Can’t Find a Dental Hygienist? What to Do Instead

If you've had a hygienist position posted for weeks — or months — you're not alone.

The hygiene shortage isn't a temporary problem. The ADA Health Policy Institute just published new data that to confirm it. Only 60% of dentists currently have an adequate number of hygienist. Among dentists actively trying to hire, 91% described it as very or extremely difficult to find candidates. Almost 40% of practices nationally are in need of a hygienist.

So, what can you actually do besides reposting the same indeed listing until you find someone?

Most practices who are looking for a hygienist are dealing with one of three situations: An open chair with no hygienist. A hygienist, but not enough days to accommodate their patient base. Or full coverage, but hygiene production isn’t where you know it has the potential to be.

Most solutions address the immediate issue—but not the underlying issue at hand.

Option 1: Temp hygienists

Temp hygienists can help to fill a temporary need, but the costs are huge. The highest hourly temp rate I have seen was $144 per hour for an urgent posting. A day of temps easily costs more than it produces — especially if your reimbursement rates are low.

Temps work best as a short-term need but not as a long-term strategy.

Option 2: Expand current hygiene days

If you have a hygienist you trust, it’s worth it to ask them if they'd be open to adding a day. Many won't — but some will, especially if the compensation is right. Even one additional day per week from an existing hygienist is more stable and less costly than rotating temps.

Option 3: Have the dentist see hygiene patients

This is not a sustainable solution.

If the doctor is seeing hygiene patients, they’re not doing restorative dentistry. That shift has a tremendous impact on production.

But, what if you rethink the way your hygiene department is running?

Option 4: Consider two-column assisted hygiene.

I know how well it works, because I’ve practiced this way myself for twenty years - and I still love the industry as much as I did the day I started.

This is the option that most practices overlook — and often the highest-leverage one.

If your hygiene schedule is full but you still can’t accommodate your patients, or production isn’t at it’s potential, there is a better way. A two-column assisted hygiene model allows one hygienist — with a dental assistant who works in the hygiene department — to see more patients, produce more per day, and still deliver thorough, quality care.

Before assuming that it’s requiring your hygienist to work harder, or faster - consider this first. I’ve been polling hygienists to see where our appointment time actually goes. And the breakdown is eye opening!

Done well, assisted hygiene can generate 50% more hygiene revenue from a single hygienist day, and it doesn’t depend on hiring another hygienist.

The challenge is implementation. First, I’m guessing most practice owners don’t have experience working this way. Second, you don’t have the time or the energy. When 1,000 other tasks are pulling you in various directions every day, who has the time to set your team up for this? And the problem is, when assisted hygiene is set up incorrectly, it creates stress and burnout — which is why many hygienists who’ve tried it and seen it fail are resistant to trying it again.

If assisted hygiene requires the hygienist to work harder or faster, it is not set up properly.

With the right flow, it allows the hygienist to stay in their highest-value clinical work.

This isn't the right fit for every practice. But believe it or. not, seeing one patient per hour isn’t for every hygienist either. If I saw one patient per hour for my entire career, I honestly don’t know if I would still be a hygienist. For those offices with a strong hygienist and a full schedule, it's worth understanding whether there's potential you're not using.

The honest answer:

There's no single fix for the hygiene shortage. But practices that are navigating it well aren't just waiting to find the right hire — they're reevaluating what they can control right now.

Scheduling structure, assistant utilization, compensation alignment. These are the areas that are actually available to you today - without waiting to find a new hygienist.

Wondering if assisted hygiene could work in your practice?