The dental hiring shortage, by the numbers.

Each quarter the ADA Health Policy Institute asks a panel of private-practice dentists whether they recruited for a role in the past three months, and if so, how hard it was. In Q3 2026, 35.1 percent had recruited a hygienist, and 88.3 percent of them called it “very” or “extremely challenging.”^[1] That share has not dropped below 87.7 percent in any quarter since the start of 2024. HPI’s own summary: “This trend has been consistent for more than two years.”^[1]

It was worse before. About 95 percent of dentists called hygienist recruiting very or extremely challenging at the end of 2022,^[10] and 94.9 percent did in Q4 2023.^[3] So the reading has eased a few points from its peak, then held.

Dental assistants are easier, but not easy. In Q3 2026, 34.2 percent of dentists recruited an assistant and 76.8 percent of them found it very or extremely challenging, up from 68.2 percent the quarter before and close to the early-2024 high.^[1] Administrative staff are easier still: in Q1 2026, 58.0 percent of dentists recruiting for those roles said it was very or extremely challenging, in a range of 55.3 to 66.6 percent since early 2024.^[2]

Why is it so hard? In Q1 2026, HPI asked dentists in their own words. For hygienists, 66.5 percent cited not enough applicants, 36.8 percent cited demands for high wages or benefits, and 7.9 percent said candidates would not work the advertised hours. For assistants, the top reasons were not enough applicants (57.5 percent), unqualified or poor-quality applicants (40.9 percent), and high wage demands (17.1 percent).^[2]

HPI’s Q3 2026 update added a question most surveys skip: did you actually fill the role? Among dentists recruiting a hygienist, 42.1 percent did, almost the same as a year earlier (42.8 percent). Among those recruiting an assistant, 66.8 percent filled it, up from 62.3 percent.^[1] As far as we found, this is the only dentistry-specific, nationally sampled time-to-fill data available.

For roles that were filled, HPI also asked how long the position had been open. Hygienist roles skew long: half took one to six months, and 21.2 percent had been open more than six months, roughly the same as a year earlier (21.5 percent). Assistant roles fill faster, but took slightly longer than a year ago: 7.5 percent were open more than six months, up from 4.5 percent.^[1]

Practices are trying. In Q4 2025, 42.3 percent of dentists said they planned to add staff in 2026; by Q3 2026, 40.7 percent said they had.^[1]

Recruiting difficulty measures the search. Adequacy measures the result. In Q1 2026, HPI asked all 796 respondents whether they had enough staff in each role. Only 60.3 percent said yes for hygienists, against 73.5 percent for assistants and 79.3 percent for administrative staff.^[2] As HPI put it in April, “only 60% of dentists have an adequate number of dental hygienists on staff.”^[11]

Benefits are part of the picture. Fewer than half of dentists (42.6 percent) said they offer health insurance, and HPI found that practices with adequate staffing offer benefits more often.^[2] One dentist’s comment in the same survey shows where some practices end up: “We now have to use a recruiter and pay 17% of first year’s wage.” That is one respondent’s experience, not a statistic.^[2]

Asked in late 2025 to name their top three challenges for 2026, 55.3 percent of dentists picked insurance issues, 54.2 percent staffing shortages, and 41.5 percent overhead costs.^[3] A year earlier, about 62 percent had named staffing shortages as the biggest challenge for 2025.^[10]

Split by affiliation, staffing ranked first for DSO-affiliated dentists, at 59.3 percent, against 53.8 percent for dentists outside DSOs.^[3] DSO dentists were also more likely to plan to add staff in 2026: 54.8 percent, against 41.7 percent.^[3]

The Bureau of Labor Statistics updated its projections to the 2025 to 2035 decade in August 2026. It expects hygienist jobs to grow 8 percent, which it classes as much faster than average, with about 15,000 openings a year, and assistant jobs to grow 7 percent, with about 53,000 openings a year.^[4][5] Openings include replacing workers who retire or change careers, not just new jobs. BLS points to the aging population as one driver: “Demand for dental services is expected to increase as the older adult population grows.”^[4]

HRSA, the federal health workforce agency, goes further. Its December 2025 projections show a shortage of 33,220 full-time-equivalent dental hygienists in 2038, larger than its projected shortage of 19,860 general dentists. For dentists outside metro areas, it projects a 46 percent shortage.^[6]

Federal shortage area designations tell a related story, with an important limit. As of September 30, 2026, there were 8,027 dental Health Professional Shortage Areas covering 78,301,897 people, with 32.94 percent of need met and 13,145 more dentists needed to remove the designations. 5,142 of them (64.06 percent) are rural.^[13]

Jobs in offices of dentists have still grown. BLS counted 1,057.6 thousand in September 2026 (preliminary), up 6.7 percent from 991.0 thousand in February 2020 and 0.8 percent from a year earlier (DSO Hire calculation).^[9]

An ADA and ADHA panel found that 7.9 percent of hygienists employed in March 2020 were not working by September 2020, falling to 4.9 percent by August 2021. As of August 2021, fewer than half of those who left had returned. Permanent exits were estimated at 1.6 percent, possibly about 3,300 hygienists nationwide.^[14]

In a June 2022 survey, 31.4 percent of hygienists and 33.7 percent of assistants said they expected to retire within five years. Those are respondents’ expectations, and the sample included former workers.^[15] The same report estimated that assistant and hygienist vacancies had cut practice capacity by about 10 percent nationally (the report says 11 percent in its body), and found more than 8 in 10 recruiting dentists had raised starting pay. It also found DSO employees less likely to report high job satisfaction, and described dental assisting enrollment declines as part of a long-term downward trend.^[15]

On the supply side, first-year enrollment in hygiene programs rose 16 percent from 2020 to 2025, according to HPI.^[11] ADA News reported “nearly 20%” growth from 2020–21 to 2024–25; the windows differ.^[10]

Assistant retention is the other half. DANB’s 2024 survey found about a quarter of assistants left their job in the prior year,^[17] and its 2022 survey found nearly one in five changed jobs.^[18] In its 2026 survey, 43 percent of assistants said they feel valued by their employer, down from 72 percent in 2020, though that survey had a 3 percent response rate.^[16] A temp staffing platform’s 2026 survey of its own audience found 60.6 percent of hygienists reporting burnout; it is a vendor convenience sample.^[19]

HPI counts 205,088 professionally active dentists in the U.S. as of 2025.^[20] (BLS reports 161,400 dentist jobs, a different measure.^[12]) The share affiliated with a DSO rose from 7.2 percent in 2015 to 16.1 percent in 2024.^[7] Practice ownership moved the other way: 73 percent of dentists owned a practice in 2023, against 85 percent in 2005.^[7]

Younger dentists are driving it. In 2024, 26.5 percent of dentists up to 10 years out of dental school were DSO-affiliated, against 14.4 percent at 11 to 25 years and 9.1 percent beyond 25 years.^[7][21] Among those less than five years out, it was 31 percent. In Arizona, Colorado, Georgia, Nevada, Oklahoma, Texas and Florida, roughly a quarter of all dentists are affiliated.^[7]

The next class points the same way. In ADEA’s survey of 2025 dental school seniors, 32 percent of those heading into private practice said they intend to join a DSO, up from 28 percent in 2021, and 35 percent among first-generation students.^[8] The 2024 class also reported 32 percent, almost double the 18 percent of 2019.^[22] Dental schools graduated a record 6,872 dentists in 2024.^[7]

For a DSO, that is good news for dentist recruiting and more support staff to hire: each new associate needs a hygiene schedule and assistants to run it.

HPI’s Q3 2026 update says hourly earnings of dental office staff rose 21 percent since January 2021, while overall inflation was 27 percent.^[1] One quarter earlier it reported 23 percent.^[23] We ran the same comparison on the current BLS series and got a somewhat smaller gap, but a gap all the same.

Staff notice. DANB’s 2026 survey reported a typical dental assistant raise of 1 to 3 percent in the past year, against inflation that “often exceeded 4%,” again with a 3 percent response rate.^[16]

• Plan hygienist hires in months, not weeks. Half of filled hygienist roles took one to six months, and one in five took longer.^[1] Start searches before a departure or a new location opens, and budget for temp coverage in between.
• Expect to lose some searches. Fewer than half of recruiting dentists filled a hygienist role.^[1] Keep a pipeline open for recurring roles instead of starting from zero each time.
• Pay and benefits are the levers candidates name. Wage and benefit demands were the second most cited hygienist recruiting problem, and practices with adequate staff offer benefits more often.^[2] Pay has trailed inflation since 2021, so check your offers against current BLS medians ($98,100 for hygienists, $48,070 for assistants) and your local market.^[4][5][9]
• Retention is cheaper than recruiting. About a quarter of assistants left a job in a year, and fewer feel valued than in 2020.^[17][16] DANB estimates replacing an assistant costs 25 percent of annual pay, though it does not publish the model, so use that with caution.^[24]
• Use your DSO pull with new dentists. More than a quarter of early-career dentists are already DSO-affiliated.^[7] Make sure the support-staff side can keep up with associate hiring.
• Watch rural and high-need markets. 64 percent of dental shortage areas are rural, and HRSA projects a 46 percent nonmetro dentist shortage in 2038.^[13][6] Recruiting there will need a longer runway.

None of this is solved by software alone. Where it can help is the routine work: DSO Hire is a hiring platform for dental groups that runs every location’s openings in one pipeline, with a flat monthly subscription and no placement fees. See plan details.

Founder Cam Eslinger walks through these findings in a LinkedIn article, The hygiene chair is still empty.