance rules. As a result, insurance has been reimbursing less for cleanings, doesn’t approve certain procedures that dentists think are necessary, and doesn’t keep up with inflation when determining benefit payouts.
The Future of Dental Hygienist Graduates in Colorado
The Colorado grants will help establish dental hygiene programs at Front Range Community College, Colorado Mountain College, and Pike Peaks State College and further expand the number of seats at the existing dental hygiene program at Community College of Denver.
Colorado has approximately 150 dental hygienist graduates each year, so double that would be 300. That’s a respectable number, but it will take years to achieve because the number of students attending dental hygiene schools in Colorado won’t double until 2025 and won’t graduate until 2026 or 2027. Also, the heavy backlog of open positions will take time to fill, which means it may take up to ten years before we see much change.
How We’re Managing the Shortage at Longmont Dental Loft
The biggest step we’re taking to address the hygienist shortage is going out of network with insurance companies. This will benefit our patients in many ways as there are a lot of advantages of seeing an out of network dentist. For example, this will enable us to maintain the highest standard of patient care, whether through technology, training, or spending more time with them. Having more revenue also means we can pay our dental hygienists competitively (i.e., their worth), helping to ensure their satisfaction and loyalty.
Summary
The dental hygienist shortage isn’t something that any private dental practice can take lightly. They’re essential to quality care, and we can’t survive without them. Transitioning to an out-of-network model is the only way we tackle this issue head-on to continue our success and longevity in this industry.
References
- Health Policy Institute. (2022, February). Economic Outlook and Emerging Issues in Dentistry. ADA.org. Retrieved October 1, 2023, from https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/feb2022_hpi_economic_outlook_dentistry_slides.pdf?rev=8fa94d2edb8f4fc096be732e6612910c&hash=F7ABCEF22C208DDECC78C460737E5432&_ga=2.269091377.1183415106.1694454868-1519314885.1694452418.
- Facts About Older Adult Oral Health. (2021, May 5). CDC.gov. Retrieved October 1, 2023, from https://www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm.
- Rappé, J., Hoeft, E. (2022, February 22). Research Reveals Impact of COVID-19 on Dental Hygienists. ADA.org. Retrieved October 4, 2023, from https://www.ada.org/en/about/press-releases/research-reveals-impact-of-covid-19-on-dental-hygienists.
- Flowers, T. Four Colorado colleges granted $5M by Delta Dental to expand oral health programs. Coloradosun.com. Retrieved November 7, 2023 from https://coloradosun.com/2023/05/02/delta-dental-oral-health-college-grants/.