Dentists Not Smiling Over Help Shortage
Broader career Opportunities keep Job openings open

As printed in the Central Penn Business Journal, November 2, 2001

By SANDY ECKERT
Contributing Writer

Thirteen ads in a recent edition of a local newspaper asked dental assistants and hygienists to apply for jobs. The openings offer evidence of a nationwide shortage that has also hit this area.

Dr. Kenneth Loeffler of Lancaster said he doesn't have a staff shortage. "But my colleagues are growling because they can't find the proper people."

The U.S. Bureau of Labor Statistics predicts that between 1998 and 2008 the number of dental assistant jobs will increase by 96,332. Dental hygienist positions will jump by 58,107. Fewer than 5,000 hygienists graduate annually, and few than 50,000 graduated in 10 years. The graduates won't even fill the new positions. Forget replacing retirees.

Dental assistants are qualified to set up equipment for dentists, hand them instruments during procedures and must be certified to do x-rays, said Ira Wolfe, a former dentist who is now president of Success Performance Solutions. The Leola-based company helps employers hire, manage and retain employees.

Dental assistants ear between $7 and $18 an hour depending on experience and skills. They can receive training through formal programs or from dentists who hire them and do their own training.

Special - or expanded - function dental assistants have additional skills and work with a dentist much as a physician's assistant does with a medical doctor. They're likely to $13 to $21 an hour, Wolfe said.

Dental hygienists polish and clean teeth and treat patients, but they do not diagnose their conditions. Hygienists are licensed by the state, but they also need certification to take x-rays, said Wolfe. Their wages run from $28 to $30 and hour in this region.

Part of the problem in attracting these dental staff members is that people - especially women, who are the great majority of dental assistants and hygienists - have more career opportunities than they did a few decades ago.

In the October issue of AGD Impact, a publication of the Academy of General Dentistry, Wolfe said, "Dentists need to realize that the labor market has changed. They are not competing with the dental office down the street for assistants. They're competing with Disney, American Airlines and a lot of other businesses."

This trend of having more job openings than people will continue for 30 years or more, said Wolfe. And the ramifications of dental staff shortages are plenty. Patients will have to wait long for appointments, and appointments will last longer because dentists will be working without assistance.

"Some procedures need two pairs of hands," Wolfe said. "So dentists will have to get competitive with wages and benefits. That will means higher costs for patients. If dentists have to hire assistants who aren't well-trained, that will have an impact on the quality of care."

Another deterrent is finding and keeping dental staff that don't work full time, said Kathy Schlotthauer, dental hygiene program director at Harrisburg Area Community Collage. Many jobs are part time, and those who would fill them need work that pays them for 30 to 40 hours a week.

The price tag on HACC's three-year dental hygienist program is $13,000 a year for those living in non-sponsoring districts and $7,000 for those in sponsoring districts, which pay a portion of the tuition for their residents enrolled at the community college. The dental assistant program costs $5,6000 for students in non-sponsoring districts and $2,800 for those in sponsoring districts.

HACC is sponsored by 22 school districts in Central Pennsylvania. These districts pay HACC a portion of the tuition for their residents.

At Harrisburg's Academy of Medical Arts and Business, tuition to become an expanded-function dental assistant is $15,200, said school President Gary Kay.

Harrisburg Dentist Dr. Eric Shirley, who believes dental assistants are harder to find than hygienists in Harrisburg, said that with starting salaries of $8 or $9 and hour, it takes a long time to recoup the cost of training or pay off educational loans. That may dissuade some from entering the career.

Fear of communicable diseases, such as HIV and hepatitis, also might be a deterrent, said Loeffler. "But only sloppy workers have anything to fear."

Those who use universal precautions, which call for the use of rubber gloves, heat sterilization for instruments and other safety measures, shouldn't be concerned.

Given the shortages, Loeffler said, it's important for dentists to maintain the staff they have in four ways. First, treat assistants and hygienists with respect. They are part of a team, not underlings in a hierarchical structure.

"A natural spin-off from respect is to appreciate the skills they bring to the table and their work ethic," said Loeffler. Then they need to be challenged. "The worst thing in any job is to be in a dead-end position where you can't grow." Offer continuing education. Always raise the bar. Ultimately, patients benefit."

Finally, Loeffler said, part of respecting and appreciating is rewarding staff with flexible hours, good pay and benefits.

Schools, too, must provide an environment of respect and appreciation, said Loeffler. And Schools must work with dentists to maintain good externship sites.

Wolfe said that the Lancaster County vo-tech system is recruiting students with large ads that tout dental work as a "desirable career." But Schlotthauer said HACC isn't going that route yet because the school has more applicants than it can accept.