The dental profession is in the middle of a staffing crunch that, by most forecasts, isn't going away soon. The ADA and the U.S. Bureau of Labor Statistics both project that the labor shortage could worsen before it improves, which means every dental practice is essentially competing for the same limited pool of qualified candidates. So what separates the practices that attract and keep great people from the ones that can't?
According to Alan Twigg of Bent Erickson and Associates, the answer starts long before a job posting goes live.
In this first installment of a new six-part series on the life cycle of the dental practice employee, Twigg joins DrBicuspid.com Editor-in-Chief Kevin Henry to talk about two foundational elements that most practices underinvest in: leadership and culture. Both, Twigg argues, are nonnegotiable in the current environment, and neither can be outsourced.
On leadership, Twigg pushes back on the idea that there is a single model worth emulating. The most common mistake, he says, is leading in a way that doesn't match your personality. Some leaders are systems-driven. Others are decisive and action-oriented. Others lead by consensus. All of those styles can work, but only when the leader is being authentic, not performing a version of leadership they've seen somewhere else.
Regarding culture, Twigg offers a framework he calls the "five-star average." The idea is that every interaction in a practice, whether it be between a doctor and team member, a team member and a patient, or colleagues with each other, functions like a silent rating. Culture isn't a mission statement on a wall. It's the cumulative result of those moments over time. And like physical fitness, it requires ongoing effort rather than a single intervention.
Twigg closes the conversation with three questions every practice owner should sit with honestly:
- How engaged is your team during meetings and huddles?
- Do your employees enthusiastically want to be there, not just show up, but are they genuinely invested?
- Does each employee, from the lead clinician to the front-desk coordinator, have a clear sense of their purpose and contribution?
"You will never find the time," Twigg says of investing in culture. "You have to make the time."
Watch the full conversation below, and listen to Twigg's Dental HR Podcast.




















