Hiring a Locum or Temp Dentist: When and How

The clearest case is a dentist's own planned absence — parental leave, an extended medical leave, military service, or a sabbatical the practice needs covered without losing patients to whoever's open down the street.

It also comes up during a sale or ownership transition, when continuity of care matters in the gap between an owner stepping back and a permanent replacement being hired and credentialed.

A third case is deliberate rather than reactive: testing a new location or a satellite chair before committing to a full-time associate, so you can see real patient volume and case mix before writing a permanent job description.

What a locum isn't is a cheap substitute for a genuine ongoing vacancy — if the seat needs to be filled indefinitely, the cost and credentialing math below usually favors hiring an associate outright.

Most associates are paid a percentage of production or collections, commonly 25–35%, or a DSO-style base salary against a lower percentage — see the salary guide for the full breakdown of those structures.

Locum and temp work is priced differently, almost always as a flat day rate rather than a share of production, because a short engagement needs cost certainty more than it needs to share upside.

There is no BLS wage series specific to locum or temp day rates — the national median for dentists overall is $170,950 a year (BLS OEWS, SOC 29-1021, May 2025), but that figure describes ongoing employment, not short-term coverage, so treat any day-rate quote from an agency or a locum directly as a local, negotiated number rather than a benchmark.

Budget it as its own line item rather than a discount associate rate: a day rate generally has to cover what an independent contractor gives up anywhere — no benefits, no guaranteed hours beyond the booked dates — and a short engagement gives a practice less negotiating leverage than a longer offer would.

A locum needs to be licensed in the state where your practice is, not just licensed somewhere.

There's no national dental licence, and licensure by credentials between states is common but not automatic or instant — the licensure and reciprocity guide covers what that process actually involves and what can extend it.

If the role prescribes controlled substances, DEA registration is a separate federal requirement tied to a specific practice address and state, so a locum who already holds one at home generally needs a new registration for your location before writing a single prescription — the DEA registration guide covers that application in full.

Practices that assume an out-of-state, already-licensed dentist can simply start next week are usually the ones surprised by how much of that timeline sits with the state board and the DEA's own processing, not with the locum's personal availability.

Start the credentialing conversation the moment you know you'll need coverage, and confirm both the licence and any DEA registration before you commit to a start date.

A short-term locum engagement looks like independent-contractor work on paper, but classification isn't a preference — it's a legal test the IRS applies to the actual working arrangement.

The test looks at behavioral control (who sets the schedule and supervises the clinical work), financial control (who owns the equipment and how payment is structured), and the nature of the relationship (a discrete, short outside engagement versus an ongoing role folded into the practice).

A short, clearly bounded engagement — a defined number of days with no ongoing schedule commitment — is what supports treating a locum as a 1099 contractor; working on the practice's own equipment and to a schedule the practice sets is exactly the kind of behavioral- and financial-control fact that cuts the other way, toward employee status, so those two facts alone don't settle it in the practice's favor.

A "temporary" arrangement that quietly turns into regular, ongoing coverage on the practice's schedule is the clearest sign it has crossed into looking like employment, regardless of what the paperwork calls it, and misclassifying a dentist who should be a W-2 employee is a compliance risk for the practice, not just paperwork — confirm the classification with a tax or employment professional rather than defaulting to whatever the last locum agreement used.

This article is general information, not legal, tax, or regulatory advice — state licensure rules, DEA registration requirements, and worker-classification tests all apply to your specific facts and can change, so confirm current requirements with the relevant state board, the DEA, and a qualified tax or employment professional before acting.