Recruitment and Retention: 3 Steps for Ensuring the Future of the Hygienists Workforce

Misty Mattingly, RDH, BS


The COVID-19 pandemic undoubtedly led to major disruption in the dental field, the effects of which we are still experiencing today. For example, according to a recent report by the American Dental Hygienists Association, the pandemic led to an estimated 8% reduction in dental hygienist employment in 2020-2021. Additionally, a separate report put out by the American Dental Association (ADA) in June 2021 found that 80% of dentists looking to hire hygienists and dental assistants are struggling to find applicants. 

On a surface level, these numbers may seem contradictory, as one would think hygienists would be seeking re-employment now that the majority of practices have reopened. However, this has not shown to be the case, and the pandemic has instead served as a catalyst for an industry that was already struggling with recruitment and retention. 

It’s no secret that the relationship between the hygienist and dentist can be a complicated one, as I’m sure many of us have experienced in one form or another during our careers. By the numbers, a recent study found that one in five hygienists have experienced workplace bullying. Another survey conducted in 2019 found that feelings of being undervalued or not respected in the workplace had led 43% of dental hygienists to seek new positions. The onset of the COVID-19 pandemic further exacerbated the existing dissatisfaction and workplace disillusionment, leading many to not only consider seeking new positions, but to leave the field or retire. 

So, what can be done to increase hygienist satisfaction in the workplace? As practices continue to re-establish normal operations post-pandemic, it is an ideal time to reflect on overall business operations and what’s working and what’s not. Part of this important conversation should include reimagining the role of the hygienist for today’s workforce, including professional recognition, promoting positive office culture, compensation, and more. 

Positive Work Culture

It is important that hygienists feel that their ideas are respected, trusted, and heard as a provider. When making decisions about office systems, ensure that hygienists are involved in the conversation and reinforce that their opinions matter. As hygiene is a key aspect of a healthy practice.

For example, I’ve seen appointment scheduling become a point of contention between staff, with hygienists sometimes feeling like the administration burden falls on our shoulders. If your hygienist staff are expressing concern about bandwidth, consider implementing other solutions and involve us in the discussion so we can find a workaround together. This could include having front office staff share the appointment scheduling workload, implementing patient self-scheduling technology, or hiring a part-time staff member to help during busy seasons.  

Professional Recognition

Out of any office staff, we as hygienists spend the most time with patients, and therefore play a huge role in building and maintaining positive patient relationships. Our rapport with patients and knowledge of their past experiences and preferences play a key part in ensuring treatment plans fit within the patient’s lifestyle and that positive outcomes are achieved. However, we can often be overlooked as an important part of the care team – by both dentists and the general public. I hope to see this change this next decade as we learn more about the importance of oral care and the oral and body connection. We know that patients with periodontal disease are 9 times more likely to be hospitalized from covid and we know that inflammation of the gums is linked with numerous diseases. So oral care that hygiene provides is no longer about just cleaning teeth, we now know it is about maintaining our patients overall health as well.

Hygienists play an active role as part of the patient’s care team, and their expertise and understanding of building patient relationships and positive chairside manner should not be overlooked. To ensure that hygienists feel like a key part of the care team, involve us in discussions about patient treatment plans, and work to create a positive work relationship. You could also include the names of hygienists on the practice’s website, and mention staff members in emails to patients. This also connects the patients with the team members in your office and leads to improved patient retention as well.

Flexible Work Schedules

The dental hygienist workforce is overwhelmingly female, with the American Dental Education Association reporting that over 94% of students currently enrolled in dental hygiene programs are women. While family dynamics have changed over the past few decades, it’s still a matter of fact that many women in the hygienist workforce are looking for flexibility in their work schedules as they juggle their personal and professional lives. The pandemic has only served to further the importance of work-life balance, and now more than ever before, hygienists are looking for flexibility in the workplace.

During the beginning of the pandemic, my team at Sage Dental implemented options for extended hours and reduced days to allow providers to choose the schedule that worked for them. We also increased vacation time to give our providers more time to decompress. These changes have been very well received, and we’ve decided to keep them going even after the pandemic subsides.  

The Future of the Hygienist Role

The silver lining of the COVID-19 pandemic is that it is setting the stage for candid conversations – both in the office and beyond. We have to look at the role of the hygienist in the future. How can we utilize technology to improve patient care and experience? How can we improve the culture in dentistry? For practices that are looking to emerge from the pandemic, better than ever, it is a chance to revisit established roles and make some long-overdue changes. It is also an opportunity to talk to patients about how the pandemic might have affected their oral health practices and to help encourage better oral hygiene habits long term.

As nationwide conversations about the U.S. healthcare system continue, it is important that oral healthcare be a part of these important conversations on multiple fronts – from educating on the importance of ongoing oral healthcare to patients, to the critical role of dental hygienists in ensuring positive patient outcomes.


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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