Resources for dental hygienists
In dentistry, most of us are focused on patient care, not tax codes or employment law. But there’s one issue that quietly affects thousands of hygienists and dental practices nationwide: employee misclassification. It often appears when dental hygienists are labeled independent contractors (1099) instead of employees (W2). On the surface, that might seem like just a line on a tax form. But your classification impacts everything from take-home pay and benefits to legal protections and long-term career security. Unfortunately, misclassification is more common than you might think, and can lead to real problems for both hygienists and dentists. In this article, we’ll explain how misclassification happens, why it matters, and what both sides of the chair can do to avoid costly mistakes.
Apr 25, 2025
What’s the Difference Between a W2 and 1099 in Dentistry?
W2 and 1099 might sound like simple tax categories, but the distinction plays a big role in how dental hygienists are paid, treated, and protected in the workplace.
A W2 employee is someone who is hired directly by the dental practice. They’re paid hourly or on salary, with taxes automatically deducted from each paycheck. They often receive benefits like health insurance, sick leave, or paid holidays, and they follow a set schedule using the practice’s tools and equipment.
A 1099 independent contractor, on the other hand, is self-employed. They’re responsible for handling their own taxes and typically don’t receive benefits from the practice. Contractors tend to have more control over their schedule and are expected to bring their own tools and supplies.
In dentistry, this distinction can get blurry. Many hygienists work consistent shifts, use the office’s equipment, and follow clinical protocols, which are conditions that fit the W2 definition. However, they may still be classified (incorrectly) as 1099 contractors. That’s where problems begin.
Why Misclassification Happens in Dental Practices
In many cases, employee misclassification results from confusion, outdated habits, or pressure to cut costs.
Some dentists and practice managers may be unaware of the legal differences between hiring a W2 employee and a 1099 contractor.
Others may assume that classifying hygienists as independent contractors is a simpler way to handle payroll or avoid additional tax responsibilities.
In some cases, hygienists may not realize they’re being misclassified, or may agree to it without understanding the long-term impact.
There’s also the issue of tradition. For decades, some dental practices have operated under the assumption that hygienists are more like freelancers than staff. However, employment laws have evolved, and these assumptions don’t always hold up under IRS scrutiny.
Even if misclassification isn’t intentional, it can still carry serious consequences.
Federal and state labor laws are clear: if a worker functions like an employee, they must be classified and treated as one. Practices that ignore this risk face fines, audits, and legal action.
What Are the Risks of Misclassification for Dental Offices and Hygienists?
Misclassifying a dental hygienist as a 1099 contractor when they should be a W2 employee isn’t just a technical mistake; it can have real consequences for everyone involved.
The impact often isn’t clear for dental hygienists until it’s too late.
Independent contractors don’t receive workers’ compensation if injured on the job. They also miss out on employer contributions to Social Security and Medicare, which can affect their long-term financial stability. Without employee status, they’re not covered by wage and hour protections, and may not qualify for overtime pay.
Perhaps most frustrating, they’re responsible for paying the full share of payroll taxes, something many don’t expect until tax season hits.
The risks for dentists are just as serious. If a state or federal agency determines that a worker was misclassified, the practice may be held responsible for unpaid payroll taxes, back pay, missed benefits, and potential penalties.
These cases can also trigger audits by the IRS or Department of Labor.
How to Know if a Hygienist Should Be a W2 or 1099
The IRS uses the “common law” test to determine whether a worker is an employee (W2) or an independent contractor (1099). This test focuses on three key areas: behavioral control, financial control, and the overall relationship between the worker and the employer.
Behavioral control looks at who sets the schedule, gives instructions, and directs how the work should be done. If the practice dictates when the hygienist shows up, what procedures to follow, and how patients are treated, that indicates employee status.
Financial control refers to who supplies the tools and how the hygienist is paid. Being paid hourly and using office-provided equipment typically signals an employee relationship.
The nature of the relationship also matters. If the hygienist works at the practice long-term, is integrated into the team, and isn’t hired on a per-project basis, they’re likely a W2 employee.
You can read more about the IRS classification here.
The bottom line: If a hygienist works regular shifts, follows office protocols, and uses your tools, they’re probably an employee, not a contractor.
What Dental Hygienists Should Know and Ask About Classification
If you’re a dental hygienist, understanding how your employment status affects everything from your paycheck to your legal protections is necessary.
Before accepting a role, ask how you’ll be classified (W2 employee or 1099 contractor) and what that means for taxes, benefits, and job expectations. If you’re classified as a contractor, remember that you’ll be responsible for paying your taxes and won’t have access to workers’ comp.
Recording your schedule, responsibilities, and working conditions is also smart. If you're being told when to work, using the practice’s tools, and following office procedures, you may be functioning as an employee, even if you're labeled a contractor on paper.
If something doesn’t feel right, don’t stay silent. Contact a trusted mentor, professional association, or legal resource for advice.
How Teero Helps Simplify Dental Hiring
Teero was built to make dental hiring easier for everyone involved. By clearly communicating job expectations and employment status upfront, we help eliminate confusion around classification.
Teero provides flexible, W2 roles in practices across the US, giving hygienists the benefits, protections, and stability they deserve. And dental practices don't have to worry about potential employee misclassification.