Written by: Alex Bush, Edited by: Courtney Keim
Psychological safety, the feeling that you can speak up, ask questions, or point out concerns without the fear of embarrassment or backlash, is one of the most reliable predictors of how well teams learn and perform (Edmondson, 1999). Healthcare research shows this clearly: when teams feel safe to communicate openly, they make fewer mistakes, adapt more quickly, and feel less stress (Edmondson & Lei, 2014; Grailey et al., 2021).
But dentistry has not been part of this conversation, even though dental care relies on some of the most interdependent small-team work in all of healthcare. From an occupational health psychology perspective, psychological safety sits at the intersection of worker well-being, team performance, and error prevention.
Dentistry is built on collaboration. Every procedure, whether routine or complex, requires tight coordination between dentists, hygienists, assistants, and front-office staff. These teams work inches apart, manage anxious patients, and make precise decisions under time pressure. When communication breaks down, there is no backup nurse or resident to step in. Most dental practices run on tight schedules, and the workflow leaves little time for discussion or clarification. A rushed moment is all it takes for someone to stay quiet, even if something feels wrong. In psychologically unsafe environments, silence becomes a safer choice than speaking up.
Yet, when teams feel comfortable voicing concerns, everything works better. Commentary from dental professionals highlights that teams who feel safe to speak up identify issues earlier, adjust more smoothly during procedures, and maintain stronger working relationships (Blythe, 2023; Bonanno, 2024). These observations align with broader healthcare research showing that psychological safety supports open dialogue, quick correction, and improved team-based decision making (Edmondson & Lei, 2014).
Psychological safety can also help ease the emotional load of dentistry. Fast-paced schedules, patient anxiety, physical strain, and constant performance pressure all contribute to stress. When team members feel able to ask for help or admit uncertainty, these demands feel more manageable. Communication becomes a source of support, not another stressor to navigate (Blythe, 2023; Bonanno, 2024).
Barriers to Psychological Safety in Dentistry
Even though psychological safety is beneficial, several features of dental practice can make it difficult to maintain. These barriers build up over time. When speaking up feels risky or unwelcome, silence becomes the default, even when someone sees something that needs attention.
- Hierarchy: The dentist is often the clinical leader and employer, creating a steep power difference. Hygienists and assistants may hesitate to question decisions, even when something seems off (Bailey & Dungarwalla, 2025).
- Time pressure: Dental schedules leave little room for clarifying questions or speaking up in the moment.
- Limited leadership training: Dentists receive extensive clinical training but rarely receive formal preparation in communication or conflict management, core skills for building psychological safety.
Differences in communication styles: As dental teams become more diverse, expectations around communication vary. Without clear norms, misunderstanding can occur (Blythe, 2023).
What Psychological Safety Looks Like in Dental Settings
Psychological safety doesn’t require big interventions or long meetings. It shows up in everyday interactions. It sounds like:
- “Let’s pause a moment, something doesn’t look right from my side.”
- “Before I bring the patient back, can we double-check the plan for this one?”
- “Today’s schedule is stacking up; we may need to adjust our timing a bit.”
- “Anything I should know before we start? What are you seeing today?”
These small moments can shift the team dynamic. They create space for clarification, early intervention, and shared understanding. Over time, they build a climate where communication is expected and valued.
How Dental Practices Can Build Psychological Safety
Improving psychological safety doesn’t require a complicated initiative. A few simple, consistent practices can make a meaningful difference.
- Use predictable communication routines: Morning huddles, quick briefings, and short debriefs create built-in opportunities for teams to share concerns or plans (Bailey & Dungarwalla, 2025).
- Model openness: When leaders acknowledge uncertainty, invite input, or admit mistakes, they send a clear signal that speaking up is appropriate (Edmondson & Lei, 2014).
- Respond constructively when someone raises a concern: Even brief, positive reinforcement, “Good catch” or “Thanks for mentioning that”, helps maintain psychological safety.
- Set shared expectations for voice: Clear norms such as “Anyone can call a pause if something feels off” reduce hesitation and ambiguity.
- Develop basic leadership and communication skills: Dental commentaries consistently emphasize that many dentists never received training in the interpersonal skills that support teams, yet these skills directly shape team culture (Blythe, 2023).
A Research Agenda
Despite dentistry’s reliance on teamwork, psychological safety in this field remains largely unstudied. Several critical research questions remain:
- How does psychological safety operate across different practice models, such as solo practice, group practices, and Dental Support Organizations (DSOs)?
- How does psychological safety relate to burnout, turnover intentions, and patient experience in dental settings?
- Which communication routines or leadership behaviors most effectively support psychological safety in dental teams?
- What interventions are feasible for small, fast-paced dental settings?
Answering these questions would help dental practices strengthen teamwork and contribute valuable insights to occupational health psychology.
Conclusion
Psychological safety supports communication, teamwork, and well-being, three elements central to high-quality dental care. Dentistry depends on small teams working closely together under pressure, making psychological safety even more important and more vulnerable. When people feel safe to speak up, teams function more effectively, errors are caught earlier, and the work environment becomes healthier for everyone. Building psychological safety within dental teams represents a strategic opportunity to improve patient safety, quality of care, and workforce well-being at the same time. By fostering environments where every team member can speak up, dentistry can move beyond reactive compliance towards proactive learning and resilience.
Alex Bush is a PhD student in the Industrial-Organizational Psychology program at Colorado State University, where he is also an Occupational Health Psychology trainee at the NIOSH Mountain and Plains Education and Research Center. He holds an M.S. in Industrial-Organizational Psychology from St. Cloud State University and has prior professional experience in workplace training and health and safety consulting. His research focuses on employee well-being across the lifespan, with particular emphasis on aging and older adults in the workplace, as well as the physical and psychosocial health and safety of dental professionals.