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Appropriate Compensation

Each day I am in the clinic at 7 am, treating patients between 8 am and 6 pm. The owner of my practice has stated that I cannot bill the morning meeting hours, instrument cleaning hours, and any time past 6 pm. It takes me a few hours to complete the required patient documentation so I often work until 9 pm. Is it legal for me to not be paid for this time?

Without more details, it is difficult to specifically answer your question; however, some areas can be addressed. First, the manner in which private practice dental hygienists are compensated can vary. Generally, they are paid hourly, daily, by commission, or a combination of these types to create a salary structure. This structure differs from individuals who are paid a salary. This difference is important because employment laws are distinct for salaried vs nonsalaried individuals. Dentists and dental hygienists must be cognizant of employment laws when determining the compensation structure as federal and state laws dictate if and when an employee is entitled to be paid for hours worked and overtime pay.

 Federal employment laws such as the Fair Labor Standards Act (FLSA) must be followed. The FLSA establishes federal minimum wage, overtime pay, reporting, and other labor laws. Additionally, it classifies jobs as exempt from minimum wage and overtime regulations or as nonexempt.1 According to the United States Department of Labor, exempt employees are those paid a predetermined salary each pay period, regardless of the number of hours worked.2 As such, these employees are exempt from the requirement to be paid overtime for hours worked in excess of 40 each week.1 Because of the compensation structure in which most practicing dental hygienists are paid, they are considered nonexempt employees, meaning they are eligible for overtime pay if they work more than 40 hours per week, or what state law dictates. 

Now that compensation and labor laws have been addressed, the daily tasks of a practicing dental hygienist must be considered. Preparing for the day—which can include reviewing records, preparing instrument trays, sharpening instruments, and attending morning meetings—occurs outside of direct patient care time. Additionally, writing progress notes, managing late arrivals, and running overtime are just a few reasons why dental hygienists work into lunch times and past the dismissal of the last patient. Additional time worked, if it is essential to the job, must be compensated for and ought to be a point of discussion when reviewing the terms of employment. Dental hygienists need to know the dentist’s expectations, what office time qualifies for compensation, and whether overtime is paid if they exceed the number of hours dictated by federal or state law. If a dental hygienist is finding that he or she cannot complete the assigned tasks for the day within a reasonable and expected time frame, he or she should discuss this with the dentist in an attempt to rectify the situation. Finding a fair solution will help dentists maintain a positive working relationship with their personnel and remain compliant with employment laws. These discussions should be undertaken during the hiring process so that employees are aware of what the dentist expects and to be sure all employment laws are followed. If you are not sure that the compensation and expectations of the dentist are legal, contacting an attorney or your state labor board is advised. 


  1. United States Department of Labor. Federal Labor Standards Act. Available​agencies/​whd/​flsa. Accessed November 15, 2021.
  2. United States Department of Labor. Fact Sheet #17C: Exemption for Administrative Employees Under the Fair Labor Standards. Available at:​sites/​dolgov/​files/​WHD/​legacy/​files/​fs17c_​administrative.pdf. Accessed November 15, 2021.
The Ask the Expert column features answers to your most pressing clinical questions provided by Dimensions of Dental Hygiene’s online panel of key opinion leaders, including: Jacqueline J. Freudenthal, RDH, MHE, on anesthesia; Nancy K. Mann, RDH, MSEd, on cultural competency; Claudia Turcotte, CDA, RDH, MSDH, MSOSH, on ergonomics; Van B. Haywood, DMD, and Erin S. Boyleston, RDH, MS, on esthetic dentistry; Michele Carr, RDH, MA, on ethics and risk management; Erin Relich, RDH, BSDH, MSA, on fluoride use; Kandis V. Garland, RDH, MS, on infection control; Mary Kaye Scaramucci, RDH, MS, on instrument sharpen­ing; Stacy A. Matsuda, RDH, BS, MS, on instrumentation; Karen Davis, RDH, BSDH, on insurance coding; Cynthia Stegeman, EdD, RDH, RD, LD, CDE, on nutrition; Olga A.C. Ibsen, RDH, MS, on oral pathology; Jessica Y. Lee, DDS, MPH, PhD, on pediatric dentistry; Timothy J. Hempton, DDS, on periodontal therapy; Ann Eshenaur Spolarich, RDH, PhD, on pharmacology; and Caren M. Barnes, RDH, MS, on polishing. Log on to to submit your question.

From Dimensions of Dental Hygiene. December 2021;19(12)46.

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