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BFS Capital Blog

When Should a Dental Office Hire a Dental Hygienist?

June 20, 2017

Help. Who needs it?

Well, probably you, if you’ve got anything resembling a healthy dental office. Once you’ve hung your diploma and got some people coming through the door, you might find yourself a little overwhelmed. As in backed up so much people can’t make appointments when they want. And when they go elsewhere, you’re leaving money on the table.

How do you fix this? By hiring a dental hygienist for your dental office. Dental hygienists are those oral health professionals with whom you’re most certainly familiar but haven’t taken the leap to hire. And it makes sense: When you’re just starting out, their median salary of about $70,000 can be a major expense. But don’t hire one and you might be limiting your practice’s growth. So how do you know when it’s time to hire a dental hygienist? Here are some tips to consider.

When Your Dental Office Has a Certain Number of Patients

According to a 2007 study by the Journal of the American Dental Association, about 76% of independent general dentists and 26% of independent specialists employ dental hygienists. About half of those who didn’t cited not being busy enough to warrant hiring one as a main factor, and over 40% cited the cost. But that cost can be an investment.

In an article from, Kristine A. Hodsdon RDH, MSEC, suggests that if you find yourself with seven or eight continuing care patients per week in the schedule, you should bring in a hygienist one day per week. Then extrapolate that formula out for however many you’re seeing, up to full time. If you’re doing five cleanings a day, you’re going to need a hygienist there every day.

Now you might be crunching the numbers and thinking “There is no way my dental office is going to be doing enough cleanings a year to justify a $70,000 salary plus benefits.” And in a way, you’re right: The sheer number of cleanings a hygienist does probably won’t bring in enough cash to cover the salary. But that’s vastly oversimplifying the issue, and understating the benefit hiring a dental hygienist can offer, such as providing you with some much-needed relief so you can perform other (and potentially more profitable) dental procedures.

When Hiring a Dental Hygienist Gives You More Time for More Costly Dental Procedures

With a hygienist doing cleanings and continuing care, it frees you up to do more restorative and cosmetic dentistry. Doing these higher-priced procedures is a more valuable use of your time, and will expand your practice into more lucrative areas. Similarly, with a seasoned hygienist working with your patients, he or she can diagnose and recommend procedures beyond what they perform.

Patients often develop relationships with regular hygienists, and see them as a “second opinion” to your recommendation. So asking the hygienist what they’ve found when you come in to meet a patient is a great way to get that additional procedure train rolling.

Basically, if you find yourself doing a lot of cleanings, and passing up restorative or cosmetic dental procedures because you can’t fit it in your schedule, you might want to look at hiring a hygienist.

When Cash In vs Cash Out Allows For Hiring a Hygienist

Another consideration when pondering, “Should I hire a dental hygienist?” is how it will impact your practice financially. In other words, you want to look at your cash in versus cash out.

Ideally, you want your total employee wages to be between 19-22% of your gross income. Bringing in a well-paid employee is going to increase that considerably, about 27% on average as reports that the average median annual wage of a dental hygienist is $69,892 as of May 30, 2017. And that’s a big financial hit.

Ideally it won’t be permanent, and within two months your hygienist should be bringing in enough additional revenue to get those numbers back down to normal. But until they are, you can expect your dental office budget to be down about 5% of your gross. And if that’s not financially feasible, you may need to hold off until it is.

When a Hygienist Can Increase Your Revenue

How much can a good hygienist increase your revenue, helping to offset the cost? Eventually, a skilled hygienist should bring in $1500 a day, or about $300,000 annually based on a 4.5 day work week over 45 weeks. The average, as we said, is about $600-$900 a week, but that doesn’t mean you can’t push for more.

On your balance sheet, your hygienist should account for one quarter to one third of your overall production, and should bring in at minimum three times their gross production. That, of course, doesn’t include the added revenue you’ll get from performing more advanced procedures because the dental hygienist you’ve hired has freed up more of your time.

Things to Consider When Hiring a Hygienist

If you’re ready to take the leap and hire a hygienist to help you better sustain or grow your dental practice, there are a few things to think about first.

Obviously a less-experienced hygienist will be cheaper, but will probably also generate less revenue. So look at experience like an investment: you’ll have to spend money to make money. More importantly than that, look for people who are social, and do things like make eye contact and give thorough answers in interviews. The hygienist will have contact with upwards of 98% of your patients, and many will spend infinitely more time with him or her than with you.

You patients need to like your hygienist more than they like you, because that is who they spend most of their time with. That relationship is key to your success, and while you want to hire someone who knows what they’re doing, more so you need someone who is good with people and offers great customer service. When screening candidates for your dental practice, it is more important to ask questions about how they interact with people than their technical knowhow. Skills can always be taught. Personality cannot.

DentReps, a dental jobs site, shares other qualities that can make a dental hygienist one to pursue when hiring. These include:

  • Being patient and understanding
  • Having a positive attitude
  • Being able to effectively communicate dental procedures in a way that makes them easy to understand
  • Being able to motivate and inspire people to perform proper home dental care without causing them worry, anxiety, or concern
  • Having enough physical stamina to be “on the go all day”
  • Paying attention to detail, especially because the mouth is such a small space and doesn’t leave a whole lot of room to work
  • Having a passion for oral health, a quality that can rub off on patients and get them passionate too

“So, Should I Hire a Dental Hygienist?”

Hiring a hygienist is a big step in growing your dental office. But if you want to expand, and make the most of the skills you’ve learned, you need help, which is exactly what hiring a dental hygienist will provide. It’s a considerable financial commitment, and maybe not one you’re in a financial position to make just yet. But hiring a hygienist is a sound business objective, and an investment that will be a great benefit to your practice and your patients in the long run.