How to hire and keep a dental team

This guide explains what public data says about hiring and keeping a dental team. It pulls from the ADA Health Policy Institute (HPI), the Bureau of Labor Statistics (BLS) and the Equal Employment Opportunity Commission (EEOC). It is general education from Copeland Consulting Services. It is not legal, tax or financial advice. Employment law differs by state, so involve an employment attorney before you finalize job ads, interview scripts, pay plans or handbooks.

Why is hiring a dental team so hard right now?

Hiring is hard because fewer trained people are entering dental assisting and hygiene than dental offices need. HPI’s workforce report says vacant assisting and hygiene positions have reduced practice capacity by an estimated 10% nationally. It also says one in three dentists with open schedule time named trouble filling staff jobs as a contributing factor.

The causes are older than the pandemic. HPI reports that enrollment in dental assisting programs has trended downward since 2015. It also reports that the pandemic hurt hygiene program enrollment. HPI concludes that shortages are likely to remain an issue for years.

Recent data shows small gains. ADA News reported in February 2025 that about 62% of dentists named staffing shortages as their biggest 2025 challenge in HPI’s late-2024 survey. Among dentists who were recruiting, the share calling assistant hiring very or extremely challenging fell from nearly 87% in late 2022 to slightly more than 70% by the end of 2024. First-year enrollment in dental hygiene programs rose by nearly 20% from 2020-21 to 2024-25.

Government projections point the same way. BLS projects 7% growth in dental assistant jobs and 8% growth in hygienist jobs from 2025 to 2035. It projects about 53,000 assistant openings and about 15,000 hygienist openings each year. Many openings come from workers who change careers or retire. Read more on each role in the posts on the dental assistant shortage and the dental hygienist shortage. The broader workforce shortage also shapes how you plan.

What does a hiring pipeline look like?

A hiring pipeline is a repeatable set of steps from an open job to a trained team member. Writing the steps down keeps the process steady when a position opens suddenly.

HPI found that dentists lean heavily on online recruiting and word of mouth. Fewer use local hygiene and assisting programs. About one in four use staffing agencies or recruiters. One dentist quoted by ADA News described candidates who do not show up for scheduled interviews. A written pipeline with quick replies and a clear next step can help with this.

Local schools are one low-cost source. One health center quoted by ADA News works with a nearby community college. Student externs work in its clinics, and the clinic can offer jobs after graduation. That is one example, not a rule that fits every office. A program near your office is worth a phone call.

What can you say in a job ad and an interview?

You can describe the job and the skills it needs. You should not write ads or ask questions that favor or discourage people based on a protected trait. The EEOC says it is illegal to publish a job advertisement that shows a preference for, or discourages someone from applying because of, race, color, religion, sex (including pregnancy, sexual orientation and gender identity), national origin, age (40 or older), disability or genetic information.

The same EEOC page covers interviews. As a general rule, it says, pre-employment information should be limited to what is essential to decide if a person is qualified for the job. It also says tests must be necessary and related to the job. It says employers must give reasonable accommodation to a job applicant with a disability, unless doing so would cause significant difficulty or expense.

Use this table as a conversation starter with your attorney. It is not a legal rule set.

The post on dental interview questions lists skill-based questions. The post on how to hire a dental assistant covers that role in more detail. Missouri’s rules for expanded duties are covered in expanded function dental assistants in Missouri.

What do wages and pay data say?

BLS reports a median annual wage of $48,070 for dental assistants and $98,100 for dental hygienists in May 2025. The median is the midpoint: half of workers earned more and half earned less. BLS reports that the lowest 10 percent of assistants earned less than $37,130 and the highest 10 percent earned more than $62,250.

Pay moved in the recruiting data too. HPI reports that more than 8 in 10 dentists recruiting assistants or hygienists in 2022 had raised starting pay. About 45% had also changed hours to meet applicant needs. HPI found that roughly half of assistants and hygienists had received a raise in the past year, and most raises were in the 1% to 3% range.

Use local data before you set a range. The posts on assistant pay in Missouri and hygienist pay in Missouri point to state figures. Pay structures such as bonuses and team compensation plans carry tax and wage law issues. Talk to your CPA and attorney before you adopt one.

What helps a dental team stay?

HPI’s 2022 survey of thousands of dental assistants, hygienists and dentists links staying to three factors: work-life balance, positive workplace culture and the ability to help patients. It links leaving to negative workplace culture, insufficient pay, lack of growth opportunity, inadequate benefits and feeling overworked.

Among assistants with low job satisfaction, the three main reasons were insufficient pay, feeling overworked and negative workplace culture. For hygienists, the three main reasons were negative workplace culture, insufficient pay and feeling overworked. HPI says these held regardless of employment status or practice type.

These are survey findings about groups. They do not predict any one person. They do give an owner a checklist of areas to look at.

HPI also notes that benefits such as health insurance, paid sick time and continuing education funds are rare overall. It says these benefits matter for recruitment and retention. A written employee handbook can state benefits and policies in one place. See what a dental employee handbook contains.

For retention in general, see employee retention and staff turnover. Burnout is a related risk, covered in the post on dental team burnout.

How should a practice onboard a new hire?

Onboarding is the structured start that turns a hire into a working team member. BLS notes that dental assistants without formal education learn through on-the-job training. In the office, a dentist, hygienist or experienced assistant teaches the terminology, instruments, daily tasks and patient interaction. That makes the trainer’s role a real job, not a favor.

A simple first-90-days plan has four parts:

1. Before day one: send the schedule, parking details and dress code. Prepare the workstation and logins.
2. Week one: pair the new hire with a named trainer. Cover safety training, which OSHA’s bloodborne pathogens standard requires at initial assignment for employees with occupational exposure. See the dental compliance checklist.
3. Days 30 and 60: hold short check-ins. Ask what is unclear and what is going well.
4. Day 90: hold a first performance review with written goals.

Written steps make the plan repeatable. They also give the next hire the same start as the last one.

How can a practice track hiring and retention?

Track a few plain counts from your own records. National figures tell you about the market. Your own counts tell you about your office. The table defines each count. It gives no target, because no published standard sets one.

Ask departing team members for an exit conversation, and write down what they say. Treat the notes as private personnel records and ask your attorney how long to keep them.

What about hiring an associate dentist?

Hiring a dentist follows the same steps, with extra contract questions. Pay structure, restrictive covenants and employment status carry legal weight. Read dental associate contracts and the post on employee or independent contractor before you draft an offer. An attorney should review the agreement.

What should you do first?

Start with data from your own office, not a national average. Count open positions, days vacant, interviews held, offers made and departures in the last 24 months. Then compare what your team says matters with the HPI factors above.

A short action list helps:

1. Update every job description to match the real work.
2. Write the hiring pipeline and the interview questions down.
3. Ask an employment attorney to review ads, questions and offer letters.
4. Check pay against local BLS data each year.
5. Hold a short stay conversation with each team member once a year and write down what you learn.

Leadership habits shape culture. The pillar on dental leadership covers how teams are led. See also dental team for the roles involved.

Next step

Read the pillar on dental leadership for the wider picture of how teams are led. To discuss team questions, contact Dr. Copeland about consulting. Dr. Jon Copeland, DDS, is a general dentist in Wildwood, Missouri.