Governance residue - Changing the emotional afterlife of regulation

We have committed to significant change and improvement in our new strategy 2026-2028. Our vision is to be a trusted and effective regulator, supporting dental professionals to provide safe and effective care for their patients.

We want to work collaboratively with dental leaders to jointly address key issues affecting the sector. This includes providing platforms for discussion.

Central to our new approach is a commitment to tackle the climate of fear in dentistry. In his blog below, Amro Alkado, Dental Practice Advisor with NHS Grampian and NES Vocational Training advisor based in Aberdeen, discusses the theory of how fear stories move faster and last longer and how only a long-term commitment to creating more positive experiences can tackle the climate of fear.

Fear inherited

A final year student recently told me: “Everyone says be careful…you don’t want to be referred to the GDC. You never know what they might do.”

This student was still in high school during the period when the GDC's reputation was at its lowest, with rising fees, hostile headlines, and unprecedented professional scrutiny. They may have only glimpsed the headlines, or perhaps not noticed them at all. But fear travels. By the time they entered dentistry, the echoes of that difficult era had already reached them, carried forward in corridor conversations and the cautious advice of mentors.

Residue vs Debt

Every system leaves a trace. In regulation, that trace is more often found in the feelings left behind than in the policies written. I call this emotional afterlife of regulation Governance Residue.

It differs from Governance Debt, which I have described elsewhere as the structural buildup of rules, approvals, and processes that weigh a system down.

Residue, though subtler, is no less damaging, and its effects are concrete:

• It drives defensive practice: Notes become shields and decisions are guided by imagined scrutiny, rather than just professional judgement.
• It corrodes psychological safety: When mistakes are feared as punishable, professionals become hesitant and silent. Risks rise when people stop asking for help or speaking openly.
• It distorts progress: Silence is mistaken for success. But residue settles quietly, ensuring that years after reforms, students still inherit the warnings of their predecessors.

I’ve felt the reach of this residue myself. Colleagues and close friends – from medicine, education, dentistry and beyond – have warned me to be careful with what I write in blogs or on LinkedIn. Their tone is always protective, but beneath it sits the same inheritance of fear: the sense that openness is dangerous, that words can be used against you. That caution shows how residue extends beyond formal regulation. It seeps into professional cultures, narrowing the space for honesty, reflection, and shared learning.

This is why cultures of fear are so hard to shift.

Fear endures

Residue is persistent because fear stories move faster and last longer than positive ones. Psychologists refer to our tendency to give more weight to threats than comforts as negativity bias.

In evolutionary terms, remembering danger kept us alive. Forgetting where the sweet berries grew was inconvenient; forgetting where the predator lurked was fatal.

That same bias shapes professional life. A single bad encounter with the regulator can echo for years, while positive experiences of proportionate handling, humane contact, and fairness take far longer to spread. It may take several good stories to outweigh one fearful one, because fear fits more neatly with the survival wiring of our brain.

This is why residue cannot be cleared by reassurance alone. What begins to shift the balance is not messaging but new experiences, repeated often enough to become stories worth sharing.

Regulatory reality

No regulator can ever be cosy. That is the structural truth of the relationship, one defined by the Dentists Act 1984; a prescriptive, stifling, and long-outdated legislative framework established before the vast majority of today's registrants had even begun their careers.

The GDC holds powers that affect people’s careers and livelihoods. That asymmetry of power will always exist, and it is right that public protection comes first.

But within that reality, there is still enormous room for choice. The tone of the first contact, the clarity of a timeline, and the predictability of a process are not cosmetic details. They are the things that decide what stories people tell afterwards.

If the experience feels opaque, unpredictable, or harsh, the story that travels is one of fear. If the experience feels proportionate, human, and clear, the story that spreads is very different: “I was treated fairly, I was kept informed, and I understood what was happening at each stage.”

This is the opportunity for the GDC. To acknowledge that a residual reputation exists, a shadow inherited from a more difficult era, but also to show that reputation is not destiny.

Trust anatomy

Fear doesn’t fade with slogans or rebrands. It fades when real experiences change. The cycle is deceptively simple to outline, but much more challenging to act upon:

Experience → Emotion → Story → Transmission.

People retell how they were treated, not the words of a strategy document. Therefore, the most critical work happens at key touchpoints, including:

• First Contact: The opening contact is where fear spikes. A clear, proportionate, human touch can shift the narrative from the start.
• The Wait: Long silences amplify anxiety. Predictable timelines and consistent, proactive communication signal that people have not been forgotten.
• Closure: A dignified, timeous, transparent closure becomes the seed of a story that spreads confidence.

If enough of these moments are handled well, fear stories get interrupted and later replaced by better ones.

Amplifying positivity

If fear stories spread quickly and organically due to negativity bias, then positive stories require assistance to travel further and faster.

Psychology once again gives us some deliberate amplification strategies:

• Let Colleagues Be the Messengers: Social proof means that a peer saying, "I was treated fairly," carries more weight than any press release or strategic document.
• Make Relief Contagious: Emotional Contagion means the feeling of relief and fairness spreads. The story "I was treated with dignity" doesn't just inform; it helps others feel safer.
• Manage Peaks and Endings: Behavioural research shows we remember experiences most vividly by their peak and ending. This is known as the peak end rule. Ensuring these are handled with humanity and clarity defines the entire story.
• Acknowledge the Past: Social psychologists talk about reciprocity; when organisations acknowledge past wounds honestly, people are far more open to believing that things have changed.
• Affirm Professional Identity: Professionals will retell stories that showcase their competence and integrity. Give them a positive one, and they will share it.

Together, these approaches do not eliminate negativity bias, but they can help reduce the lag it creates. They allow positive experiences to ripple out more quickly, so that the profession does not have to wait a decade for better stories to take root.

The redemption arc

In recent years, the GDC has taken essential steps, including changes to fitness to practise, a stronger focus on prevention, and more transparent communication.

Yet, the feedback I hear and the experience I regularly see in my own advisory work is unambiguous: processes are still too slow, communication breakdowns remain a common and distressing theme, and the profession craves more upstream involvement to prevent issues before they escalate.

The challenge now is to accelerate this progress with tangible urgency. Every humane first contact, every proportionate decision, and every respectful closure plants a new story in the profession. Each one is a counterweight to the folklore of fear.

That is the redemption arc. Not a rebrand or a campaign, but a long-term commitment to creating experiences that allow a different story to be inherited.

Closing reflection

Residue will not vanish on its own. Fear has a half-life measured in decades, and it will continue to pass from mentor to trainee unless something interrupts it. Every contact is therefore more than a case; it is a legacy.

What the profession inherits tomorrow depends on the choices made today: to keep passing down fear, or to leave behind a residue of trust.