How to Win the Talent War

Written by: Joanne Miles, MAADOM, RDA


What Dental Practices Can Do to Retain Top Dental Assistants During a Work Shortage

Are you singing the “I need a dental assistant blues?” You’re not the only one.

Dentistry is staring down a massive cavity in the experienced dental assistant department. According to a report from the American Dental Association Health Policy Institute, 62.2% of dental assistants are performing a mass exodus from the dental profession. Insufficient pay, burnout, and unbearable workplace culture are the top three reasons for assistants’ disheartening departures.(1) 

This shortage limits the ability for practices to get patients seen on time, since there is not enough bandwidth to allow multiple patients in treatment rooms. This also has a cascading negative effect on dental assisting across the entirety of dentistry. Practices short on experienced assistants lean heavier on the assistants they do have, which can cause those assistants to burn out quicker.

Dental assisting used to be an attractive and respected career. Today, experienced dental assistants are embarrassingly neglected, grossly underappreciated, brutally overworked, and they’re leaving the profession for greener pastures, with careers that offer enticing pay and toothsome benefits.

There is hope. In today’s environment, dentists who strive for improved relationship building will win over the best dental assistants in their area—not only from the dental office down the street, but from enticing careers outside of dentistry. As a business advisor to many dental practices, a member of the American Association of Dental Office Management (AADOM), and a career dental assistant since 1986, I’ve gained a unique perspective on how to hire, train, and retain great dental assistants in any market. 

There are five areas of focus that will allow you to create a successful strategy in developing and retaining dental assistants at the top of their game. 

When you want to hire and retain the best dental assistants you can, just remember TEETH:

  • Teach
  • Encourage
  • Empower
  • Trust
  • Honor

Teach: Candidates seeking to change jobs are looking for enriching opportunities, not only a paycheck. 

When you hire a dental assistant, go into it knowing one day they will leave. It’s inevitable. Maybe they will want to start a family, or go back to school, or their spouse may someday relocate. The only unacceptable reason for your assistant leaving is stagnation. Your dental assistant should never leave your practice because they feel bored. Doctor, it is your job to invest in them.

Dental assistants are an asset, not a liability. Fully engaged dental assistants will always feel that their gifts and skills matter to your practice, your patients, and you; and they will always produce better results than the assistant who feels like a “brain on a shelf.”

Here are six tips on teaching, which will be beneficial to your dental assistant and your overall practice: 

  • Just because your new dental assistant has 10 years of experience, it does not mean they know how you want things done. Don’t assume anyone on your team instinctively knows how you want things done—you need to teach them.
  • Walk them through your procedures and explain not only how you want something done a certain way—but why.  
  • Remember, everyone learns differently. Ask your team how they learn best and adapt your teaching style to the way they learn. You will get much better results.
  • When developing policies in your practice, write them down and keep them in a current file for team reference. 
  • Often filming a quick training video, or taking pictures of a tray and room set-up for specific procedures are helpful for dental assistants to refer back to. This resource allows for independent learning, and freeing up other team resources to be with patients.
  • Train your team. Once they’re proficient, perhaps challenge them to make things more efficient than they currently have them set up. 

Encourage: Doctor, your team wants to have a positive professional relationship with you. Here’s how you can be there for them without crossing personal or professional boundaries. 

There is not a single team member who should care more about your practice than you do, doctor, so stick around (or in other words, don’t leave early). There is so much that goes on in your practice, leaving little time for team check-ins. Doctors should make themselves available at the beginning or end of the day for follow-up conversations. If possible, the doctor should do everything they can to be the last person out the door.

As humans, we are built to be in relationship and community with each other. In professional journals like Harvard Business Review, Forbes, Inc., and Fast Company, you’ll find a bevy of articles focused on the relationship between bosses and their team members, employee productivity, and staff retention. In fact, a Gallup study published in 2015 found that employees who have managers who regularly communicate with them are almost three times more engaged than employees who have managers who communicate infrequently. The study also found that employees who feel their opinions count at work are more likely to stay with their company.

In this report, Gallup surveyed more than 2.5 million manager-led teams across 195 countries and found that employee engagement is strongly linked to the quality of the employee-manager relationship. The report also found that managers who focus on their employees’ strengths and development can have a significant impact on employee engagement and retention.

Overall, it is clear that having a positive relationship with employees can have a significant impact on their job satisfaction, productivity, and retention. (resource: )

So how do you develop a relationship with your employees without crossing the professional line?

  • Take time to get to know your employees.  
    • Ask them what is most important to them in life.
    • Get to know more about their families. You don’t need to go deep into their family tree, but at least know the names of their spouse and children. 
    • Find out what hobbies they’re into.
    • Share about yourself to find areas of commonality and to show your humanity. 
    • Find some organizations that you and your team can volunteer for together as a team.
    • Plan some appropriate team outings where you can all get to know each other on a personal level and bond as a team.
  • Create a culture of positivity.
    • Have your team fill out a “Favorite Things Sheet,” so when you catch them doing something right, you can customize your acknowledgement of a job well done.
    • Foster positivity in your communication and your personal attitude.
  • Create clear boundaries. 
    • Communicate clear role expectations and enforce them equally. 
    • Have an open-door policy but denote clear times when you are available to talk.
    • Decline any invitations that require you to spend time outside of work that does not include the entire team.

Empower: It’s not enough to assume competency, you must acknowledge it, and then empower the team to act on it.

You know that saying, “you catch more flies with honey?” The same applies to your team.

Doctor, you have been trained to find the things that are broken or wrong, share about them, and then fix them. For most of your day, you work in a dark small field of vision at four- to six-times magnification, so the “problems” in your patients’ mouths tend to stand out. Then when you have to look up and take care of your team, it requires a total mind reset, where you have to start looking at what’s going right instead. That’s a hard thing to do. It’s not your fault, but it is your problem, and you need the proper tools and honed leadership skills that weren’t taught to you in dental school. 

  • Dentists who have happy, engaged team members have built the muscles of learning to take off their loupes, and find all the “right things” happening around them with their team and vocally acknowledge it. Saying “Thank You” is a courtesy, not an acknowledgment. The simple way to empower your team is to catch them doing something right, praise them for it, and be specific.
  • When you give feedback to your assistants, give them words of encouragement to bolster the behavior you would like to see more of. Tell them, “Hey, you did a great job just now with Mrs. Smith’s post-op X-rays. You split those roots so I can see how well the root canal fill turned out in each root. When the roots are not split that makes it hard to know if we accomplished a good fill for the patient. You have great X-ray skills!” 
  • Even when you feel frustrated, stop and think about what you are going to say. Ask yourself if what you want to share is phrased in an encouraging manner, or if it sounds like you’re attacking them. You want to ensure you’re being more encouraging than anything. Say more things like, “When you did this, it was awesome,” because, remember, you want to talk about the behavior, not the person. It is important to be honest in your criticism. Say something along the lines of, “I’d like to see less of _____, and here’s why,” and explain with kindness, like, “Hey, did you notice when you polished this margin you went a little too deep with the bur? Try it this way instead,” and then show them. They’re more likely to do things the way you want more often.
  • Empower your team to make great decisions in taking care of your patients. This can come in many forms. Here is an example:
    • Give them the power to make something right that went wrong with a patient by giving them a specific dollar value to make it right. For example, take the patient whose lab case did not return in time for their next visit. Your dental assistant can call the patient, explain the delay and send them a $100 gift card to go out to dinner on you. It could even come in the form of an adjustment to the patient’s account.  
    • By setting the boundaries and training the team on how to implement this, you empower your team to be the best patient and practice advocate possible.   

If you want to go further with team empowerment, I highly recommend the book Crucial Conversations: Tools for Talking When Stakes Are High, by Joseph Grenny, Kerry Patterson, Ron McMillan, Al Switzler, and Emily Gregory.

Trust: Providing opportunities to gain responsibility and be accountable becomes a point of pride for team members. It shows that you trust the team. You know at what level you can trust them if you take an active role in their development.

Some dentists have a hard time allowing their dental assistants to try new things because there are high stakes involved—especially with patients’ lives and doctors’ licenses on the line. But imagine the feeling of being able to delegate certain things that you know your dental assistant can handle, with the proper amount of training. Not only will you preserve your time for things only the dentist can do, but you’ll keep your dental assistant engaged and interested in their jobs. If the only things your assistant does is operatory prep and room sterilization, they will not stay long. 

When any workplace feels unbearable, the employee will find something better to do with their time—that might include finding a dental assistant position at a practice that teaches them more, or it might even mean they leave dental assisting for good. 

There are several models and frameworks that explore the relationship between trust and delegation, such as the Situational Leadership Model from The Center for Leadership Studies, which suggests that the level of trust and competence of the follower should inform the level of delegation by the leader. 

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Another framework is the Trust Equation, which suggests that trustworthiness is equal to the sum of credibility, reliability and intimacy, divided by a person’s self-orientation.

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Overall, the relationship between trust and delegation is complex and can depend on various factors such as the context, the individuals involved, and the task at hand. Therefore, it’s important to approach each situation with an open mind and be willing to adapt to the needs and capabilities of those involved.

Honor: Be clear on your mission and communicate everything with integrity and honesty. Be thoughtful in your words and actions.

In my career, I couldn’t possibly count the number of times I have heard of how team members would walk off a virtual cliff for their leaders/bosses. The reason for this always comes back to honor.

Here are ways you can honor your team:

  • Treat everyone on your team equally. Do not play favorites.
  • Be true to your own words. If you promised things to your team, you must follow through. The fastest way to break trust with your team is to go back on your word. Some doctors will implement a bonus system and then when the team reaches the goal, the doctor backs out because they felt it was too much money to award the team.
  • As a leader of your practice, you need to model the behaviors you expect from your team.

Be careful of the behaviors that derail honor – they tend to show up when you are under pressure and can burn out your dental assistant

  • If you ask your dental assistant to do treatment that is outside their license scope.
  • If you ask your dental assistant or team to post a code that does not reflect the work you have done.
  • Taking shortcuts with patients’ treatment.
  • Having favorite team members and letting them get away with things other team members would never be able to get away with, like allowing them time to leave early, or excusing them from tasks others have to take on.

Your dental assistant is the backbone of your practice, and if you treat them with the respect and appreciation they deserve, they will become an invaluable asset to you and the rest of your team. When you honor and trust them, they will feel empowered to perform their duties to the best of their ability, and this will translate into a better experience for your patients. It’s not just about the practical benefits of employing a great dental assistant. When you teach, encourage and empower your dental assistant, you invest in their personal and professional growth. You show them they are valued, that their work matters, and that they have the potential to achieve great things within the dental profession.

When that day comes for them to move on to new opportunities, you want them to remember you not just as a boss, but as a kind mentor. You want them to look back on their time at your practice with gratitude and pride, knowing they were part of something special. Treating your dental assistant well is certainly good for your business, but it’s also the right thing to do.

When you care about the people who work alongside you every day, they’ll care about you and the job they do.




Joanne Miles, MAADOM, RDA, is an Investment Grade Practices™ Business Advisor for Productive Dentist Academy. She is known throughout dentistry as the Swiss Army Knife for business, with decades of industry experience, including working with private multi-location practices. Joanne shares proven methods to guide dentists to grow their businesses. Joanne brings positive energy and solutions to help everyday dentists and their teams achieve extraordinary results, so they can realize the freedom that private-practice ownership can provide.

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Joanne Miles, MAADOM, RDA

Joanne can be reached at or on LinkedIn at 


Dental Assistant = Safety Net

The dental assistant is the first person to greet and begin getting to know your patients when they arrive. Once they have, does your dental assistant pay attention to how the patient is doing? Is the patient nervous or does the patient seem ill? Have they taken enough time to build relationships and trust with each patient to know how things are going in their lives?

So much can affect the dentistry you do—including the overall health and mindset of your patients. 

Investing in your dental assistant’s development will not only let them see that you value them, it will also elevate your patient’s experience and help them see that they have an advocate.   

Some of the advantages of taking the time to invest in your dental assistant’s development are:

  • They will be able to review the health history and have a good understanding of why we ask every question that is asked on that health history. 
  • They will be able to help the patients see how the medications they are taking can link to specific risk factors that can affect their overall health and change their dental outcomes or prognosis. 
  • They are your safety net in ensuring that all the bases are covered from communicating follow-up and post-op instructions to your patients. 
  • They can ensure that the chart notes are entered correctly and ready for your final review.
  • You can delegate procedures that are within their scope of practice in your state, freeing you up to spend more time with your re-care exams or seeing other restorative patients.
    • The Dental Assisting National Board Page is a great resource to use for you to understand the requirements for your dental assistants in your state as well as view different dental assisting levels, along with the requirements for each. You can also view the allowable duties at each level. (