Dental Hygienist Shortage Exposes Wide Gaps Across the Sun Belt

Thirteen Georgia counties had no actively practicing dental hygienists in 2025. Along the Texas border, the number of hygienists per resident was barely half the rate elsewhere in the state. In Florida, one in five surveyed hygienists expected to stop practicing in the state within five years.

The figures reveal a growing challenge for dental care across parts of the American Sun Belt: even as the number of trained professionals increases, their distribution and availability remain uneven.

The problem is particularly significant for communities where preventive dental care is already difficult to obtain. Dental hygienists perform routine cleanings, assess gum health, take X-rays and provide other preventive services that help patients avoid more serious dental problems.

A national shortage has made hiring increasingly difficult, but state workforce figures from Georgia, Texas, Florida and North Carolina show that the pressure is not distributed equally.

Georgia Had 13 Counties Without a Practicing Hygienist

Georgia counted 7,330 actively practicing dental hygienists in 2025, equivalent to 65.6 per 100,000 residents.

Yet 13 of its 159 counties had no practicing dental hygienists, leaving approximately 77,458 residents living in counties without a locally recorded provider.

The Georgia Board of Health Care Workforce's 2025 report identified substantial differences between metropolitan and rural communities.

The number of counties without a hygienist has improved since 2021, when 22 counties reported none. But substantial gaps remain.

The statewide count also conceals significant local differences. Fulton County had 890 hygienists, while Gwinnett had 653 and Cobb had 590. Smaller counties, including Warren, Clay, Glascock and Charlton, reported none.

Those figures measure where professionals practice, not whether residents can obtain services in neighboring counties. They nevertheless illustrate the additional travel that may be required when preventive care is unavailable locally.

Georgia's workforce challenge could become more pronounced as its population grows.

The Georgia Dental Association has made expanding and distributing the hygienist workforce a legislative priority. It cites federal projections indicating the state could face a shortage of more than 1,000 full-time hygienists by 2038.

The association is seeking additional training capacity, incentives for professionals working in rural counties and a licensing pathway for qualifying internationally trained dentists.

Texas Border Communities Have Far Fewer Hygienists

Texas has increased its dental hygiene workforce over the past decade, but the benefits have not reached all regions equally.

The state had 15,009 dental hygienists in 2024, up from 12,214 in 2015.

Along the Texas border, however, there were only 26 hygienists per 100,000 residents in 2024, compared with 49.4 per 100,000 in non-border counties.

The Texas Department of State Health Services' June 2025 workforce presentation documented that gap, even as the number of hygienists working in border communities increased from 573 to 716 between 2015 and 2024.

The disparity extends across a region that includes both metropolitan and rural communities.

A larger statewide workforce does not automatically resolve shortages in places where fewer professionals choose to practice.

For residents of underserved communities, the issue is not simply whether Texas is producing enough dental hygienists. It is whether those professionals are available where patients need them.

Florida Faces a Potential Retirement and Retention Problem

Florida's dental hygiene workforce is also confronting questions about its future size and geographic distribution.

Of 18,115 hygienists who applied for license renewal during the state's 2023-2024 survey period, 16,433 completed the workforce questionnaire.

Among respondents, 77.8% were already practicing clinical dental hygiene in Florida or had accepted employment to do so.

The Florida Department of Health's workforce survey also revealed significant geographic differences.

Miami-Dade County had 1,199 practicing hygienists represented in the survey, followed by Broward County with 1,192 and Palm Beach County with 975.

By comparison, Lafayette and Glades counties each had just one practicing hygienist among respondents. Jefferson and Dixie counties each had three.

These are survey counts rather than a complete measurement of appointment availability. They also reflect the 2023-2024 workforce, not a new count for October 2026.

The survey raised another concern: 20.2% of respondents said they planned to stop practicing dental hygiene in Florida within five years, including 11.9% who planned to retire from clinical practice.

Those intentions do not establish how many will actually leave. They do, however, point to the importance of replacing departing workers while maintaining services in communities that already have relatively few providers.

North Carolina Is Training More Hygienists, but Gaps Remain

North Carolina illustrates how a growing dental workforce can coexist with shortages in particular communities.

The state increased its number of dental hygienists from 3,669 in 2000 to 6,784 in 2024, a gain of 76.5%.

But the number of hygienists relative to dentists has declined from its earlier peak.

North Carolina had 1.26 hygienists for every dentist in 2011. By 2023, that ratio had fallen to 1.09.

The North Carolina Oral Health Collaborative's April 2026 workforce analysis also highlighted the geographic concentration of dentists. More than half of active dentists practiced in just six counties containing approximately 35% of the state's population.

The state's community college system is working to expand dental hygiene education, with programs currently graduating approximately 260 hygienists annually and plans that could increase the number to 400 by 2028.

Increasing training capacity could help dental practices hire new workers. But the location of those graduates, their willingness to work in underserved communities and their long-term retention will also influence whether access improves.

Nearly Nine in 10 Recruiting Dentists Report Difficulty Hiring

The challenge extends beyond the Sun Belt.

In the second quarter of 2026, 36.8% of dentists in the American Dental Association's national survey had recruited a hygienist during the preceding three months.

Among those recruiting, 87.7% described the process as very or extremely challenging.

The ADA's second-quarter dental economy report showed that serious recruitment difficulties have remained above 87% since the beginning of 2024.

These figures are national and do not establish identical vacancy rates in Georgia, Texas, Florida or North Carolina.

The reasons behind the hiring problem are also disputed.

The American Dental Association has emphasized the difficulty practices face finding qualified applicants willing to work at available wages and schedules.

The American Dental Hygienists' Association argues that retention deserves greater attention, citing compensation, benefits, workload, working conditions and limited professional autonomy as reasons hygienists leave jobs or the profession.

In its May 2026 workforce statement, the hygienists' association opposed replacing licensed professionals with alternatively trained personnel as a response to shortages. It called instead for stronger workplace protections, better benefits and policies that make it easier for qualified hygienists to practice across state lines.

More Graduates May Not Be Enough

The different experiences of Sun Belt states illustrate why expanding the workforce is not solely a question of training more people.

Georgia has counties without locally recorded hygienists. Texas has a pronounced difference between border and non-border communities. Florida faces potential workforce departures, while North Carolina is expanding education programs after years of uneven growth.

The challenges overlap, but they are not identical.

In rural communities, the availability of a dental hygienist may depend on whether a local practice can support another position, whether a professional is willing to commute and whether there are sufficient patients to sustain the service.

In metropolitan areas, practices may face a different problem: competing with other employers for licensed professionals who have multiple employment options.

The consequences extend beyond the dental industry.

Routine preventive care helps identify oral health conditions before they require more extensive treatment. When hygienists are unavailable, dental practices have less staffing capacity to deliver those services, although the state workforce figures do not establish how many appointments have been delayed or canceled.

Across the Sun Belt, the number of dental hygienists is increasing in several states. The harder challenge is ensuring that enough of those professionals remain in practice and are available in the communities where patients need them.