The job outlook for dental hygienists in most areas has been quite dismal for a long time now. I can remember when I graduated from dental hygiene school in 2004 and jobs were plentiful. During that first year after graduation, I got so many calls for subbing that I would simply ignore them half of the time.
I took the abundance of work for granted. Little did I know at the time that a big and unwelcome change for most dental hygienists was on its way, and that it would stay for a long time.
As we all know, the job market became oversaturated as more and more dental hygiene programs were created. According to American Dental Hygiene Association, there were just 202 dental hygiene programs in the United States as of 1990. (1) By 2014, this figure had swelled to 335 schools. Then, when we factor in the recession that began in 2008, an inevitable disaster was in the making, as the supply of dental hygienists far outnumbered the demand.
I remember for years rarely hearing about any job openings for dental hygienists in my area. It seemed like dental hygienists stopped by my office quite regularly to drop off résumés when there were no positions available. My work schedule slowed down substantially, and I dreaded the times that I was sent home for lack of patients. During those years, I no longer encouraged any curious young students to become a dental hygienist. I loved my job, but I was very concerned about my financial future and where the dental hygiene field was headed in general. Slowly though, as time passed by and the job market improved overall in the United States, I found that my schedule grew stronger too.
Then in the spring of 2017, I finally began to see a positive change in the job market in my area for dental hygienists. Honestly, I thought it was just a fluke at first glance. I started seeing a few job listings here and there on my local dental hygiene Facebook groups, which was weird since I was so used to not seeing much at all ever. Then the requests for subs on the same Facebook groups started getting more frequent too.
I regularly get to hear about what’s going on at the other dental offices near me, as a result of working as a professional educator on behalf of Waterpik, and I have been hearing good things. More and more often, I am surprised to hear word about offices hiring hygienists, both full and part-time positions. Several offices even asked me if I am interested in subbing when I never brought up the subject at all. At this point, I was beginning to wonder if this change was only local to my part of Indiana, or if a larger trend was occurring.
Opinions from hygienists across the country
I turned to Facebook to further investigate this issue. I posted on the Colgate Oral Health Advisor Group, which I thought would be a good forum since it has over 13,000 members. I asked if any of the dental hygienists on that page had noticed a change in the job market in their area within the past year.
I received a lot of interesting responses that indicated how different each area of the country can be. Some hygienists in areas such as Seattle, Washington; Oregon; Texas; and Columbus, Ohio did reply that the job market in their region had improved considerably. Some even commented that they had a difficult time filling open positions. Yet other hygienists from areas such as San Diego, Texas; North Carolina; and Pennsylvania commented that their areas are saturated with hygienists and job opportunities are still difficult to find.
A common theme mentioned is that the jobs that are available may not be the ones that are desirable. Some of the areas where jobs are more prevalent mentioned that the positions are most commonly part-time and lack benefits. Of course, this has been a long-term issue with dental hygiene in general, but I think having benefits, such as health insurance, has become a top priority for many hygienists since health-care costs continue to rise. Other people commented that they saw the same offices hiring repeatedly, especially the corporate offices.
According to the opinions I heard, it looks like change is happening, both in good and bad directions, and it is difficult to tell where it will all lead to at this point.
The potential for the growth of dental hygiene
An important and ongoing issue in dental hygiene has always been access to care, and this issue has great potential to affect the dental hygiene job market. Consider what would happen in the United States if cost was no longer a barrier? Most likely demand for dental hygienists would grow tremendously as a consequence as the demand for dental care grew. Just imagine if everyone in the United States actually got the opportunity to receive regular preventative care and what a challenge it would be for the dental community to meet this need. Bottom line is that the potential for growth is present and we need to be prepared for it.
Currently there are 185,000 dental hygienists in the United States. (2) According to the 2017 Census Bureau figures, the population of our country is 325.7 million. (3) If we divide the number of hygienists available by the population, the resulting figure shows that currently that each hygienist would be responsible for treating 1,761 people. This current ratio is only feasible because currently many of these people never receive dental care.
The next logical question to ask is how many patients a hygienist can reasonably provide treatment to. For example, say a hygienist gives care to 8 patients a day for 4 days a week. If she sees the patients 2 times a year (on average) for 50 weeks a year, this means she is able to treat approximately 800 patients per year. This number, of course, is an oversimplification, but it gives us a good estimate to work with. And one can easily see that a potential shortage of dental hygienists could occur if the problem of access to care was resolved.
According to the Health Resources and Services Administration’s (HRSA) Health Workforce Simulation Model 2012-2025, there will be a 28% growth in the number of dental hygienists and only a 10% growth in the demand for hygienists in the same time period. (4) This projection, therefore, estimates a continued oversupply of dental hygienists, especially evident in California, Texas, and Florida. On the other hand, shortages are predicted in West Virginia, North Dakota, South Dakota, Mississippi, and Montana.
This simulation model also predicts a shortage of dentists that will affect all 50 states, as more dentists leave the field than graduate from dental schools. Furthermore, it is also projected that dental hygienists may continue to take on additional roles and responsibilities in the dental office in order to make up for the shortage of dentists. Currently, the years covered by this simulation are halfway complete and it will be interesting to see if these projections are correct in the end.
My final verdict as to if the dental hygiene job market has finally turned a corner is to wait and see. Overall there are many variables that come in play, especially as the role of an advanced dental hygiene practitioner further develops. Presently, it sounds like overall there are more jobs than before, but they are not necessarily the type of job situations that many dental hygienists find optimal. Only time will tell if the dental hygiene job market will rebound on a permanent basis.
Editor's note: This article first appeared in RDH eVillage. Click here to subscribe.
1. Dental Hygiene Education: Curricula, Program, Enrollment, and Graduate Information. American Dental Hygienists’ Association website. https://www.adha.org/resources-docs/72611_Dental_Hygiene_Education_Fact_Sheet.pdf. Published October 21, 2014.
2. Facts about the Dental Hygiene Workforce in the United States. American Dental Hygienists’ Association website. https://www.adha.org/resources-docs/75118_Facts_About_the_Dental_Hygiene_Workforce.pdf. Updated August 2018.
3. Quick Facts: United States. United Stated Census Bureau website. https://www.census.gov/quickfacts/fact/table/US/PST045216.
4. National and State Level Projections for Dentists and Dental Hygienists in the U.S. 2012-2025.Unites States Department of Health and Human Services - Health Resources and Service Administration website. https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/nationalstatelevelprojectionsdentists.pdf. Published February 2015.
Amber Metro-Sanchez, BA, RDH, practices dental hygiene with Dr. Chris Bible at Comfort Dental in Fort Wayne, Indiana. She also works as a professional educator on behalf of Waterpik. Amber was a member of the 2015 Colgate Oral Health Advisor Board. Amber is also a contributing author for the Colgate Oral Health Advisor webpage. She can be reached at [email protected].