By: Candy Velez, CRDH, BSDH, IgniteDDS Dental Hygiene Coach
The Hygiene Shortage Conversation We Aren’t Having
If I called your hygienist today and said, “I know a great hygienist looking for a new practice. Would you recommend yours?” what would your hygienist say?
Would their response be an immediate:
“Absolutely. Give them my number. I’d be happy to tell them about our practice.”
Or would there be a pause followed by:
“Yeah, it’s a nice office, but…”
We can learn a lot from what comes after the but.
At a time when practices are struggling to find hygienists, the conversation often comes back to the same reality: there simply aren’t enough hygienists.
That may be true. But when the pool is already small, perhaps there is another part of the recruitment conversation worth exploring:
Would the hygienists already inside a practice put their own reputation behind encouraging another great hygienist to work beside them, or would they hesitate?
The Relationship Bank Account
Years ago, someone shared an analogy with me that has stayed with me: every relationship has a bank account.
Over time, deposits build trust, respect, and goodwill. Feeling heard and supported makes deposits. So do fulfilled promises, clear expectations, appreciation, and consistency between what is said and what is actually followed through on.
Inevitably, there will also be withdrawals.
Some are significant: a moment of disrespect, an unfulfilled promise, an unmet expectation, or a concern that is repeatedly dismissed.
Others are simply part of working together. Someone calls out. The schedule falls apart. Equipment breaks, and there are days when everyone has to give a little more than expected.
The goal isn’t to avoid every withdrawal. That’s unrealistic.
The goal is to make enough deposits that, when a withdrawal happens, there is something in the account to withdraw from.
The problem begins when small withdrawals become so routine that we stop noticing how much they’ve changed the balance.
Small Things Aren’t Always Small
Consider something as basic as hygiene instruments. Are they sharp? Are there enough sets? Does a new hygienist simply inherit whatever the other hygienists don’t want to use?
Or does someone say:
“Here’s what we currently have. Tell us what you like to work with and what you need to provide great care.”
It may seem like a conversation about instruments. But the message underneath is much bigger:
What you need to succeed here matters. And that message adds value in the relationship account.
What Happens on the Hard Days?
Culture becomes most visible when someone is struggling.
Imagine this: A hygienist is running 15 minutes behind. The next patient has been waiting. Notes need to be finished, the room needs to be turned, and the hygienist has not had a break all morning.
One common response is:
“How much longer are you going to be?”
A kinder response might be:
“Can I help?”
While the intention is good, when someone is already overwhelmed, even figuring out how someone can help can feel like one more thing to manage.
So, the response is often:
“No, I’ve got it. I will be ready in a few minutes.”
Now imagine instead:
“I noticed you haven’t had a break all morning. Take five. We’ll help you. We’ll turn the room and get your next patient started.”
That kind of support doesn’t happen accidentally. It requires a team trained well enough to recognize what needs to happen, capable of stepping in to help without asking how, and empowered enough to do it.
The difference may be five minutes. But those five minutes can say a great deal about what it feels like to work as a part of the team.
It All Adds Up
Of course, the relationship account is influenced by far more than instruments or difficult days.
It can be affected by PTO that looks generous on paper but brings guilt when someone actually uses it. The great hourly rate that diminishes when hours vanish with cancellations. The opportunity for growth that was promised but never materialized.
And deposits can be equally easy to overlook: a sincere thank-you, a concern taken seriously, respecting clinical judgment, a promise kept, or simply noticing the extra effort that day.
None of these moments alone define a workplace.
But together, they create an experience. And over time, they create a balance.
So, What’s the Balance in Your Practice?
No practice will get everything right. That isn’t the point. However, this is an opportunity to get curious.
- What consistently makes deposits into the relationship account with your team?
- What quietly makes withdrawals?
Are there promises that haven’t been fulfilled? Expectations that were never clearly communicated? Small frustrations that have become so normal that no one speaks up anymore?
And perhaps most importantly:
Would the people experiencing the practice every day calculate the balance the same way that leadership does?
Which brings us back to the question we started with. In the middle of a very real hygiene shortage, if someone called your hygienist today and asked:
“Would you recommend your practice to another great hygienist?”
What would they say? Would they confidently put their own reputation behind inviting someone they respect to work beside them? Because hygienists talk to hygienists.
And when someone asks, “What’s it really like working there?” the answer won’t come from a mission statement or a benefits package.
It will come from lived experience. So if the answer might be:
“Yes, but…”
Don’t be afraid of the but. Get curious. Find out what follows it.
Because that may be exactly where the next deposit needs to be made.
