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Navigating conflict with communication

March 1, 2019
Julie Whiteley, BS, RDH, shares some communication strategies dental hygienists can use to manage dental office conflict more effectively.

Julie Whiteley, BS, RDH

I recently spoke to a group of dental professionals about communication skills and relationships with patients. As I drove home, something struck me: we are in a relationship-driven profession, yet some of the least healthy relationships we have are with one another.

Think back over your career. Can you think of times when a relationship with a coworker or manager was a regular stressor? Have you ever held back from asking for what you wanted or what you thought you deserved? Have you ever had an experience where you felt as if you were talked about versus talked to? Have you ever participated in the negative office talk instead of speaking to someone directly? Personally, I have experienced all of this. What I’ve learned, however, is that open, honest communication is imperative in any relationship and can be lacking in our profession at times.

Some of us hold back from speaking up because we are fearful about how the recipient’s reaction could make us feel. Many of us are caretakers and empaths, and we absorb energy like sponges. We try to avoid toxic, negative energy and conflict. We often work in such small groups, and holding back may feel like the best way to keep the peace. Is it really, though? Often, we slowly build up more and more resentment and frustration, and it can become unhealthy and unbearable.

At the other end of the spectrum, some approach conflict, whether real or perceived, argumentatively. Sometimes things can get blown out of proportion and escalate as both parties’ defenses rise, and there is a lot of talking (or yelling) with little to no listening. Often the intent in the argument is to be right, not reach resolution. The end result can be an uncomfortable, strained professional relationship.

In a real relationship, neither of these tactics will bring about any resolution and can often make things worse.

A 2008 study by CPP Inc. found that employees in US companies spend approximately 2.1 hours each week involved in conflict.1 This is two and a half weeks of time each year that go toward the goal of arguing, as opposed to collaboration. This is a detriment to production and to the health of the employees. According to the 2015 Hiscox Guide to Employee Lawsuits, 85% of employees experience some kind of conflict at work and 29% experience nearly constant conflict at work.2 Furthermore, many employees and employers do not receive basic conflict management classes.2 Of those who do, 95% say that the training has helped them navigate workplace issues in a more positive way.2 A Columbia University study showed that companies with a healthy culture report a turnover rate of just 13.9% on average, compared to 48.4% of companies with poor culture.3

My intent here is to share some tips to open the lines of communication with colleagues, even when it’s challenging.

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Find the right time and setting

When we need to have a conversation that may not be easy, an on-the-fly conversation in the middle of a busy workday is probably not ideal. Chances are you will not have the privacy needed or the appropriate time to talk without interruption. It is best to find a time and a location that will enable you to talk freely without interruption.

Don’t vent or gossip

Venting to a coworker can feel therapeutic when something happens that frustrates us. Although having a sounding board is important, seeking the advice of someone outside of the office may be better in matters that involve other staff members. Sometimes stories circulate, and it can become like the telephone game—by the time the story works its way back to you, it might be very different from what actually happened. Further, you could run the risk of being seen as an office gossip or someone who likes to stir the pot. Colleagues may be less likely to trust you. Additionally, venting can become chronic and create negative energy in the office. Have you ever worked in an environment cloaked in secrets, negativity, and complaining? It’s draining and creates unnecessary office drama and stress.

Speak directly

If you have an issue with a specific person, speak to that person directly. For example, perhaps you are working with a newly hired hygienist, and you are frustrated that she is not following the office’s standard of care. You notice she has downtime, yet she is not perio charting. You worry about what you feel is a lower quality of care for the patients. Further, she is not helping out in the sterilization area. Rather than discuss your concerns with the doctor or office manager first, approach her directly.

You are not her supervisor, nor should your tone cause you to come off as such. You can, however, have a conversation to help her adapt to her new job: “I’ve been working here for a few years, and I know how challenging it can be to start over somewhere new. Is there anything I can do to help you get used to how we do things here? Dr. Smith is a very perio-focused doctor, so we do a full chart on each person every year, and I wanted to be sure you knew our protocol. Do you need some help learning the software? We only have one assistant in the office, and the sterilization area gets backed up if we don’t all pitch in. I can show you how we organize the workflow.”

Try to remember that being new is hard, and you have to work with this person. Try not to make assumptions that she is lazy; it’s possible she came from a very different environment, and the standards at your office were not made clear to her. I think we’ve all experienced some of the lack of communication that can occur in an office. Starting your relationship with mutual respect and open conversation is a huge start.

Approaching the doctor or office manager first will cast a negative light on you with your new colleague, and you might be viewed as a tattletale or complainer who isn’t giving a new person time to settle in. Also keep in mind that some managers may struggle with addressing less-than-stellar performance; it can be frustrating to report something several times and see that nothing is done. Sometimes all someone needs is a little direction from a helpful colleague to learn the culture and expectations of a new office. If the situation continues or is serious, you may need to involve the manager.

Another hard reality is that not everyone is going to work like you, and sometimes we simply have to let the powers that be decide what is going to work best for the practice.

Use facts, not emotions

Emotions can run strong, but they shouldn’t lead a conversation. When they do, nothing gets accomplished. Even when you are angry, hurt, or frustrated, stick to the facts. Instead of starting the conversation by saying, “I’m angry,” or “I feel taken advantage of,” try a different tactic. Recently, I spoke with a hygienist who was angry that the office manager took lunch orders from all of the staff except for the two hygienists. To her, it felt deliberately exclusive and as though it was done with ill intent. She confronted the situation with fact, versus emotion, and it was resolved: “Mary, we noticed that you put in a lunch order each day. Judy and I often don’t get much time for lunch, and we would appreciate it if you could include us going forward.” This could have been an argument in what I like to call “the great continental divide” that can happen between the business staff and clinical team, but the office manager was apologetic and I think a little embarrassed that she was so respectfully called out on what looked like bad behavior.

Take a pass on being passive aggressive

Making snarky comments, using a rude tone of voice, giving the silent treatment, and cloaking the truth in humor may feel empowering, but these are not effective ways to get the results you are looking for and often backfire. I had a conversation with someone who felt excluded from the social aspects of a small office. Her response was to shut down and avoid speaking to anyone unless it was work-related. When she finally confronted the situation, she realized that she misread her coworkers, and by shutting down, she alienated herself from the team.

On this same point, speak to someone directly instead of via notes or texting when possible. A lot can be lost in the written word. Plus, I’ve seen people accidentally implicate themselves by leaving a written trail of inappropriate notes. I was recently involved in a situation where an assistant was frustrated with a hygienist for something she felt the hygienist should have done. Her response was to leave a note telling her to “do her damn job.” It was the assistant who got the talking-to from the doctor for leaving such a note.

Think before you act

Have you ever experienced a knee-jerk reaction? What I mean is, have you immediately reacted in the heat of the moment and later realized that you may have misread the situation or overreacted? Words and actions can be a bit like squeezing toothpaste out of the tube. Once it’s out there, you can’t put it back. You might be able to clean it up a bit, but you can’t undo it.

When something happens, take some time to process how you feel and why it’s affecting you that way. Maybe the action was a “trigger” for something else you’re feeling. Emotional triggers are those events or thoughts that cause us to automatically react. For example, I once received an email from an office manager expressing “disappointment” that I would not be attending a staff meeting that was scheduled on my day off. It struck a nerve, and I immediately responded with a strongly worded email. (Remember my suggestion to avoid notes and texts? Email falls in that category too!) Needless to say, the conversation went downhill . . . fast. Fortunately, we were able to have a sit-down conversation and hash things out professionally and respectfully. She agreed that her intent was lost in the email and that we should have spoken directly. I admitted that I overreacted. One of my triggers is when someone says I’ve “disappointed” them, and I was also struggling with work and family balance at the time. In hindsight, I could see my need to respond, but my scathing response was more than the situation warranted.

When we are triggered, we might feel justified in reacting, but the truth is if we can break it down and identify our real triggers, we can more clearly see when we might be overreacting and make a choice to respond in a healthier way.

Drop the defense

In my role in human resources, I often worked with people who were angry about feedback they had received from a coworker or manager. When we hear something that isn’t positive about ourselves, our first instinct can be defensiveness. When you receive feedback, my advice is to consider the following questions: Is the feedback true, despite the fact that hearing it stings? Is there something you are doing or not doing that is causing someone to perceive things this way? Is this completely untrue, and is further clarification needed?

When we respond to a situation from a place of defense or heightened emotions, the situation is left unresolved, and it can escalate quickly. We cannot change what someone says, but we do have control over how we allow it to land on us and how we choose to respond.


Have you ever had an experience where someone was talking, but you weren’t fully listening because you were using that time to formulate what to say next? There is a quote that goes something like, “If you want to be listened to, you should put some time into listening.” You may be surprised by what you hear. You may also be better able to understand the other person’s point of view. It doesn’t always mean that you will agree, but understanding is a huge step in resolving conflict.

At this point, you may be thinking, “I need a more aggressive approach than what’s been suggested here.” Consider the difference between aggression and assertiveness. Aggressive is defined as “ready or likely to attack or confront”; “pursuing one’s aims and interests forcefully, sometimes unduly so.”4 It is usually the result of too much negative emotion. Assertion, on the other hand, is defined as “having or showing a confident personality.”5 Synonyms are “self-assured,” “forthright,” and “determined.” It’s about standing up for yourself and treating people with respect while you do so.

Let me be perfectly clear in saying that we do not need to tolerate inappropriate behavior, situations that violate employment law, or unhealthy work situations. We need to be able to speak up and advocate for ourselves and know the proper channels. We need to face these challenges head on, armed with factual information, and from a place of empowerment.

Be confident

Be confident in what you are saying. You’ve heard that dogs can identify fear. There are people with that same trait. Consider the tone and volume of your voice, your body language, and your ability to keep eye contact. If someone, particularly the bullying type, sees you are lacking confidence, he or she might take the opportunity to attempt to derail you. A large part of confidence can come from having solid information to back you. For example, perhaps you weren’t compensated for time you feel you should have been paid. Do your research and gather facts from reputable sources. It can be a challenge, but when you approach conflict by trying to resolve things for the benefit of all involved, the outcome is often better. Also, don’t be so confident that you fail to listen to the other side of the story.

Some final thoughts

Despite our best efforts, some situations leave us in predicaments where we feel that nothing has changed or that we simply cannot resolve an issue. At those times, we need to ask ourselves if we can get past it or if we need to consider moving on from an environment that no longer suits us. Be careful to not make ultimatums unless you are willing to accept all possible outcomes. I have seen those situations turn out poorly in that the person does not get the desired result and also ends up out of a job. This can cause a gap in employment that may need to be explained to prospective employers.

Remember that respect is both given and earned. Zig Ziglar has been quoted as saying, “In many ways, effective communication begins with mutual respect—communication that inspires, encourages others to do their best.” But there are times when you might be in a conversation with someone who is not respectful. Similarly, you may find yourself in a conversation that is not going anywhere or is escalating negatively. When that happens, confidently protect your personal boundaries and professionally end the conversation.

Finally, we are working in practices that are often small and busy. From time to time, conflict can arise even in the best of work environments with the most solid relationships. Conflict is part of any relationship, but the key is how it is addressed and resolved. Prompt dialogue that is mutually respectful and professional—and not personal—is important. It is critical to be able to say what you need to say and come to an agreement, decide to let it go, or determine if you are in the best work environment for you. It is also helpful to strategize solutions to avoid repeating the same conflict. It might feel uncomfortable at first, but having tough conversations gets easier with practice, and the end result can be a work environment that is more open, peaceful, and rewarding.


1. New study details both crippling and beneficial effects of workplace conflict on businesses [news release]. Mountain View, CA: CPP Inc.; October 6, 2008. https://shop.themyersbriggs.com/PRESS/Workplace_Conflict_Study.aspx.

2. 2015 Hiscox Guide to Employee Lawsuits: Employee Charge Trends Across the United States. Hiscox website. www.hiscox.com/documents/the-2015-hiscox-guide-to-employee-lawsuits-employee-charge-trends-across-the-united-states.pdf. Published 2015.

3. Medina E. Job Satisfaction and Employee Turnover Intention: What Does Organizational Culture Have To Do With It? New York City: Columbia University; 2013.

4. Aggressive. The Oxford Pocket Dictionary of Current English via Encyclopedia.com. https://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/aggressive-0.

5. Assertive. Oxford Living Dictionaries. https://en.oxforddictionaries.com/definition/assertive.

Julie Whiteley, BS, RDH, is certified in human resources. She holds degrees in business administration and dental hygiene and has worked extensively in both fields. She is on the faculty of Massachusetts College of Pharmacy and Health Sciences University in Boston. She bridges her knowledge and experience from business, clinical hygiene, and teaching to deliver information and programs that enhance dental practices. Contact her at [email protected].