The RN and RDH Shortage: How big is this problem?
First in a series contrasting nurse and dental hygienist shortages
The nursing shortage is making headlines. It should. Nurses make up the largest segment of healthcare providers (source) and understaffed hospitals have worse patient outcomes (source).
There’s another vital healthcare provider shortage that, while not making headlines, is close to my heart: dental hygienists. Over the next few weeks, I’ll examine these two professions and see if there are common causes (and potential cures) for the problem.
A national or global workforce shortage can be the result of declining inflows and/or accelerated outflows. An individual business may experience a shortage of personnel for a myriad of local reasons, such as pay/benefits or culture. In this series, we’ll examine each one as it pertains to nurses and dental hygienists in the U.S.
The Nursing Shortage
The Federal Reserve Economic Data System provides a strong data set on the number of employed nurses (source):
As we can see nursing employment has largely recovered post-pandemic.
In 2022, The National Center for Health Workforce Analysis predicted a shortfall of 78,610 RNs in 2025 that will be eliminated by 2035 as the number of FTE RNs reaches 3.9 million (source). A 2024 JAMA article updated projections of RN FTEs and confirmed the shortage should be eliminated by 2035 (source).
The Dental Hygiene Shortage
Here’s a chart from the ADA of estimated job counts for dental hygienists (source):
Within the first several months of the COVID pandemic, the ADHA estimates that 8% of hygienists left the profession (source), which is supported in this data. As of 2023, the number of jobs has yet to recover to pre-pandemic levels.
Unfortunately we do not have robust data on the predicted demand for hygienists. The ADA has declared that there is a shortage and cites as evidence a quarterly Economic Outlook survey of dental practices (source). The most recent survey reveals a consistent trend of roughly a third of dental practices having actively hired a hygienist within the past three months between Q1 2022 and Q4 2024 (source). As of Q4 2024, over 90% of those practices cited that the recruitment process was either “extremely challenging” or “very challenging.”
Shortfall Conclusions
The COVID pandemic created a short-term decline in the number of jobs in both professions. Nursing has rebounded to pre-pandemic levels but hygiene has not.
The shortfall of RNs is expected to improve and eventually be eliminated over the next ten years, while the shortfall of dental hygienists remains unknown.
In the rest of this series, we’ll examine:
Inflows: Is there a healthy pipeline of nursing and dental hygiene students? Should we be opening more programs? Even if we have an adequate supply of these professionals, will they be evenly distributed?
Outflows: Should we be concerned about Baby Boomers retiring? What about trends in nurses and hygienists quitting the profession?
Turnover: If the shortfall is eliminated, healthcare organizations and their patients will still struggle if they can’t retain talented team members.