Workforce Shortages

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Workforce Shortages

Proven strategies to recruit, retain, and thrive in a staffing crisis

The conversation around orthodontic staffing has shifted from a temporary challenge to a long-term reality. What once felt like a post-pandemic disruption has become a persistent workforce shortage affecting nearly every corner of the specialty. From treatment coordinators and orthodontic assistants to schedulers and clinical leads, practices across the country are navigating gaps that directly impact starts, chair flow, and morale.

The consensus in the field is clear: Staffing is no longer just an operational issue. It’s a defining factor in how practices grow, adapt, and sustain themselves. The question is no longer whether shortages exist, but how practices can respond in ways that are practical and sustainable.

The new reality of orthodontic staffing
Hiring has become one of the most time-consuming and unpredictable aspects of running an orthodontic practice. Positions that once filled quickly can now sit open for months. Applications are fewer, expectations are higher, and competition—not just with other orthodontists, but with GPs offering aligners and DSOs expanding into the space—is more intense than ever.

Candidates have more options and greater negotiating power than they did even a few years ago. Compensation expectations have risen, but salary alone is rarely enough to secure long-term commitment. Work environment, flexibility, and culture now play central roles in attracting and retaining team members. That shift has forced practices to rethink not only how they hire, but how they operate. Simply replacing a departing team member is no longer a reliable plan, and many offices are exploring ways to do more with fewer people while maintaining quality of care.

The hidden cost of shortages
The immediate impact of staffing shortages is obvious: longer wait times and reduced scheduling capacity. The secondary effects, though, are often more damaging.

Team burnout is the most common consequence. When positions stay unfilled, existing staff absorb the extra work, and over time that leads to fatigue, frustration, and turnover—a cycle that’s hard to break. Patient experience suffers as well, and in orthodontics, the stakes differ from those in general dentistry. Patients are in active treatment for 18 to 30 months, so a stretched team doesn’t just affect a single visit—it affects the relationship. Rushed adjustment appointments, rescheduled debonds, or unfamiliar faces at every visit erode the trust that keeps patients referring friends and family. Addressing staffing challenges isn’t just about filling positions. It’s about protecting the team’s health and the continuity of care that defines a strong orthodontic practice.

The treatment coordinator problem
No role illustrates the shortage better than the treatment coordinator. The TC is the first person a prospective patient meets, the one who translates the clinical consult into a confident yes, and the one who shapes whether a practice hits its start goals for the month. The position is also one of the hardest in the specialty to fill and one of the most expensive to lose.

Strong TCs combine clinical knowledge, sales instincts, and emotional intelligence, and that combination rarely walks in off the street. Many practices are now growing TCs from within—promoting assistants or schedulers who already understand the practice—and investing in sales training, financial presentation skills, and case acceptance coaching. It’s slower than hiring someone with experience, but the retention is significantly better, and the cultural fit is built in.

Rethinking recruitment
Traditional job postings aren’t enough on their own anymore. Recruitment has to be proactive and creative. Some practices are building relationships with local dental assisting programs and orthodontic training courses to create pipelines for new assistants. Others are using social media—particularly the behind-the-scenes content that does well on Instagram and TikTok—to showcase their culture and connect with candidates in a more personal way.

Speed matters more than it used to. Delays in responding to applicants cost offers. Streamlining the hiring process, conducting interviews efficiently, and making timely decisions have all become essential. Hiring today is as much about marketing as it is about evaluation. Candidates are choosing practices just as much as practices are choosing them.

Retention as a priority
If recruitment is harder, retention is even more critical. Keeping a strong team in place reduces the constant churn of hiring and preserves the patient relationships that take years to build.

Compensation matters, but it’s only one piece. Culture matters just as much: A supportive, respectful environment significantly impacts job satisfaction, and team members who feel valued are more likely to stay. Flexibility has become a real differentiator; four-day workweeks, modified hours, or clustered adjustment days that free up the rest of the week can make a position far more attractive. Growth opportunities matter too. Cross-training assistants toward TC roles, sending team members to ortho-specific CE, or paying for Dental Assisting National Board certification signals that the practice is invested in the person, not just the position. And recognition, even simple acknowledgment of effort, has a meaningful impact on morale.

Technology and automation
Technology has become one of the most effective tools for managing staffing challenges in orthodontics, and the specialty has more levers than most. Remote monitoring platforms let patients check in from home between appointments, cutting the number of in-office visits per case and freeing chair time for new starts. Virtual observation appointments can replace routine progress checks. AI-assisted treatment planning software shortens the time a doctor spends at the computer. Automated appointment reminders, digital consent forms, and online new-patient paperwork reduce the front office load considerably.

In-house aligner workflows, from intraoral scanning through 3D printing and tray trimming, also reshape how staff time is used. Practices that invest in these systems often find they can run leaner at the front desk and rely less on outside lab coordination.

The goal isn’t to replace people; it’s to support them. Used well, technology boosts productivity and takes pressure off the team, which, in a shortage environment, may be its most valuable function.

Adjusting scheduling strategies
Orthodontic schedules have their own logic, and practices are getting more strategic about how they use it. That might mean clustering adjustments into specific days to open up longer blocks for new-patient exams and starts. It might mean extending appointment intervals for stable patients and relying on remote monitoring to cover the gap. Some offices are intentionally capping daily patient volume to protect quality and reduce strain on the clinical team.

It sounds counterintuitive at first, but the trade-off often leads to more consistent performance and a better patient experience. Efficiency isn’t just about volume; it’s about matching workflows to the staff and chairs available.

Communication in a staffing-constrained environment
Staffing challenges inevitably show up in patient interactions, and in orthodontics, where patients return every four to eight weeks for close to two years, those interactions add up. Clear communication becomes essential. When delays or scheduling changes happen, transparency is key. Patients are generally understanding when they feel informed and respected.

Framing these conversations around a commitment to quality care helps. Explaining that the practice is adjusting appointment intervals or consolidating visit types to make sure each patient gets appropriate attention manages expectations without sounding defensive. There’s also room to educate patients about the broader environment. Most people are aware of workforce challenges in other industries and can relate to similar issues in healthcare.

Looking ahead
Industry reports suggest workforce shortages across dentistry, including orthodontics, will continue for several more years. That reality calls for a shift in mindset: Instead of waiting for conditions to revert to old norms, practices are adapting to a new standard. The challenges are real, but so are the opportunities. Practices that embrace innovation, prioritize their teams, and stay flexible are the ones best positioned to succeed.

The ongoing shortage is reshaping how orthodontic practices operate—recruitment, retention, workflows, patient communication—and while the challenges are significant, they aren’t insurmountable. Focusing on culture, leveraging technology, investing in team development, and keeping communication open go a long way. Maybe most importantly, there’s a growing recognition that success isn’t defined by how many starts a practice can squeeze in, but by how well it can serve patients with the resources available.

What staffing strategy has made the biggest difference in helping your practice stay efficient and maintain team morale during ongoing workforce shortages? 
What’s your take?

Share your thoughts in the comments below.

Hot Topic articles draw inspiration from active online discussions among orthodontists. Written by the editorial team with the assistance of AI, each piece is thoughtfully developed and refined under full editorial oversight.
Orthotown Magazine
May 2026
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