FSC ____________________________________________ ESS ____________________________________________ TSS ____________________________________________ CCS ____________________________________________ Lead Technician _________________________________ CAD Designer ___________________________________ OfficeDesign Workbook An Essential Step-by-Step Resource for Designing an Efficient Practice Build, Remodel, or Move 800-645-6594 Practice-BuildingOverview Create a business plan DDS ESS HSFS FSC TSS DONE Your Personal Tasks Equipment Sales Specialist Henry Schein Financial Services Field Sales Consultant Technology Sales Specialist Check as objective is completed • What is the mission statement for your practice? • • r • What is your practice philosophy? • • r Clinical • • r Patient Experience • • r Personal Professional • • r • • r Perception in the community/What kind of dentist are you? • Prequalify for available funds • • • r • Secure working capital • • • r • • • r Deposits and initial expenses • Develop a fee structure • • r • What are your growth aspirations? • • r What are your financial objectives? • • • r Revenue • • • r Expenses • • • r Capital budget • • • r Personal income/retirement planning • • • r • • r Transition planning: Sale of practice, associate/partner considerations • • • Is there enough space to meet your growth objectives? • • • r • Does it represent the type of dentistry you do? • • • r • Is your location optimal? • • • r • Is it ergonomically designed? • • • r • Is your equipment state of the art? • • • r • Does it create a positive patient experience that will • • • r Is your current facility consistent with your business goals? 2 make the discerning patient want to come back? Chapter 1: Practice-Building Overview DDS ESS HSFS FSC TSS DONE Your Personal Tasks Equipment Sales Specialist Henry Schein Financial Services Field Sales Consultant Technology Sales Specialist Check as objective is completed • • r Will you be satisfied with the outcome? • • r Is the space sufficient? • • r What will it cost? • • r What are the trade-offs? • • r Will it ultimately meet the vision/mission of your practice? • • r • • r Existing patient flow • • r Is it what you really want? • • r Assessing value of practice (Determining value of patient records • • r • • r • • • r • Bank/Financial Funding Specialist • • • r • Financial Consultant/Investor • • • r • Realtor • • • r • Equipment Manufacturer • • • r • Lawyer • • • r • CPA • • • r • Henry Schein Office Design Consultant • • • r • Practice Management Consultant • • • r • • r Should you buy, build, or renovate? • Can your current facility be updated to meet your needs? • Are you better off buying an existing practice? is the most difficult task in the purchase of a practice.) • Should you build? Determining ROI based on current and estimated business Phase One: Getting Started (allow about 3 months) Building your team • Technology Sales Specialist • 3 Chapter 1: Practice-Building Overview DDS ESS HSFS FSC TSS DONE Your Personal Tasks Equipment Sales Specialist Henry Schein Financial Services Field Sales Consultant Technology Sales Specialist Check as objective is completed • • • r Population • • • r Growth • • • r Age • • • r Income characteristics • • • r • Competitive landscape • • • r • Who is practicing nearby • • • r • Other businesses that may drive or deter traffic • • • r • Regulatory issues • • • r • Zoning • • • r • Parking • • • r • Licensing requirements • • • r • Architectural plan (outside of facility) • • r • Dental design plan (interior of facility) • • r • Layout • • r • Number of operatories • • r • Size of rooms • • r • Public, semi-private, and private zones • • r • Lighting • • r • Equipment selection • • r • Function • • r • Ergonomics • • r • Integration • • r • Marketability • • r • Patient experience • • r • Expandable platform • • r • Budgeting • • r • Reputation of manufacturer • • r • Warranty • • r • Installation • • r • After-sales support • • r • Interior design • • r • Color scheme • • r • Furnishings • • r Site selection • Demographics Build site plan 4 Chapter 1: Practice-Building Overview DDS ESS HSFS FSC TSS DONE Your Personal Tasks Equipment Sales Specialist Henry Schein Financial Services Field Sales Consultant Technology Sales Specialist Check as objective is completed • Flooring • • r • Accessories • • r Build site plan (continued) • Technology • r • Entertainment • r • Communications • r Phase Two: Design Process (allow about 3 months) Office design process • Organize all information into preliminary plan • • r • Work back and forth with revisions • • r • Troubleshoot flow issues • • r • Finalize technology order/purchase agreement • r • Troubleshoot code compliance issues • • r • Maintain good communication with ESS • • r • Finalize equipment order/purchase agreement • • r • Produce final spec plans per ESS’s specifications when applicable • • r • New Construction • • • r • • • r • • • r • • • r Northern orientation • • • r Info should be available at the local building office • • • r • • • r • • • r • • • r • • • r Design Build—New building from the ground up Requires plot plan showing main entrance, adjacent buildings, and setback requirements Description of surrounding area and architectural setting Leasehold—Buildout of an existing empty suite Dimensional CAD file on disk or e-mail from architect or developer or 1⁄4" scale plan with dimensions Name and contact info for architect or developer Site address 5 Chapter 1: Practice-Building Overview DDS ESS HSFS FSC TSS DONE Your Personal Tasks Equipment Sales Specialist Henry Schein Financial Services Field Sales Consultant Technology Sales Specialist Check as objective is completed • Finalize equipment order/purchase agreement • • r • Coordination between Henry Schein/equipment • • r • Apply for permits • • r • Bid process • • r Award bid (selection of General Contractor) • • r GC determines subcontractors • • r Determine Project Manager (typically Equipment Sales Specialist) • • r Establish construction schedule • • r • r • r • r Phase Three: Construction Process (allow 7–11 months) Establish construction documents manufacturer/architect Construction begins • Project Manager meets with General Contractor to manage trades and job changes • Project Manager coordinates layout of mechanical specifications for dental equipment and directs GC to instruct trades • Project Manager handles delivery of equipment to meet opening of office Phase Four: Preparation for Opening (allow 1 month) Consult with Field Sales Consultant to select merchandise and small equipment • Pre-marketing activities • • Installation of equipment • • Inventory buildup and management • • Opening day • • Training on equipment and technology r • • • • r • • • r r • r Phase Five: After Opening (ongoing) Building traffic • Advertising • • r • Referrals • • r • Consultation options • • r 6 Ask your Sales Consultant about currrent Sect. 179 tax incentives. Chapter 2: Design Fundamentals DesignFundamentals Suggested number of operatories Suggested size of sterilization area • One full-time doctor (and one hygienist): 4 or 5 operatories Cosmetic or prosthodontic practices: low operatory turnover • One full-time doctor (and two hygienists): 5 or 6 operatories Pediatric, family, preventative, orthodontic practices: high • Two full-time doctors (and two hygienists): 6 or 7 operatories operatory turnover • One operatory should be vacant about 50% of the day (operatory turnover rate influences sterilization area size) Benefit to the Practice: If these guidelines are followed, the practice’s productivity will increase by at least 20% and the Calculating the number of cassettes and tubs/trays needed for the practice physical and emotional stress of the day will be dramatically For the hygienist: reduced. (Number of patients treated daily / 2) + 1= number of setups needed for a half day. With this calculation, Suggested usable square footage in office instruments must be processed twice daily. • 4–5 operatories at 500 sq. ft. of office space per operatory • In a full day, 50% of the procedures will be restorative. (4 operatories = 2000 sq. ft. office) • 6–7 operatories at 450 sq. ft. of office space per operatory • 8 or more operatories at 400 sq. ft. of office space per operatory Benefit to the Practice: Productivity is increased while physical and emotional stress is decreased when the above office sizing guidelines are followed. Suggested size of building site For orthodontic and pediatric practices: 7 times the size of the office building For all other practices: 6 times the size of the office building Benefit to the Practice: Adequate parking and all building codes can be accommodated with this guideline, thereby reducing For the doctor: Restorative setup should be equipped for amalgam, composite, and crown & bridge procedures. Number of restorative setups needed = (number of patients treated daily / 2) + 1 • For a full day, begin with no less than two setups per specialty procedure per doctor (periodontal, endodontic, oral surgery, exam, etc.) • As an alternative to the above calculation, the following calculation can be performed: Review two months of appointments; total the number of each type of procedure. The daily average of a specific procedure = total number of each type of specific procedure / number of days patient frustration and avoiding space-saving compromises during construction. 7 Chapter 2: Design Fundamentals Calculating the number of cabinets needed in sterilization throughput increases and labor costs decrease with stainless • 10 trays / upper cabinet and 3 tubs / lower cabinet steel cassettes because individual instruments are not • 20 cassettes / upper cabinet and 3 tubs / lower cabinet handled…only groups of instruments. Benefit to the Practice: Central sterilization is not undersized and, therefore, instrument and weekly supply storage can be centrally arranged for quick distribution to any operatory. All operatories should be identically equipped so that any operatory can serve any purpose. This reduces stress during the day as procedure time requirements change in any operatory. Calculating the counter space needed in sterilization area • 4–6 operatories using trays: 16 linear ft. of counter space; using cassettes: 11 ft. • 7–8 operatories using trays: 22 linear ft. of counter space… the maximum for any sized office; using cassettes: 13–14 ft. Benefit to the Practice: Adequate counter space is critical to the efficient flow of instruments through sterilization and the reduction in repetitive motions (and labor time) by the assistants. With greater instrument throughput, fewer instrument setups are needed to meet the demands of the practice. • Use an instrument washer to wash and dry instrumentation Over the Patient (trans-thoracic) See Figure 1 • Class IV and V movements are necessary with this system…and are physically devastating over time • High fear environment for patient Dual unit or split system See Figure 2 • Class IV movement requirements decrease and Class V are eliminated, reducing the physical damage to the brachial plexus and shoulder muscles of the dental treatment team • Four-handed dentistry can be practiced with this configuration personnel (labor) costs is greater than the cost of the washer. • All Class IV and V movement can be eliminated, negating the physical damage to chamber and a “flash” cycle sterilizer for flexibility and speed the brachial plexus and shoulder muscles of in instrument processing. the dental treatment team. (and cost) of the sterilization area by one third. Instrument Figure 2 • Operatory is defined as left or right handed (disadvantage) Flexible rear delivery system See Figure 3 • Use stainless steel cassettes to decrease the size requirement Figure 1 • Not designed for four-handed dentistry because the cost savings in office space (construction) and • Use (both) a standard cycle autoclave with a large diameter 8 Determining a preferred delivery system This configuration is ideal! Figure 3 Chapter 2: Design Fundamentals • Single operator (Dr. or RDH) use is possible with some Class IV movement Benefit to the Practice: The ergonomic objective: minimizes Class IV and V movements while employing Class I-III • Ambidextrous (no left- or right-handed operatory movements of the finger, wrist, and elbow with occasional configuration… anyone can effectively use the operatory) • Low fear for patient; patient does not view handpieces shoulder rotation, but not elevation. This prevents chronic damage to the back, neck, and shoulder. The seated doctor should have their feet flat on the floor with the pelvis and Dental chair design thighs at approximately a 10° angle to the plane of the floor. See Figure 4 This position will keep the operator’s back upright without the • Employ a dental chair with a narrow, active use of back muscles. The operator should then address the thin back reclined patient such that the operator’s elbows are at his side Benefit to the Practice: Allows operator (Dr. or RDH) to come close to the patient and hands “drop” to the patient’s head and mouth. Figure 4 (legs completely under the chair) and maintain a posture with Delivery of your dental technology the back held upright and the operator’s elbows at their side. The location of your computers, monitors, and mounts dictates This prevents back, neck, and shoulder injury over time. the flow and function of how well your technology fits into how you practice dentistry. You dental technology should Dental stool design complement the everyday patient and operator flow and See Figure 5 enhance the efficiency of your practice. A two monitor approach • The stool seat should cant forward to is the most versatile way to use and extend the reach of your allow the hips to tilt; thereby practice management and digital technologies. straightening the back • The piston or stem of the seat should be tall enough to allow the operator Figure 5 Determine desired type, number, and location of radiographic units or assistant’s thighs to be positioned at approximately a 10° Type 1: Periapical, panoramic, cephalometric, cone beam CT; angle in relation to the floor. This significantly contributes to Type 2: Digital, phosphor plate, or film based a sustained, effortless straight back posture without actively It is recommended that digital or phosphor plate radiography be using the muscles of the back. employed in dental practices. The quantum leap in diagnostic • The assistant’s stool should place the eye level 6˝–8˝ above value of the digital radiograph makes the purchase of the the doctor’s eye level. This position affords a clear view of the sensors and software a true value proposition. Ignoring the operating field. mechanical advantages of the absence of film, the processing equipment and maintenance, and the time saved, the analytical 9 Chapter 2: Design Fundamentals software used to examine the radiograph will reveal pathology films will be retaken because of tube-head drift or difficulty in that even the most highly trained radiologist will not be able aligning the patient, film, and tube-head due to the complete to discern with the naked eye and conventional film-based extension of the radiographic unit. radiography. The radiograph is composed of 256 shades of gray from absolute white to black, but the human eye is capable of detecting only 12 to 14 shades of gray. A tremendous amount of information is present, but not detected, when conventional film and equipment (i.e., the eye), are employed. Diagnostic software can shift the gray scale range of the entire image and also stretch the gray scale of the image on the monitor so that the pathology “enters” the gray scale range of the human eye. Hair-line fractures, quantitative determination of a structure’s density, distance measurement, and many other diagnostic functions can be employed. Digital imaging transforms radiography from a diagnostic aid to a pathopneumonic diagnostic tool. Type of lab: production or polishing/pour-up A production lab (i.e., one that produces crowns, bridges, etc.) should have 150 sq. ft. for the first lab tech and 75 sq. ft. for every other technician. A polishing/pour-up lab can be effective with approximately 60 sq. ft. Location of technology closet All the technology in your office; Computer Network, Phone System, Sound System, and Video Systems need a central location for wiring and to place the equipment that manages the systems. This location should be isolated and ventilated Number and location of periapical units to ensure good airflow and temperature control. A properly It is recommended that each operatory have a periapical unit to the life of your equipment and protecting your technology enhance productivity. The unit should be placed behind the head investment. A 3΄ x 3΄ closet is a perfect space to hold your of the patient. This tube-head placement is a recommendation technology components for today and tomorrow. of dental radiologists because the consistency of quality films greatly increases when the X-ray tube-head is placed behind the head of the patient. There are significantly fewer retakes because overlapping, elongations, and cone cuts are avoided with the centralized positioning of the tube-head. This does not imply that good radiographs cannot be obtained from side or swing through cabinet delivery; it does mean that consistently more 10 planned technology closet can reduce clutter while extending Types of operating lights/ “heads-up” operating display • Track light offers the most positional flexibility, followed by chair mounted light, then fixed ceiling mount. • The ratio of (foot-candle) intensity of the operating light to the (foot-candle) intensity of the ambient light over the head of the patient should be approximately 10:1. As the ratio Chapter 2: Design Fundamentals becomes greater than 10:1, the risk of eye strain increases. For Benefit to the Practice: The patient will trust the doctor and staff example, if the operating light has an intensity of 5,000 lumens that the treatment proposed is appropriate and that the office is (2500 foot-candles), the ambient (ceiling) lighting above the capable of delivering the desired treatment results. Staff attitude patient’s head should yield about 250 foot candles. will improve because they will not experience back and neck • 5000 lumens is the maximum intensity of most operating lights and is very adequate for the eye with normal accommodation. pain and their efficiency will increase; the efficient business staff will have one person for every $50,000 of monthly production. Benefit to the Practice: Maintaining the suggested ratio of operating light intensity to ambient light intensity will prevent eye fatigue and headaches…especially in the afternoon. • Use the heads-up display for viewing the operating field with great clarity and magnification. This technological feature promises to be the most significant addition to the operatory since the advent high-speed handpieces. Benefit to the Practice: It positively changes the posture of the doctor to lift the head thereby preventing neck and back strain. It dramatically improves the visual clarity of the operating field without the need for eyewear that distorts the normal Types and methods for patient entertainment and education The patient experience while at your office can be enhanced with video and audio entertainment in your lobby and in each operatory. With patient education, music, or cable television, you will need to decide how these technologies will be delivered and make sure your lobby and operatory design reflect the integration of this equipment to ensure a seamless look and feel to your practice. In particular, a lobby TV and overhead music can provide a relaxing and entertaining atmosphere in your office. field of vision. Furniture/finishes The appearance of the office (furniture, flooring, technology) must be congruent and consistent with the level of care proposed to the patient. • Computer monitors in the business area should be at least 19˝, not placed in a corner, and the screen should be lower than the eye level of the operator. • Staff seating in the business area should employ chairs that have a pelvic tilt so that the thigh of the seated person is at a 10° angle; this automatically places the back in an upright position. 11 Design Ideas: Notes: 12 Ask your Sales Consultant about currrent Sect. 179 tax incentives. Office & Interior Design Solutions He n r y S c h e i n De n ta l , a single source for a l l of y o u r d e n ta l n ee d s . T hrough the optimal use of space, equipment, and design elements, the Henry Schein Dental Office Design Group will transform your practice into a well-organized business and an efficient public space that offers the ultimate in patient care. Henry Schein Dental’s National Design Group has one of the only full-time, dedicated dental office design teams in the industry. By working closely with you and your Equipment Specialist, we will: Provide the plans for remodeling an existing office, expanding your current office, relocating to a new office or new construction. O ffice Design G r o u p M a k e yo u r Coordinate the entire planning process with architects, contractors and equipment specialists. Design a plan that will enhance the doctors’ image while fostering a stress-free and more efficient environment for both doctor and staff. Contact your Henry Schein Equipment Specialist at 1-800-645-6594 or officedesign@henryschein.com dream office a rea l i t y w i t h h e n r y s c h e i n d e n ta l . O nce we design the perfect office for you, why not let us finish the job? Our Interior Design Group can provide all the help you need in furnishing and decorating your office. Services available include consultation, material selection and ordering, coordination of material delivery, and installation. Need a fresh look? Let our interior designers help you create an atmosphere that truly represents the way you care for your patients and support team. •Refresh your floors •Repaint your walls •Re-upholster your furnishings •Renew your spirit BEFORE AFTER I nteri o r Design G r o u p 1-800-336-8397 · officedesign@henryschein.com He n r y S c h e i n De n ta l Nat i o n a l De s i g n G R O U P 10920 West Lincoln Avenue · West Allis, Wisconsin 53227 · henryscheindental.com 13 Chapter 3: Clinical Equipment & Technology Benefits ClinicalEquipment& TechnologyBenefits • Chair time saved in hygiene. The average hygienist saves the Imaging equivalent of one appointment per day. That alone will pay for Cone Beam CT Cone Beam CT or 3D imaging is the new frontier for digital radiography. As with other digital radiography systems, the system is significantly more accurate than film based systems and can reduce radiation by up to 95%. There are plenty of applications for this technology. Implant dentists are some of the early adopters as the technology can greatly aid them in presurgical treatment planning to determine the width of the ridge, the quality of the bone, and the location of the mandibular nerve. Cone Beam CT can also be helpful to oral surgeons or any dentist who extracts teeth for preparing to remove impacted third molars. An additional benefit of Cone Beam CT is the ability to view both arches simultaneously. Digital Pans Many offices find the image quality to be so diagnostic that they often take many more pans and in some cases, have replaced their standard full-mouth series with a digital pan and bitewings, augmenting with PAs as required. These systems quickly produce excellent diagnostic images, showing the entire mouth, which allows patients to better understand the process. • Dramatic price decrease over the past five years. • Patient comments are very positive about the comfort and your digital pan while dynamically improving your treatment plan presentations. • An office with high-quality digital panoramic imaging will need far fewer sensors and use the ones they have far less. • New high-resolution technology virtually eliminates the need for FMXs because the image is so clear. • Images maintain clarity as you magnify to diagnose caries, lesions etc. Patients report that they understand their diagnosis better due to the full image of the entire jaw and dentition. • Higher level treatment plans and full-mouth reconstruction case acceptance greatly increases as patients see the fullmouth x-ray and understand the cause and effect of their conditions like never before. • Only 17 seconds to complete a digital pan, which is a minimal amount of time for a patient to remain completely still while the image is being produced. • No need to worry about damaging expensive intraoral digital sensors. • Saves chair time, which allows you to see additional patients and increase your production. A digital pan takes about 1 minute compared to 10–15 minutes for a film pan. efficiency of the new technology compared to traditional intraoral x-rays. 14 Ask your Sales Consultant about currrent Sect. 179 tax incentives. Chapter 3: Clinical Equipment & Technology Benefits • No learning curve for staff. Most offices take pans already and some of the higher-end pans even use patented technology to automatically sense the density of hard and soft tissue and adjusts the kV or mA parameter settings (most digital pans don’t do this, thanks to the OP’s patent on AEC). • Positive tax implications. Sterilization Instrument Cassettes There are few clinical operational changes available in a practice that offer such a big bang for the buck as switching to stainless steel cassettes. The efficiencies of instrument management in the operatory and sterilization gained daily will save the average Digital Sensors practice over an hour each day when a coordinated cassette The benefits and ROI of digital sensors have been well known system is employed for all instrument setups. And, instrument for years. Every office spends more than they probably know on management systems utilizing cassettes will require much film, chemicals, processor cleaning supplies, repairs, mounts, less space in sterilization...about a third less counter space is and duplicating film. Another cost that is often forgotten is labor; required to process instruments in cassettes compared to tray such as the time needed to clean the processor and mount the based instrument management. films. There are many reasons to consider getting digital sensors. Handpiece Care/Maintenance Systems Some of the main advantages include: • Speed: Images are on the screen in 1–3 seconds; a huge benefit for offices that need immediate images, such as endodontics procedures and implant placement. • Eliminate the hassle and costs of film, chemicals, chemical disposal silver traps, and the maintenance and staff training of related MSDS sheets. • Improved diagnosis by providing software tools for image enhancements. • Practice Marketing: Practice seen as high-end and cutting edge. • Increased case acceptance: When we involve the patients (co-diagnosis) and they can see what we see, they are more accepting of our treatment plans. X-ray Digital Processors Digital Processors are an excellent solution for offices looking for quality digital radiographs and are easy for the staff to learn. It’s a simple transition from film. Image quality tends to be on par with film and most processors allow for scanning at different resolutions. Here is another labor-saving device in sterilization that contributes to fewer required assistant hours. This translates into decreasing the practice’s labor costs. Handpiece repair costs, for the life of the handpiece, are typically double to triple the cost of the handpiece when handpieces are manually maintained by staff. The decision to employ this system in sterilization has no downside! Sterilizers/Autoclaves When considering a sterilizer for the sterilization area, it is important to match the throughput of the instrument cleaning and drying workstations with that of the sterilizers. If an instrument washer is used, then a sterilizer with a higher throughput should be considered; faster cycles and greater instrument/cassette capacity are desirable. Many practices are well-served with two sterilizers: one with a larger chamber for larger cassettes or instrument loads; one with more rapid cycles for “flashing” instruments. Sterilization Cabinetry The compelling reason to consider prefabricated sterilization cabinetry is that the functional design has been developed for decades and the ergonomics of instrument flow and work stations have been incorporated into the design. Consider using translucent glass or plastic in all upper cabinets so that all supplies can be seen by the assistants; sticky labels on expensive wooden doors cheapens the look of sterilization cabinets and decreases efficiencies. 15 Chapter 3: Clinical Equipment & Technology Benefits Operatory Cabinetry Operatory Cabinetry design in the operatory should be selected based Delivery Systems Delivery systems have always been at the heart of the operatory, and the new systems yield a new pulse to the rhythm of movement of the dental team. There is increasing awareness of ergonomics among the dental treatment team and this is reflected in the new delivery system designs; damaging Class IV and V movements can be minimized with flexible rear delivery configurations while offering the added feature of creating an ambidextrous operatory for the left- or right-handed doctor or hygienist. And, the ability to place the delivery system behind the chair creates a low fear environment for the patient as they do not see the handpieces. upon the type of delivery system employed. For example, with flexible rear delivery a 12 o’clock cabinet and bilateral assistant side cabinets would be most appropriate to maximize the benefits of the delivery system. However, if operatory width is a concern in a smaller office, free-standing cabinet “islands” can be placed between operatories to serve as a pair of opposing side cabinets and wall. To maximize practice efficiencies, it is suggested that operative/crown & bridge tubs be stored in each operatory, but all instrument cassettes or procedure trays should be stored in sterilization; the function of any operatory should be defined by the instrumentation brought into the operatory for a specific procedure. Dental Chairs Dental chairs have been in the operatory since the dawn of dental treatment. New designs now allow the doctor and assistant to move closer the patient, dramatically enhancing the ergonomics of the operatory. Employing thinner and narrower designs, dental chairs are reducing the daily physical stress on the dental team because the doctor and assistant can minimize trunk flexion (bending) and rotation, as well as arm extension; both movements, when repetitive, are very damaging to the musculoskeletal system. Operatory Lights Good operatory lighting can make the difference between feeling energetic or exhausted at the end of the workday. Ophthalmologists suggest that the ratio of (foot-candle) intensity of the operating light to the (foot-candle) intensity of the ambient light over the head of the patient should be approximately 10:1. As the ratio becomes greater than 10:1, the risk of eye strain increases. For example, if the operating light has an intensity of 2500 foot-candles, the ambient lighting above the patient’s head should yield about 250 foot candles. Light Dental Stools mounting also influences ease of light positioning and visibility; Most members of the dental team believe they are positioned track light offers the most positional flexibility, followed by around the patient, but the science of ergonomics reveals that chair- mounted light, then the fixed ceiling mount. the patient and assistant are positioned relative to the doctor’s placement, and the stool is integral to that placement. The stool seat should cant forward to allow the hips to tilt downward and thereby straighten the back, whereas the piston or stem of the seat should be tall enough to allow the operator or assistant’s thighs to be positioned at approximately 10° (in relation to the floor). The assistant’s stool should place the eye level approximately 6˝–8˝ above the doctor’s eye level. This position affords a clear view of the operating field. Dental Handpieces The number of choices for dental handpieces is legion and the reasons for specific selections are highly personal. When selecting a handpiece, however, consider whether the design of the handpiece facilitates accessibility to all areas of the dentition. Power is also a major consideration with electric handpieces offering a great deal more cutting effectiveness than their air turbine alternatives, but the small variation in effective cutting technique of the electric handpiece must be addressed to optimize clinical results. And, the regularity and thoroughness of electric handpiece lubrication and cleaning must be observed 16 Ask your Sales Consultant about currrent Sect. 179 tax incentives. Chapter 3: Clinical Equipment & Technology Benefits with an effective handpiece maintenance system. operations. • “Same-day dentistry” means in a single appointment, the CAD/CAM technology The E4D Dentist™ system is designed with the patient and dentist can offer a completed procedure to on-the-go patients. • A natural aesthetic look is achieved because a patient’s operator in mind. From the very beginning, D4D has involved restoration can be custom designed to match the neighboring dental professionals in the development of the E4D system, teeth as well as polished or stained and glazed with ease. resulting in an easy-to-use product and process that can provide • E4D has partnered with the best in dentistry. Distribution a significant return on investment. Intuitive and fun to operate, and service is provided by Henry Schein Dental. Restorative the E4D empowers you to create beautiful restorations that materials are provided by 3M ESPE and Ivoclar Vivadent provide the form, fit, and function that dental professionals and diamond burs are provided by Premier Dental demand and patients prefer. Products Company. • Laser technology captures hundreds of thousands of data points showing what really exists in the oral environment. Dental lasers Using multiple images, the E4D avoids interpolating data and Laser therapy has been associated with the term, “minimally captures more detailed information such as undercuts invasive dentistry.” Lasers are comfortable for patients and are and contours. You can even distinguish between hard and considered to be safe and effective. soft tissue. • Some traditional procedures usually performed under • The DentaLogic™ software features intuitive and easy-to-use tools that you can operate in whatever way you choose. You can change shapes or sizes by specific numbers of microns or degrees, or you can use the Rubber Tooth feature to simply push or pull any area of the proposal to reshape or resize. • Every E4D owner receives a two-day educational program for the dentist and an assistant at E4D University (included in the system price), where they learn directly from the manufacturer (travel and accommodations included). • Support-On-Sight™ is available for the dentists and office team to contact E4D’s customer support team. With the office’s anesthesia do not require anesthesia with the use of the laser. • Procedures performed using dental lasers may not require sutures as there is little bleeding. • Offices can perform procedures they used to refer out as they have far more control over the outcome. • Bacterial infections are minimized because the high-energy beam sterilizes any area being worked on. • Because dental lasers are very precise medical devices, they can actually minimize the amount of damage caused to the tissue surrounding a procedure’s area of focus. • Wounds heal faster and tissues regenerate quicker. permission, a customer support representative can remotely access the E4D system to diagnose, support, and guide 17 Chapter 3: Clinical Equipment & Technology Benefits Intraoral cameras Mechanical Over 50% of offices have an intraoral camera. Intraoral cameras Vacuums and Air Compressors are lightweight and easy to move from room to room. They can easily maneuver into tight spaces such as the distal of second molars. They can interface using multiple methods to the computer, including USB, Firewire, S-video, or RCA. They can interface directly with an existing TV. • Improved communication with insurance companies. • A technology that patients really appreciate. Although there are a number of vacuum systems and air compressors from which to choose, many offices make the mistake of creating a room to small to adequately house the equipment. The space should be a minimum of 5.5΄ x 5.5΄, should not be next to any patient area such as the waiting area, and should be equipped with adequate sound board and ventilation. Computer network Laboratory Dental Computer Network Dust Collection/Evacuation Systems The computer network is the backbone that all of your computer-based software and hardware technologies plug into. It is important to make sure the computers, servers, software, networking, and cabling are right sized for your office’s needs today and vision for tomorrow. It is also key to ensure that your network’s configuration is fine tuned to operate compatibly and efficiently with your software and hardware. Practice management software Practice management software should provide intuitive patient scheduling, a comprehensive fee schedule, insurance management, up-to-date and easy-to-read document charting, proposed treatment and easy-to-document treatment notes. Look for systems that integrate with patient education for easy explanation of treatment options. Electronic services attached to practice management software can automate online scheduling, help to complete health history information, and ease communication with your insurance partners. Your ideal system should be tightly integrated with your digital solutions, allowing one patient record and easy-to-access digital radiographs and A dedicated dust collection system is essential in any lab that will be trimming models or dies. Over the course of your practice life, the health advantages of a dust collection system designed specifically for dentistry far outweigh the cost. Select one that will meet your individual needs at the bench if you have space considerations or a larger one for more general use. Laboratory Cabinetry Utilizing prefabricated lab cabinetry has the advantage of years of design refinement. Consider employing countertops for use while standing as well as sitting if you plan on trimming dies or doing wax-ups. The finishing and polishing lab requires approximately 60 sq. ft.a to efficiently process lab work and store case pans. Model Trimmers Model trimmers can be loud and make nervous patients imagine the worst if they hear the noise. Newer trimmers can dampen the noise, and are available in both wet and dry trimming modes. If trimming ortho models, the feature of quick and easy wheel changes can be advantageous. documents for your team. 18 Ask your Sales Consultant about currrent Sect. 179 tax incentives. Chapter 3: Clinical Equipment & Technology Benefits Notes: 19 DreamOfficeChecklist Merchandise r Acrylics & Reline Materials r Alloys & Accessories r Anesthetics r Articulating Paper and Accessories r Burs–Carbide & Diamond r Cements & Liners r Cosmetic Dentistry r Crown Forms, Bands & Shells r Disposables r Endodonic Instruments r Endodonic Products r Evacuation Products r Finishing & Polishing r Handpieces & Accessories r Impression Materials & Accessories r Infection Control r Instruments r Laboratory Products r Matrix Materials & Accessories r Pharmaceuticals r Pins & Posts r Preventives & Prophy Materials r Retraction Materials r Rubber Dam & Accessories r Sutures & Suture Needles r Uniforms r Waxes r X-ray Products r Stationery & Office Supplies r Toys Operatory room setup r Chairs Exam room setup r Chairs Hygiene room setup r Chairs r Delivery Systems r Film Processor r Delivery Systems r Lights r Vacuum Systems/Air Compressors r Lights r Stools r Nitrous Oxide Systems r Stools r Cabinets r Instrument Management System r Cabinets CAD/CAM & Digital Impressioning r E4D CAD/CAM X-rays r Intraoral Miscellaneous Technology r Computers (dental network) Lasers r Hard Tissue r Sensors r Software r Panoramic r Patient Education r Cone Beam CT Radiography r Entertainment Large equipment Technology r Soft Tissue HSD0528
