A retention crisis, not a supply crisis: ADHA's 2026 position on dental hygiene workforce solutions

What it says#

The statement opens with its thesis in two sentences: "New research confirms what dental hygienists have reported for years: the profession is not suffering from a shortage of qualified people. It is suffering from a systemic failure to keep them."

It then builds from three sources. First, ADA HPI's April 2026 analysis, which ADHA reads as confirming "that only 60% of dentists report having adequate hygiene staffing and that 91% of those actively recruiting rate it as very or extremely challenging," and which ADHA says shows the dynamic has "persisted unchanged for three years despite record enrollment in dental hygiene programs." Second, the 2022 joint report from ADA HPI, ADHA and other organizations, which identified the chronic drivers of hygienist departure as negative workplace culture, insufficient compensation, lack of growth opportunity, inadequate benefits, feeling overworked and communication failures. ADHA's gloss: "These are retention failures, not pipeline failures."

Third, and the newest material here, the GoTu 2026 State of Work Report, described as the largest ongoing study of the U.S. dental workforce, developed in partnership with ADHA, with responses from nearly 8,000 dental professionals across all 50 states and three years of data behind it. The figures ADHA pulls from it: 59% of dental professionals received no raise in the past two years, 74.7% receive no bonus and 44.7% have no benefits at all, with better compensation the top desired improvement for three consecutive years by a 20-point margin over the next item. Burnout affects 54.1% of all dental professionals and 60.6% of dental hygienists, with workload at 65.7% and toxic office culture at 62.4% named as the leading causes, which ADHA calls "structural, organizational conditions that cannot be resolved at the individual level." On movement, 64% report that their longest tenure at any single practice is five years or less and office-switching is "accelerating, not stabilizing"; 62% of hygienists say greater clinical autonomy would increase their likelihood of staying in the profession. And on commitment, 82.8% plan to remain in dentistry for at least the next decade, which ADHA reads as the point: "The commitment to the profession is intact. What is eroding is the willingness to remain in specific workplaces."

The statement then does something a data report would not. It reviews the solutions proposed in recent ADA HPI analysis and by other dental organizations, naming foreign-trained dentists practicing as dental hygienists, expanded scope for dental assistants to perform hygiene-adjacent procedures, and accelerated alternative licensure pathways, notes that several states have moved to implement such models, and says ADHA does not support them as solutions. Its argument is that substituting alternative personnel "does not address why hygienists leave," risks patient safety, undermines professional standards and demoralizes a workforce already signaling distress.

What ADHA supports instead is seven items: fair, responsive and transparent compensation assessed against current market data; competitive benefits including health insurance, paid leave and continuing education funding, which it notes are absent for nearly half the hygiene workforce; positive and accountable workplace culture, with the line that "Culture is not a soft issue. It is a retention variable with measurable consequences"; professional autonomy and full utilization of scope; licensure portability through the Dentist and Dental Hygienist Compact, where ADHA reports that 89.6% of hygienists familiar with it support it and more than half report a high likelihood of practicing in another state if it were in effect; targeted pipeline growth through the Hygienist Inspired Chairside Recruitment Program, now active in nine pilot states with the Delta Dental Foundation; and professional development, mentorship and career pathways.

Who it applies to#

The statement speaks for the American Dental Hygienists' Association and addresses three audiences by name: the ADA, dental employers and policymakers. Its subject is the U.S. dental hygiene workforce. The GoTu figures it quotes cover dental professionals broadly, nearly 8,000 of them across all 50 states, with hygienist-specific cuts called out separately, so read each percentage for which population it describes. The burnout number is a good example: 54.1% is all dental professionals, 60.6% is hygienists.

For an owner this is the other side of the table. HPI's work tells you how hard the chair is to fill; this tells you what the people you are trying to hire say about the job. It is not evidence in the research sense, and it does not pretend to be; it is the profession's reading of evidence it helped produce.

It carries no legal weight. Nothing here changes a practice act, a board rule or a contract. Where it touches law, in the compact and in state scope proposals, it is advocating, not reporting a rule.

What changed#

This statement supersedes ADHA's Position Statement on Dental Hygiene Workforce Shortage of December 2, 2024. The framing has sharpened: where the earlier document addressed the shortage, this one argues about its cause and names specific policy responses it opposes. The new evidence is the third edition of the GoTu State of Work Report, which gives ADHA three years of workforce data rather than one, and HPI's April 2026 analysis, which reported record hygiene enrollment and graduates alongside flat employment. ADHA uses that combination to make its central claim, that the pipeline is producing people who are not staying.

The disagreement with the ADA is also newer and more explicit. ADHA writes that these substitution proposals "have been advanced even as the ADA's own HPI research, co-produced with ADHA, documents precisely why hygienists are leaving," and calls workforce policy that ignores jointly produced evidence "not a data-driven approach." It still describes itself as engaged in ongoing collaborative discussions.

Where the source is#

The statement is a free three-page PDF on adha.org, posted in the April 2026 uploads folder with a file name dated April 30, 2026, and carrying the notice "© American Dental Hygienists' Association, 2026." Its final page lists its key sources: ADA HPI's "We Have a Major Dental Hygienist Shortage" (April 2026), ADA HPI's State of the U.S. Dental Economy Q1 2026 (April 2026), the ADA HPI and ADHA Dental Workforce Shortages report (2022), the GoTu and ADHA State of Work Report, 3rd Edition (April 2026), and ADHA's Workforce Growth Initiatives (April 2026). The HPI documents are free on ADA.org and covered separately in this directory. The GoTu report is a commercial publication and is not hosted by ADHA; the figures quoted here are as ADHA reports them, not read from that report.