For practices
Hiring a self-employed dental hygienist.
Hiring a self-employed dental hygienist is allowed, as long as the work is genuinely independent.
- Speed
- Often arranged quicklyfrom a network we know personally
- First
- We look at the factsdoes self-employment fit how the work actually looks?
- If it doesn’t fit
- Secondmentthe same person in a different arrangement
Why this comes up so often.
Hiring a self-employed dental hygienist is quick and flexible, and for many practices the most normal thing in the world. But since the Dutch tax authority started looking more closely at false self-employment, the question has become sharper: is it actually still allowed in your situation?
Dental hygienists are scarce, and you notice it straight away in the waiting time for prevention. A practice that can’t get its prevention team staffed sees patients go elsewhere — and they rarely come back.
Honestly: we don’t judge on behalf of the Dutch tax authority, and we don’t give tax advice. What we do is choose the arrangement that fits how the work actually looks in the practice — and warn you when a construction doesn’t strike us as sustainable. Better that conversation up front than a back tax bill afterwards.
Independent work by a dental hygienist.
Their own clinic, in the scheduling too
A dental hygienist works fairly independently by nature: their own clinic, their own patients, and referring back to the dentist when needed. That fits self-employment well. The picture shifts as soon as the practice decides the schedule entirely: the appointment length, the order and which patients come in.
So leave the scheduling of the clinic to the dental hygienist as much as possible. That is practical too. Practices schedule very differently, and we notice that for dental hygienists the time per patient is more often a reason to leave than the salary. Do agree how the records are kept in your system, so the dentist can see what has been done.
The prevention team and the fixed rota
The biggest risk lies in how a dental hygienist fits into the team. The same days every week, among salaried colleagues doing the same work, is the strongest signal that it is no longer independent work. In a practice with its own prevention team, that picture forms quickly.
So go through the five questions from the decision guide: who sets the rate, whether the dental hygienist may send another qualified colleague as a substitute, and who carries the risk of illness, an empty schedule or a complaint. The more often the answer points towards the practice, the more it looks like salaried employment.
What you check in advance
A dental hygienist has no compulsory BIG registration as a dentist does. Dental hygienist is a legally protected professional title, though, with the BSc in Oral Hygiene as the training behind it. So ask for the diploma. The voluntary KRM quality register is separate from this. Keeping up their own continuing education is part of visible entrepreneurship, though, so also ask how the dental hygienist does that.
The Wkkgz requires an independent care provider to have a complaints scheme and to be affiliated with a recognised disputes body. Also ask about professional liability insurance, and make sure it is in place before the first working day. What else a self-employed professional arranges is on the page about insurance as a self-employed professional in dental care.
How it works.
We look at the actual situation
Does someone run their own schedule, set their own rate, have the right to send a substitute, work for more than one client? That determines whether it holds up as genuinely independent work.
Self-employment fits? Then we find the right contractor
From a network we know personally — not from a database of keywords.
Self-employment doesn’t fit? Then we say so
And then secondment is the alternative: the same person, a different arrangement, no discussion afterwards.
Also possible.
Dental hygienist, other arrangement
Interim, other role
- Hire a self-employed dentistThe same approach, for a dentist.
- Zzp-orthodontist inhurenThe same approach, for an orthodontist.
- Hire a self-employed practice managerThe same approach, for a practice manager.
- Recruitment and selection in dental careLooking for someone permanent? This is how we go about it.
Frequently asked questions.
May a self-employed dental hygienist give anaesthetics and take X-rays at my practice?
That differs from practice to practice and depends on how the dentist sets up the collaboration. Agree in advance which procedures the dental hygienist carries out at your practice and how referrals back work; extending that afterwards rarely goes smoothly. The rules on independent powers for dental hygienists are not yet final. Check the current position with the BIG register or the professional association.
Can a self-employed dental hygienist also work for other practices?
Yes, and that is a good sign rather than a problem. Several clients are part of genuine entrepreneurship, just like their own rate and their own liability insurance. For your scheduling it does mean the dental hygienist isn’t always available when you want. Agree the days per period, rather than counting on a fixed place in your rota.
How often should I review the self-employment arrangement?
At least once a year, and at every extension. An arrangement that was right in January may have drifted by December, for example if fixed days have crept in unnoticed. Record per person what you assessed and why. In an inspection, what counts is that you looked at it seriously.
As a practice owner, how do I hire a self-employed dental hygienist, and who arranges it?
Through Denta Staffing: we find a self-employed dental hygienist in our network and check beforehand whether self-employment fits how the work will actually be done. If it fits, we put the days, rate, period and replacement arrangements in writing before anyone starts. If it doesn't, for example because someone would be on fixed days in your rota structurally, we say so and look at secondment.
What does a self-employed dental hygienist cost?
A self-employed dental hygienist usually charges € 50 to € 70 per hour. On top of that comes our hourly margin; the maximum is listed under frequently asked questions.
What changes for self-employment and secondment from 2027?
From 31 December 2026 there will be a statutory presumption of an employment contract, tied to the hourly rate, and the Self-Employment Act is in the works. The timeline and what you can already do now are on the topic page on self-employment and flexible work rules.
Can I still use a self-employed contractor?
As long as it is genuine self-employment, yes. But someone who is a fixed part of your rota, works under your direction and has no other clients doesn’t look self-employed — whatever the agreement is called.
What does the Dutch tax authority look at?
Mainly at the facts: is there a relationship of authority, does the work have to be done personally, and is there genuine entrepreneurial risk? The paperwork weighs less heavily than how things actually run in the practice day to day.
And if self-employment isn’t possible?
Then secondment is the route: the person joins our payroll and works in your practice. You keep the cover and the risk doesn’t sit with you.
Do you arrange the agreement?
We make sure the arrangements are clearly on paper before anyone starts: days, rate, period and substitution. For tax or legal assessment we refer you to your own adviser — that is where it belongs.
