A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

The Sting of Exclusion

How to foster a sense of belonging and engagement in your dental office.


Only 21% of employees say they belong and are engaged at work. That leaves 79% who dont feel a sense of belonging.1 They are experiencing the opposite of inclusion the sting of exclusion.2 These employees are more likely to join the quiet quitters or become part of the great dental resignation. These folks are also more likely to speak poorly about your practice in person or on social media.1

According to the American Dental Association Health Policy Institute, 90% of dentists note that recruiting dental hygienists and dental assistants is “extremely challenging.”3 The following are common struggles experienced by front office managers: inability to attract qualified candidates to open positions, high turnover rates, decreased employee satisfaction, increased legal action, and reduced productivity.

If you have faced any of these challenges, it’s time to close the sting of exclusion by transforming your office culture into one of belonging. The following steps can help.

Define Your Culture

Creating an inclusive workplace starts with the leaders, practice managers, and the team followed by your organization’s systems, policies, processes, and vendors, then your patients and the community you serve.

The first step in developing a more inclusive culture is to assess the current culture’s ideological, interpersonal, and internalized assumptions, behaviors, rules, policies, or structures. The following questions are discussion starters for culture change:

  • What beliefs exist around what makes a good employee, manager, provider, or founder?
  • Regarding the implicit or explicit work group, policies, behaviors, and values, how do employees really treat each other? How does leadership really treat others?
  • How do employees feel about their presence in the office because policies, behaviors, and values shape their experiences?

Identify Exclusive Behaviors

Identifying exclusive and inequitable workplace behaviors is key to creating change. Following are examples of exclusive traits.2,4 Check which characteristics you have accepted in the context of practice, interpersonal, or internalized values and ways of being.

  • Perfectionism is the idea that if you make a mistake, you are the mistake.
  • Either/or thinking is the belief that things are either good/bad, right/wrong, with/against us.
  • Sense of urgency is the need for quick wins that often sacrifice intentionality.
  • Defensiveness is when people respond to new ideas with resistance.
  • Only one right way is the idea there is only one correct way to solve a problem.
  • Paternalism is the belief that only those with positional power can make sound decisions.
  • Power hoarding/power scarcity is the thought that power is scarce, and those in leadership feel threatened when anyone suggests changes.
  • Fear of open conflict is when politeness is used to deny people from being themselves.
  • Individualism is when competition is valued more than collaboration.
  • Objectivity is the belief that the workplace has no room for emotions.

Create a Path to Culture Shift

Now that you have identified exclusive traits within your practice, you are ready to clarify what kind of culture you want.

Rhodes Perry, the author of Imagine Belonging, has identified belonging characteristics that everyone can embody to transform their workplace culture. Here is a partial list:

  • Appreciation is when you value the contributions made by a colleague and you separate those contributions from any mistakes they may have made.
  • Intentionality requires you to center people and the process of developing trust.
  • Listen to understand, not respond.
  • Cross-cultural communication encourages you to consider diverse communication styles.
  • Trust means ensuring that colleagues know the decision-making process, what it is, how decisions are made, how it impacts them and the process, and their role in that decision-making.
  • Both/and thinking asks colleagues to develop more than two alternatives.
  • Power sharing means, at times, localizing decision-making.
  • Sonder is the recognition that each random person you pass is living a life as vivid and as complex as your own.
  • Psychological safety means centering the feelings and safety of those with the least power over the comfort of those with the most power.


Designing a workplace culture of inclusion  can improve recruitment and retention efforts, lead to more engaged leaders and teams, increase productivity and job satisfaction, reduce turnover, and build a positive reputation.

Platinum Rule vs Golden Rule

We trust our managers, leaders, and team members to treat everyone equally. Yet, whether explicit or implicit, in-group and out-group dynamics occur4 and not all employees have the same lived experiences at work.

When we’re committed to developing a sense of belonging, consider the platinum rule vs the golden one. The golden rule encourages you to treat others how you want to be treated. This approach completely dismisses the diversity of thought, learning styles, motivational levers, gender, sexual origination, age, ethnicity, religious and spiritual practices, abilities, and neurodiversity present in our workforce. The platinum role offers an inclusive alternative. It encourages treating others how they would like to be treated.5

This shift centers ALL employees and allows us to look deeper into relationships, communication, behaviors, processes, and culture through a lens of diversity, equity, inclusion, and belonging. Research from the JBC Inclusion Model shows that individuals whose behaviors fostered a feeling of inclusion and belonging in their workplace described feeling welcomed, being seen, valued, respected, and heard. These are the cornerstones of inclusion and belonging.6



  1. Gallup. State of the Global Workplace. Available at: gallup.com/workplace/349484/state-of-the-global-workplace.aspx. Accessed July 13, 2023.
  2. Perry R. Imagine Belonging. Hartford, Connecticut: Publish Your Purpose; 2022.
  3. American Dental Association. Economic Outlook and Emerging Issues in Dentistry. Available at: ada.org/​resources/​research/​health-policy-institute/​economic-outlook-and-emerging-issues. Accessed July 13, 2023.
  4. Okun T. White supremacy culture — still here. Available at: dismantlingracism.org/uploads/4/3/5/7/ 43579015/white_supremacy_culture_-_still_here.pdf. Accessed July 13, 2023.
  5. Economy P. How the platinum rule trumps the golden rule every tme. Available at: inc.com/peter-economy/how-the-platinum-rule-trumps-the-golden-rule-every-time.html. Accessed July 13, 2023.
  6. Brown JC. Practitioner program level 1 and 2. Available at: jenniferbrownconsulting.com/​courses. Accessed July 13, 2023.

From Front Office Magazine. August 2023; 1(8):8-9.

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