How the IRS Draws the Line
The IRS uses three categories to determine whether a worker is an employee or an independent contractor.
Behavioral control covers whether you direct how, when, and where the work gets done. This includes scheduling, instrument use, protocols, and who assists with patient care. The more control you have over those details, the more likely the worker is an employee.
Financial control looks at who sets the fee, covers expenses, and bears financial risk. Independent contractors typically set their own rates and absorb their own costs. Employees receive a set wage and are reimbursed or provided what they need.
Nature of the relationship considers whether benefits are involved and whether the arrangement looks like an ongoing employment relationship. If a hygienist works your schedule, uses your equipment, and answers to your clinical team, that looks like employment regardless of what the contract says.
The important thing to understand: the law determines classification based on the reality of the working relationship, not the label. If you classify someone as a 1099 contractor but the day-to-day arrangement functions like employment, a court or agency will treat them as an employee. In dentistry, legal limitations on dental hygienists and supervision requirements can make true contractor status harder to justify than many practice owners assume.
Why Misclassification Is a Serious Risk
Some practice owners classify temp workers as 1099 contractors because it simplifies payroll on the surface. The problem is that the savings are often illusory, and the downside can be severe.
If a state or federal agency determines your worker was misclassified, your practice may be responsible for:
Back payroll taxes and unpaid benefits
Penalties — often double or triple damages per affected worker
A look-back period that can stretch several years
Plaintiffs' legal fees if you lose a misclassification suit
For dental hygienists specifically, misclassification is particularly common and particularly risky. Most hygienists work under dentist supervision, use practice-owned equipment, see patients provided by the office, and follow a schedule set by your team. That arrangement satisfies the IRS definition of employment in nearly every case. These kinds of employee misclassification issues can create expensive long-term liability for dental practices.
What It Means for the Hygienist
Workers on the receiving end of misclassification bear real costs too. A 1099 contractor is responsible for the full 15.3% self-employment tax — covering both the employer and employee share of Social Security and Medicare. Beyond taxes, they forfeit:
Workers' compensation if injured on the job
Unemployment insurance if a position ends
Overtime protections under wage and hour law
FMLA rights and anti-discrimination protections
Whistleblower protections under employment law
When practices use 1099 platforms that misclassify hygienists, they may be passing costs and risks onto the worker — while simultaneously creating liability for themselves.
How to Protect Your Practice
The simplest way to eliminate misclassification risk when using temp staff is to work with a staffing platform that employs hygienists directly as W2 workers. When the staffing company is the employer of record, they handle payroll taxes, workers' compensation, and employment law compliance. You get the clinical coverage you need without taking on the associated legal exposure.
If your office regularly relies on short-term coverage, working with a temp hygienist agency can reduce administrative burden and help you avoid unnecessary classification risk. This is especially important in temp dental hygienist work, where the day-to-day structure of the shift usually looks far more like employment than independent contract work.
That's exactly how Teero operates.
Every hygienist on the Teero platform is a W2 employee. We handle taxes, workers' comp, and insurance so your practice doesn't have to. We also verify licenses, confirm eligibility to work, and check OSHA and HIPAA compliance before anyone walks through your door.
When a Teero hygienist covers a shift at your office, you're not taking on a contractor. You're working with a vetted professional whose employment relationship is fully handled — so you can stay focused on your patients.
