Dentists Hygienists & the Economy

Post comments about dental hygienists’ hours to our blog.

Dental hygienistsThe average dentist is seeing more holes in his or her schedule – and in that of the dental hygienist as well.

In this survey, over one third of dentists say they’ve made dental hygiene changes as a result of the slow economy.

  • 61% say they haven’t made any changes
  • 33% have cut hours from hygienists’ schedules
  • 11% have reduced the number of hygienists
  • 5% have reduced pay for hygienists

“Upon doing a practice analysis, we found we overpaid our hygienist by $13,000," said one dentist. "We paid more in hourly plus benefits than we collected!"

Here’s more of what dentists had to say about teeth cleaning,
oral health, and dental hygienist payment:

Dental hygiene is essential to getting patients in the door

  • “Hygiene is the fuel that feeds the fire.” (California dentist)

Hourly compensation

  • “I have placed my dental hygienists on an hourly rate rather than a daily salary. When a patient cancels and we cannot fill in schedule, the hygienist MUST clock out. They are paid as a dentist!" (California dentist)
  • “Our hygienist was paid salary and now she is paid hourly – with the expectation that she leaves early if there are multiple cancellations.”(New Jersey dentist)

Compensation based on production

  • “Instead of any raises, we put our hygienists on a bonus system based on achieving a minimum daily production.” (General dentist)
  • “We have not directly reduce their pay. However, compensation is based on a percent of production, and since production is down, their salaries are down." (Louisiana)

Demand for dental hygiene is still strong

  • “Hygiene has been busier and more productive during 2009.” (Arkansas dentist)
  • “Hygiene at our office, which has a dentist and a prosthodontist, has remained strong throughout this economy. We are very thankful.” (Ohio
  • “Dental hygiene positions are all but nonexistent in the North San Francisco Bay Area. Our hygiene staff is grateful for employment. Even though my schedule is sometimes not filled, the demand for hygiene services has not declined in the last 18 months."

Recall and internal dental marketing are so important

  • “We are doing concentrated calling on all past due recall patients. As a result, our hygiene area was up over 5% last year and is continuing the same trend this year. Patients will pay for hygiene if they understand it can prevent more expensive dental treatment.” (Missouri dentist)
  • “I have not had any of our hygienists ask for a raise. We have not cut hours, but we have worked very hard at activating past due patients, with good success.” (General dentist)

Empty hygiene schedules

  • “We are having a very difficult time keeping our hygiene schedule full.” (New York dentist)
  • “We have at least two cancellations in hygiene daily. Most tell us to reschedule later into the year. Other simply say they are not coming. My hygienist is on a years contract. What is the policy for reducing hours on contract workers?” (Bermuda dentist)
  • “We used to have a backlog of patients wanting prophy appts, but now don't have the long waiting list.” (California dentist)
  • “It doesn't make sense, but it seems that patients who would not have any expense out of pocket are not scheduling hygiene appointments. Go figure. Naturally, that is affecting the dentist's schedule as well.” (Practice manager)

Empty doctor schedules

  • “Hygiene is the one aspect of the practice that hasn't shown lower numbers. I'm glad we instituted a good recall systems several years ago. Now my schedule, on the other hand, reminds me of 2002 and early 2003. 2010 isn't starting out much better and has led me to think more about possible PPO participation as a possible solution.” (Pennsylvania dentist)
  • “Lots of open appointment time.” (General dentist)
  • “More holes in the schedule.” (Michigan dentist)

Patients aren’t showing up

  • “The increased number of patients failing confirmed appointments tipped the numbers to the point that we cut back from 4 days with a hygienist [with holes] back to 3, then back to 2, then back to one, and now back to where the Dr. does all the patient visits. This change was over the past three years.” (California dentist)
  • “I have noticed more last minute patient cancellations.” (Illinois dentist)
  • “We are seeing more no-shows, and some people are wanting to wait a year instead of 6 months for their next dental cleaning. We are booking ahead now and that seems to be working out well.” (Hygienist)

Dentists doing hygiene

  • “More of the hygiene is being done by dentists when the staff is small and the work load has decreased. Less patients scheduling.” (Illinois
  • “If things slow down more, I will cut my hygienists days or time and do it myself until there is a buildup of patients making more appointments.” (New York dentist)
  • “In our area we have an over supply of dentists. We also have a large number of dentists trained in foreign countries. I have found that Asian dentists and foreign-trained dentists tend to not use hygienists. They perform very inadequate hygiene themselves but charge just a much or more. It is a shame but it is a increasing trend.” (California dentist)

More time off, less pay for hygienists

  • “Not many changes. More willing to consolidate schedules and have one stay home.” (Washington dentist)
  • “When there are openings in their schedules, we have paid them at their seminar/training/administrative rate for those hours."
  • “We are considering reducing hours.” (New Jersey dentist)

Cutting part-time hygienists

  • “Reduced hours with part time hygienists only. Full time have stayed the same and even been given a modest raise.” (South Carolina dentist)
  • “I cut a dental hygenist who worked just one day.” (Texas dentist)

Taking on more duties

  • “I have asked the hygienist to do extra duties when an assistant took another position. Recall and answering the phone when available.” (Indiana dentist)
  • “They have to take on more responsibility.” (Massachusetts dentist)

Hygienists must pay their own way

  • “Upon doing a practice analysis, we found we overpaid our hygienist by $13,000. We paid more in hourly plus benefits than we collected!” (General dentist)
  • “Hygienists seem oblivious to their role as income generators paying their way.” (Missouri dentist)

Some are doing well

  • “We gave a pay increase, and we are currently looking for another part time dental hygentist.” (General dentist)
  • “I tell my staff that we all have to work smarter and harder to attain the same results of years past. We are actually blessed with some growth in this tough economy.” (Alabama dentist)
  • “The gross receipts were down about 1% last year, but the profits were slightly up.” (Pennsylvania dentist)
  • “We have not seen an effect to date, thank god!” (New York dentist)

It’s an employer’s market

  • “This would be a good time to upgrade your hygiene dept if that is necessary. More RDH's are available than usual.” (General dentist)”
  • With this economy, I'm seeing more hygienists competing for our full-time jobs that offer benefits.” (California dentist)

It’s a challenge

  • “It is definitely more challenging. We have one business employee dedicated to our hygiene department as well as have our hygienists, assistants, other business personnel and docs stress prevention on a regular basis. Mostly we hope our concern for our patients' welfare will get us through these difficult times. So far, so good.” (General dentist)
  • “We have a very periodontal oriented office. A lot of our patients are switching themselves to twice a year. They only want what the dental insurance will cover. We give them a lot of knowledge on why this is not good for their health and let them make the decision. Some patients will follow our advice or negotiate every 4 months instead of 3. But I would say that when they have their mind made up even with the recommendations that were given to them they are going to follow what their dental insurance plan dictates.” (Utah dental office worker)


Note: Survey sample included 139 respondents.

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