The supply of dental clinical and administrative staff is dwindling for various reasons. Meanwhile, the demand for their specialized skills is increasing, and there are few ways to fill the staffing gap. Dentists can’t avoid the severe healthcare workforce shortage, they can prepare for it and proactively combat it.
Pandemics, recessions, staffing shortages … they’re all obstacles to providing excellent patient care. The first two are out of our hands, but understanding the causes of the healthcare staffing shortage is the first step of finding a way out of the maze.
DentistryIQ summarizes what’s challenging about staffing a dental practice today:
“As the dental industry contends with a critical staffing deficit, its challenges are compounded by multiple factors. A scarcity of dental professionals, particularly hygienists and assistants, has become pervasive, with a staggering 95% of dentists encountering considerable difficulties in recruiting hygienists and over 87% facing challenges in hiring assistants.”
The need is deeply felt right now across all dentistry staff. ADA News says 24% of dentists claim they don't have enough administrative staff, and 32% state they don't have enough clinical staff.
Based on our research, the factors that created this scenario are:
- The rate at which people in the dental industry are retiring
- The staff who did not return after the pandemic
- Dental professionals leaving the field/industry
- Too few new graduates coming up the ranks to replace those who walked out.
It’s a complex problem for dental business owners. The Bureau of Labor Statistics anticipates thousands more new dental clinical and administrative positions will need to be filled within the next 10 years.
With hiring becoming increasingly difficult, dentists and business owners are scrambling to cover not only clinical roles, but also administrative positions, such as billing specialists. A dental practice can’t be a one-person show — it needs trained and experienced people in place to handle both the clinical and administrative tasks as patients are treated.
What can dentists do to combat the healthcare workforce shortage? This article explores why the healthcare staffing shortage will be an ongoing problem for dental business owners, and also shares proven ideas that are working for our client-partners at DCS.
Key takeaways for dentists facing the healthcare staffing shortage:
- Three factors combined to create today’s dentistry staffing gap
- Continued profitability lies in a proactive approach
- Establish succession plans before valuable team members retire
- Leverage technology to automate routine processes
The Problem: Mass retirement, the pandemic, fewer graduates, and high turnover in a dental industry with increasing needs
The hiring pool is draining faster than it’s filling, and the available staff are spread thin and unevenly nationwide. Dr. Bicuspid says that hiring has recently become easier due to layoffs, but that doesn’t solve the larger problem of there not being enough dental professionals to supply the current — and increasing — national demand.
Staffing a dental practice is even more difficult in certain areas. Current data from The Health Resources & Services Administration shows a high number of HPSA (Health Professional Shortage Areas) in rural areas, alongside an uneven distribution of need across the United States. For dental health, at the time of this writing, there’s a need for 10,153 dental practitioners to serve the 60 million people living in the 7,067 HPSAs nationwide.
So, why is the dental staffing shortage happening now?
Over 40% of dental clinical and admin roles retiring within 10 years
Mass retirement is one factor, as Baby Boomers and Generation X wind down their careers. According to respondents for Dental Post’s 2024 survey:
- 21% of practice managers plan to retire within six years, and 43% in the next 10 years. (30% of practice managers are 55+ years old)
- 32% of billing specialists plan to retire within six years, and 47% in the next 10 years. (52% of billing specialists are 55+ years old)
- 24% of front-office associates/receptionists plan to retire within six years, and 41% in the next 10 years. (29% of these other front-office staff are 55+ years old)
Plus, the ADA’s recent research tells us one-third of dental assistants (34%) and dental hygienists (31%) expect to retire within five years. These represent considerable percentages of the entire dental industry workforce, and the loss of vital staff needed to run a dental business.
But retirement isn’t the only factor causing the staffing shortage.
The COVID-19 pandemic and The Big Quit
Since its start in 2020, the COVID-19 pandemic had a detrimental impact on dental teams. The ADA’s data shows that the national “supply” of dental hygienists and dental assistants took a notable hit in 2020, -12.2% and -11.1%, respectively.
Both of those clinical roles have been recovering ever since, with mixed results. According to the most recent data available from the ADA, dental hygienists are still 5% below their pre-pandemic supply. Dental assistants, however, surpassed their pre-pandemic numbers in 2022, and by the end of 2023, there were 5% more than before the pandemic.
In the ADA’s Dental Workforce Shortage report, their discussion of general outflows has a more extreme interpretation:
“Due to a multi-year partnership between the ADA and ADHA, we know that fewer than half of dental hygienists who left employment early in the COVID-19 pandemic returned to the workforce in 2021. Further, an estimated 3.75% of dental hygienists voluntarily left the workforce in 2021, including 1.6% who permanently left due to retirement or a career change.”
The dental industry could contend with staff aging out of the workforce, and even a global catastrophe, but the third facet will make it difficult — maybe even impossible — to close the staffing gap.
Declines in dental school graduates
Our review of the Commission on Dental Accreditation’s (CODA) 2023 survey data found dental hygienists graduating at an erratic cadence from 2005 to 2022, with a slight decline overall. The graduating dental assistants, however, displayed a severe overall decline for that period, with a troubling trend.
The decline of dental assistant graduates started in 2011 and continued through 2022, with the deepest dips in 2012 and 2020, at -12.6% and -11.4% respectively. We look forward to seeing if the upcoming 2024 report shows a break in this unfortunate 12-year trend.
Complicating the limited supply of staff are the thousands of dental professionals who are looking for new jobs in other practices or leaving the industry altogether.
Job mobility and abandoning the field
People leave jobs for a variety of reasons, from toxic workplaces to insufficient benefits. Taken as a whole, these reasons for job changes create a strong ripple in dental’s shrinking hiring pool. Amplify 360 reported in a 2024 survey:
“Billing specialists who changed jobs in the previous 12 months were 17.33%. At the time of the survey, 18.92% were applying for jobs or planning to apply for new jobs before 2025. Another 45.95% reported they might apply for new jobs. The top motivation reported was a desire for higher income.”
The quest for a better salary has billing specialists on the move, but the ADA’s Dental Workforce Shortage survey found that pay isn’t the biggest problem when hiring for clinical roles.
“Demand for high wages, benefits” was reported as a struggle when hiring for dental hygienists (28.4%) and dental assistants (17.3%). But “Not enough applicants” was the greater challenge by far — 77.8% and 57.5%, respectively.
And while some dental pros are hopping around the industry, others are leaving dentistry.
The ADA’s report doesn’t state how many have left the field, but it does share why they left:
“Factors associated with attrition include negative workplace culture, insufficient pay, lack of growth opportunity, inadequate benefits, and feeling overworked.”
But dentistry recruiting isn’t only about filling the office staff roster. It’s also about hiring the right people — with the right training and skills — who will help grow and nourish the dental business.
The Dilemma: Dental is a niche industry that requires niche skills
Clinical and administrative roles at a dental practice require a specific set of skills. It’s typical for practice owners to assume they can easily fill these roles with anyone — but these positions are more complex than many realize.
The administrative team (which may be just person for a small dental business) handling billing tasks, should have deep expertise in insurance and billing before handling this critical part of the dental revenue cycle. It’s not a role that can be learned on the job, as even small mistakes are expensive. Why? Because dental insurance is maddeningly complex, the guidelines vary by insurer and change every year, and denied claims are costly.
When mistakes are made submitting or following-up with dental insurance claims, the dance of denial and appeal causes delays in claims revenue and inconsistent cash flow, and even dips in overall revenue.
That’s why hiring the right person with the right dental billing training and experience is a must: Dentists’ bottom line depends on it. In Dental Economics, Roger Levin stated:
“For the first time in dental history, we are noting numerous practices that have lower production and revenue because they cannot properly staff or hire skilled staff members.”
A prospective dental billing employee must know how to collect from both dental insurance and patients strategically, effectively, and efficiently, so that the dental business can continue to function and grow.
Now that we’ve laid out the cause of the staffing shortage and the challenges dentists face when staffing their front office, let’s look at solutions to this unavoidable industry-wide threat.
The Solution: Reduce and eliminate manual processes to operate with smaller dental teams
Instead of struggling to replace retirees or combat turnover by hiring yet more full-time employees, many dentists turn to outsourcing administrative tasks to revenue cycle management experts and automated technology.
Partner with a third-party billing service
Sprout Dental, a private dental practice in Pennsylvania owned by Dr. Kady Schloesser, felt the financial pinch in 2020, at the start of the pandemic. Her team was struggling to handle the insurance billing, and it was beginning to show in their numbers.
She was looking at a 90% outstanding accounts receivable (AR) insurance report for bills over 30 days old — virtually no one was paying their bills, and it had slowed her cash flow to a trickle. So she outsourced their insurance billing to DCS, an established revenue cycle management provider who has managed insurance billing since 2012.
Within 7 months, DCS’ experts tripled Sprout Dental’s monthly insurance collections, and reduced outstanding insurance AR for the 30-day mark from 90% to 23% — a 67% improvement. This yielded a massive revenue boost that leveled out into consistent cash flow. Read more about prout Dental here.
Dealing with both insurance billing and patient billing is time-consuming, and too valuable a task to be set aside until someone on the dental team has some extra time to push the paperwork. The entire dental business is at stake.
Amber Jean of Children’s Dental Care is a DCS client-partner who battled staff turnover, then finally solved her problem with DCS insurance billing services:
“After our Financial Insurance Coordinator of 15 years moved on from our office, I wasn’t sure where to turn. While interviewing, it was impossible to find someone who had the dental knowledge and insurance expertise combined. A quick Google Search for third-party billing led me to DCS. They have been fabulous to work with.”
Enlist today’s automated technology
It’s not just experts at their disposal when dentists outsource their revenue cycle: Technology helps, too. Automation isn’t stealing jobs — it’s making people’s jobs easier.
DCS uses automated software for an entirely hands-free patient billing solution, and incorporates technology in many of its in-house revenue cycle management workflows.
Marko Vujicic, the Chief Economist and Vice President of the Health Policy Institute (HPI) at the American Dental Association (ADA), predicts:
“In the next two to five years, this is almost going to become standard practice, using these automated tools. There’s simply way too much pressure on margins; there’s pressure to be more efficient. Practices are going to have to invest in these.”
DCS’ automated patient billing solution uses sends payment reminders to patients via text and email, and includes a direct link to a payment portal. Dentists can also offer payment plans using this technology that will notify a patient of their monthly payment.
This technology manages all the tedious hands-on processes of patient billing, which gives a dental team more time back in their day to interact with in-person patients, rather than being bogged down with mailing statements and payment reminders.
Dentists collect faster because patients find it easy to pay from any digital device, at any time, using their favorite payment method. The ease and convenience of automated billing is a win-win-win.
Another DCS customer, Horizon Dental, faced a skills problem when it came to this point of their revenue cycle — they didn’t have the right person in place to handle patient billing:
“We had a former office manager that was doing the billing. She wasn’t doing it correctly, and we weren’t getting paid for a lot of stuff. With DCS Patient Billing, we’ve seen higher payouts and consistent follow-up on balances. We definitely recommend DCS: We love working with them.”
Needless to say, DCS customers don’t face the healthcare workforce shortage with the same anxiety as other dental professionals. With experts on hand and technology running on autopilot, they have the support needed to maximize their profitability and continue growth.
How has the healthcare staffing shortage impacted the dental industry — and who’s conquering it?
To recap:
- The healthcare staffing shortage is a result of a worldwide pandemic, mass retirement, people leaving the industry, and increased demand combined with too few people entering the field.
- The skill set needed to fill these positions is specialized and complex, and these roles have a direct impact on the bottom-line revenue of every dental business
- Revenue cycle management (RCM) experts and automated technology help close the gap to bypass the staffing shortage and increase overall revenue
While dentists can’t control the healthcare staffing shortage, they can control how they approach it: Head-on and with confidence, through proactive management and expert support.
DCS is a full-service RCM solution for dental business providers looking to thrive despite the staffing shortage. By working with DCS, they streamline their workflows, increase their revenue, and improve the patient experience.
Dentists who will win the battle against the staffing shortage and other RCM challenges start here: Book a free 30-minute consultation today.
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