STAFFING STRATEGIES

How DSOs are finding and keeping staff in a challenging hiring market

Ask any DSO operator what is slowing growth this year: staffing. Among dentists who tried to hire in the last quarter, three in four said recruiting hygienists was very or extremely challenging, and nearly as many said the same about assistants. The bottleneck is real, and it shows up on tomorrow’s schedule.

What’s happening: The hiring market for clinic staff remains tight. In Q2 2025, 37.1% of dentists recruited hygienists and 39.7% recruited assistants. Of those recruiting, 74.1% reported hygienist hiring as very or extremely challenging, and about 71% said the same for assistants. 

Most owners also reported staff wages edging up, with many expecting another 1 to 5% rise over the next six months. According to the Bureau of Labor Statistics (BLS), employment of dental hygienists is expected to grow by 9% by 2033, “much faster” than the average occupation.

How the industry is responding: Some DSOs are investing to create supply. Heartland Dental and Concorde Career Colleges are opening a co‑branded campus in Fort Myers in fall 2025, designed to train up to 120 hygienists and 72 assistants annually using Concorde’s curriculum, with Heartland funding construction and equipment. Heartland also runs a ten‑week dental assisting course to move candidates into chairs faster.

The industry is also embracing more temporary staffing. ADA Member Advantage endorsed onDiem in June for compliant, on‑demand staffing. Some companies, like Kwikly, Cloud Dentistry and GoTu, also offer marketplaces for DSOs to access a large, verified talent pool.

Yes, but: There are tailwinds forming in the labor market. First‑year enrollment in dental hygiene programs rose nearly 20% from 2020 to 2024, suggesting more graduates ahead. BLS data also confirmed where wages have landed: Median pay in May 2024 was $94,260 for hygienists and $47,300 for assistants.

Why It Matters: Staffing is now a strategic lever and a potential edge DSOs can earn in the market, not just a back‑office function. Given that, some practical moves for smart DSOs to consider include:

• Stand up or co‑brand training in your hotspots. Heartland’s Fort Myers model shows how to anchor a market with a steady flow of graduates. If bricks and mortar are out of scope, consider digital options or partnering with local colleges for “externships.”

• Build an internal float pool for hygiene. Post dedicated “float hygienist” roles across a region, with premium pay and mileage, to cover vacations and vacancies without collapsing the schedule. Aspen Dental’s postings illustrate the approach.

• Blend temp coverage the right way. See temps as an opportunity for recruitment and operate accordingly. Track conversion from temp to permanent as a KPI. Use compatible HR platforms to reduce misclassification risk and administrative lift.

• Create visible ladders. Fund expanded-scope training for assistants and structured continuing education (CE) for hygienists.

• Comp with intent. Benchmarks have shifted. Validate that your hygiene and assisting pay bands reflect today’s medians, then pair dollars with four‑day weeks, team bonuses, and schedule control.

Bottom line: The staffing crunch is easing in slow motion, not disappearing. Treat talent as a supply chain: Invest upstream, maintain flexible capacity, and lock in retention with growth, flexibility, and fair pay. Operators who master “build, borrow, keep” will protect same‑store growth now and be first to capture demand as new grads hit the market over the next 12 to 24 months.