Summary
The cost of an understaffed dental practice is almost always higher than the lost production number on a single empty chair, because it stacks up through rescheduled patients, backlogged hygiene recall, and a remaining team quietly burning out.
This article walks through how to actually calculate what an empty chair costs your practice, not just for the hour it happens but for the weeks that follow, and what proactive staffing looks like when it is treated as a normal part of running a practice instead of something you only think about during a crisis. Mayday has filled more than 20,000 dental shifts nationwide with an average time-to-fill of 5 to 7 days, which is the kind of speed that turns a potential week of empty chairs into a single missed morning.
What an Empty Chair Actually Costs, Beyond the Obvious
Ask most office managers what an empty chair costs and they will estimate lost production for the day. That number is real, but it is only the first layer. A single hygienist out for a day in a practice that sees eight to ten patients can easily mean over a thousand dollars in lost production from that one day alone, before you count anything else.
Lost Production Per Hour and Per Day
Start with a simple number: your average production per chair, per hour. Multiply that by the hours the chair sits empty, and you have your baseline loss. It sounds simple, and it is, but very few practices actually calculate this number and keep it visible, which means the true scale of a staffing gap is often underestimated until months of small gaps add up into a real dent in annual revenue.
Patient Attrition From Rescheduling
The harder cost to measure is what happens after the reschedule call. Some patients happily rebook for the next available slot. Others do not. A patient who gets bumped once might tolerate it. A patient who gets bumped twice starts looking for a new dental office, especially if they were already on the fence about their current one. Every canceled appointment carries a small but real risk of losing that patient permanently, and that risk compounds the more often it happens.
Staff Burnout on the Remaining Team
When one person is missing, the rest of the team absorbs the difference. A dentist ends up doing tasks a hygienist normally handles. A remaining assistant runs between two operatories instead of one. This works fine for a single day. It becomes a real retention problem when it happens every few weeks, because your best team members start to wonder if the practice will ever actually be fully staffed, and burnout is one of the most common reasons good employees start looking elsewhere. Our article on why staff retention matters in dental practices covers this pattern in more depth.
The Hygiene Recall Backlog That Keeps Growing
Hygiene schedules are unforgiving. When a hygienist is out and appointments get pushed, those patients do not disappear, they just get squeezed into an already full calendar weeks later. If short-staffing happens repeatedly, the recall backlog keeps growing rather than resetting, and a practice can end up carrying a hidden debt of overdue patients that takes months of overtime hygiene days to work through.
- Lost production for the specific hours the chair sat empty
- A portion of rescheduled patients who never rebook at all
- Overtime or overflow costs as remaining staff cover the gap
- A hygiene recall backlog that compounds instead of resetting
- Lower online reviews and slower new patient growth tied to a rushed, understaffed feel
Mayday’s network includes 2,000+ vetted dental professionals and 2,000+ dental offices nationwide, with an average time-to-fill of 5 to 7 days against a 42 to 63 day industry average, which is often the difference between a single rough morning and weeks of lost production.
A Simple Way to Calculate Your Own Per-Chair Cost
You do not need complicated software to get a useful estimate. A rough calculation is far better than no calculation at all.
- Find your average daily production per chair by dividing your total monthly production by the number of operatories and the number of days they are typically staffed.
- Divide that number by your average hours per day to get an hourly production figure per chair.
- Multiply that hourly figure by the number of hours a chair sat empty during a call-out or a staffing gap.
- Add a rough estimate for rescheduled patients who are unlikely to return, even a conservative 5 to 10 percent of that day’s rescheduled appointments.
Once you run this calculation even once, most office managers are surprised by how quickly the number adds up. A single day of an empty hygiene chair in a mid-size practice can easily represent well over a thousand dollars once you count the production loss alone, and that is before factoring in any patients who do not come back.
Why Proactive Staffing Beats Reactive Staffing
Emergency staffing has its place, and it solves the immediate problem when someone calls out with no warning. But practices that only ever staff reactively tend to experience this same expensive cycle over and over. Proactive staffing means treating coverage as an ongoing part of your operations, not just a fire drill you deal with when it happens.
This might mean keeping a standing relationship with a staffing agency so you are never starting from zero, cross-training your front desk on basic scheduling triage during a gap, or simply building slightly more slack into your schedule during months when call-outs historically spike, like flu season. Our guide on how temporary staffing plays a role in clinic success looks at this shift from reactive to proactive staffing in more detail, and the research on whether hiring temp staff benefits dental clinics breaks down the numbers further.
Already dealing with a call-out today? Read how emergency dental staffing works to get same-day coverage, then come back to build a longer-term plan.
Building a Staffing Buffer Instead of Waiting for the Next Crisis
The practices that avoid this whole cycle almost always have one thing in common: they treat staffing shortages as predictable rather than surprising. Call-outs happen. People get sick, take vacations, and occasionally leave without much notice. None of that is shocking once you have run a practice for more than a year or two.
- Build a relationship with a staffing agency before you need one, so the first call you make during a real gap is not also the first time you have ever used the service.
- Track your own call-out patterns over a year so you know which weeks or seasons carry the highest risk.
- Keep your practice profile and preferences on file with an on-demand platform so requests move faster each time.
- Review your true per-chair cost periodically so the cost of understaffing stays visible instead of hiding inside a bigger line item.
None of this eliminates staffing gaps completely. But it shrinks the gap between when a chair goes empty and when it gets filled again, and that gap is really where all the cost lives. Our breakdown on how to lower your total labor cost is a useful next step if you want to look at staffing costs across your whole practice rather than just one empty chair at a time. Our piece on boosting efficiency and reducing costs with temporary dental staffing is another good read if you want more ideas along these same lines.
It also helps to remember that a staffing plan is not a one-time project you finish and forget. Practices grow, patient volume shifts, and team members move on for reasons that have nothing to do with how well they were treated. A staffing plan built once during a calm month should be revisited every so often, the same way you would revisit your budget or your marketing plan, so it keeps matching the reality of your practice instead of describing how things worked two years ago.
A Quick Example: What One Bad Month Can Look Like
Numbers are easier to trust when you see them worked through, so here is a simple example. Imagine a practice with an average production of 250 dollars per chair hour. A hygienist calls out for a full day, an eight hour shift, with no coverage arranged. That is 2,000 dollars in lost production before you count anything else.
Now add the ripple effects. Say six patients were on that day’s schedule. Four reschedule without issue, but one pushes their appointment out by three months and one simply never rebooks at all. If that lost patient represents even 400 dollars a year in hygiene and related production, you have quietly lost more than the original day’s number, and that is from a single call-out. Multiply this by even three or four unplanned gaps over a year, which is not unusual for a busy practice, and the total easily runs into five figures once you are honest about all the pieces.
This is exactly why treating staffing as a line item worth planning for, rather than an afterthought you deal with when it happens, tends to pay for itself many times over. A single same-day placement that costs a few hundred dollars in agency fees looks a lot more reasonable once you compare it against a number like that.
Frequently Asked Questions
How much does an empty dental chair actually cost per day?
It depends on your average production per chair, but many practices find that a single day of lost hygiene production alone runs well over a thousand dollars once you include the hours the chair sat open. Add in patients who reschedule and never return, and the real number is usually higher than the first estimate.
What is the biggest hidden cost of a dental staffing shortage?
Patient attrition from rescheduling is often the most underestimated cost, because it does not show up immediately. A patient who gets bumped may not officially leave the practice, they may simply stop scheduling their next visit, and that loss is easy to miss until new patient numbers start slipping months later.
How does understaffing affect dental chair utilization?
When a hygienist or assistant is out, the chairs they would have staffed sit idle or get covered inefficiently by remaining staff, lowering overall chair utilization for the day. Over time, chronic understaffing keeps utilization consistently below what the practice’s physical capacity could otherwise support.
Can temporary staffing really prevent the cost of an empty chair?
Yes, when it is used proactively rather than only during emergencies. A temporary professional filling a single day or week keeps chairs staffed and patients on schedule, which prevents the rescheduling and recall backlog problems that tend to compound the longer a gap goes unfilled.
How do I calculate the real cost of a staffing gap in my own practice?
Start with your average production per chair per hour, multiply it by the hours the chair was empty, then add a conservative estimate for patients who reschedule and do not return. It will not be a perfect number, but it gives you something concrete to compare against the cost of arranging coverage.
Is it cheaper to use a staffing agency or just let a chair sit empty occasionally?
For most practices, the cost of a staffing agency shift is far lower than the combined cost of lost production, staff overtime, and patient attrition from even a single empty day. The math tends to favor coverage once all the downstream costs are actually counted instead of just the shift rate.
How often do dental practices actually deal with staffing shortages?
More often than most owners expect going into it. Between illness, vacations, family emergencies, and normal staff turnover, a busy multi-provider practice can easily face several unplanned gaps over the course of a year. Treating this as a rare event rather than a predictable part of running a practice is usually what leads to scrambling every time it happens instead of having a plan already in place.
Stop guessing what an empty chair costs your practice. Visit the dental practice hub or contact Mayday at (888) 899-4386 to build a staffing plan that keeps your chairs filled before the next gap happens.
