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 just a local problem or a temporary one. Over the past several years, the supply of hygienists has shifted significantly, and practices across the country are now feeling the impact. The Bureau of Labor Statistics (BLS) predicts that this year there will be approximately 15,300 open hygiene positions. Many hygienists left the field after the pandemic or opted for early retirement. Hygienists have more leverage than ever, and temp rates have climbed to the point where filling a single open day can cost your practice more than it produces.

So what do you actually do?

First: Understand what you're solving for

Most practices in a hygiene shortage are dealing with one of three situations:

An open chair with no hygienist to fill it. A hygienist, but not enough days to meet patient demand. Or full coverage, but hygiene production still isn’t where it should be.

Most solutions address the immediate gap—but not the underlying constraint.

Option 1: Temp hygienists

Temp hygienists can help to bridge a gap, but the economics need to be watched carefully. The highest hourly temp rate I have come across was $144 per hour for an urgent posting. A day of temps can easily cost more than it generates — especially if your reimbursement rates are low or your schedule isn't running efficiently.

Temps work best as a short-term bridge, not a long-term strategy.

Option 2: Expand current hygiene days

If you have a hygienist you trust, the conversation worth having is whether 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 can help in the short term, but it’s not a sustainable solution.

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

But what if the issue isn’t staffing at all? What if it’s how the department is structured?

Option 4: RETHINK THE STRUCTURE.

This is the option 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, the problem may not be a staff shortage, it may be structure. A two-column assisted hygiene model allows one hygienist — with a dedicated assistant — to see more patients, produce more per day, and still deliver thorough, quality care.

Before assuming your hygienist doesn’t have enough time, it’s worth looking at how that hour is actually spent - the breakdown is eye opening. In recent survey data, a significant portion of the hygiene appointment is spent on tasks that don’t require a hygienist.

Done well, this model can generate 50% more hygiene revenue from a single hygienist day. It doesn’t require hiring. It requires an structure.

The challenge is implementation. When assisted hygiene is set up incorrectly, it creates stress and burnout — which is why many hygienists who tried it are resistant to trying it again. If assisted hygiene requires the hygienist to work harder, the system is wrong.

With the right structure, it removes friction so the hygienist can stay in their highest-value clinical work — and the system supports them.

This isn't the right fit for every practice. But if you have a strong hygienist and a full schedule, it's worth understanding whether there's capacity 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 for the right hire — they're looking at what they can control right now.

Schedule structure. Assistant utilization. Compensation alignment. These are the levers that are actually available to you today.

If you’re trying to determine what’s actually limiting your hygiene department, I’m happy to walk through your schedule with you.