Solving the Dental Hygiene Shortage

Solving the Dental Hygiene Shortage

A heated debate unpacks the fractured future of dental hygiene


Thread summary: The Dentaltown.com thread on “Solving the Hygiene Shortage” is a massive, multi-perspective debate over the economics, ethics and logistics of addressing the shortage of dental hygienists. Here’s a distilled summary: Hygienists are in short supply and commanding high wages and large sign-on bonuses, while dental schools pump out debt-saddled dentists with stagnant wages. Dental schools prioritize dentists for tuition revenue but ignore hygiene programs because they’re less profitable. Some argue hygiene program tuition should double to incentivize schools to expand training. Most dentists reject this, warning it would backfire by raising registered dental hygienists’ (RDHs’) financial expectations and making the shortage worse.

Many advocate shortening hygiene training to 3–6 months or pushing cleanings to expanded function dental assistants or even dentists, especially in “comfort” or high-volume models. Others argue this would lower the standard of care and erode the preventive health role of hygienists. The comparison is made to dental therapists and mid-level providers in underserved areas. Some hygienists say this undermines their licensing and professional identity.

There’s growing tension: DSOs are adapting fast by hiring dentists to do hygiene and offering clever sign-on bonus structures. Solo PPO practices say they’re getting squeezed—unable to raise fees but forced to pay inflated RDH wages. Many are going out-of-network or doing their own hygiene. Dentists note hygienists don’t seem to value long-term jobs, loyalty or teamwork—and leave early in their careers. Others counter that dentistry itself has shifted into a profit-first model and hygienists are responding to market incentives. Ultimately, the discussion exposes deep fractures between organized dentistry, RDHs, DSOs and insurance companies. Many agree that the root cause is low insurance reimbursement for hygiene services. Until that’s fixed, everyone is just rearranging deck chairs—whether through legislation, on-the-job training or new practice models.


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