While staffing crises at hospitals continue to make headlines, dental care — too often overlooked and treated as separate from medical — is also experiencing a significant workforce challenge. In my role leading dental at Sun Life U.S., which includes DentaQuest, the nation’s largest Medicaid dental benefits organization, I know full well that you cannot be healthy without a healthy mouth. Considering the many connections between oral health and chronic diseases such as diabetes and heart disease, the disconnect between medical and dental causes real harm and has lasting consequences, beyond the mouth. That’s why regular dental care is so important.
But if you’ve tried to make a dental appointment recently, you may have noticed something. Like others in health care, many dental professionals left the workforce during the last few years, citing the pandemic as the impetus for leaving. The difference is, according to preliminary federal data, other areas of the health care sector have seen a labor rebound while employment at dental offices remains down — at all levels of the field.
One survey showed more than 3,000 dental hygienists permanently retired amid the pandemic, while the American Dental Association’s Health Policy Institute (HPI) in 2022 estimated roughly one-third of dental assistants and hygienists are expected to retire within five years. HPI data also shows dentists’ median age is 51.5 years, pointing to a coming retirement boom. HPI estimates the labor shortages have caused an 11% reduction in dental practice capacity. More than half of dentists told HPI they want to add staff this year, and 90% said they found hiring to be extremely or very challenging.
The pandemic heightened competition in part by shining a light on the importance of allied dental professionals (like hygienists and assistants) to successful practices, prompting a need to align pay with the value of these roles. To ease recruitment woes, dentists have started making competitive changes to their staff’s compensation. Many changed working hours to meet applicants’ needs, added retirement plans and health insurance, and offered a sign-on bonus and paid time off. None of these benefits are common in the industry — fewer than half of dentists offer their staff health insurance coverage, for instance. And within Sun Life’s own business and engagement with dental offices, we’ve seen pay rates rise as much as 30% to 40% in some regions.
But this is only one of the changes the industry needs to make to ensure everyone has access to oral health care. We have a unique opportunity right now to address long-standing gaps in racial and gender representation in health care, and to increase access in underserved communities.
Diversifying and growing our dental workforce starts with focusing on our young people. Most people decide to go into a dental profession during or even before high school, yet students in many underserved communities rarely have the opportunity to learn about or experience these career paths, let alone see people who look like themselves reflected in the workforce.
Increasing the numbers of Black, Latino, and American Indian/Alaska Native dentists and allied staff requires not only financial investment in pathway programs for students, but cultural and systemic changes to address the challenges faced by these students. It’s no coincidence that dental deserts are predominantly in rural and lower-income communities, increasing barriers for the people who most need dental care. This means investing in dental programs and scholarships in targeted geographic locations, as well as supporting community-based externships, research, and programs that can help drive systemic industry change.
These investments are crucial to advancing the oral and overall health of our communities. Staffing and workforce challenges contribute directly to access issues, particularly for those who are underserved. These populations already face significant obstacles to accessing care, from language barriers to coverage gaps and transportation challenges. We can and should begin educating the next generation of dental professionals in ways that directly address these obstacles, such as adding language requirements or a focus on public programs like Medicaid.
There are many changes that must be made to respond to the challenges facing our dental workforce and the broader health care field. What we know is that this is a pivotal moment — and there is a lot more we can all do to seize it and bring lasting change.
Steve Pollock is president of dental at Sun Life U.S. This includes overseeing DentaQuest, the second-largest dental benefits provider in the U.S. by membership and the largest under Medicaid, as well as growing positions in commercial and additional dental markets and support from approximately 80 Advantage Dental+ practices, which bring care to underserved communities.