Professions exist to serve the needs of society and, in the case of the dental profession, patients. Academic dental institutions strive to help meet these needs by educating and developing future practitioners, educators, researchers, and citizen leaders who serve the community and shape the changing environment in which they provide care. As patient needs, practice patterns, scientific evidence, and economic conditions evolve, dental education must respond with self-assessment and innovation. Guiding any institution through authentic reform requires a number of strategies. Lee Bolman and Terrance Deal suggest four organizational constructs, or frames, through which to observe and navigate a complex organization: Structural, Human Resource, Political and Symbolic. This qualitative case study examines a major curricular reform initiative in a North American school of dentistry through Bolman and Deal's organizational frames.