The 4 Biggest Threats to Your Dental Practice in 2023

As we all tumble into the New Year, we think it’s a good time to pull off the band-aid. Last year was tough. The two years before it were even tougher. This year… well… it’s going to be tough too. Across the dental industry, there are some unavoidable problems that are piling up.

Today, we want to look at the 4 biggest threats to your practice in 2023. If you can successfully navigate these 4 threats, you will thrive. Otherwise, you’ll struggle like many other offices across the US and Canada.

After looking at the data, talking to offices, and seeing the broader trends across countries, these are the 4 challenges we believe will define 2023.

The Staffing Shortage

We’ve talked about this a lot this year. But for good reason. This is a dental industry threat that directly involves our business, and we spend a significant amount of time and resources trying to help dental offices navigate this chaotic labor ecosystem.

Here’s the sucky part: there’s no easy fix. There just aren’t enough heads. It’s really that simple, and there’s no way around it. We’re huge advocates for dental professionals, and we help them find work daily. Still, despite our day-over-day growth, we don’t have enough amazing hygienists to fill every vacancy. No one does. We would know; we get significantly more dental applications than even the largest DSOs.

This threat isn’t about winning; it’s about surviving. That’s where we thrive. Our massive ecosystem of recruiters helps independent dental offices find meaningful talent. From proactive staffing to finding permanent staff to support growth, we’re helping offices navigate this crisis.

But we can’t solve it. It will take time. We expect the labor crisis to last at least the next half decade — if not the next entire decade.

We won’t focus too much on this. Last week, we created an entire article on this subject. Give it a read if you’re struggling to navigate the staffing shortage. It should help.

Increased Labor Costs

Along with the staffing shortage, labor costs are increasing significantly. The unique combination of high demand and inflation is a perfect storm for rapid wage increases. We expect wages to continue to climb somewhat rapidly over the next few quarters before tapering off slightly. Our wage data shows a bump in every province and every state (that we collect data on).

So, what do you do with that information? Good question. But a hard one to answer. Many dental offices are giving proactive raises to prevent potential attrition. Not a bad idea. But most hygienists aren’t leaving due to wages (hint: it’s culture, flexibility, and happiness). We recommend fixing those issues too. Or, at the very least, create a more positive culture and improve employee happiness if you can’t afford wage increases.

You don’t have to spend big to improve the lives of your hygienists and assistants. That said, we highly, highly recommend raising wages to meet raises in suggested bill rates in the yearly Fee Guide. For example, we’re giving a 7.5 percent raise to all of our hygienists — which reflects the 7.5 percent rate increase in hygiene work.

This is also a good time to lean heavily into proactive staffing. Hire a temp a few days a week/month to give you the revenue you need to hire another full-time employee. That way, you don’t have to burn revenue on onboarding, training, and upfront hiring costs. You get the revenue boost, put it back, and use it to test the waters of hiring another full-time employee and give you the extra cash you need to do so without impacting growth.

We also recommend giving inflation bonuses. Yes; it’s costly. But here’s the big thing: it costs much more to lose on your hygienists or assistants. Make sure you’re paying attention to your overall work culture and pay as you continue to ride the wave in 2023.

Pushback Against Changes

This is actually a unique challenge that we’re noticing this year. Many offices are hiring consultants and experience to help them sail through these tricky financial quarters (growth + inflation + recovering from COVID losses = chaos). Yet, employees are pushing back against changes.

It’s tough. You need to cut costs. But your employees are hyper-resistant to making any changes in their daily workflows. Worse, they may seem resentful toward the people you hired to help you fix your revenue headaches.

This is actually part of a larger issue. As a whole, the dental industry is pretty resistant to change. Outside of independent office owners or DSOs, everyone else very badly wants to pretend things are the same as they were pre-pandemic. But they’re not. All of these issues we’re discussing are happening, and you need to make changes to successfully overcome them.

To win, you need to practice good change management. We won’t give you a complete course on this (who are we?) But we will link some of our favorite change management practices below:

Shrinking Reimbursements Meet Rising Costs

The elephant in the room is big, smelly, and angry. Your costs are rising with inflation. Yet, your revenue isn’t. Unfortunately, dental offices that rely heavily on PPOs (somewhat rarer in Canada) have it the worst. Your costs are rising due to inflation, your employee’s wages are rising due to the staffing shortage, and you’re dealing with a wealth of time-consuming problems — yet your revenue is static. It’s a problem; a big one.

We’ve even seen some major dental magazines signal the “end of PPOs.” Probably not. But, it does raise some concerns that are shared across offices and countries. It’s hard to raise your rates. And, even if you do, those raised rates likely can’t make up for lost income across all of these other buckets. Worse, the hyper-competitive nature of the market puts pressure on dentists to keep rates low. And, even if you team up with private health insurance companies, reimbursement rates aren’t rising as inflation does. In some markets, they’re even going down.

There are plenty of tips to help you increase profits. And, companies like WORKFORCE can help you ease your staffing shortage. But, make no mistake, all dental offices will feel inflation to some degree. At the end of the day, it’s a problem that impacts everyone across the United States and Canada. Don’t try to fight back against it. Instead, we recommend paying careful attention to the books, doing your best to boost profits, and focusing on growing your office sustainably. Inflation will ease. Offices that successfully ride the wave with patience, forward-thinking, and a game plan will survive. The rest will either fall to the wayside or be absorbed by an increasing number of DSOs at a low price point.


We can’t solve all of these problems. But we can help. We give dental offices the tools and reach they need to secure best-in-class talent. Sign up today to see how WORKFORCE can help you navigate the staffing shortage.

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