Weathering the Storm of Dental Hygiene Turnover by Jodie Heimbach, RDH

Weathering the Storm  

Retaining dental hygienists through the wake of a pandemic

by Jodie Heimbach, RDH

If you’ve been battling dental hygiene turnover in your practice over the past several months, you’re not alone.

According to a report published February 2021 in The Journal of Dental Hygiene, an estimated 8% of hygienists have left the field voluntarily, citing health concerns related to COVID-19.

Adding insult to injury, the DentalPost Dental Hygienist Salary Survey says 43% of dental hygienists are open to a job change within the next year. While the exodus of hygienists may feel like a critical issue facing dentistry, here are steps you can take to protect your practice, your sanity and employee retention.

Burnout: Acknowledge the threat

Employment company Indeed conducted a recent study of 1,500 U.S. workers and discovered an alarming statistic: 52% are experiencing burnout. To reverse the trend of hygienists leaving en masse, the first thing to do is recognize shifts that are negatively affecting professional satisfaction:
  • Changes in personal protective equipment (PPE) protocols are causing hygienist fatigue.
  • Hygienists are feeling overwhelmed by so much to do in one appointment because of increased protocols.
  • Patient anxiety and negativity are on the rise.
  • Fewer team members are often on hand to serve patients.
  • Team members are being asked to do more with little recognition.
Keeping the lines of communication open is a great start. If you haven’t already, acknowledge the impact of what’s changed with your team, and let them know you are here to partner with them for solutions. Empower your hygienists to learn new techniques and education that will benefit your patients, practice and team.

Really listen to their concerns

As patient advocates, your hygienists are one of the best ways to establish trust and build great relationships with patients. “I love my patient relationships,” explains Kathryn Gilliam, a registered dental hygienist in Houston. “I love that I know all about them and their families, and that we spend focused time talking about their oral and overall health connections and partnering to achieve their optimal health goals.”

Be a proactive leader by creating an open-door, safe environment for your hygienists to express what they’re experiencing. Schedule one-on-one time and actively listen to what they have to say, rather than mentally preparing what you want to say next.

For example, if a hygienist tells you she can’t work in an office that’s too hot because of the additional PPE equipment, consider her perspective: 76 degrees Fahrenheit may seem acceptable, but your hygienist may be sweating buckets under her gloves. If a few degrees is all it takes to retain a happy and productive hygienist, the cost difference to adjust the temperature in-office pales in comparison to hiring and training a new hygienist.

Investing one-on-one time with your hygienists may reveal easy improvements that are well within your control—and budget. Rather than assuming your hygienist wants a raise to stay, consider asking some exploratory questions that can reveal your hygienists’ inner motivation:

Ask what that they need to provide the best service to their patients:
  • “Do you have enough instrument setups?”
  • “Do you need to replace or add instruments?”
  • “What home-care aids would help you educate patients better to bring them to health?”
It’s in your control to help them be the best they can be:
  • “How can I help support you better in co-diagnosis?”
  • “What could make your day run smoother?”
  • Schedule monthly or biweekly meetings to review cases, discuss feedback and provide space to air any other concerns.
“My doctor respects my knowledge and supports my recommendations,” explains Gilliam. “She asks my opinion and listens to my ideas. And I love that we have access to advanced technology to best treat our patients.”

Dentistry: A team sport

Show your team that every patient belongs to the practice as a whole, not just the clinician. For example, if a hygienist is running 10 minutes behind, an assistant may be free and available to take the patient in. Supporting the hygienist by updating medical history, taking necessary X-rays, or offering to talk with the patient not only helps the team but also provides a seamless patient experience.

Continuing education can—and should—be fun for everyone, rather than seen as just another annual requirement. Consider new products and services you both want to introduce and take a collaborative approach to learning. Harmonizing your CE efforts with your philosophy of care and supporting your hygienists by investing in the education they’re interested in provides alignment that benefits both you and patients.

“I love and respect our owner doctor,” Gilliam says. “It’s very important to me that our values are aligned. She is a progressive practitioner who believes in treating the whole patient, and who is constantly pursuing leading-edge continuing education for herself and the whole team.

“I love that my patients know I’m a continuing education junkie, a science nerd and an educator, and that they ask about the new things I’ve learned since their last visit. When they appreciate the care I give them, and when they are excited about the improvements in their oral and overall health, it makes my day.”

Another facet to thinking of dentistry as a team sport is remembering that many times, the other roles in the practice don’t have the opportunity to see or understand everything the hygienist does throughout the course of an appointment. This is one of the reasons patients are often “squeezed” into the schedule, increasing stress on the hygienist.

Holding a team meeting to familiarize your team with the role of hygienist is educational and can be a morale boost for the hygienists. Not only can the hygienist demonstrate all the steps in an appointment, but she can also explain why it matters and how it affects long-term patient health. If you want to increase interaction, provide time for a fellow team member to be the patient while the rest of the team observes.

When your team understands the value each role brings to the whole, appreciation and respect for the time needed to provide optimal care increases.

Empower your team and inspire collaborative learning and gratitude:
  • Establish an annual CE budget.
  • Encourage your hygiene team to join a study club.
  • Demonstrate why working collaboratively elevates patient health.
  • Explain how each role in the practice supports your philosophy of care.
Valued: Help your hygienist feel seen and heard

One of the traps dentists often fall into is allowing the daily grind to take center stage. Putting out fires and running from task to task obscures the bigger picture, causing important milestones like team check-ins to erode over time. Before you know it, annual reviews are missed and your hygienist feels invisible.

Annual reviews and relationship check-ins are more than providing a wage increase. They’re vital opportunities to help your hygienist feel seen and heard. Use these opportunities to listen, provide feedback and teach your hygienist about the business side of dentistry.

For example, if you’re unable to provide a financial adjustment during a review, use this opportunity to explain why. Your hygienists may not realize that although they produce $2,000 a day, the office does not receive full reimbursement on that amount from insurance companies. It’s also a good time to consider providing an alternative benefit, such as increasing vacation time. You can use this time to have a conversation about new ways to increase production, such as additional services that can be incorporated that are not currently offered.

Vocalizing your gratitude publicly is an easy and completely free way to help your hygienists feel respected and appreciated. Recognizing a good job in the moment reinforces the positive performance you see and reminds your hygienists of the value they bring. (“Suzy, thank you so much—you did an amazing job with Mrs. Jones! Her gums look so much healthier.”)

As the leader in your practice, you are responsible for creating the team atmosphere you desire. Taking advantage of these few mindful adjustments, you can weather the storm and look forward to retaining loyal hygienists in your practice.

Author Bio
Jodie Heimbach, RDH Jodie Heimbach, RDH, is a business development consultant at Productive Dentist Academy. She is passionate about helping clinicians incorporate risk factors and underlying drivers into the patient discussion so they can connect and own their health condition. Providing customized workshops, Heimbach helps dentists and teams design a periodontal standard of care that promotes early disease intervention. Email:

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