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DSO Leaders Predict Hiring and Staffing Trends for 2024

By Planet DDS
February 7, 2024

This article was written by Planet DDS staff and originally published on

Hiring challenges dominated dental industry headlines in 2023, and the crisis isn’t over yet. Within five years, about 34% of dental assistants and 31% of dental hygienists indicated they plan to retire, according to the ADA’s Health Policy Institute (HPI). 

We asked DSO executives to answer two questions: 

  • What remains your biggest hiring challenge?
  • What is one tip that has helped your organization hire and retain quality doctors and/or team members?

Five leaders of groups ranging in size from four practices to over 150 shared their top tips:

Lorri Detrick, President and COO of Riccobene Associates Family Dentistry (65 locations in North Carolina, South Carolina, and Virginia)

Hiring for all positions remains a challenge but at Riccobene we have seen an improvement year over year for the past three years in our overall staff retention rate. Specifically, for doctors our retention rate is over 90% and for hygienists, over 80% and these two groups have been consistently high throughout Riccobene’s history.

In the second half of 2021 we implemented two processes that have been instrumental in driving retention and engagement. First, we started completing ‘stay’ interviews with all employees twice per year to evaluate engagement, flight risk, and to be proactive about meeting our employees’ needs before they feel they need to seek employment elsewhere. Second, we started conducting a ‘leadership roadshow’ consisting of our Chief Dental Officer, our Chief of Staff, and myself during which twice per year we visit each office and have one-on-one, face-to-face conversations with every doctor in the company (currently we have about 150 doctors). In these meetings we ask probing questions about professional, financial and personal goals and we listen to, and more importantly, act upon their feedback.

In 2022, we engaged with an outside Professional Development and Leadership Coach who works with all our Office Managers and Functional Leaders. Our investment into the Professional Development of our leaders has certainly also been part of the positive trends we are seeing around retention. When managers are able to build relationships, build teams, and have difficult conversations, employees stay engaged.

Dr. Sulman Ahmed, Founder & CEO of DECA Dental (150+ locations in Arizona, Colorado, Florida, Georgia, North Carolina, Tennessee, Texas and Washington)

Our industry’s biggest challenge remains managing inflationary pressures while trying to maintain the best talent available. Many dental assistants have permanently left our profession during and after the pandemic. Many have not and will not be returning, creating a permanent shortage for fast-growing companies like Deca. We have created our own dental assisting school, where we don’t charge assistants to train them and often even pay them during the training process. They get to extern in our offices, and if they like it, they stay on, and if not, then they are free to join any other dental office. We are training and bringing new talent into the profession to help us and other dentists.

Dr. Larry Moray, Founder & CEO of MyOrthodontist North Carolina / Key Dental Management Solutions (14 locations in North Carolina)

Our staffing has seemed to be cyclical for quite some time.  We have had periods of ‘full employment’ and those in which we are short-staffed to varying degrees.  Our company is founded on core values that embody and promote service and giving and we have found that being up front and honest in communicating these values has resulted in great applicants and hires even during the current staffing shortages nationwide.  Of course, I just jinxed us!

Dr. Kalpesh Patel, Founder and CEO of Active Dental (4 locations in Texas)

Our biggest challenge is hiring hygienists. Our patients still need hygiene and that’s the bread-and-butter entry point into our practices.

One thing that that has helped us is that we value teamwork and culture above everything else. Our doctors are stepping up. Our hygienists are loyal and amazing, and since our practices are close to each other, our hygienists are willing to travel. Everyone is always communicating and not working in silos, and our culture keeps our team working together and smiling.

Morgan Baum, Director of Human Resources at Smile Design Dentistry (54 locations in Florida)

Our biggest hiring challenge is staying competitive in recruiting dental assistants. The demand for this role has risen significantly recently, prompting us to find innovative ways to stand out.

Effective communication has played a crucial role in our ability to attract and retain high-quality team members. This involves keeping candidates informed throughout the hiring process, providing regular feedback and praise to employees, and maintaining transparency about the company’s goals and objectives. Fostering a sense of belonging and involvement is key, and I believe it truly makes a difference.

For more strategies that can help you create a great culture that will help you hire and retain great team members, check out this video, “Overcoming Staffing Shortages in Dental: Implementing the Right Processes, Technologies, and Solutions.”