Patients judge the dental service they receive by the interaction with the service providers-the dentist and his or her staff-as they are unable to judge the technical quality of the service. To perform well as a service provider, employees such as dental nurses have to be well motivated and satisfied with their position. A study of the role of the dental nurse in contributing to service quality in dentistry was carried out through interviews with dentists and nurses at 20 dental practices in the South Thames region in 1995. The results revealed that while dental staff believed that the role of the dental nurse was important in terms of the patient's view of the practice, perceptions of the nurse's role differed. The majority of dentists felt that the nurse's role should be to anticipate their needs, while the nurses' opinions were evenly divided between putting the needs of the patient first or those of the dentist. Nurses also felt that their role was stressful and reported a lack of praise and recognition of their efforts by dentists. Few practices had written contracts or performance appraisals. The results indicated a lack of effective communication in many dental practices, producing role strain for the nurse and reducing job satisfaction. Increasing job satisfaction reduces staff turnover, resulting in more consistent service quality and reducing associated costs. In order to achieve this, several recommendations are made with the aim of improving communication between staff in dental practices.