How to Shore Up the Dental Hygienist Workforce After COVID-19

Misty Mattingly, RDH, BS


The impacts of the COVID-19 pandemic have been pervasive. And like so many areas of medicine, the dental field has not been immune to burnout, particularly among hygienists.

A recent study published in the American Dental Hygienists’ Association’s Journal of Dental Hygiene found that “COVID-19 has led to a reduction in the dental hygienist workforce that is likely to persist until the pandemic passes” and that “employers may continue to experience difficulties in filling vacant dental hygienist positions until the pandemic subsides.”

Why has the pandemic impacted the hygienist workforce so profoundly? What was it really like for hygienists over the past year, and what will it take to rebound, recruit new hygienists, and shore up the profession? Through the lens of my own team at Sage Dental, I witnessed the challenges, fear, and hope that has brought us to this point.

The Impact on Our Workforce

March 13, 2020. The day we were forced to close our offices and furlough our hygiene team was the saddest day of my career. A global pandemic had been declared, but there was still so much we didn’t know. We were all scared about the virus itself, but even more so about the implications it could have for our patients, jobs, and families.

As a field, we were feeling incredibly vulnerable. Early reports indicated that hygienists could have been at the highest risk of contagion because of their obvious proximity to the respiratory droplets carrying the virus. Despite this fear, I knew that the care we provided to our patients was essential to their overall health, and I was determined to get our team back to the jobs they were so dedicated to.

With the other members of the leadership team at Sage Dental, we dove headfirst into research about the virus, how it spread, and what options there were for reopening in some capacity. I stayed up day and night, exploring every product on the market, determined to make sure we had a safe environment for both our patients and providers to return.

I even contacted a CEO at home to ensure they were able to get us the needed aerosol reduction devices in time for our reopening date. I wanted the team’s return to be seamless and feel confident they had all the necessary equipment to ensure their own safety as well as the safety of our patients.

In May 2020, after two months of closure, we reopened our 50+ dental offices, covered in the best personal protective equipment (PPE) available and with new technology to keep us as safe as we possibly could be. Our precautions included intraoral and extraoral suction, aerosol reduction tools, air purification systems, and UV/ozone sanitizers to sterilize PPE if the shortage continued.

To date, we haven’t had a single COVID-19 transmission at any of our locations, and we’re back up and running at full capacity. Currently, we’re seeing 105% of the patient volumes we saw pre-pandemic.

While ensuring employee safety was critical to getting them back into the office in 2020, it was really only the first step in turning the tides for this struggling field.

Implementing Changes for The Long Term

With practice doors reopening and vaccination rollout in full force, there are some pandemic silver linings worth thinking about. While we undoubtedly have some long months ahead of us as patients return to care, we have new tools and knowledge at our disposal that will hopefully improve the dental field for the better. In many ways, this past year has shined a light on what we as an industry need to do to recruit and retain the best hygienists in the long term.

For example, offering hygienists a flexible work schedule is not only important during a global pandemic. According to the American Dental Education Association, over 94% of students currently enrolled in dental hygiene programs are women, and the average age is 43 years old.

Despite the fact that many women are opting to have fewer children or none at all, the fact is that moms still make up a large part of the dental hygienist workforce, and they have long been looking for more flexibility in their work schedule—pandemic or not.

At Sage, we implemented a more flexible schedule for providers struggling to balance home and work life, including options for extended hours and reduced days, which we plan to continue even after the pandemic subsides. We also increased our hygienists’ vacation days to allow them more time to decompress.

Another result of COVID-19, and one that should become part of the broader dental culture, is more regular communication from practice/DSO leadership. At the height of the pandemic, overcommunication was often a necessity due to the implementation of new protocols, changes in scheduling, and other factors.

For many in the field, this created a more regular and open dialogue between the leadership team and employees, which is critical to employee satisfaction. Maintaining this more open dialogue will go a long way toward retaining your best employees and encouraging them to do their best work.

Finally, and most importantly, the pandemic made it clearer than ever how important it is to prioritize technology in the office. The use of innovative technology like teledentistry was certainly critical to getting through the COVID-19 shutdown, but there is more value than just treating patients during a pandemic. Teledentistry has the power to change the way we evaluate dental emergencies, check in between major appointments, and reach patients who live remotely or have challenging schedules.

In many ways, the pandemic provided the final push for practices that had long been considering this more modern approach to healthcare. I am excited to see the growth of teledentistry in our industry, as the capabilities and improvement in access to care are endless.

Additionally, with accredited hygiene programs across the country prioritizing new and exciting dental technology in their curriculum, practices should also be implementing these tools. Many young hygienists are now looking for forward-thinking organizations to join, and practices should be eager to take advantage of their knowledge and enthusiasm to improve patient care.  

Supporting Hygienists Now and in the Future

My hope is that as we emerge from this pandemic and continue to learn from this past year, the hygiene profession will come back stronger than ever. I believe that hygienists continue to be underutilized and that there more we can do to improve our patients oral and overall health.

In fact, a recent study found that COVID-19 patients are at least three times more likely to experience complications if they also have gum disease—something good oral hygiene care can easily prevent. There is no doubt that the work we do is important, and it is important that practices around the country support the work environment and tools for us to be our best.

Ms. Mattingly is the vice president of hygiene operations at Sage Dental, responsible for overseeing operations and managing a team of more than a hundred hygienists across its 65 practices. She is dedicated to advancing the use of innovative technology in the dental field, including artificial intelligence and teledentistry. Mattingly also is the past president of the Georgia Dental Hygienists Association and a past delegate for the American Dental Hygiene Association.

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