With over 40 years of experience in the dental field, Debbie Gabbard has dedicated her career to helping practices thrive—from front office roles to office management. Dentistry is not just her profession; it’s her passion. Over the years, she’s had the privilege of leading four dental practices to be recognized as Top Dentists in her region. She’s also successfully managed two practice sales and doctor transitions, ensuring smooth and supportive changes for teams and patients alike. She specializes in building strong, efficient, and patient-focused practices, and particularly enjoys mentoring and supporting new practices as they grow. Outside of work, she finds joy in traveling, cooking, and spending quality time with her grandchildren.
As a dental office manager with decades of experience, I’ve seen my fair share of staffing challenges. Nothing compares to the current shortage of dental hygienists. Dental hygiene is critical to overall health, yet the profession faces a growing shortage. I believe it is not one specific thing, but a handful of challenges that have created the perfect storm for an ongoing crisis. What was once considered an attractive profession is now looked over. The shortage of dental hygienists is a reality unfolding right in front of us in offices across the country—a growing void leaving dental teams stretched thin, patients waiting longer for appointments, and hygienists questioning how much more they can give. Why is that? What is causing the current shortage? And is there relief insight?
The Lasting Impact of COVID-19
The COVID-19 pandemic accelerated the workforce decline. Concerns about safety and insufficient protective measures led many hygienists to leave the profession. COVID-19 didn’t just shake us in supply costs; it shook our profession. Dental, as we knew it, abruptly changed in the blink of an eye. I remember the first day our team returned to work in unfamiliar territory— the anxiety of maneuvering through new waters, N95 masks, patients waiting in the parking lot for the call to come in, and repeatedly reading the CDC guidelines just to survive. Our old routine no longer existed. We found our patients were delaying or skipping regular dental visits, leading to a decline in their preventive care.
Now that patients are back, their oral health is often worse than before. Delayed treatment means longer and more intensive appointments, adding increasing pressure to an already limited workforce.
Burnout and Workplace Stress
Burnout remains one of the leading causes driving hygienists out of the field. Burnout isn’t hypothetical—it’s happening. Long hours, high patient volume, and the physically demanding nature of the job result in emotional exhaustion and physical wear. The repetitive nature of clinical work and challenging positions tax the human body. Add to that the emotional pressure of being expected to maintain patient rapport, catch early signs of oral disease, and keep production up. Many hygienists feel overworked, undervalued, and unsupported. We all know there is a hygiene shortage, but our office will not contribute to that. We love and value our hygienists—they are family, and they are irreplaceable. And we protect our hygienists, because they are amazing! We are a privately owned practice that chooses to put our team first. Without your team, who are you? Our office has a designated team member who helps with sterilization, chart preparation, operatory setup, breakdown, or whatever it takes to alleviate burnout and physical strain. We start on time and leave on time. Everyone gets a lunch break.
Most importantly, we do not “overbook” or “squeeze” another patient into an already busy schedule. Do we get tired? Of course. But we’re not burned out.
Barriers to New Grads and Sustainability
Another key contributor is the rising cost of dental hygiene education. I believe the idea of mounting student debt is discouraging to potential candidates. Statistics show that the average cost for hygiene school is $40K. Many individuals instead opt for careers that offer higher pay with lower physical demands and a better work-life balance. We are often asked to be a shadow office for hygiene students. I enjoy this opportunity to learn from students, calm their nerves, and answer questions they may have. One of the ongoing issues office managers face is receiving qualified applicants. Every student who comes through your office could be your next best hire. In sharing conversations with the students and established hygienists, I find the difference in why candidates want to become a hygienist and why some want to leave the field interesting. Although excited about their new career choice, I can see and hear their concerns about financial anxiety and burnout. Our seasoned hygienists are tired. Change is not easy, and it has been a change for them. Even with the new grads coming in, retention is an ongoing issue.
The Risks of Role Dilution
In some states, dental assistants are now being trained to perform certain hygiene tasks under general supervision. While this may offer short-term relief, it presents significant risks. Dental assistants, although essential to the dental team, do not receive the same specialized training or licensure as dental hygienists. Delegating complex tasks to less-qualified personnel compromises patient care and devalues the profession and public trust. Dental hygiene is not a simple skill transfer. Hygienists are more than plaque removers; they are also educators.
Conclusion
Where do we go from here? How do we encourage retention and growth in this perfect storm? Solving this crisis requires a renewed commitment to investing in and supporting dental hygienists. Make education affordable and accessible through funding and scholarships to reduce the financial burden. This also includes improving workplace conditions and preserving the integrity of the dental hygiene role.
Most of all, it means that we acknowledge that dental hygienists aren’t interchangeable. They are essential!
