What turnover costs a practice

The cost of an open clinical position

When a hygienist leaves, the practice may need to reschedule appointments, arrange temporary coverage, or see fewer patients. Separate appointments you can reschedule from production you expect to lose. Hygiene vacancies can also affect restorative treatment identified during visits.

When a dental assistant leaves, other employees often absorb the work. DANB research found that about half of those responsibilities go to another assistant, one quarter to the dentist, and the remainder to the office manager or hygienist. When a dentist or hygienist covers assistant duties, they have less time for their usual patient care responsibilities.

A front office departure can affect calls, scheduling, insurance coordination, and patient follow-up. Missed calls, delayed scheduling, and unfinished follow-up can affect the practice for weeks.

Hygienist replacement costs and lost production

Dental industry estimates put the cost of replacing a hygienist at $8,000 to $12,000. Direct hiring expenses are commonly estimated at $4,000 to $8,000, including advertising, recruiter fees, background checks, and onboarding. Filling a position can take six to twelve weeks. Local competition, location, and compensation can all affect the timeline. Across industries, replacement costs have also been estimated at half to twice an employee's annual pay. Use that broader range when estimating replacement costs for other positions.

Assistant vacancies create additional costs when other employees take on the work. DANB estimates that an assistant position left open for a year can cost more than $30,000 in reassigned work. Including lost efficiency brings the estimate close to $60,000. The same research found that one in four practices reschedule or reduce patient visits when an assistant is unavailable, with an associated decline of approximately 6% in average daily revenue. More than half of practices identified hygienists and assistants as the hardest positions to fill. Calculate your practice's cost using payroll, coverage expenses, hiring costs, and appointment production.

Dental assistants About 23% changed employers in 2024

The 2025 DentalPost report found that roughly 23% of dental assistants changed employers in 2024. Vacancies often shift work to dentists, hygienists, and other assistants. DANB estimates annual reassigned-work costs above $30,000 for an open position, with additional costs from lost efficiency.

Dental hygienists 20.5% changed employers in 2024

The same report found that 20.5% of hygienists changed employers in 2024. Industry estimates put replacement costs at $8,000 to $12,000, with hiring often taking six to twelve weeks. Lost appointments and related treatment opportunities can increase the cost.

Front office and treatment coordinators Keep appointments and patient follow-up on track

Front office employees handle calls, recare scheduling, treatment coordination, and collections. Include the effect on these responsibilities when calculating vacancy costs.

Calculate the cost for your practice

Use your practice's actual numbers in five categories:

Recruiting: Advertising, agency fees, screening, and other hiring expenses.

Onboarding: Training time and the cost of preparing the new employee for the role.

Temporary coverage: Temporary staffing, overtime, and additional coverage expenses.

Lost production: Appointments that cannot be recovered during the vacancy and the new employee's initial training period.

Compensation savings: Wages and related costs saved while the position is vacant.

Add the first four categories and subtract compensation savings to estimate the net cost.

For lost production, estimate the appointments your practice expects to miss or cannot reasonably reschedule. Subtract the costs you would have incurred to produce that revenue. This gives you the estimated financial impact after the costs of providing care.

Use the same calculation for each departure. At year-end, compare the total with what the practice spent on recruiting, training, compensation, and retention.

What helps people stay

During regular check-ins, ask employees what is working well and what would make their workday better. Gallup's 2024 research found that 42% of voluntary leavers believed their manager or organization could have done something to prevent their departure. An earlier Gallup study in 2019 reported 52%. The 2025 DentalPost report identified work environment, higher pay, and appreciation among the leading reasons hygienists and assistants changed jobs. Review compensation, scheduling flexibility, clear expectations, regular feedback, and the everyday experience of working in the practice.

The first few months are a good time to build relationships and establish clear expectations. A structured onboarding plan helps new employees understand their responsibilities, build confidence, and develop good working relationships. Regular check-ins give employees a chance to raise concerns and discuss what is working. Ask about workload and address concerns while there is time to improve the employee's experience. Keeping experienced employees means fewer replacement hires and less time spent training new staff.

Track turnover alongside your practice numbers

ADA Health Policy Institute polling found that about 62% of dentists named staffing their top business concern. Maintain relationships with potential candidates and temporary staffing contacts. Have a coverage plan for essential positions.

Each month, look at employee departures, days positions remain open, average time to fill by role, first-year employee retention, recruiting and onboarding expenses, and appointment capacity affected by vacancies. These numbers show which roles take the longest to fill, which departures cost the most, and where your hiring and retention efforts are paying off.