Temporary Dental Hygienists: W-2 vs. 1099
A Quick Guide for Alabama, Georgia, Tennessee & Florida Dental Practices
The short answer: Being temporary does not make a hygienist a 1099 contractor.
A contract stating “independent contractor” does not override the actual working relationship.
Whether a hygienist works one day, one week, part-time, or at multiple dental offices, worker classification depends on the actual working relationship—not what the practice calls the worker or whether a 1099-NEC is issued.
The Federal Rule
The IRS looks primarily at behavioral control, financial control, and the relationship between the parties.
What About Your State?
A hygienist is more likely to be a W-2 employee when the practice:
sets the schedule and provides the patients;
provides the operatory, equipment and supplies;
establishes office and clinical procedures;
requires the hygienist to personally perform the work; and
pays the hygienist by the hour, day, or shift without meaningful business risk.
A Dental-Specific IRS Ruling
Rev. Rul. 58-268 is especially important.
The IRS determined that a dental hygienist was an employee even though she:
worked only 1–2 days per week;
worked for multiple dentists; and
was paid a percentage of patient charges.
She used the dentists' offices, equipment and supplies. The overall relationship—not how often she worked—controlled the classification.
ALABAMA
The Dental Board has directly addressed this issue.
The Board of Dental Examiners of Alabama specifically warns:
“Temporary or part-time doesn’t automatically make you 1099.”
The Board explains that Alabama's supervision requirements and the control normally exercised by a dental practice generally point toward W-2 employee status.
Takeaway: Routine 1099 treatment of temporary hygienists is particularly difficult to support in Alabama.
GEORGIA
Georgia requires dentist supervision of dental hygiene and specifically states that its general-supervision rules do not establish independent dental hygiene practice.
However, Georgia dental regulations also contemplate that a hygienist could potentially have an independent-contractor relationship.
Takeaway: Georgia does not appear to prohibit 1099 status outright, but the hygienist must still genuinely qualify as an independent contractor under federal law. Simply being a temp isn't enough.
TENNESSEE
Tennessee's Board of Dentistry rules describe hygienists practicing under direct or general supervision “in the employment of a licensed dentist.”
The dentist also delegates or assigns the hygienist's permitted duties.
Takeaway: For the typical fill-in hygienist working in a dental office, these requirements—combined with the federal IRS factors—provide substantial support for W-2 treatment.
FLORIDA
Florida permits different levels of hygienist supervision depending upon the procedure and setting, so its rules provide more flexibility than Alabama.
However, a temp who works from your schedule, treats your patients, uses your operatory and supplies, and works within your practice's delegation and clinical structure still presents many of the IRS characteristics of an employee.
Takeaway: Florida's broader hygiene scope does not automatically create 1099 status. Federal worker-classification rules still apply.
The Easiest Way to Think About It
If your temporary hygienist is working with:
YOUR patients + YOUR schedule + YOUR office + YOUR equipment + YOUR supplies + YOUR procedures
there are significant indicators that the hygienist should be treated as a W-2 employee.
A 1099 arrangement becomes more defensible when the hygienist actually operates an independent business—controlling how and when services are provided, making a meaningful business investment, marketing services independently, bearing business expenses and having a genuine opportunity for profit or loss.
Bottom Line
“Temporary” is a scheduling description—not a tax classification.
Before paying a temporary hygienist as a 1099 contractor, dental practices should evaluate the actual relationship under federal worker-classification rules as well as the dental-practice requirements of their state.
Key Authorities
Federal: IRC § 3121(d)(2); Treas. Reg. § 31.3121(d)-1(c)(2); IRS Publication 15-A; Rev. Rul. 58-268; Form SS-8.
State: Board of Dental Examiners of Alabama; Georgia Board of Dentistry; Tennessee Board of Dentistry; Florida Board of Dentistry and applicable dental-practice statutes and regulations.
This information is intended for general tax and business guidance and is not legal advice. Worker classification depends upon the specific facts and circumstances of each arrangement.
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