21
votes
The San Francisco Bay Area shortage of dental hygienists
Link information
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- Title
- They earn $70 an hour and are in high demand. So why are so many leaving this job?
- Published
- Dec 11 2025
- Word count
- 1166 words
From the article:
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I don’t think this article explained very well why this career is less attractive than it used to be. Perhaps it hasn’t changed that much, but nursing pays better?
This seems like yet another problem that could be mostly mitigated or completely eradicated by universal healthcare and better labor practices/protections.
The "family business" aspect of many dentist practices has a big impact on this too. I'm not going to claim being a family member working for them is a great experience, especially in such an imbalance of power as that between hygienist and DDM. But also having been a random person working for a family owned dept store, the pay sucked, the benefits weren't great (my mom worked there at one point too) and the people in charge were always micromanaging things. I could have made more money at Walmart.
Doctors offices aren't run like family businesses these days and it seems like the dental profession is having to reckon with hygienists being professionals themselves, not replaceable or obligated
(Which is to say I agree with your solutions just with some specific things going on in this industry)
My dentist in NJ is amazing. They are fully staffed, have a full care system that lets you interact completely via text, including chatting with technician/front desk for scheduling.
The facility has it centered around the hygenists: The workspace is entirely theirs, they don't move around during visits except to take a break while the dentist steps in. They can handle scheduling/rescheduling as part of the the appointment, making it easier for patients to have a preferred hygenist.
It's the epitome of 'empower the employee' and it seems to be working. I don't think I've seen more than 2 face changes in 4 years, in a junior role.
I also have a general impression that hygienists at the dentist we go to are treated well. They don't seem to have much turnover. But it seems unlikely that they would complain to the patients.
I can't imagine the pay is great and given how expensive that area of the world it is, can't be easy to live near by. The fun part of being affluent but have no teeth cause you got nobody to help DDS, fair exchange IMO.
In which case, they're going to have to pay more and treat hygienists better. Family businesses just have not been pleasant to work for IME, and perhaps dentists also need to pivot to a medical practice model that isn't just 4 brothers with DMDs whose father and uncles were also DMDs (why does that mean Doctor of Dental Medicine, titles are weird)
The lack of benefits alone seems like a perfectly valid reason for it to be declining. Benefits like health insurance and retirement are more crucial than ever right now, and it sounds like insurance companies aren't keen to cover part-time roles of any sort without raising rates. The lack of insurance is especially bad since the article mentions some having to pay out of pocket for physical therapy relating to pain from doing their jobs, so that cuts into the paycheck.
Combine that with potential personality clashes and cliquey environments, which can be particularly bad in smaller environments like dental practices, and it's understandable people change fields. Some people might stick out bad environments for the benefits, but it sounds like even good practices are likely struggling due to simple economic factors.
For a simple why, look into the next tier of enshittified gig economy platforms. An Uber-style "independent contractors" platform for nursing and hygenisists: Gale
"Let's them work how they want" is business code for "undermine nursing unions and murder any semblance of stability."
Dental hygienists are not nurses so that link doesn't seem directly relevant? Dentists and hygienists don't seem to be mentioned. But I wonder if there any similar companies for hygienists?
People in this very topic are explaining how working for family businesses isn't necessarily better. Though, perhaps some of them do treat hygienists well? It's going to vary depending on who owns the business.
From a brief search, it looks like hygienists haven't historically been unionized, but they do have professional associations that do advocacy.
Sure, some of them certainly do. The article highlighted the family business practice history of dentistry which led to my reply to someone's broader statement highlighting one facet of the situation. But overall, regardless, they're not being treated well enough to maintain their staffing. I personally suspect the history of family practices contributes to that.
But maybe the damage has been done and no matter how good the benefits and pay now there's just not enough interest in the field due to the historical treatment of hygienists regardless of the type of practice.
As far as I can tell, I'm the only "people" complaining about working for family businesses.
Since there's such a huge market demand, the "part time" status (for a significant percentage at least) is likely a deliberate policy by the dental office to avoid having to pay benefits. There are so many jobs that just ever so coincidentally work out to 34 hours per week :/
I'm not sure that part-time is always bad. Nowadays it's common to have couples where both people work. But a well-paying part-time job might work out pretty well for some families, when the spouse can get healthcare for the family?
Also, from the article, it sounds like it would be pretty physically demanding to work full time?
And it sounds like being part-time isn't new, but maybe there are fewer people nowadays where this sort of arrangement works for them.
I'm certain that this is true in some offices, but it doesn't make much sense for offices desperately trying to hire new hygenicists for the business to remain viable. (And honestly doesn't really make sense in a market for which there's a demand for hygienicists.) For example, one dentist was quoted as saying that he's started having to try to hire assistant dentists to do hygiene work. There's just no way that would be the choice over offering full-time hours and benefits to a hygenicist.
The 34 hours a week thing is more for like fast food jobs where the supply of workers outstrips the demand.