‘Courageous Followership’ in Your Dental Practice

By Lexi Marino January 25, 2021

In this episode, we caught up with Dr. Kelly Tanner, RDH, PhD owner of Kelly Tanner Leadership, and Next Level Dental Hygiene Leadership to understand the purpose of “courageous followership” and how it allows for better enjoyment at work for the dentist and their team.

Watch this video to learn the following:

  • How leaders become great by learning to follow their employees
  • Importance of dental isolation tools to keep teams safe from viral infection
  • Why big changes at your practice should be made as a team

Rolando Mia, from Zyris, is the host of our series, Dental Voice. In this show, we focus on the latest news, topics, and conversations happening in dentistry and assess differing views across the nation. In Season 2, we’re focused on, “What’s Working and What’s Not”, where we’re debunked myths by assessing trial and error since the start of Covid-19.


Rolando Mia: Good day, everybody. Welcome to Dental Voice Season Two with Zyris. Dental Voice is about hearing from clinicians, specifically the experiences that they’re having, understanding things that they’re experiencing, and also getting advice based on real experiences.

Today we have Dr. Kelly Tanner. She studied at Old Dominion, is a PhD, a former Associate Professor at Thomas Nelson Community College, the formal coordinator of the SACSCOC accreditation, Adjunct Professor at Old Dominion University, professional education at Phillips, and owner of Kelly Tanner Leadership, and Next Level Dental Hygiene Leadership.

So with that, good morning, Dr. Kelly Tanner. Welcome.

Dr. Kelly Tanner: Good morning. Thank you so much for having me. It’s such an honor.

Rolando Mia: When you consider everything that’s going on with COVID, what are you’re seeing about this as it relates to the dental office, the team, and then the hygiene team?

Disruptors Are an Opportunity For Change

Dr. Kelly Tanner: Yeah, thank you. Great question, because obviously COVID has affected all of us and will continue to do so. So it’s not just about dealing with the now. It’s about how we look ahead in this and try to determine what really our supply chain looks like, the obstacles that we’re going to come up against, and opportunities, also.

I think that all of us can say, of course, this has been a difficult time and in many layers of our life, but what I have found is that there’s been a lot of good that’s come out of it, as well. Any big disruptor gives the us opportunity to change and grow, just like with leadership, just like with, I mean, think about the first car. Think about technology. Think about, I mean, anything. We have gotten so accustomed to being, we have to be in person. We must do things like this and slotted in utilizing different formats and different styles now is a great opportunity for us. So I say, let’s look at the other side of the opportunity and see what these disruptions really offer us.

Rolando Mia: So I love the context. You’re right. Disruption forces us to have to get out of our normal, right? And because of that, all of a sudden, we’re out of our comfort zone and we’re having to do with lot. We’re hearing so much in the dental practices. They’re having to change. The biggest issue right now is the change that everyone in the dental practices is having to deal with. PPE, processes, engagement. What are some of the thoughts around change that you could share with us for people going through that and how they interact with each other?

Have the Courage to Be Vulnerable With Your Boss

Dr. Kelly Tanner: Yeah, that’s a great question because there’s been a lot of that, of course, emerging back into the workforce, there was a lot of anxiety and we didn’t know what was going to happen. And, you know, I guess you would call it the fallout, the transmission rate would be even if, even knowing what we knew at that time, what it was going to be like until we did it, until we actualized that into where we are now.

And so I think now we’re comfortable in our zone but now there’s still opportunity for growth and where we’re seeing the opportunity with this disruption is the communication in the offices and how that transparency between all of those team members can really help strengthen that team.

You have to be open and vulnerable to really ask for what you need. And then also the team as it relates to the dental hygienists and the assistants, all of them are leaders in their practice. You know, they’re looking to the doctor for, “What are we doing now? What are we doing to overcome this obstacle that could be an opportunity? How do we get masks? How do we get the plastic containers?

What does this look like when we can’t get the wipes that pull out of the canister that are on back order, infinitely and perpetuity? I mean, what are we doing?” It’s an opportunity for that practice manager to really explain, to say, “You know, here’s what our plan is and to say part of it is also that we don’t know.”

That honesty, it’s kind of like I said in one of my videos, when you’re at the airport and your flight’s been delayed, right? You’re always looking at the big board to say, “Okay, when is my flight going to be? What’s the new flight departure? What’s the new flight departure?” And then as soon as it comes up, you can get on with life. But until that time, you’re just hanging in limbo.

So, I think the better the communication, the better. The questions and the ability for that practice leader, for that dentist, owner, or even the hygienist who is leading their team can answer those questions to really get to the why and what the anxiety is about to then fold it back into, “Okay, here’s our plan. Here’s our plan for now. It may change next week, but here is our plan for now and this is why.”

Rolando Mia: See, I love the context around that. Open communications, candor, directness. How do create the courage to speak up? To be able to go up to your dentist and say, “Hey, I need to talk to you.”

Courageous Followership: What Does This Mean?

Dr. Kelly Tanner: Yes, and I think this kind of folds into one of my favorite topics. I’ll try not to go too far in a rabbit hole, but courageous followership. And we hear a lot about leadership, but we don’t hear a lot about followership.

So in a practice, we have traditionally thought of the dentist as the leader, the owner, you know this is going back 25 years ago from where I grew up in this industry, 27, maybe 30. So going back that far, you’re thinking of the dentist as that leader and you’re going to them saying, “Okay, what are we doing? What are we doing?” And then sometimes it’s just like, okay, if I’m not being heard, then it shuts off that line of communication. So those followers give power to that leader, though.

And unless they bring up that opportunity for conversation, the leader never knows what is really going on. But really, you can’t be a leader without followers. So it’s a symbiotic relationship where those followers, which are the rest of the dental staff, have to ask questions. We have to engage in that dialogue. It’s a responsibility that we have to the office, to our patients, and for our profession.

Rolando Mia: I like that. A leader needs followers. But something I also took out of what you were saying, which is to be a leader, you also have to be able to follow. And I think that’s something that I don’t know a lot of people fully would fully embrace, you agree?

Dr. Kelly Tanner: I agree. And one of the reasons why these dentists or whoever’s hiring these professionals who work with them is because they’re talented folks. And so one of the opportunities I see with the offices I work with is stepping back and saying, “here’s our challenge. Let’s get together and let’s hear all ideas of, you know, here’s what we’re up against. Here’s our challenge. Where is our opportunity? What types of ideas do you have? Here’s what we’ve thought about. Here’s what we’ve done in the past and here’s what we’re going to try. Talk to me.”

So, that input of that followership and some people may be more of the bystander but maybe they’re the glue of the group that holds it together who can come in and offer some suggestions. But I think the “we-ness” starts there because it’s about the we in the practice and the patients feel that.

Rolando Mia: So the context is huge. When people become stressed, it’s here with us forever.

So what advice or how would you, what would you tell people who are stuck in the “I have no idea what to do” mindset?

Asking For Help

Dr. Kelly Tanner: Well, I think you have to ask for help and that’s a part of why people follow you because you tell the truth, you’re a truth teller. And I think that’s important for both sides of it. Really keep that open dialogue, it’s the openness of a leader. And that ability for that and that room, that leader, that follower, or that employee to step into that space to be able to connect and come up with that solution.

Rolando Mia: Yeah, I could see that because right now, I would venture guess virtually nobody knows what’s going on. So the more, the better and the more dialogue, the better, I think, too. And as you were talking, it makes you think as a dentist or even the person, the lead, whatever, in the practice, you can’t do it by yourself. So reach out, ask for help. And then I guess be open, which is pretty cool, right?

Dr. Kelly Tanner: Yes, and so it’s really figuring out what the anxiety is. If a person’s kind of retracted from a group as you can tell something’s wrong, the practice owner or whoever is interacting with that individual, it may be the assistant, it may be the doctor, whoever has the closest relationship to go to them. It’s just like in any other relationship. “Hey, I sense that something’s distracting you. I sense that…”.

So give them an opportunity to talk about the stressors in their life, what obstacles they are facing personally, because they do, we all have these. I don’t know, in Virginia where I am, in the locality that I’m in, we’re all doing the nine-week homeschooling sessions. And so it’s like, is everybody on, are we good? I mean, there’s a lot of that going on at home for folks who are having to struggle with all that. So it’s all the little things that add up to the big things that affect patient care that they need to know that their doctors and their team care enough about them to notice, to say something seems off. How can I help you?

Rolando Mia: What are some of the things that you’ve been seeing with regard to the hygienists out there who are still feeling maybe apprehensive of going back to work because of COVID-19 transmission?

Understanding Your Employee’s Anxieties

Dr. Kelly Tanner: I think there’s a lot of opportunity there to understand, too, what the anxiety is really about. Is it about that they think they’re going to contract it? Because there’s a lot that we can do by isolating the areas, by putting on all the proper PPEs, the protocols. And then also, it disrupts their flow of care if they have to do something different because now, you’re having to rinse with the stuff and then ask different questions and make sure that they’ve got this form filled out and the temperature.

So it’s all these little disruptions that people were not used to, and they didn’t have to really account for in their care. But what a lot of offices are doing, the offices that I coach do and consult with is they’ve actually lengthened those appointment times and they’ve implemented an assistant so they can take care of same-day care while the patient’s already there, the operatory’s already there, if there’s active infection, to be able to do that and then have the tools that you need such as isolate the areas like with Isolite® or Isovac®. Of course, y’all’s products are the Cadillac in everything.

Then also getting them comfortable with that training to say, “Here’s how you use it. Here’s how you work it into your workflow.” Because that also could create anxiety. So be chairside with someone who can, whether it’s a representative or I’m not sure of your structure, but you know, I’m a consultant and I’m a dental hygiene coach. So I’m coming into the operatory. How about at this time, if you tried doing this, what about if you stop right there? And then it’s usually, “Yeah, I can do that. That actually makes sense that I can do it.” So talk them through their processes and have it be their idea based on their processes.

Rolando Mia: Education is huge. We’re hearing that sometimes new technology, new systems are basically given to the teams and said, “hey, you got to do this.” And then they’re kind of left to their own devices. So the message about take the time to educate, take the time to understand, I think is huge.

Do you feel that there is a fatigue that teams are facing? A lot of practices have been operating the same way for years, 10, 15, 20 years, and all of a sudden now it’s changing. Do you think that change fatigue is causing some of this?

Change Fatigue Brought on by COVID-19

Dr. Kelly Tanner: It’s a real thing and it’s not just the dental practices changing. It’s all the external environments that are changing that you have to keep up with and manage and try to figure out that you’re bringing in to work.

What the hygienists do that I work with is they say, “Kelly, I am running behind because of this. Could I have a 20-minute gap here where the assistant is doing something else?” Or we troubleshoot it. It’s a conversation of, tell me what you need. That’s always what, tell me what you need. Tell me what you’re feeling. We’ll work through it. If you need 20 minutes to catch up with your notes, if you need to be staggered, if you need to come in 20 minutes late, because the hygiene care system that you have set up to do a lot of same-day care, we’ll take care of the rest for the production and the office to make sure that it’s covering three times the hygienist salary because that’s what a lot of the practice providers are thinking about.

If you’re taking care of your people, they’ll take care of you. But the change fatigue is big. And I think that, and I don’t know about you, Rolando, but I know that I felt it and I’m not even in the clinical operatory every single day. It’s just coming out of the, it’s kind of like a cocoon of COVID and saying, “Okay, here’s all the things I have to adapt to that have been disrupted.” But that’s really an opportunity for growth. And I think it has strengthened a lot of teams because you know what our teams say, “I never realized how much this practice cared about me.”

Rolando Mia: Unfortunately there are practices where employees feel like they are not cared for. What do you do then?

Your Employees Need to Feel ‘Cared For’

Dr. Kelly Tanner: There’s usually a lack of communication. It’s just like any relationship when you feel like, because if you don’t understand why decisions are being made, you build resentment and it’s got to be that radical candor, being able to have that conversation.

So, it’s better to just talk about it and be transparent, to say, “Listen, this is what I’m up against. How do I overcome this and what do I have to support me?” I hear that every day, “Kelly, this isn’t working. I’m not able to do this.”

Taking care of your team and for them to feel like that they are cared for is really going to be, you know, it gets them past those little humps in the day where they feel like they’re so, you know, they feel like they can’t overcome it. They can’t, and it’s that you can do it, we’ve got this attitude that you’re building in the background for them and with them.

Rolando Mia: I love that. Thank you for that. I really appreciate it. Again, it’s getting the courage to just be honest, be genuine, and express that.

I believe, too, that a lot of times, the dentists feel the pressure that everything is sitting on them. So they’re like, leave me alone, when in fact, they also need to reach out. So it’s kind of, that’s pretty cool. I love the message. Let me ask you this. Infection control, the issue of using the Cavitron, and I want to, I’d love to get your perspective on this. Initially guidance was, “Ah, you got to do hand scaling. No more Cavitron. No more ultrasonic instruments, nothing like that.” What are your thoughts on that?

Using High-Speed Dental Tools in the COVID-19 Era

Dr. Kelly Tanner: Yeah, this is a topic of conversation and I’m sure that, you know it’s, yeah. It’s the tipping point, right? On I think the person’s got to make the personal decision for themselves of what they’re going to do.

So I graduated from hygiene school from Old Dominion University in 1996. And at that time, we were taught to only hand scale and only use that ultrasonic if you really needed to. So I thought I was a wuss if I used an ultrasonic scale. I’m just telling you, okay? I thought I was a wuss.

So then growing up and evolving and learning about how it disrupts the biofilm and how much more effective it is with the lavage and the disinfection, all of this, all of these things, there are people who say if you’re not utilizing it, you’re doing substandard care but if you are, it puts them at risk.

So I mean, I am of the belief and this is my opinion, okay? This is my opinion based on evidence and what we know about COVID right now today and then what we have for the isolation, disinfection. I say use your Cavitron when you need it for active infection. If it’s a localized area, use it for a localized area. If you’re doing a scaling and root planing, do not put that off. That infection is in the body. It’s an oral systemic leak. And it’s even more important now because of the inflammatory process it’s provoking within the body with COVID. So it makes them more susceptible for it.

I think we need to use it where it’s indicated. Use your Isolite, use your Isovac, use your other systems that you’re using and then your HEPA filters. We make sure that they are in all the operatories where Cavitrons are being used and protect yourself. Use like you did, like you learned in hygiene school. Wear your gowns. Wear all your garb, that you were supposed to be doing anyway. So protect, use what you know, do what you know to do, what’s effective for the patient and it’s fine. It’s science. We’ve got it.

Rolando Mia: Well, it’s science, we’ve got it. Right on.

Dr. Kelly Tanner: It’s science, all right? I mean, if you’re taking all the aerosols out, you’re protecting yourself and the next patient. You’ve disinfected the oral cavity with the hydrogen peroxide rinse. Where are we missing this?

Rolando Mia: And what’s the good news, though, is the fact that when you look at the number of COVID cases, dentistry is not the super spreader of it and it’s really good to hear that in our industry, you’re not seeing massive cases coming out of dentistry right now. So yeah, it must be. It definitely is working, I’m going to say.

Feeling Safe In Your Work Environment

Dr. Kelly Tanner: I feel safer at work than I do anywhere. I mean, other than my own home. I really do, because of all the protocols we have in place. That’s one of the safest places to be, in my opinion.

Rolando Mia: That’s cool. That’s so cool. So you teach, you’re a professor. What advice or what feedback would you give people who are considering entering into the profession of hygiene?

Dr. Kelly Tanner: Dental hygiene is one of the best professions in this world. I love it. You can make such a difference. You can show and do your clinical work and if that’s all you want to do at the end of the day, you can do that. But the opportunity to learn, grow, impact at different levels and change people’s lives there’s still that opportunity every day as well. You know, just like HIV, we did not know, hepatitis B, we didn’t know what we didn’t know, and we learned more about it. And every day, we get closer to an answer.

So I say, follow your dream. The rest will take care of itself. You are protected in the meantime. And you know, you’re going to come out on the better side of this and it gives you an opportunity to be a change agent, a change leader in your industry because you have been through that experience.

Rolando Mia: Oh, I love that. A change agent, a change leader. We’re going to get it. Right on.

Got this. Science, man, science. So had you always wanted to be a hygienist, or you know, you have passion, you have energy. Did you want to do something else?

Finding a Sense of Purpose in Dental Hygiene

Dr. Kelly Tanner: Oh, gosh. You know, ever since I was 17 and I was a sterilization assistant in the office and I had a really close relationship with my hygienist and I remember the first time I looked in the patient’s mouth, I was like, “Can I assist you to do the probing?”

I realized that it really fit what I wanted to achieve. I knew I had a purpose. I knew that I was a servant. I knew I had gifts to serve. And it seemed like there was a huge amount of opportunity. And so, yes, I mean, the dental industry, maybe I would go back and be an orthodontist. I don’t know, because they have pretty cool job with changing people’s overall everything, but dentistry is where it’s at.

Rolando Mia: And then what’s awesome, too, is you practice as a professional hygienist, and then you decided to go ahead and get your PhD. What was your dissertation?

Dr. Kelly Tanner: It was, that’s a long title, but basically it was looking at what dental hygienists wanted, felt like they wanted to develop leadership, like what they thought that was important to them in all the different seven roles of a dental hygienist.

So I looked at, it was a composite study, and it was rank ordered. So everybody in each group looked at, I said, okay, what do you think the most important leadership skills are? Okay. They are, you know, communication. This is for all the educators and then the clinicians and then the researchers answer this. Okay, now how do we go about developing those? And then they rank ordered and then I brought them all together and I said, okay, what are the number one, the top five rank order that you feel like that hygienists need to be leaders?

Because we have such an understudied area of leadership in dental hygiene. You know, you look at nursing and they have books and even dentistry. I think it’s valuable for us because leadership just as it stand alone, it weaves into all areas of our life. And the number one thing that all hygienists said that we need to learn, communication. So it’s about listening. It’s about being a courageous follower.

Also, there are ways to go into offices to offer assessments of how people are communicating. It’s like a profile assessment of how you fall into which category and then how you communicate the hotspots that you’re like, “Oh, that’s why it ticked me off when they say it like that because I’m this letter and they’re that letter.” But then it also translates into how they’re able to talk to their patients because usually once you take this assessment, and it’s like, “Oh, I know Rolando’s an S. He’s an S all day long. What do I know about S’s? He’s a stabilizer, he’s all these things.” You can start to identify that in your patients and then you can change the conversation, so.

Building Team Comradery Through Courageous Followership

Rolando Mia: That is cool. I really appreciate you taking the time. If you were to give a summary, for our listeners, what’s kind of the message you’d like to get out to the community?

Dr. Kelly Tanner: Sure. I think that in this, I think there’s a lot of grace that needs to be given to everyone and the opportunity to be heard on both sides and respectfully, you know, but for that follower to step up and ask for what they need, give ideas, ask about where you are in the process. How are we getting ahead of this? How are we going to remain employed during certain aspects of this?

You know that openness, that vulnerability that has to occur between the teammates and then encouragement also between teammates as well to say, “We’ve got this. How can I support you?” And then work on your communication. If something is really… It’s what people don’t say, right? That you pick up on. It’s not always what people say. So what are they not saying that you can pick up on?

Come to them with compassion and then also give people opportunity to offer advice to you and be open there because we’re all going through a disruption and that disruption is room for growth in all of us. And we all have room to grow.

Rolando Mia: That is cool. Thank you. Thank you so much for that.

Dr. Kelly Tanner: Thank you, Rolando.