The rapid review of published literature from the past 10 years indicated the perceived shortage of DAs may be due to the lack of uniformity in education and regulation across the provinces (for instance the majority of DA schools are found in unregulated provinces, causing labour mobility issues).
Review of grey literature, including social media platforms, suggested retirement of the baby boomer cohort may lead to workforce shortages and that older, more experienced DAs face age discrimination, including insufficient remuneration and unhealthy workplace culture. Review of grey literature showed a culture of bullying, harassment and disrespect is a systemic experience in DA work; this data echoed the results of the CDAA Healthy Workplace Survey conducted in 2018.
The literature review findings informed the survey questions which focused on three topic areas: DA demographics, DA educational context and DA work context. Survey questions included: 7 questions on demographics; 3 questions and 3 Linkert scale statements on education; the section on work context included 10 multiple choice questions, 12 Linkert scale statements, 2 check box questions and 7 open-ended questions. The survey was answered by 1627 DAs in an online survey between March 5 - 25, 2019.
The survey results contributed valuable information about Canadian DAs who are all but invisible in the published and grey literature. Some results, such as the overwhelming representation of women in the profession, are not surprising but provide important contextual relevance; in 2017 Canadian women earned 88.5 cents for each dollar earned by a man and the wage gap widens for immigrant women, Indigenous women, women of colour and women with disabilities (Employment and Development Canada, 2018).
The low number of DAs over 60 (5.5%) may indicate ageist hiring practices and the majority (68%) of DAs being first generation may indicate that not only are workers not staying in the profession, they are not recommending it to the next generation.
The majority of respondents (72%) felt their education had well-prepared them for work and described positive educational experiences; the 66% of respondents who said they were unaware of dental assisting as a career path in high school may indicate assisting is not seen as a first choice of career. Wording of questions about the impact of availability and selection of training programs were unable to discern their influence on career choice so future research should explore this question; provincial discrepancies such the majority of training programs existing in unregulated provinces (49 of 92 schools are found in QC and Ont.) and tuition costs varying from less than $300 to over $18,000 may significantly impact regional workforce availability.
Survey results show the majority of DAs work full time in private practice in a single location and report positive relationships with dental team members; they unfortunately also indicate that most DAs have experienced workplace harassment from employers, patients and colleagues. DAs report an overall disregard by the dentist for their legal scope of practice and almost 40% of DAs do not feel fairly compensated for the work they perform, many voice concerns over a lack of respect, benefits and advancement opportunities.
Helping people was cited as both a motivation to pursue DA work and as significant source of job satisfaction yet DAs report being unable to live off their income; DAs in earlier generations may have been second income earners unlike the DAs of today who are just as likely to be self- supporting heads of single parent households.
It is not possible to determine if Canada is experiencing a shortage of DAs but it is worth noting that 14 % plan to leave their current employer, about 1/3 report awareness of an opening in their place of work and almost half (46%) of respondents are uncertain if they will remain in the field.
The CDAA congratulates the 1627 DAs who participated in the survey on having their voices heard nationally! There is much to be learned from their shared experiences of DA work in Canada and the data indicates there is a need for further research in dental assisting work.
It is not possible to say definitively through this survey whether there is a DA work shortage or not, but it does indicate the profession may have difficulty with workforce retention and, possibly with future recruiting.
The CDAA has approached the CDA to begin working collaboratively on addressing the findings of this report. It is the CDAA’s intention to develop an action plan that will improve workplace factors that are impacting the recruitment and retention of dental assistants.
In addition, the CDAA will continue to collaborate with both the Canadian Dental Association (CDA) and Canadian Dental Hygienist Association (CDHA) as members of the tripartite working group, the Healthy Workplace Working Group (HWWG), established in July 2019 to address the findings of the Healthy and Respectful Workplace Survey.
The HWWG’s primary objective is to develop resources for dental teams to improve work processes and create healthy work environments.