'The worst I've seen': Dental practices struggle with staffing shortages | WBUR News

  
Via:  sandy-2021492  •  3 months ago  •  44 comments

By:   WBUR

'The worst I've seen': Dental practices struggle with staffing shortages | WBUR News
Shortages in hygienists, dental assistants and front office personnel are delaying routine dental care for some patients. In some cases, the wait can last months.

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August 23, 2022

  • Gabrielle Emanuel

Dental practices are facing labor shortages that are delaying routine care for some patients, and the delays can stretch on for several months. The shortages are compounded by what dentists describe as higher-than-normal patient demand because ofcare that was deferred early in the pandemic.

The shortages are affecting a range of positions, from hygienists to dental assistants to front office personnel. Jeffrey Karen, a pediatric dentist in South Weymouth and a trustee for the Massachusetts Dental Society, said this is a particular problem because dental procedures often can't be done without an assistant present.

"I've been practicing for about 15, 20 years now, and I would say this is pretty much the worst I've seen it," Karen said, noting that wait times for care vary greatly from one practice to the next.

At the Boston University Dental Health Center, patients won't find appointments for a cleaning until 2023, unless there is a cancellation. Kelly Marcinkewich, the center's associate director, attributed much of the issue to the pandemic driving staff to leave the field.

"We have observed during the COVID-19 pandemic a realignment of the region's workforce away from certain types of jobs in healthcare, which we believe has caused an industry-wide staffing shortage that is affecting many local dental practices, including ours," Marcinkewich wrote in an email. "At the same time, there has been an increase in the number of patients seeking appointments for exams or cleanings that they delayed earlier in the pandemic."

The dental health center serves some Boston University students and employees, including staff at WBUR.

Pamela Maragliano-Muniz, a dentist in Salem, said delays until 2023 are on the extreme end of the spectrum, but staffing issues are "widespread" in the field. Based on conversations with her colleagues, she said, "It seems like most practices are looking for help."

The staff shortages are not just a local or regional problem.

"That's absolutely issue number one," said Marko Vujicic, the chief economist and vice president of the Health Policy Institute at the American Dental Association.

Vujicic said roughly 40% of dental practices nationwide report having open positions and say they are looking to hire new staff members. Among practices with openings, 90% report it is extremely difficult to find workers.

"That's an astronomically high number," he said. "And frankly, it's not going to go away overnight, and it's affecting patients."

The Massachusetts Dental Society is in the early phases of rolling out a campaign to attract more high school graduates to the field. In particular, the hope is to draw more people to train as dental assistants.

"There are plenty of [dental] assisting schools in our state, but a lot of them are having trouble filling their classes," the group's trusteeKaren said.

For dentists in Massachusetts to operate at full capacity, the number of dental assistants would have to double, according to Karen. At a minimum, he'd like to see the number of dental assistants increase from the roughly 9,500 that are currently licensed statewide to 19,000.

The plan, Karen said, is to launch an advertising campaign in the next month on platforms like YouTube, TikTok and Snapchat as well as work with high school guidance counselors to elevate the profile of the profession.

"The goal of what we're trying to do with this whole advertising campaign is to prevent an access to care problem," Karen said.


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sandy-2021492
Professor Principal
1  seeder  sandy-2021492    3 months ago
The shortages are affecting a range of positions, from hygienists to dental assistants to front office personnel. Jeffrey Karen, a pediatric dentist in South Weymouth and a trustee for the Massachusetts Dental Society, said this is a particular problem because dental procedures often can't be done without an assistant present.
"I've been practicing for about 15, 20 years now, and I would say this is pretty much the worst I've seen it," Karen said, noting that wait times for care vary greatly from one practice to the next.
 
 
 
Split Personality
Professor Principal
1.1  Split Personality  replied to  sandy-2021492 @1    3 months ago

My daughter works (past and present) for a firm that manages large practices, then handles the billing for

insurance, federal state and local government plans and prisoners.

She has been working from home since Covid started and finally picked a local dentist for a routine check

up.  She speaks the lingo.

When she showed up she gave the receptionist the approved routine number and said she also wanted 

the hygienist to look at tooth # 30 which she said was beginning to feel sharp on her tongue.

When she got situated the dentist himself came in to do the exam and it turned into a 45 minute interview.

Last I heard she was holding out to keep working from home if she took the job.

 
 
 
sandy-2021492
Professor Principal
1.1.1  seeder  sandy-2021492  replied to  Split Personality @1.1    3 months ago

We're so small an office that that just wouldn't work for us.  My front office staff train to work chairside, too, in case somebody is sick or on vacation.  It turned out that was extremely wise when both of my assistants had Covid at the same time - we were able to keep the office running with the gal who was out front running to the back to assist when needed.  It was a rough two weeks, though.

 
 
 
cjcold
Professor Quiet
1.2  cjcold  replied to  sandy-2021492 @1    3 months ago

Used to be a paramedic and folk are even trying to get me to come back in my 70s.

 
 
 
Kavika
Professor Principal
2  Kavika     3 months ago

Our dentist is experiencing a shortage as well. He has openings for hygienists and other positions. 

 
 
 
sandy-2021492
Professor Principal
2.1  seeder  sandy-2021492  replied to  Kavika @2    3 months ago

I'm fully staffed now, but when one of my employees told me she was moving out of the area, it took almost two months to find a replacement for her.

 
 
 
devangelical
Professor Principal
2.1.1  devangelical  replied to  sandy-2021492 @2.1    3 months ago

I have a friend that's a hygienist. she worked for a dentist for almost 20 years and was then let go by the guy who bought the practice. all she could find for a year afterwards was temp work thru an agency and she thought about retiring. now she's complaining about working too hard, 5 days a week instead of 4, since she took her contacts she made doing temp work and got on with those dentists. they now schedule her 1 day a week each and she comes in to do her thing, while the dental offices stay open and that dentist gets to go play golf for half the day. she's turning down work and making twice as much money as before, and she got to tell the dentist that let her go to stuff it when he called and begged her to come back.

 
 
 
sandy-2021492
Professor Principal
2.1.2  seeder  sandy-2021492  replied to  devangelical @2.1.1    3 months ago

Good for her.

It's always been hard to hire a hygienist in my area.  There's a hygiene program at our local community college, but they only admit 12 students every 2 years, and a lot of those are willing to commute to the Northern Virginia area for higher wages than we're able to pay in my county.  I'm very glad to have my hygienist, and I treat her accordingly.  Same for my other employees.

 
 
 
igknorantzrulz
PhD Quiet
2.1.3  igknorantzrulz  replied to  sandy-2021492 @2.1.2    3 months ago

I need a tank for my 'Race Car", i'll pm you, andwe can laugh about it, but, you may have to be an oral surgeon to obtain, i guess

send irregardless, thanks in advance

 
 
 
cjcold
Professor Quiet
2.1.4  cjcold  replied to  igknorantzrulz @2.1.3    3 months ago

I can still get a tank filled because people know me

 
 
 
Trout Giggles
Professor Principal
3  Trout Giggles    3 months ago

I was about to have my dental implant fully completed when covid hit. I had to wait another 3 months to get the job done. But my dentist's office seems to be fully staffed. They never have any problems with keeping my appointment with the sadists

 
 
 
devangelical
Professor Principal
3.1  devangelical  replied to  Trout Giggles @3    3 months ago

is it a front tooth that's missing? are the local goobers hitting on you if you smile at them?

 
 
 
Trout Giggles
Professor Principal
3.1.1  Trout Giggles  replied to  devangelical @3.1    3 months ago

You're a riot.

They only hit on blondes with big boobs. They don't care about the number of teeth

 
 
 
devangelical
Professor Principal
3.1.2  devangelical  replied to  Trout Giggles @3.1.1    3 months ago

you know how much I miss you when you're gone...

 
 
 
cjcold
Professor Quiet
3.1.3  cjcold  replied to  Trout Giggles @3.1.1    3 months ago

I've always liked blondes with tiny tits.

 
 
 
CB
Professor Principal
4  CB     3 months ago

Well, this is as great a place as any to drop this FYI: I got my crown work done on the one tooth that was weirding me out during "the covid years." It was around I wanna say - May 2022? I don't quite remember I just do stuff and the days keep speeding away/by! 

I feel better. Still have stray mouth stuff that I can't quite put my finger on (onset of old age?). Who knows.

Dentist office was the best and speedy too. Just a dentist, assistant, and front desk (wife or additional staff interchange).  :) I feel good.

I thought a crown should last for 'life'! So I was disappointed and upset when the old one didn't.

Glad it worked out!  And, you all played a part in its repair being expedited as I dropped my resistance on principle, and took the advice given here to heart!

 
 
 
Ender
Professor Principal
5  Ender    3 months ago

I hate to say it but I would think working on teeth is not for everyone. I don't know if I could do it.

One of my friends kids started out going to dental school (whatever you call it) then switched to optometry.

Never did hear exactly why, I am thinking he wasn't cut out for it.

 
 
 
Trout Giggles
Professor Principal
5.1  Trout Giggles  replied to  Ender @5    3 months ago

Open mouths make me squeamish. I admire anybody who has the guts to look inside my mouth

 
 
 
magicschoolbusdropout
Sophomore Principal
5.1.1  magicschoolbusdropout  replied to  Trout Giggles @5.1    3 months ago
I admire anybody who has the guts to look inside my mouth

Looking, Looking, Looking !

256

 
 
 
Ender
Professor Principal
5.1.2  Ender  replied to  Trout Giggles @5.1    3 months ago

I know it is really against popular opinion, yet I am really not a fan of kissing. People slobbering all over each other. People grinding on each others faces and making these smacking noises, grates on my nerves if not give me a little ill feeling...

I can't stand when they do that on tv or in a movie.

 
 
 
Trout Giggles
Professor Principal
5.1.3  Trout Giggles  replied to  Ender @5.1.2    3 months ago

I like it..with the right person.

 
 
 
magicschoolbusdropout
Sophomore Principal
5.1.4  magicschoolbusdropout  replied to  Ender @5.1.2    3 months ago
People slobbering all over each other. People grinding on each others faces and making these smacking noises

256

I Feel your pain...... Blah !

 
 
 
sandy-2021492
Professor Principal
5.2  seeder  sandy-2021492  replied to  Ender @5    3 months ago

My class lost one person.  He had good grades, but decided it wasn't for him and went into research, instead.  I was a bit shocked. We were assigned lab benches alphabetically and were always right next to each other, and I never had a clue he was unhappy.

 
 
 
devangelical
Professor Principal
5.2.1  devangelical  replied to  sandy-2021492 @5.2    3 months ago

I had my daughter fixed up to work for my dentist in some capacity while she went to school to become a hygienist after graduating high school. after what I spent on getting her teeth fixed, I thought it was a nice gesture by my dentist. she lasted less than 2 weeks and said the thought of putting her hands in strangers mouths made her nauseous. based upon her current success in life, she was more suited to the business world.

 
 
 
sandy-2021492
Professor Principal
5.2.2  seeder  sandy-2021492  replied to  devangelical @5.2.1    3 months ago

It's definitely not for everyone.

And besides the "ick" factor, hygienists have a high rate of burnout.

 
 
 
charger 383
Professor Quiet
5.2.3  charger 383  replied to  sandy-2021492 @5.2.2    3 months ago

Don't let the hygienist or assistants at your office get burnout,  or you! 

 
 
 
squiggy
Junior Quiet
5.2.4  squiggy  replied to  sandy-2021492 @5.2.2    3 months ago

They get frustrated by the patient’s lack of dilligence?

 
 
 
sandy-2021492
Professor Principal
5.2.5  seeder  sandy-2021492  replied to  charger 383 @5.2.3    3 months ago

Thanks.  Doing my best.

 
 
 
sandy-2021492
Professor Principal
5.2.6  seeder  sandy-2021492  replied to  squiggy @5.2.4    3 months ago

That's some of it.  I'm sure it can also get a bit monotonous.  I get to do different procedures all day long.  My hygienist - cleaning.  Cleaning.  Cleaning.  Cleaning.

There's also something peculiar to dentistry and hygiene - our training seems to cause us to internalize our patients' problems.  I think it is worse in hygiene training.  We're taught that if a patient isn't brushing and flossing like they should, it's our fault for not motivating them properly.  If they don't show for their appointments, it's because we haven't stressed the value of dental care enough.  It doesn't seem to matter where you did your training; all dental programs seem to embrace this mindset.  I remember hygiene students crying in the bathroom on the dental hallway when they'd been reamed by their instructors because their patients' mouths were a mess.  That will mess with your head.

 
 
 
Perrie Halpern R.A.
Professor Principal
5.2.7  Perrie Halpern R.A.  replied to  sandy-2021492 @5.2.6    3 months ago

You are doing your best. Ask any doc, how many of them make recommendations and their patients don't listen. 

 
 
 
sandy-2021492
Professor Principal
5.2.8  seeder  sandy-2021492  replied to  Perrie Halpern R.A. @5.2.7    3 months ago

Of course.

I think it hits hygiene students harder because they're younger.  Dental students have already graduated college by the time they enter dental school, and some have worked in other fields for a while, so they tend to have a bit more life experience than hygiene students.  I think that makes it harder for hygiene students to resist the unhealthy mindset that school tries to instill in them.

 
 
 
Trout Giggles
Professor Principal
5.2.9  Trout Giggles  replied to  Perrie Halpern R.A. @5.2.7    3 months ago
patients don't listen. 

<raises hand>

 
 
 
squiggy
Junior Quiet
5.2.10  squiggy  replied to  sandy-2021492 @5.2.6    3 months ago

Sad to see them feel that way. It's really society's indifference and willingness to tolerate a range of disease that's entirely preventable. There seems to be no interest at work, during the day, for personal care. I'm still trying to name a worthwhile food that presents cellophane as it's final wrapper.

 
 
 
Perrie Halpern R.A.
Professor Principal
6  Perrie Halpern R.A.    3 months ago

This is just making me feel guilty about not going for my cleaning....

 
 
 
Revillug
Freshman Guide
6.1  Revillug  replied to  Perrie Halpern R.A. @6    3 months ago

I started using Crest Gum Detoxify with an electric toothbrush (and Listerine rinse) when Covid broke out. I felt like I really needed to get to the dentist in early 2020 and it cleared the gum irritation and bleeding completely up.

It's still kind of strange with 400 to 500 deaths per day and all this talk about waning immunity and evolving strains. The cleaning is going to have to wait a bit longer.

 
 
 
CB
Professor Principal
6.1.1  CB   replied to  Revillug @6.1    3 months ago

Dentists, in my opinion, (been several times since things eased up in 2021-2022) are conspicuously clean with their tools and keen with their own protection (as they are looking down the mouth and up the nose of patients all day!) Where I live that translates to distill water in the 'tank,' N95 masking, and everything wiped down before you are seated. And if it suits-and it does for me-I nicely and firmly ask them about the water they use, if everything is done with hygiene in mind. They are glad to reply and tell me, you, what steps they have taken for safety sake!

Nowadays, I trust all my dentists, doctor's offices, and hospitals to take good care of me. Mind you, I am in California. And if I don't know something is just so-I ask before we do 'the work.' :)

 
 
 
Revillug
Freshman Guide
6.1.2  Revillug  replied to  CB @6.1.1    3 months ago

I think I got Covid at the local hospital during the vaccine drive back in early 2021.

 
 
 
CB
Professor Principal
6.1.3  CB   replied to  Revillug @6.1.2    3 months ago

Well, of course, I am not referring to scenarios that place anybody at a higher risk of infection from an array of viruses. :)  It is my working theory that no one truly knows the instance of contamination with a microscopic germ that is 'airborne.' But, I do understand your narrowing of possible venues, nevertheless.

 
 
 
Revillug
Freshman Guide
6.1.4  Revillug  replied to  CB @6.1.3    3 months ago

Even back in mid 2020 at my local hospital in NYC when we were the epicenter of the world there were hospital workers milling around the hallways with no masks on or their masks around their necks.

I'm kind of disgusted with all the medical professionals with their pretend protocols in place to protect the rest of us. Where there is money to be made in America Covid is of secondary importance.

 
 
 
CB
Professor Principal
6.1.5  CB   replied to  Revillug @6.1.4    3 months ago

This can't be about the politics of Covid-19 for me, Revillug. This is about people with the right expertise, the right policies in place, and a right spirit trying to do what's best—even should it go varying ways wrong, possibly. :)

Of course, I mean, if somebody is just out to get you or me-well with an airborne virus they probably have a high degree of succeeding in doing so!

 
 
 
Revillug
Freshman Guide
6.1.6  Revillug  replied to  CB @6.1.5    3 months ago
This is about people with the right expertise, the right policies in place, and a right spirit trying to do what's best

Good luck with that alternate universe.

In my universe all people care about is making money and not getting successfully sued.

 
 
 
CB
Professor Principal
6.2  CB   replied to  Perrie Halpern R.A. @6    3 months ago

Go for the cleaning. . . I have had my cleaning done and it was easy peasy (and yes - the dentists were SUPER clean and mindful of hygiene to the "nines.") I am in California.

 
 
 
Hal A. Lujah
Professor Expert
7  Hal A. Lujah    3 months ago

This may sound weird but I haven’t been to a dentist in over 12 years.  My whole life, every time I went to a dentist they “found a cavity”.  One dentist even told me I have teeth that are genetically susceptible to cavities, regardless of the fact that I have always been fanatical about brushing and flossing.  All those fillings turned my teeth into Swiss cheese, and several of them in the back have broken because the tooth became too thin from being excessively drilled.  I quit going to the dentist because I felt like they were just wrecking my teeth faster than I could ever do it myself.  If I’ve had a cavity within the last 12 years I haven’t even felt it.  I guarantee you though that if I went to the dentist twice a year over that period I would have so many more fillings that there would be barely anything left of my natural teeth.  Funny how that works, huh?  Was it that I had genetically bad tooth enamel, or just good insurance?

 
 
 
Ender
Professor Principal
7.1  Ender  replied to  Hal A. Lujah @7    3 months ago

Some people don't believe me but I had two baby teeth until I was almost 30. The second teeth from the center ones top. One side a tooth grew in a little crooked and the other side never did. Had to get it fixed.

 
 

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