How To Be Dental Office – Dental practices have flows and functions that can be optimized to better serve dental staff and patients.
Looking around an old house, one might be confused to find a small metal door leading to a cellar, a small niche built into the wall or a small staircase, hidden from view. These are old design trends from years past (coal ducts, telephone alcoves, and maid’s ladders, respectively) and not something you’d see in a modern home.
How To Be Dental Office
Like home design, dental practices take their cues from trends in both function and fashion. A practice designed in the 1950s, while utilitarian at the time, likely needed an overhaul to make it work for the modern dentist. But it’s not just practices from the 1950s that need renovation. The way dentists work today is very different from how they worked 70 years ago, and even a few years ago.
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“What is your perspective on the optimal office then and now?” asks Jeff Carter, DDS, owner of the dental practice design firm Practice Design Group. “Our design understanding of the optimal office 10 years ago may have been very different from yours or someone else’s. Are we comparing the 2022 office, versus 2017, versus 2010, versus 2000?”
Not easy to see changes in form and function. Doctors who may not have noticed the trend made me wake up one day feeling suddenly out of date.
Stephanie Woeste, Midmark’s director of dental marketing, observes that doctors seem to be more open to recommendations and advice.
“We’ve seen that clinicians who are looking at either a significant remodel or a new building really pay attention to best practice recommendations – even more than they ever did,” he says. “They realized that this was a big investment of not only money, but also time. It’s a lot to manage as they train and keep their patient flow going. What we offer is a design service that complements their practice, and that’s the point – not just adopting new trends, so to speak, but really focusing on what best suits their practice and needs.
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“The first question to ask is, ‘Are you trying to expand your capacity to see more patients?’” he continues. “Are you bringing in other doctors – such as visiting specialists – into your practice? That’s a big trend. Are you adopting a new technology that you have to accommodate to? There is a lot to think about – from an objective point of view. What do you want to achieve and then hone? What new trends might apply to what you want to achieve and go from there.
One of the current trends embraced by many practices is to have a lab or specialist in-house. This makes the pairing more obvious and conspicuous to the patient.
“One of the biggest changes we saw in our design was to increase the size of the lab or even show the lab and procedures inside,” said Jen Rhode, Senior Design Manager, Henry Schein. “For many years, a laboratory was something that housed a small workstation with small equipment like lathes, model trimmers and such. We will usually hide the laboratory out of sight of patients, in a private hall or in an enclosed space from sterilization as it can easily become cluttered and create noise that is unappealing to passers-by. With the addition of scanners, 3D printers and milling units, a number of technologies, especially high-investment technologies, have moved laboratories to the forefront of efficient workflow planning and practice marketing.
“Another trend we’re seeing in practice design is combination specialization or accommodating visiting specialists,” he continues. “The more procedures you can keep ‘at home’, the more desirable the practice will be for patients. This symbiotic relationship also benefits practitioners in sharing real estate and staff, particularly for front-office processes. If a practice doesn’t want to share space completely, we’ve also seen requests for 1 or 2 larger flexible treatment rooms suitable for special procedures. Combining small rooms with basic work stations in or around private zones can also serve as temporary private offices for specialists, or as spaces for teledentistry appointments.”
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How dynamic is the practice design? That is, is it something that changes every year? Every f5 years? Every 10 years?
“It depends on the practice, because if the practice is structured in an optimal way – if you have really good workflows, if you have good safety practices – then the things you need to change might be, maybe, to accommodate the new technology,” Woeste said. “It doesn’t have to be a dramatic change. It’s really, ‘What do you need to change?’ ‘What is in your practice?’ And it’s going to facilitate change, because what we’ve seen during COVID, is if doctors have the right structure – adequate workflow, adequate security setup, and practice processes – then the things they need to change are much smaller. So maybe they need to focus on air quality, because of aerosols. Some of these could be simpler to execute. Or maybe they should take some patient facilities for a while – you don’t want those magazines out of the way, that sort of thing. But as far as major practice design changes, I think it just depends on whether the needs and goals of the practice change.
“Basically, dental practice designs haven’t really changed in over 20 years,” Rhode said. “The common zone, proximity, and patient-staff workflow remains the same. This is not to say there aren’t any adjustments or recommendations regarding the most efficient treatment room layout, or the best sterilization configuration. This varies mostly from doctor to doctor and can depend on location or demographics. It’s important for clinicians to analyze their changing demographics in the patient base and community every few years to see what trends and design philosophies resonate best with their needs.
The dental practice that is designed and built today is likely to be different from the practice that was designed and built 20, 10, or even 5 years ago. Technology, use of space, and aesthetics are the drivers of change. But so are the ergonomics of the people who work there.
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“These changes are gradual because the principles they emerged in the 60s and 70s are, by and large, still valid today,” observes Dr Carter. “Nothing radical. All the principles of flow apply to a high degree, except for those which gradually expand in size. Bigger people. There is more equipment. If you look at a floor plan from 30 or 40 years ago, a lot of the streams look the same. But if we go in and put a ruler on the operator, for example, we used to make the operator nine feet wide and nine foot six operator. Well, now we’re up to about 10 foot five wide, because people are bigger. We’re bringing more mobile accessories – digitization, scanning units – things like that.”
“If you look at a floor plan from 20 or 30 years ago and one today, you will see that things that have evolved, have changed,” he highlights. “For example, one of the simplest things is how do you log in and out of the carrier? There are only so many entry points. How do you get in and out most efficiently? They would run studies, but it was undoubtedly what they called ‘two-headed entry’, where at the end of the operator’s head, there were two openings – one on the right side, one on the left side. So, if I were a doctor or his assistant, I would have my own opening for going in and out of the operating room, then the patient would face the foot of the operating room. And, ideally, they have a nice big window where they can look outside and get some natural light and it relaxes them, but it’s very efficient.”
Some of those changes have also evolved from the way dentists work. The concept of “4-handed dentistry” of course changes the size requirements of an operating room.
“Emphasis and understanding and appreciation of what 4-handed dentistry should be doing is slowly slipping away from us,” said Dr Carter. “In the early 2000s, things got bigger, but we are using principles that have developed years later. We gradually increase the size of items, adding space in certain rooms for more function and flow.
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“But we see that people don’t understand the concept of 4-handed dentistry,” he continues. “We hear, ‘Well, I didn’t do that anyway.’ So, we got pushback and we got frustrated because some of these principles were misunderstood. It’s a challenge to make people understand and appreciate them.”
“My dentist is standing,” says Dr
