Staff payroll for dental practices typically runs between 25-30% of collections. This includes everyone on your payroll. Hygienists, dental assistants, front office staff, and office managers all count toward that number. If you’re above 30%, your staffing costs may be eating too much of your revenue. Below 20% and you might be understaffed or underpaying.

Start with fully-loaded labor costs, not just hourly wages or salaries. Add employer payroll taxes (around 8% of wages in California), workers’ compensation insurance, health insurance contributions, retirement plan matches, and paid time off. A hygienist making $50 per hour might actually cost you $58-62 per hour when you factor everything in. Working with someone who understands medical practice accounting helps you calculate these numbers accurately from the start.

Break your payroll budget into clinical and administrative categories. Clinical staff like hygienists and assistants should scale with production. More operatories running means more clinical hours needed. Administrative staff is more fixed but still needs to grow as patient volume increases. A front office team that handled 800 active patients just fine might struggle at 1,200.

Hygienist pay often includes production-based bonuses or commission structures. Budget for base pay plus a realistic estimate of what they’ll earn on production. If your hygienist produces $1,200 per day and earns 33% of production, your daily cost is $400 plus payroll taxes and benefits on top.

Build in room for annual raises and potential new hires. Most practices give 2-4% annual increases to retain good staff. If you’re planning to add a second hygienist or expand hours, those costs need to be in the budget before you commit.

Track actual payroll against your budget monthly. Compare payroll costs as a percentage of that month’s collections. Slow months will spike your percentage even if payroll stays flat. Busy months will look better. Looking at rolling 3-month averages smooths out the fluctuations and shows the real trend.

Reimbursements can be delayed and insurance payments fluctuate month to month in dental practices. This makes cash flow less predictable than in businesses where customers pay immediately. Having a realistic payroll budget, and tracking against it consistently, helps you maintain reserves for slower periods. For small business bookkeeping in Los Angeles, especially in healthcare, this kind of forward planning prevents the scramble when a big insurance payment gets delayed.