Holloway J A, Chestnutt I G. It's not just about the money: recruitment and retention of clinical staff in general dental practice - part 1: dentists. Prim Dent J 2024; 13: 38-54.

Holloway J A, Chestnutt I G. It's not just about the money: recruitment and retention of clinical staff in general dental practice part 2: dental care professionals. Prim Dent J 2024; 13: 55-63.

Job satisfaction is key.

Access to NHS dental care has become a significant issue in the UK, with increasing numbers of practices becoming fully private and thus creating a barrier to those from lower socioeconomic backgrounds. Oral health inequalities will therefore be exacerbated, particularly in remote or deprived areas. Understanding factors which affect job satisfaction may inform recruitment and retention and help to provide a more stable workforce, able to meet the needs of the whole population.

Herzberg's ‘motivation and hygiene' theory postulates that job satisfaction and dissatisfaction exist on different continuums. Motivations - achievement, recognition, repsonsibility, work itself, advancement, personal growth - increase job satisfaction but their absence does not increase dissatisfaction. Hygiene factors - work conditions, co-worker relationships, policies and rules, supervisor quality, salary - prevent job dissatisfaction but do not contribute to job satisfaction.

Following a narrative literature review, 22 papers were found relevant to dentists' job satisfaction. The most frequently mentioned cause of job dissatisfaction was working under target-driven, restrictive contractual arrangements, the consequences of which are mentioned as insufficient time with patients, unfair remuneration arrangements, and lack of quality equipment. Motivators include autonomy and control over workload, the ability to provide high-quality care and to help people, skills development, a variety of work, the opportunity to take on additional roles (develop a portfolio career), and a structured career path. Hygiene factors include a non-corporate environment, reduced risk of litigation, employment status, peer mentoring, and the availability of professional networks.

Fewer (n = 11) papers were found relevant to dental care professionals (DCPs). For all groups - hygienists (DHs), therapists (DTs), nurses (DNs), technicians (DTs) and clinical dental technicians (CDTs) - recognition by other members of the team, particularly dentists, was a motivational factor. Feeling valued, positive team relationships, and increased collaboration were all considered hygiene factors. For DTs, a variety of work was a motivator, but the majority of DTs are expected to carry out only hygiene work. For DNs, further training and extended duties were a motivator but frequently, within the NHS, remuneration and opportunity did not follow. Fair remuneration and access to NHS employment benefits may improve DN retention. Similar to DNs, DTs and CDTs were motivated by opportunities to progress with skills development, with remuneration a source of dissatisfaction.