Objectives: Oral health care nowadays requires teamwork: dentists working with colleagues, dental hygienists, assistants etc. Although procedures differ between practices, different team-members will be involved in providing care for a patient. General opinion is that the dentist should be the director of care. Little is known however about the nature of ‘directing oral care'. An exploratory research-project was undertaken to identify current methods of directorship by dentists in group practices. Method: An item list for interviews was derived from 4 theoretical general types of leadership. A dentist and a dental hygienist were independently interviewed from different group practices. Each interview was recorded and transcribed. Interviews were held until saturation: no more new aspects of directorship were identified. From the transcriptions and in relation to general impressions of the nature of directorship in the group practices, (a) directorship in oral care and (b) key criteria to identify the ways directorship, were described. Results: Following interviews in 5 practices no further new aspects of leadership were elicited. Four theoretical types of leadership were identified in oral care. Differences were seen relating to various areas of directorship: from business-aspects only to all aspects of practice. Additionaly differences were seen in the way directorship was carried out: from enforcing to facilitating. A list of key-criteria was found, which can be used as a scale to describe directorship and to discriminate between different types of directorship. The scale was applied to 2 further practices and was found to be useful.
Conclusion: Directorship by dentists in oral care differs, but is mostly related to differences in general leadership style. Interestingly not only the nature of directing, but also the area directed were discriminatory factors. The resulting scale needs further testing, but has great potential for use in research related to effectiveness and efficiency in dental teamwork.