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Disrupting dentistry: What flexible staffing means for the post–COVID-19 build-back

Nov. 10, 2020
What can dental practices do to navigate the disruptions COVID-19 has brought on? Melissa Turner, BASDH, RDHEP, EFDA, says flexible staffing is a great tool to help the industry rebuild. But first we need to disrupt a these three assumptions.

It’s been more than six months since the dental industry came to a halt and faced significant and unforeseen challenges due to the COVID-19 pandemic. Even though the majority of dental practices are currently open for service, according to a survey by the American Dental Association’s Health Policy Institute (HPI), only 21.7% of general practice dentists reported a return to full patient volume as of early October 2020.1 As we continue to rebuild and return to maximum capacity, many practice owners are turning to one tool to help mitigate the impact and uncertainty of the current state of affairs: flexible staffing.

According to a 2019 article in Forbes magazine, flexible staffing may indeed be the “…secret superpower for small businesses.”2 Of the nearly 3,000 dentists surveyed in the HPI report, many claimed they have found it “extremely challenging” to recruit for open positions over this time.3 While we can’t predict the future, one thing we know for certain—uncertainty in any industry drives the need for more flexible staffing.

But what kind of an impact can flex staffing have in dentistry? More importantly, can it actually help the industry rebuild? Though flex staffing has been around for a while, its value spiked in the technology boom of the 1990s when it became the preferred staffing model for tech companies. As millennials demand career flexibility and become a larger part of the workforce, as the gig economy seemingly becomes an official way of life, and as baby boomers explore ways to slowly ease into retirement, the dental industry is on the verge of redefining itself with the impending shift.

Additionally—and specific to our industry—more females will be graduating from dental school than males in coming years, leading dentistry into a new era where females not only make up the majority of the clinical workforce but also the majority of practice ownership and industry leaders. These factors, combined with the impact of the shutdown and increased concerns about safety in the workplace, uniquely position the dental industry on a remarkable precipice of change.

Joe Fogg, CEO and cofounder of onDiem, an on-demand staffing company based in Portland, Oregon, is seeing these changes firsthand: "2020 has been a pivotal year for flexible staffing," said Fogg. "Dental professionals, faced with on-the-job safety concerns and new challenging life circumstances, are looking for opportunities that put them in control—of their own safety, of their earning power, and of their schedule. Flexible work offers all of those things, and we're seeing more people embrace it."

So what can dental practices do in their efforts to navigate the current and impending disruption to our profession? The answer: Learn from the past and take a card from the tech company playbook of the 1990s—fully embrace flex staffing. To begin this full embrace, let’s disrupt a few assumptions about flex staffing.

Assumption no. 1: My patients don’t like seeing a new and unfamiliar hygienist.

Reality: Your patients have the ability to immediately accept any new member of your dental team, regardless of whether they are temporary or permanent members. The secret to this success is to completely eliminate the surprise. When confirming patients’ appointments, let them know how excited you are to have them meet your new team member. If you know certain patients may have a more difficult time accepting change than others, simply have the temporary hygienist call them to confirm their appointments and make introductions then. Better yet, create a value-driven appointment in which you set up a virtual consult between the patient and the temporary dental hygienist under the guise of a COVID-19 prescreening/medical history update.

Keep in mind that how you think about and treat your flex team member will trickle down to your patients. If your mindset is to envision the flex staffer as a permanent part of your team, your patients will immediately feel comfortable and more readily accept the change.

Assumption no. 2: Temporary team members are not hard workers.

Reality: Temporary team members will provide the same standard of care (if not better) than permanent team members. In fact, temporary team members are some of the hardest working people you will ever meet. Take a moment to imagine how adaptable and resilient one must be to work in a new environment, with a new team and new patients over and over again. Temporary team members typically have seen it all—the good, the bad, the ugly—and sometimes they’ve worked in a hundred or more dental practices over the course of their careers. This experience, by nature, can be invaluable to employers! If you listen closely to your temps, you may even learn a few things about how you and your team can improve your clinical practice.

Assumption no. 3: My state dental regulations make it difficult for me to utilize a flex pool.

Reality: While state dental practice acts were initially written preflex staffing, rules and regulations are consistently analyzed and reviewed to allow for relevance within the current climate. However slow this process may seem, working together with stakeholders and strategic partners is an imperative strategy to create state practice acts that make sense for modern times. Keep in mind that the practice of dentistry looks different from state to state for dentists and practice owners, but especially so for licensed dental hygienists and dental assistants. The truth is, we are living in a time when the world is flatter than ever, and with that comes a nomadic workforce that characteristically doesn’t think twice about moving from state to state, or even across the world.

Note also the importance of consulting with legal counsel when considering whether or not to categorize flex team members as independent contractors or onboard them as W-2 employees. Recommendations may be different from state to state as well as specific to the clinical role.

In 2020, dentistry in America came to a halt due to the COVID-19 pandemic. As the industry builds back, it's more important than ever to consider what the future holds. For dental professionals, the change that accompanies dentistry’s new normal isn’t only related to COVID-19. As luck would have it, impending gender and generational shifts have collided to force the dental industry to begin to redefine itself. Though we don’t know much yet about how to navigate these changes, one thing we do know is that flexible staffing is here to stay for dentistry!


  1. What is the current status of your dental practice? COVID-19: Economic impact on dental practices specialist report—week of October 5. American Dental Association Health Policy Institute. https://surveys.ada.org/reports/RC/public/YWRhc3VydmV5cy01ZjdjOWViNTY3OTY3MDAwMGY4MGJjMGYtVVJfM3BaeGhzWm12TnNMdjB4  
  2. Burnford J. Flexible working: the way of the future. Forbes. May 28, 2019. https://www.forbes.com/sites/joyburnford/2019/05/28/flexible-working-the-way-of-the-future/#6d22b8e34874
  3. Masson G. Dental reopenings account for 10% of all US job gained last month. Becker’s Dental + DSO Review. Becker’s Healthcare. June 5, 2020. https://www.beckersdental.com/dentists/35657-dental-reopenings-account-for-10-of-all-us-jobs-gained-last-month.html

More about flexible staffing: The top 10 tips for successfully utilizing temporary and flexible staffing

Melissa Turner, BASDH, RDHEP, EFDA, an award-winning thought leader, influencer, and dental advisor, is cocreator of Care for a Better Tomorrow. She is chief hygiene officer for Cellerant Consulting and ia nationally published author and speaker. Cofounder of the National Mobile & Teledentistry Conference and the American Mobile & Teledentistry Alliance, Turner is the creator of the I Heart Mobile DentistryFacebook community and is affectionately known on Instagram as @thetoothgirl. She can be reached at [email protected].
About the Author

Melissa Turner, BASDH, RDHEP, EFDA

Melissa Turner, BASDH, RDHEP, EFDA,is an award-winning thought leader, influencer, dental advisor, and cocreator ofCare for a Better Tomorrow—an alliance of leading dental brands and industry experts committed to reimagining a better tomorrow. She is chief hygiene officer forCellerant Consultingand is a nationally published author and speaker. Cofounder of theNational Mobile & Teledentistry Conferenceand theAmerican Mobile & Teledentistry Alliance, Turner is creator of the I Heart Mobile DentistryFacebook community and is affectionately known on Instagram as @thetoothgirl. She can be reached at[email protected].