How Much Is Enough for What You Do? The Hygiene Wage Surge and Its Ripple Effect

I’ve been in the dental industry for about eight years. I’ve witnessed plenty of change in that time—but nothing as disruptive, or as quietly telling, as the hygiene wage surge that started bubbling up before COVID and exploded after. In 2018, you could already feel the pressure. The hygiene talent pool was thinning. Demand for preventive care was steady or rising and experienced hygienists were starting to ask for more.

Then COVID hit, and everything accelerated. Those close to retirement fast-tracked their exit. Others left the workforce entirely, re-evaluating risk and work-life priorities. The result? A sharp and sudden decrease in available talent—especially for hygiene roles and in the vacuum, wage expectations surged.

Offices backed up with re-care appointments and new patient demand were forced to compete for a limited number of hygienists. Those who remained recognized their leverage—and used it. At the same time, hygiene students entering the workforce were being coached by instructors to expect more. Not just slightly more a lot more.

What had been a $38–$40/hour wage crept into the $50s. Then the $60s. And in the Twin Cities today, $70+/hour is no longer rare.

It’s become the new baseline. But here’s the issue: the economics don’t support it.

In a typical general dental practice, a provider’s wage must be offset by producing about three times their hourly rate in net production. That 3x benchmark isn't arbitrary—it covers wages, overhead, insurance reimbursements, supplies, facility costs, and still allows for some margin. At $70/hour, that means a hygienist needs to consistently produce $210/hour just to keep the model viable. That’s not impossible—but it is extremely difficult to maintain across a full schedule, five days a week, year-round. That’s exactly where things are starting to crack.

Behind the scenes, dental boards—including in Minnesota—are beginning to expand the allowable functions for licensed dental assistants. Some clinics are now experimenting with hygiene-free models, leaning into a combination of dental therapists and assisted hygiene workflows to meet operational needs. These aren't fringe outliers. These are respected, established practices adjusting in real time to a broken labor equation.

And here's the real risk: if the industry continues to chase unsustainable wage structures, it could trigger a long-term realignment that decreases the role of hygienists in general practice settings altogether.

This is not about blaming hygienists. Their clinical expertise and relationships with patients are incredibly valuable. But wage expectations that are untethered from the financial realities of operating a business don’t just strain budgets—they rewrite business models.

And when that happens, people get left behind.

The fact is, the shift is already happening—not loudly, but operationally. Quietly. Practices that once hired two full-time hygienists are opting to restructure. Schools are updating their assistant training curriculums to meet new clinical demands. Dentists are investing in workflows that don’t rely so heavily on hygiene hours to keep production flowing.

So the hard questions need to be asked.

How much is enough for the work you do? And is what you’re asking sustainable—not just for you, but for the business that employs you?

Because if we don’t collectively balance the value of skilled clinical work with the economic viability of dental practice operations, we’re heading toward a structural reset. When that reset comes, it won’t be dramatic. It’ll be quiet. Permanent. Some may find the opportunities they once counted on have shifted somewhere else entirely.

This is all my opinion but after over 30 years in operations I have seen similar market events. The time for honest, informed discussion is now—before the model evolves without you.