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Silo mentality: The silent toxin in dentistry

April 1, 2020
Silo mentality in dentistry exists in many forms, but are we doing anything to recognize it? Better yet, what are we doing to break down the silos and become true teams who serve patients to the best of our abilities?

We have all experienced some form of silo mentality but may not have realized that there is a name for it. The silo metaphor was introduced by Neebe in 1987 for organizational behaviors.1 Silo mentality in dentistry exists in many forms, but are we doing anything to recognize it? Better yet, what are we doing to break down the silos and become true teams who serve patients to the best of our abilities? Let’s first define the term—silo mentality. I define silo mentality as a mindset present when departments do not share information with other departments in the same organization, in our case, a dental practice. 

Silos in health care are especially challenging because organizations can be complex, and a high level of cooperation is needed to provide the best care for patients. No matter the size of the dental practice or organization, silo mentality is a consequence of the organizational structure, as departments are divided functionally and professionally, and are provided with insufficient communication channels.2 In a traditional dental practice, there are often a front-office team and a back-office/clinical team. When information is not shared between the two departments, patient experiences can suffer. 

Let’s compare the term to actual silos. If you grew up in, or have driven through, the Midwest, you’re familiar with the tall silos that farmers use to store their grain or silage. Due to the natural fermentation of chopped silage, a silo gas forms shortly after grain is put into the silo. If farmers are not aware of the hidden silo gas, they can inhale the nitrogen dioxide, which causes irritation to the nose and throat and inflammation of the lungs. If silo gas poisoning is not treated immediately, it can be deadly. Silo mentality in the workplace can have this same effect! It can be a silent poisoning in organizations that, if not identified early, can be toxic to the culture and team. 

Silo mentality can create inefficiencies and destroy cultures in dental offices. The silo effect can create barriers within departments, leading to an “us and them” mentality. These barriers create anxiety in teams, making it difficult to form and integrate processes interdependently.3 We are all familiar with the struggles in dentistry when the front-office team doesn’t work well with the back-office team. We have also experienced times when information was not communicated or shared from the doctor or a fellow hygienist. Whether intentional or not, it’s never good to feel like communication is off in the office. 

What to ask to determine if your dental office has silo behavior

  • Is the team truly aligned? 
  • Does everyone on the team have the same vision?
  • How often are goals for the office or organization communicated?
  • How resistant is the team to change?
  • How well does your team collaborate and share ideas?
  • Does each department work to protect its own interests?

If you’ve determined that there is some form of silo behavior in the office, now what do you do? Or did you read those questions and think, no, our office is good? Great! In both situations, I’ll discuss how to squash the silo behavior or prevent it from creeping in. 

In order to break down or prevent silo mentality, there must be a unified vision. Just like anything in life, if we don’t know where we’re going, how are we going to get there? The team must work toward the same goals and be in alignment with those goals. There must be mutual respect across all departments. Finally, there must be a great line of communication across the organization. 

Fostering collaboration between departments

Patients, team members, and information flow between departments; these do not stay in separate silos. We must think of communication in the same way. How do we ensure that everyone in the office knows the necessary information for each patient and the essential information to help the day run efficiently? To align as a team, there should be a true communication system in place. This can look different in every office, so decide as a team what works best for you. 

Optimizing a system or protocol in one department may not actually improve the patient experience if it’s not aligned with the other departments. The keys to making improvements in the patient experience is to consider the functions of each department, identify the strengths, and then leverage those strengths. A system works when all departments understand the “why” and work to achieve the same goal. 

How to cultivate team collaboration

  • Create a clear vision and share the expectations
  • Foster a “safe” environment where team members feel they can truly share their thoughts and opinions
  • Establish team goals together
  • Play to each team member’s strengths
  • Encourage creativity and innovation 
  • Communication

Everyone knows how important strong communication is for a team, but frankly, many of us are not actually great at it. Just because you email team members 50 times a day does not mean you have strong communication in the organization. My own definition of communication is clear and concise dialogue between people, where active listening is present. It is extremely important to have a good cross-team communication plan in place. Taking the time to develop a communication plan as a team will build trust, efficiencies, and a better culture for years to come. 

I encourage you, no matter your role in the practice, to identify how the organization communicates and then determine if the communication is getting through to all departments. Is the communication being shared with the right people? What is the perception of the communication you’re sharing? If you determine that communication is lacking, bring the team together to develop a new communication plan.

Tips for cross-team communication

  • Define roles and set expectations as a team
  • Determine the best form of communication (face to face, email, phone calls)
  • Have planned meetings and stay focused 
  • Ensure alignment across all teams (meetings will encourage alignment)
  • Be cognizant of communication differences and respect those differences
  • Be an active listener and encourage all team members to speak up

To get rid of toxic silo gas, a window must be opened for the gas to escape. Similarly, a communication window must be open in all departments to avoid or break silo mentality. Overall, one of the greatest ways to avoid and understand concepts such as silo mentality is to be aware of their existence. With a cohesive team and communication systems, your culture and the patient experience can thrive, and silo departments can be avoided.  


1. Cilliers F, Greyvenstein H. The impact of silo mentality on team identity: An organisational case study. S Afr J Ind Psych. 2012;38(2).

2. Alves J, Meneses R. Silos mentality in healthcare services. Presented at 11th Annual Conference of the EuroMed Academy of Business. September 12, 2018..

3. Vatanpour H, Khorramnia A, Forutan N. Silo effect a prominence factor to decrease efficiency of pharmaceutical industry. Iran J Pharm Res. 2013;12(suppl):207-216. 

Ashley McCauley, MS, RDH, is the clinical director for First Impressions, a pediatric group located in Wisconsin, and a podcast host for the Dental Podcast Network. Her advanced degree in organizational leadership allows her to speak and write on practical solutions for growth and development. She can be reached at [email protected].