As dentists, you've seen the numbers on repeat. In fact, you likely didn't need to see the data to know there is a serious problem. You live it every day.
"As a dentist, I am not working at the highest scope of my license. Instead, I am doing other services that a hygienist or dental assistant would do," said Dr. Vinod Miriyala, an Ohio-based dentist with extensive experience in both public and private settings. "This is not an improving situation, and we have to do something more to address it."
At Delta Dental of Tennessee, we are acutely aware of the challenges dental offices face regarding staffing. The issue is top-of-mind for the dentists in our networks, and it is also top-of-mind for us.
Delta Dental plans across the country have spent a great deal of time, effort and resources on the subject and are rolling out and designing several measures aimed directly at providing tangible relief.
Evolution of the issue
The pandemic. That's the easy answer to the question of what caused the hygienist shortage. But, there is nuance in the causation.
"I think we now know that the problem was pre-existing, but it reached a breaking point during COVID," said Miriyala, who serves on the board for the Delta Dental Foundation.
"The hygienist workforce predominantly consists of women. When it came to COVID, my experience was that they had to make a decision about taking care of family at home. They put their family first by cutting down hours or leaving the workforce, and rightfully so. Others took on opportunities outside of direct patient care."
DataUSA.io, an online resource that compiles public data from U.S. government sources, shows that in 2022, 94.4% of hygienists in the nation were female.
Data from the Bureau of Labor Statistics reveals that women left the workforce at a rate nearly four times higher than men, with some 865,000 women leaving the workforce in September of 2020.
When looking specifically at dental hygienists, an American Dental Hygienists' Association study published in the February 2021 issue of the Journal of Dental Hygiene found the leading concern (48.3% of the total) that led to a hygienist leaving their position was that they simply didn’t want to work as a hygienist until the pandemic was under control. Caring for family was a cited reason for leaving but it was at a much lower clip—10.4%. Concern over workplace safety standards (12.7%) actually drove more hygienists away from the profession than did childcare concerns.
Bureau of Labor Statistics numbers indicate the number of people in the workforce has rebounded and is poised to surpass pre-COVID totals. But filling vacant hygiene positions, unfortunately, remains difficult.
"Initially, I thought things would die down after COVID and we would see things go back to normal. But that's not what happened. In fact, many (hygienists) left dentistry entirely," said Miriyala.
The basic economic principle of supply and demand came into play to combat the issue and try to retain current staff or attract new ones. Pay
rates for hygienists climbed fast, but it didn't have the impact one might expect. Despite the increase
in compensation, the recruitment rate hasn’t met or surpassed the attrition rate.
"The hygienist is the gatekeeper of our practice. They are the face of our clinical care. They see more patients, typically, than we do as dentists. They are the primary caregivers once a patient is stabilized," he said.
A focus on dental support
Delta Dental of Tennessee has spent a great deal of time, effort and resources on the subject, talking
to legislators and participating in a workgroup started by former Tennessee Health Commissioner
Dr. Lisa Piercey.
Convened in 2021, the group consisted of oral health stakeholders from across the state to develop recommendations to increase access to high-quality, affordable dental care for Tennesseeans.
A major part of that is having the dental professionals to provide it. The shortage is increasingly problematic in the rural areas
of our state.
The average student loan debt for dental support majors in Tennessee varies depending on degree level, but it ranges between $18,000 and $25,000. Without assistance in repaying those loans, some graduates are unable to even consider working in
underserved areas because of lower income potential.
That was a major focus for Delta Dental of Tennessee and its Smile180 Foundation in helping create the state's Healthy Smiles Initiative. art of this program provides educational loan repayments for dental professionals who are working in underserved areas, for example in health department dental clinics and safety net clinics. The goal — to get these dental professionals providing care in areas of high need.
Learn more about how to apply for loan repayment here.
