If you’ve tried to hire a dental hygienist lately, I probably don’t have to tell you that something has changed.
The applications aren’t pouring in. Positions are staying open longer. Compensation expectations have shifted. Practices are competing for the same professionals, and in some communities, it can feel like there simply aren’t enough hygienists available.
And that’s not just a feeling.
According to the American Dental Association’s Health Policy Institute, the United States is experiencing a major dental hygienist shortage. Recent data shows that only 60% of dentists report having an adequate number of hygienists on staff. Among dentists who have recently recruited hygienists, the overwhelming majority say finding them is very or extremely challenging.
So yes, the hygienist shortage is real.
But after more than four decades in dentistry, I think there’s another question practice leaders need to be willing to ask:
Is the shortage the only reason we’re struggling to keep our hygiene departments staffed?
Recruiting Is Only Half the Conversation
We can’t manufacture more hygienists overnight.
There are encouraging signs. Enrollment in dental hygiene programs has increased, and 2025 saw the highest number of dental hygiene graduates on record. But the ADA’s analysis suggests that the imbalance between supply and demand isn’t going to disappear quickly.
That means practices have to think beyond recruitment.
If finding your next hygienist is difficult, keeping the great hygienists you already have becomes even more important.
This is where I believe we need to put some heart back into the workforce conversation.
We can talk about job postings, signing bonuses and hourly rates all day long. Compensation matters. Benefits matter. Scheduling matters.
But so do leadership, communication, culture and whether someone actually enjoys coming to work every day
What Are Hygienists Walking Into?
When I work with dental practices, I’m interested in what happens after someone accepts the job.
Is the hygiene department supported or constantly pressured?
Are expectations clear?
Are the doctor and hygienist clinically aligned?
Are there consistent periodontal protocols?
Does the schedule allow clinicians to provide the level of care they’re expected to deliver?
Can team members raise concerns without feeling like they’re creating a problem?
Do hygienists understand how their role contributes to patient health and practice growth, or are they primarily hearing about production?
And here’s a big one:
Do your people feel valued?
Because hiring someone into a dysfunctional system doesn’t fix the system.
It just gives the dysfunction a new employee.
Retention Has Become a Leadership Strategy
For years, practices could sometimes tolerate culture problems because another applicant might be waiting.
Today’s workforce doesn’t give leaders that luxury.
When qualified professionals have choices, culture becomes part of your competitive advantage.
That doesn’t mean leaders shouldn’t have expectations or hold people accountable. I believe strongly in accountability.
But there’s a tremendous difference between accountability and creating an environment where people feel constantly criticized, unheard or exhausted.
Great leaders learn that difference.
They communicate expectations. They listen. They develop people. They recognize strengths. They address conflict instead of allowing resentment to grow. And they create systems that help good people do good work.
That isn’t “fluff.”
In today’s dental workforce, that’s business strategy.
Don't Let a Shortage Lower Your Standards
There’s another danger I see when practices become desperate to hire: they start hiring anyone willing to say yes.
I understand the temptation.
You have patients waiting. Your current team is stretched. Production is affected. The schedule needs help.
But a warm body isn’t necessarily the right body.
A poor culture fit can create additional turnover, conflict and stress for the team you’re trying to protect.
Instead, get clear about the practice you’re building and the people who will thrive inside it.
Then look inward.
If you found the perfect hygienist tomorrow, would your practice be a place they would want to stay?
That’s the question I want dental leaders asking.
We Can't Control the Shortage. We Can Control What Happens Inside Our Practices.
Dentistry has a workforce challenge that will require bigger solutions, including education, workforce development and strengthening the pipeline into dental careers.
Individual practices can’t solve all of that.
But you can influence what happens inside your four walls.
You can build better systems.
You can strengthen communication.
You can develop stronger leaders.
You can create clinical consistency.
You can recognize and use the strengths of your people.
And you can build a culture where great hygienists don’t spend Sunday night dreading Monday morning.
The hygienist shortage may be bigger than your practice.
But becoming the kind of practice great people want to join, grow with and stay with?
That’s something we can work on right now.