2023’s Big Challenges, Big Decisions

Part 1 of Team Retention and Hiring Insights from DentalPost’s Annual Dental Practice and Salary Survey

During August through mid-October 2023, DentalPost conducted a combined dental practice and salary survey, receiving responses from:

• 534 dentists
• 1,802 registered dental hygienists
• 547 dental assistants
• 413 dental practice managers
• 85 dental billing specialists employed by dental practices
• 86 other front office team members

Salary survey results, including mean and median incomes for each dental position, are available for download here. Below are key trends and takeaways from the hiring and retention questions DentalPost asked in the survey.

The greatest challenges faced by private dentists in 2023 were the retention and recruitment of dental hygienists and dental assistants. 

One of DentalPost’s authors and thought leaders, Amanda Hill, BSDH, RDH, has conversed with hundreds of her colleagues over the past year and came to the conclusion that the dental landscape has significantly changed with more dental employees looking for benefits and opportunities for growth. This makes DSOs or even positions outside of clinical dentistry more appealing. Hill worries about fewer new workers entering the profession to replace those who are leaving or retiring.

DentalPost’s most recent salary survey affirms that dental team members are seeking traditional benefits and are adamant they need annual cost of living raises.

What was interesting to us at DentalPost is that 33.5% of the job changers wanted better (more stable) hours, 27.23% needed to relocate with their families or could find better commuting situations, and 21.21% changed for the benefits. Just over 51% claimed they changed employers to settle into a better work environment. Overall, though, higher income was a principal driver for 53.85%.  

The vast number of job openings and competitive offerings in 2023 made high turnover possible. Dental practice owners nationwide had to face their fears and find the means to pay higher wages and salaries, provide more benefits, and work with smaller teams who requested shorter work weeks. Congratulations to dentists who had the fortitude and creativity to keep going and survive the pressures of overhead inflation, PPO reimbursements, team expectations, technology changes, and patient opinions.

Just how big was the team retention and hiring challenge of 2023?

Nearly 45% of surveyed dental employees were looking at job postings and contemplating a career move at the time of the survey (August-October 2023).

• 13.3% of all dental employees were actively applying for jobs.
• 11.92% of responding dental hygienists were actively applying for jobs.
• 21.81% of dental assistants were actively applying for jobs.

Retention and hiring needs were on most dentists’ minds.

Among the 545 open comments from dentists and practice managers, there is ample evidence to support the claim that retention and hiring was their biggest career concern and the one that kept them awake at night in 2023. One commenter summed up what many communicated, “I feel like I’m fighting a tug of war with team members thinking the grass is always greener. Despite increasing salaries and benefits, I live in fear of losing my employees.”

Attracting experienced applicants was difficult and for many dentists even impossible. On top of that, many reported they couldn’t replace poor performers who lacked “work ethic.” They knew many of their colleagues were in similar straits, especially in rural and downtown “metro” offices. 

The Top Six Reported Retention and Hiring Challenges

Dental team members considered their options and 18.75% decided to take new jobs.

Nationwide, job applications increased as job opportunities increased and colleagues found or negotiated better compensation. Turnover in Q4 of 2022 through Q3 of 2023 was greatest among dental assistants, employee dentists, and dental hygienists. Although practice managers were applying for new jobs, fewer ultimately decided to change employers.

Changed Jobs (Employers) in the Previous 12 Months:

Associate Dentists	28.21%
Dental Hygienists	19.35%
Dental Assistants	24.72%
Practice Managers	7.77%
Billing Specialists	17.33%
Front Office Associates/Receptionists	17.65%

Turnover was primarily driven by the desire for higher income, a better work environment (including a more appreciative employer), and/or a new location. Some respondents changed jobs because they wanted to work fewer hours. A few dental assistants and front office associates who changed jobs reported that they still need more income to cover living basics, so would be considering changing employers again in 2024, perhaps, outside of dentistry.

With the exception of front office associates/receptionists, 75% or more of the dental professionals who changed jobs met some or all of their goals.

Achieved Some or All of Their Goals by Changing Employers:

Associate Dentists	100%
Dental Hygienists	87%
Dental Assistants	75%
Practice Managers	78%
Billing Specialists	77%
Front Office Associates/Receptionists	66.5%

By and large, dental practice owners increased both pay and benefits.

The national averages recorded in the 2024 Annual DentalPost Salary Survey indicate that dental practice owners increased not only the wages and salaries of their employees but also their benefits. In addition to increasing pay (see the 2024 Annual Salary Survey), employers increased benefits to retain and attract team members. 

• The percentage of front-office team members receiving a variety of benefits rose from 73% in 2022 to 92% in 2023. 
• The percentage of clinical team members receiving a variety of benefits rose from 79% in 2022 to 89% in 2023.

Some of the changes employers made to better compensate employees, included: 

• Converting unused sick days to paid time off 
• Adding flexible PTO associated with months and years of service
• Providing dental care to employees at cost or no cost
• Providing dental care to immediate family members at a discounted cost–sometimes via free membership in an in-house dental membership club
• Honoring requests to work fewer hours per week
• Establishing a Health Reimbursement Arrangement (HRA) for employees

Did increased benefits make a difference in hiring and retaining clinical team members in 2023? It is likely yes because 3% of responding dental assistants and 2.8% of responding dental hygienists took the time to comment that they were especially happy with their benefits. Almost equivalent percentages took the time to comment that they were especially happy with their pay. A slightly larger 3.75% took the time to comment that they especially like the dentist they work with, mentioning “ethical,” “considerate,” “kind,” “caring” and “respectful.” And 13.6% took the time to comment that they were especially happy with their work environment. These data signal that job happiness is not all about the money but also about the work milieu and feelings of satisfaction derived from doing their work in a comfortable social setting.

Survey respondents who felt especially fortunate in 2023 took the time to express gratitude in comments about their employers such as these: 

• “I love my boss. She is my mentor–an amazing dentist.”
• “My new dentist encourages us to spend time with patients and provide the highest quality care. I love this!”
• “The dentist is honest, honorable, communicative, and appreciative. I am so glad I came here.”
• “My dentist increased my hourly rate and listened to me about working too many hours. I love the hours I have now and will happily stay. Great dentist and patients.”
• “Thankful for the new opportunity to work in a great environment with wonderful coworkers.”
• “I’ll stay. I’m fortunate to have good pay and to work with a nice dentist. Patients love us and we love them.”

Coming Up: Part 2 of this series will discuss more survey results focused on jobseekers’ plans for 2024.