EVERETT — Inside mouths, dentists say, it’s an ugly scene these days as wary patients return. Cracked teeth, cavities and gum disease after months of pandemic stress, shoddy hygiene and poor diets. The bad brushing isn’t the only problem.
At the same time, staffing shortages are leaving dentists overwhelmed and undermanned.
At All Smiles Northwest on Colby Avenue, owner and dentist Michelle Steinhubel said she lost two employees from causes related to the pandemic. Since then, she’s juggled staffing, but it often means long days, short lunches and patients waiting for open appointments.
The jobs aren’t easy to fill. Hygienists and assistants are highly skilled positions. A hygienist needs a bachelor’s degree and years of training in a clinical setting. Dental assisting has fewer academic qualifications but still requires licenses and education that takes months.
Candidates can’t be hired off the street, Steinhubel said.
“It seems like an ever-decreasing pool of applicants that actually apply for the job,” she said.
Dentist Amy Norman said trying to fill an assistant opening at her Everett office has felt like six months of fishing in a lake with no fish.
“We are getting spread really thin, there is a lot of fatigue,” Norman said.
Already down one position, Norman said she schedules selectively and pays the travel costs of an assistant who commutes from Spokane to work three days at a time.
“A lot of the things we do in a dental office require four hands, so if I don’t have those extra two hands, I’m not able to do it by myself,” she said.
A survey released in February by the state’s dental hygienist and dental association outlined the significant demand. More than 900 open hygienist positions were reported statewide with only about 220 hygienists actively seeking employment. Dental assisting had more than 1,100 openings and fewer than 200 qualified folks in search of a job.
Bracken Killpack, executive director of the Washington State Dental Association, said local clinics are at the epicenter of the shortage.
“It is an issue we are seeing across the board, but it is particularly pronounced in Snohomish and King counties,” Killpack said.
On average, hygienist jobs are open for more than four months before being filled, and assistant positions are open for about three and a half months.
Shannon Cole knows the need well. As the co-founder and staffing director of Dental Temps Staffing Solutions in Arlington, Cole assists more than 450 dental offices in the Puget Sound area and beyond to find stand-in professionals.
Despite having more than 300 qualified temporary employees to deploy, Cole said, there are over 150 open positions she still can’t cover.
“We can’t fulfill more than half of our orders,” she said. “If we filled all our orders it would bring in $5 million a year.”
Cole said 1,600 temps have not returned to work following pandemic closures citing safety concerns, kids to educate at home, taking another job or reaping unemployment benefits.
Dental Temps Staffing Solutions began a marketing campaign and offered incentives, signing bonuses and hazard pay to attract hygienists and assistants — to no avail. Cole said the staffing agency has about 90 open hygienist positions and 40 or so assistant jobs.
In downtown Everett, Cynthia Curtis owns and instructs at the Northshore Dental Assisting Academy. For almost two decades, the school has instructed fledgling aides in a four-month program preparing them for work.
Curtis said she is in constant communication with dentists trying to find jobs for students. Of late, she’s hearing of low wages or poor benefits keeping assistants away from the field.
“We saw a lot of people bail and they used COVID as their out,” Curtis said. “I think they forgot that they had been working in someone’s mouth for 18 or 20 years.”
In a rigorous line of work, Curtis said, assistants want to be paid what they are worth, or they opt for a less challenging profession. More than half the former students Curtis hears from after interviews report an issue with the compensation they are offered, she said.
Earlier this month, about a dozen students rehearsed molds, impressions, X-rays and more at the academy.
Brecca Yates, an instructor with the school, maneuvered between manikin heads reclined in dentist chairs, offering advice and support. When class isn’t in session, Yates is a dental assistant in a Mukilteo office where, she said, short-staffing means missed breaks and running around a lot more.
“We are definitely getting put a little bit behind,” she said. “We are having to know how to be quicker on our feet and think faster and be more on top of things.”
Patient care remains the priority, Yates said, including fitting patients in on days when appointments are all booked up. Even on the longest days, Yates said, she feels taken care of at the office.
Fellow instructor Kaitlyn Doohan said she switched dental assisting jobs at the beginning of the pandemic to find a more accommodating office. As a newer assistant, she desired training and proper attention that can be difficult to find.
“I think it has been challenging for students to find that home,” Doohan said. “There is a bigger expectation out of assistants and more responsibility that comes with that.”
Dental assisting student Perla Galvan, 22, said she’s heard of staffing shortages and poor pay impacting the profession, but she wasn’t swayed away from the field. COVID-19 was a concern, but her will to learn was greater.
“The pandemic will get in control, but my career’s not going to stop,” she said.
In May, Galvan will complete her coursework and enter the field. She wants an employer who values the work she does and is willing to pay accordingly.
At the practice Steinhubel has owned since 2005, she said, some young applicants are expecting pay typical of a 15- or 20-year veteran of the field. It creates a challenge for dentists who are still recovering from last year’s closure.
“You sometimes have to let really qualified applicants go, because you literally can’t afford them,” she said.
Norman also said she is paying some positions much more than she was five years ago or offering signing bonuses.
Rising wages are an issue across the industry, Killpack said.
“With a very scarce supply (of job candidates), one of the only options employers have to get someone is to increase salary,” he said. “It becomes unsustainable to pay the salaries that the market is commanding right now.”
The extra cost could be passed on to patients.
Dentists also warn of longer wait times for routine check-ups and challenges freeing time for emergency work as staffing shortages continue to limit the patients that can be seen.
“We don’t want to compromise the care we give patients,” Steinhubel said.
Ian Davis-Leonard: 425-339-3448; firstname.lastname@example.org; Twitter: @IanDavisLeonard.