For over twenty-five years. dental education has had the benefit of environmental analyses and institutional planning for change. Strong programs for leadership development have emerged to give direction to these efforts. Leading and thriving, not merely surviving, are universal aspirations, yet we remain vexed by finances, structures, and traditions.This article takes a look at change and examines the difference between technical frameworks for leadership and adaptive leadership. Leadership for change is viewed as an activity. not as a position of formal authority. The skills necessary to address the beliefs, attitudes, and culture that place limiting boundaries on adaptive leadership are described. Using the work of Heifetz and Linsky, the relationship between authority and adaptive leadership is defined. Resistance to change is presented as reaction to loss, which needs to be addressed in a fundamental way, through leadership activity and engagement. If change and innovation are to be sustained, leadership must be less accidental. less technical, and more adaptive.