What will your next dental operatory look like? You probably already have the vision dancing around in your head. Perhaps the overall look and feel you want to present to patients is homey, cozy and friendly. Or you may wish to convey a high tech, sterile environment. Whatever the vision, if you are an associate about to strike out on his or her own for the first time or an old pro with an operatory in need of an upgrade, here are some of the issues you should consider before you purchase new equipment.
Explain the dream
The better you can explain your vision to your dealer or manufacturer, the better they will be able to assist in creating your new operatory room. Questions you should be able to answer range from: “What kind of perception do you want your patients to have about your operatory?” to “What kind of delivery do you prefer?” and “What is your most comfortable work position?” (i. e., at 12 o’clock, 11 o’clock or 1 o’clock) “What elements of your current operatory do you want to keep and which do you want to eliminate?” suggests PaulaVogel, a spokesperson for A-dec Inc. The closer you come to explaining your desire for the operatory, the more likely you will achieve the dream.
Examine the space
When searching for a new office, you need to consider more than just the location. Purchasing or leasing a space that is already a dental office is ideal, but not always possible. When starting from scratch, there are several things to keep in mind for your operatories before you sign on the bottom line. Where is the plumbing or how easy will it be to plumb the space? Are the floors even enough to install patient chairs? Where are the windows? Is the ceiling strong enough to hold dental lighting or will it need to be reinforced?
Ross McCallum, national marketing director of Patterson Dental Canada tells the story of a dentist-friend who became excited about a space he found to purchase. “He said the price was right and he wanted to purchase it right away,” McCallum says. However, the location was a former gas station. “I told him unless it was offered for free, it wasn’t worth it. Cleaning up [the underground gas tanks] would have been an exorbitant cost.” McCallum adds that dental equipment dealers are willing to go to a location with you to determine if the space in question is appropriate for a dental operatory. Although this case may be extreme, it drives home the point that choosing the right space is critical.
Consider the size of the operatory rooms
Operatory rooms are getting larger, notes John Caise, an equipment manager with Henry Schein Canada. He says operatory rooms have traditionally been nine feet by ten and a half feet. Today, operatories are usually 11 feet by 12 feet, although hygiene rooms may be slightly smaller. Dentists are also using operatories as one-stop shops, from taking the digital X-rays to performing the required treatments, all in the same room. More procedures in the same room requires a larger space to accommodate the various equipment. But you must ensure the equipment reaches the patient. Wall-mounted lighting still has to reach the patient chair, and the chair may need to swivel to reach an X-ray, for example. “Cords have to be longer too,” notes Caise.
A place for everything… and everything in its place
Pierre Hunter, national equipment & technology director for Patterson Dental Canada says a current trend for dentists is to have neat and tidy operatories. “They don’t want thousands of items sitting on the countertop, they want the technology integrated into the cabinets,” he says. Or, quite simply, that there would be a place for everything and that everything would be in its place. Dentists often see 10 or more patients a day. “The experience of the first patient should mirror that of the eighth patient and so on,” Hunter says.
Yanic Desrochers, a district sales manager for Planmeca Inc. says dentists like cabinets with lots of drawers. As a result, many dentists are shifting to cabinets with hands-free sensors to eliminate the need to touch surfaces, limiting cross-contamination as much as possible.
Dentists should also consider which positions they prefer when performing treatments. If, for example, you prefer to be in the 12 o’clock position, you should ensure that there is ample space between your cabinets and the patient chair.
Beware of residential cabinets
While residential cabinets may seem like a bargain for the dentist on a redesign budget, Peter Jugoon, vice-president of marketing and planning for Henry Schein Canada, offers a caution. “Those cabinets aren’t built for the wear and tear that dental equipment is built to handle,” he says, adding that dental cabinets are built like a tank, whereas residential cabinets will likely wear out in six months to a year. Also, standard residential cabinets are 24 inches deep, but dental cabinets are 20 inches deep, a factor that must be kept in mind when designing your new floor plan. Dental cabinets are also laminated on the inside, limiting banging of drawers. The extra lamination also further prevents water damage. “Water is the enemy in a dental office,” notes Caise.
As bright as you need and no more
Dr. Lance Rucker, chairman of operative dentistry at the University of British Columbia, says some dentists will crank lights as high as they will go, but “this can shut down the iris and cause eye strain.” Instead, you should use “as much light as you need to do the job at hand and no more,” he suggests. He adds the light should be uniform, without shadows, and must fill the width of the oral cavity when the patient’s head is turned 45 degrees to the right and 45 degrees to the left. “If they understand how to make the equipment work optimally for them, rather than working for their equipment, dentists shouldn’t have to touch the light again once it is set for a given procedure,” Dr. Rucker explains. “However, often the light is moved again and again.”
Light mounting options include wall or cabinets mounts, ceiling mounts and chair mounts. Wall-or cabinet-mounted lighting offer great stability, have fewer surfaces to clean and can fold away when not in use. Ceiling lighting also offers great stability and have a smaller area to clean, but your ceiling must be able to support the lighting. Chair mounted lighting is the most economical choice, but also offers the least stability. “If the lighting is unit-mounted and the patient moves around a lot, this may cause the light to shudder a bit, which can be very distracting,” says Tony van der Made, Canadian manager of Sirona Dental Systems.
Have a seat
The patient chair is where the clinical work all happens. In the past, Dr. Rucker says chairs were more esthetically pleasing than functional. “It’s quite critical that the chair can be placed fully supine,” he notes, adding that working at a partial supine can lead to musculoskeletal injuries for the clinician. How low the chair needs to go depends on the operator’s height. The lower the chair can be positioned, the better it will accommodate shorter members of the dental team.
A solid headrest is also needed. Dr. Rucker says the headrest needs to be able to comfortably support and articulate the patient’s head so that the maxiallary plane can be positioned 20 degrees to either side of vertical — a motorized headrest is best. A thin but sturdy backrest is also ideal as you will need enough room to position your legs under the chair.
Consider your own stool
After considering what you need to provide patients with an ergonomically correct chair, don’t forget your own seating. Caise notes that the most forgotten element of the operatory is usually the dentist’s stool. “Dentists will spend thousands of dollars on patient chairs, but they don’t spend a lot of time or money on their stools,” Caise says. “Consider all of the back pain and carpal tunnel syndrome that dent
ists develop. Finding the right stool is critical.”
Maintain the equipment
While you hope your dental equipment will not have any problems, maintenance and service calls are sometimes unavoidable. “Make sure you buy your equipment from a company that has a good reputation for service and support,” says van der Made. Ask the dealer what its typical service response time is and make sure that is in line with your expectations.
Plan for new technology
Yanic Desrochers says the future of dentistry will include dental units that have their own IP (Internet protocol) address and will be connected to the Internet for remote maintenance checks. “It will be similar to when you bring your car into the dealership for a diagnostic and the mechanic hooks it up to a computer,” he explains. “Everything will be computer-driven. That’s where the future is headed for managing the dental unit.”
In the very near future, Dr. Rucker says ergonomic software will drive intelligent furniture, allowing dentists to preset preferred positions for lighting and chairs. “That will be available in the next two or three years,” he notes.
McCallum also notes that only about 6% of dentists have CAD-CAM systems in their operatories, a statistic that is likely to grow now that several dental manufacturers offer these systems. “We don’t know what the future holds,” he adds. But one sure thing is that some dental equipment, such as your cabinets, patient chairs and lighting, will likely outlast current dental technology. Have a plan that allows you to easily upgrade as the latest technologies become available, should you wish to do so.
Do your homework
Dental equipment for a new operatory — or to replace an outdated one — should be carefully considered. The environment will explain to patients who you are and what you stand for. You can’t plan a whole new office in a few minutes. It takes some pre-planning. “Visit half a dozen dental facilities to see how your colleagues have upgraded,” suggests McCallum. “Also take a look at dental office design web sites to find what you want.” The more effort you put into choosing your new operatory, the more likely you will achieve your ideal work space.
