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Biggest Source of Margin Compression in Dentistry | Professional Insights

 Across the dental profession, practice owners and clinicians are feeling it: doing more dentistry, seeing more patients, and yet margins continue to tighten. While there are several contributing factors, one stands above the rest as the single biggest driver of margin compression in dentistry today.

Labor.

Labor Costs Are Rising Faster Than Revenue

Staff wages, benefits, and recruitment costs have increased dramatically over the past several years. Hygienists, assistants, and front-office team members are in high demand, and the supply has not kept pace.

Many practices have experienced:

  • 20–40% increases in hygiene wages

  • Higher overtime costs due to staffing shortages

  • Signing bonuses, temp staffing, and recruiting fees

  • Increased benefit costs to remain competitive

At the same time, reimbursement rates—especially from PPOs—have remained largely flat. When your largest expense grows rapidly but your revenue per procedure doesn’t, margins get squeezed.

Hygiene Economics Have Fundamentally Changed

Historically, hygiene was one of the most predictable and profitable parts of a dental practice. Today, many practices are operating hygiene at or near break-even.

Shorter hygiene schedules, higher hourly wages, cancellations, and difficulty filling open chairs all contribute to reduced production per hour. Even practices with strong demand struggle if hygiene capacity is inconsistent.

When hygiene underperforms, it creates downstream effects:

  • Fewer diagnosed cases

  • Lower restorative and specialty production

  • Increased stress on doctors to “make up” the difference

Inefficiency Is the Silent Margin Killer

Rising labor costs alone don’t tell the full story. The real margin compression happens when inefficiency meets higher wages.

Common examples include:

  • Overstaffing without clear role accountability

  • Underutilized doctor time due to scheduling gaps

  • Manual processes that should be automated

  • Poor case acceptance from rushed or disorganized handoffs

Paying more for labor isn’t the problem—paying more for unproductive labor is.

Technology and Supplies Matter—but They’re Secondary

Supply costs, labs, technology investments, and inflation all contribute to margin pressure. However, these expenses tend to scale with production or improve efficiency long-term.

Labor is different:

  • It is largely fixed in the short term

  • It increases regardless of daily production

  • It directly impacts every hour the practice is open

That’s why labor has become the dominant force behind shrinking margins.

The Practices That Win Think Differently

The most resilient dental organizations aren’t trying to “cut their way” out of the problem. Instead, they focus on:

  • Production per hour, not production per procedure

  • Clear role design and accountability

  • Smarter scheduling and capacity management

  • Investing in technology that removes friction

  • Supporting teams so they stay longer and perform better

At LADD Dental Group, we believe margin pressure isn’t solved by working harder—it’s solved by working smarter, together.

The Bottom Line

Margin compression in dentistry isn’t a temporary trend—it’s a structural shift. Labor costs are here to stay, and practices that adapt their systems, workflows, and mindset will continue to thrive.

The future of dentistry belongs to practices that treat efficiency, team development, and patient experience as strategic advantages—not afterthoughts. 



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