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Solving office conflict with communication

May 1, 2021
Dental offices are full of people with strong opinions, which can lead to conflict. How can this conflict either be avoided or solved?

Just as we do not get to choose our family, we usually don’t get to choose our coworkers. The work dynamics, often in a stressful environment, can lead to interpersonal conflict. The seed of bitterness, often sown by a perceived misdeed, grows and can create dental office conflict that affects the entire team. Patients start to notice, and it reflects poorly on the practice. Many disagreements are petty and manageable if they’re addressed before irreparable damage is done. Sometimes it can even lead to some parties losing their jobs.

Dental hygienists are often driven and organized, and these traits can serve us well, but we must learn how to deal with others who may not share our ideals.

When I started out as a 21-year-old assistant, I was met with a hygienist who refused to take or develop x-rays or clean instruments, because “I went to college to ensure I don’t have to do the meaningless work.” (Those were her exact words!) I quickly learned that the conflict between the hygienist and assistants was well-established. I was dumbfounded since I had the perception that the dental office should operate as a team. The experience shaped my perception of work environments that I still carry today. I’ve heard from assistants that they expect hygienists to be “princesses” who are unwilling to help where needed. Hygienists need to work to change this perception. While there are a few divas among us, there are many more who are team players.

What causes tension?

When I first got into dentistry, I didn’t consider that working with a group of type A personalities would mean so many different approaches and opinions to patient care. Because of this, one of the most common sources of dental office conflict is office or procedural policies. Whether it’s roles and duties or infection control practices, egos often get involved. The important part that many forget is not to take it personally, and instead discuss things as adults and stay open-minded. When you don’t discuss a conflict and are already at odds, that conflict will grow.

Dental hygienists versus office managers is another common conflict. We see office managers who rule with an iron fist and change procedure codes to ensure insurance payments, and this can be a source of contention (and fraud). Office managers are often the first to complain that hygienists are overpaid. As one of the most trusted members of the team by the dentist, they often control the finances and schedules. As a hygienist, make yourself a valuable and trusted source of information to your front office. The code changing is often based on misinformation and assumptions. Explain the reason for the treatment provided and make your clinical notes very clear.

Interpersonal conflicts are more apt to be arguable when it comes to values. These are often deeply personal and can drive a wedge between individuals. There is wisdom in avoiding religion, politics, or other emotionally charged topics with patients, and this should apply to coworkers as well. In instances where a personal value is the root cause, it’s best to agree to disagree and move on.

It’s important to recognize the root cause of conflict. Is it based on a difference of opinions, or factual disagreement? Often a little clarification can dispel the confusion and both parties may find they had the same goal all along. For example, one provider may state that there are no alternatives to chlorhexidine, and another may state that there are. The conflict may be solved by providing information from a credible source for discussion, and realizing everyone has the same goals.

I often hear from young hygienists who are struggling with conflict in their offices, and this is making them question their career choice. Most of the time it’s the new hygienist who reaches out for help and considers leaving the field. One of my first questions is, “Is this the first office you’ve worked in?” It is often their first experience, and they’re still gaining confidence in their skills and learning how to work in an office full of strong personalities.

I have found myself struggling with much younger staff members who joined the practice and seemingly did not have the same work ethic. Those of us who have been in the field for a while have an opportunity here—mentorship! Many times, the perceived lack of work ethic is simply a lack of confidence in what they should be doing. Rather than getting frustrated, you can train and mentor them in the ways of the practice. Through mentorship and guidance, I’ve watched many new hygienists and assistants blossom into excellent clinicians and team players. It can be intimidating to be a new employee, so the existing team should welcome them with open arms.

And remember—not every office is the right fit. We’ve all invested time, money, and tears to obtain our education and license, and we owe ourselves the chance to find the right dental home. When I hear from struggling hygienists who found new positions and are happy again, that makes me joyful.


Conflict is bound to happen. It’s important to recognize the signs and craft the skills to deal with difficult people. In many instances, the other party needs acknowledgment that their views and opinions are heard, even if you don’t agree. The conflict may stem from nothing more than a bad day or high stress, and all it takes is a little understanding. Depending on the conflict, a resolution may be found through collaboration if both parties are willing to cooperate. Keep this constructive and productive, and remember—it’s not a win or lose situation. Avoid hostility and involving other members of the team. This will only serve to deepen the divide. Criticizing another’s character is one of the quickest ways to ensure the conflict continues and will prevent any positive changes in the relationship. Instead, share your feelings and then actively listen to the other party’s concerns. Healthy relationships have give-and-take, and at times you must be the bigger person. Learn to pick your battles.

One of the most valuable tools you have to avoid and address conflict is communication. Stay calm and professional when conflict arises and address it quickly rather than letting it fester. Make yourself a valuable team member who helps when the need arises. Help with sterilization, call patients to fill the schedule, and simply take out the trash when needed to establish yourself as a team player. We all have days that are tougher than others for a variety of reasons. Become an ally and mentor and show others the respect they deserve as trained professionals. Most importantly, recognize when a practice is not a good fit for you. If you dread the daily drama, it may be time to look for a practice that appreciates your skills and knowledge. 

JAMIE COLLINS, BS, RDH-EA, is a practicing clinical hygienist in Idaho and Washington states. She has been in the dental field for nearly 20 years, both as an assistant and a hygienist. With a passion for patient care, especially for those with higher risk factors, she enjoys sharing the tips and tricks of the dental profession through speaking and writing. In addition to being in clinical practice, she is an educator, has contributed to multiple textbooks and curriculum development, and is a key opinion leader. Contact her at [email protected].

About the Author

Jamie Collins, BS, RDH-EA

Jamie Collins, BS, RDH-EA, is licensed in Idaho and Washington states and dedicated to advancing the dental profession. More than 20 years in the dental field has led her to becoming involved in many aspects of patient care. With a passion for patients with high risk factors, Collins enjoys sharing the tips and tricks of the dental profession through speaking and writing, with over 80 articles published worldwide. Collins has also contributed to multiple textbooks, curriculum development, and as a key opinion leader for various companies. She was named the Professional Education Manager at MouthWatch. Contact her at [email protected] or visit mydentaleducator.com.

Updated August 8, 2022