By now, most dentists agree on one thing:
“It’s hard to hire hygienists.”
But the more important question is:
Why is it so hard—and what does that mean going forward?
Understanding the why behind today’s hiring challenges is critical, because it shapes:
-
How practices operate
-
How buyers evaluate opportunities
-
And how sellers position their practices
The Reality: This Isn’t Just a Tight Labor Market
Nearly 2 out of 5 dentists report actively recruiting hygienists, and among them, over 90% say it is very or extremely challenging
That level of difficulty isn’t typical—and it suggests something deeper than a temporary hiring cycle.
This is not just a shortage.
It’s a structural shift in the labor market.
What’s Actually Driving the Hiring Challenge
Let’s break down the key forces behind it.
1. There Simply Aren’t Enough Candidates
The most commonly cited issue is straightforward:
-
There are not enough applicants
In many areas:
-
Practices report receiving few—or even no—qualified applications
-
Competing practices are all trying to hire from the same limited pool
This creates a situation where:
Demand far exceeds supply
2. Wage Expectations Are Rising
Among available candidates, compensation expectations have increased significantly.
Practices are facing:
-
Higher hourly wage demands
-
Increased expectations for benefits
-
Competition from other practices and corporate groups
At the same time:
-
Insurance reimbursement has not kept pace
This creates a difficult balancing act:
Pay more to hire—or protect already tight margins
3. Work Preferences Are Changing
Many hygienists are no longer looking for:
-
Traditional full-time roles
-
Fixed schedules
Instead, they may prefer:
-
Part-time work
-
Flexible hours
-
Temporary or contract positions
This shift reduces:
-
Full-time availability
-
Long-term staffing stability
4. Qualification and Fit Issues
Even when candidates apply, practices often report challenges with:
-
Experience level
-
Clinical skill
-
Reliability
In some cases:
-
The candidate pool is large—but not well-aligned with what practices need
5. Mismatch Between Economics and Expectations
This is one of the more subtle—but important—factors.
There’s a growing mismatch between:
-
What hygienists expect to be paid
-
What practices can sustainably afford
Especially in practices heavily tied to insurance:
The math doesn’t always work.
What This Means for Practice Owners
This environment requires a different approach to hiring.
It’s no longer just about:
-
Posting a job
-
Waiting for applicants
Owners need to think more strategically about:
-
Compensation structures
-
Work environment
-
Scheduling flexibility
-
Retention, not just recruitment
What This Means for Sellers
If you’re preparing to sell, buyers will look closely at:
-
Your current staffing situation
-
Your ability to maintain the team
-
Your approach to hiring and retention
Even if hiring is difficult:
A clear, realistic plan matters.
Sellers who can demonstrate:
-
Stability
-
Thoughtful management
-
Awareness of the issue
tend to instill more confidence.
What This Means for Buyers
For buyers, this is one of the most important risks to evaluate.
Key questions include:
-
How difficult is hiring in this specific market?
-
What is the current team situation?
-
What would it take to recruit and retain staff?
At the same time, this challenge can create opportunity.
A buyer who can:
-
Build a strong team
-
Offer the right structure
-
Adapt to changing expectations
may be able to:
Unlock production that the current owner couldn’t.
The Bigger Insight
The hygienist shortage isn’t just about hiring—it’s about alignment.
-
Between wages and reimbursement
-
Between employer expectations and employee preferences
-
Between traditional models and current realities
And until those align more closely:
This challenge is likely to persist.
Looking Ahead
Next week, we’ll broaden the lens:
> How hiring challenges differ between hygienists, assistants, and administrative staff—and where the market may be easing.
If you’re navigating hiring challenges—or evaluating how staffing impacts your practice or a potential acquisition—understanding these dynamics is critical.
That’s where a thoughtful, strategic approach makes all the difference.