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ESS ____________________________________________
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OfficeDesign
Workbook

An Essential Step-by-Step Resource

for Designing an Efficient Practice
Build, Remodel, or Move

800-645-6594
 Practice-BuildingOverview
DDS ESS HSFS FSC TSS DONE
Your Equipment Henry Schein Field Technology Check as
Personal Sales Financial Sales Sales objective is
Create a business plan Tasks Specialist Services Consultant Specialist completed

• What is the mission statement for your practice? • • r

• What is your practice philosophy? • • r
Clinical • • r
Patient Experience • • r
Personal Professional • • r
Perception in the community/What kind of dentist are you? • • r
• Prequalify for available funds • • • r
• Secure working capital • • • r
Deposits and initial expenses • • • r
• 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
Transition planning: Sale of practice, associate/partner considerations • • • • r

Is your current facility consistent with

your business goals?
• 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
make the discerning patient want to come back?
2
 Chapter 1: Practice-Building Overview

DDS ESS HSFS FSC TSS DONE

Your Equipment Henry Schein Field Technology Check as
Personal Sales Financial Sales Sales objective is
Should you buy, build, or renovate? Tasks Specialist Services Consultant Specialist completed

• Can your current facility be updated to meet your needs? • • 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
• Are you better off buying an existing practice? • • r
Existing patient flow • • r
Is it what you really want? • • r
Assessing value of practice (Determining value of patient records • • r
is the most difficult task in the purchase of a practice.)
• Should you build? • • r
Determining ROI based on current and estimated business • • • r

Phase One: Getting Started (allow about 3 months)

Building your team
• 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
• Technology Sales Specialist • • r

3
 Chapter 1: Practice-Building Overview

DDS ESS HSFS FSC TSS DONE

Your Equipment Henry Schein Field Technology Check as
Personal Sales Financial Sales Sales objective is
Site selection Tasks Specialist Services Consultant Specialist completed

• Demographics • • • 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

Build site plan

• 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

4
 Chapter 1: Practice-Building Overview

DDS ESS HSFS FSC TSS DONE

Your Equipment Henry Schein Field Technology Check as
Personal Sales Financial Sales Sales objective is
Build site plan (continued) Tasks Specialist Services Consultant Specialist completed

• Flooring • • r
• Accessories • • r
• 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
Design Build—New building from the ground up • • • r
Requires plot plan showing main entrance, adjacent buildings, • • • r
and setback requirements
Description of surrounding area and architectural setting • • • r
Northern orientation • • • r
Info should be available at the local building office • • • r
Leasehold—Buildout of an existing empty suite • • • r
Dimensional CAD file on disk or e-mail from architect • • • r
or developer or 1⁄4" scale plan with dimensions
Name and contact info for architect or developer • • • r
Site address • • • r

5
 Chapter 1: Practice-Building Overview

DDS ESS HSFS FSC TSS DONE

Your Equipment Henry Schein Field Technology Check as

Phase Three: Construction Process (allow 7–11 months)

Personal Sales Financial Sales Sales objective is
Tasks Specialist Services Consultant Specialist completed

Establish construction documents

• Finalize equipment order/purchase agreement • • r
• Coordination between Henry Schein/equipment • • r
manufacturer/architect
• 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

Construction begins
• Project Manager meets with General Contractor • r
to manage trades and job changes
• Project Manager coordinates layout of mechanical specifications • r
for dental equipment and directs GC to instruct trades
• Project Manager handles delivery of equipment • r
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 • r
• Installation of equipment • • • r
• Inventory buildup and management • • • r
• Opening day • • • r
• Training on equipment and technology • • 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
• One full-time doctor (and one hygienist): 4 or 5 operatories
• One full-time doctor (and two hygienists): 5 or 6 operatories
• Two full-time doctors (and two hygienists): 6 or 7 operatories
• One operatory should be vacant about 50% of the day
Benefit to the Practice: If these guidelines are followed, the
practice’s productivity will increase by at least 20% and the
physical and emotional stress of the day will be dramatically
reduced.
Suggested usable square footage
in office
• 4–5 operatories at 500 sq. ft. of office space per operatory
(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
patient frustration and avoiding space-saving compromises
during construction.
Suggested size of sterilization area
Cosmetic or prosthodontic practices: low operatory turnover
Pediatric, family, preventative, orthodontic practices: high
operatory turnover
(operatory turnover rate influences sterilization area size)
Calculating the number of cassettes and tubs/trays
needed for the practice
For the hygienist:
(Number of patients treated daily / 2) + 1= number
of setups needed for a half day. With this calculation,
instruments must be processed twice daily.
For the doctor:
• In a full day, 50% of the procedures will be restorative.
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
7
 Chapter 2: Design Fundamentals
Calculating the number of cabinets needed in sterilization
• 10 trays / upper cabinet and 3 tubs / lower cabinet
• 20 cassettes / upper cabinet and 3 tubs / lower cabinet
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
because the cost savings in office space (construction) and
personnel (labor) costs is greater than the cost of the washer.
• Use (both) a standard cycle autoclave with a large diameter
chamber and a “flash” cycle sterilizer for flexibility and speed
in instrument processing.
• Use stainless steel cassettes to decrease the size requirement
(and cost) of the sterilization area by one third. Instrument
8
throughput increases and labor costs decrease with stainless
steel cassettes because individual instruments are not
handled…only groups of instruments.
Determining a preferred delivery
system
Over the Patient (trans-thoracic)
See Figure 1
• Class IV and V movements are necessary
with this system…and are physically
devastating over time
Figure 1
• High fear environment for patient
• Not designed for four-handed dentistry
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 Figure 2
• Operatory is defined as left or right handed (disadvantage)
• Four-handed dentistry can be practiced with this
configuration
Flexible rear delivery system See Figure 3
• All Class IV and V movement can be
eliminated, negating the physical damage to
the brachial plexus and shoulder muscles of
the dental treatment team. Figure 3
This configuration is ideal!
 Chapter 2: Design Fundamentals
• Single operator (Dr. or RDH) use is possible with some
Class IV movement
• Ambidextrous (no left- or right-handed operatory
configuration… anyone can effectively use the operatory)
• Low fear for patient; patient does not view handpieces
Dental chair design
See Figure 4
• Employ a dental chair with a narrow,
thin back
Benefit to the Practice: Allows operator
(Dr. or RDH) to come close to the patient Figure 4
(legs completely under the chair) and maintain a posture with
the back held upright and the operator’s elbows at their side.
This prevents back, neck, and shoulder injury over time.
Dental stool design
See Figure 5
• The stool seat should cant forward to
allow the hips to tilt; thereby
straightening the back
• The piston or stem of the seat should
be tall enough to allow the operator Figure 5
or assistant’s thighs to be positioned at approximately a 10°
angle in relation to the floor. This significantly contributes to
a sustained, effortless straight back posture without actively
using the muscles of the back.
• The assistant’s stool should place the eye level 6˝–8˝ above
the doctor’s eye level. This position affords a clear view of the
operating field.
Benefit to the Practice: The ergonomic objective: minimizes
Class IV and V movements while employing Class I-III
movements of the finger, wrist, and elbow with occasional
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
thighs at approximately a 10° angle to the plane of the floor.
This position will keep the operator’s back upright without the
active use of back muscles. The operator should then address the
reclined patient such that the operator’s elbows are at his side
and hands “drop” to the patient’s head and mouth.
Delivery of your dental technology
The location of your computers, monitors, and mounts dictates
the flow and function of how well your technology fits into
how you practice dentistry. You dental technology should
complement the everyday patient and operator flow and
enhance the efficiency of your practice. A two monitor approach
is the most versatile way to use and extend the reach of your
practice management and digital technologies.
Determine desired type, number,
and location of radiographic units
Type 1: Periapical, panoramic, cephalometric, cone beam CT;
Type 2: Digital, phosphor plate, or film based
It is recommended that digital or phosphor plate radiography be
employed in dental practices. The quantum leap in diagnostic
value of the digital radiograph makes the purchase of the
sensors and software a true value proposition. Ignoring the
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
that even the most highly trained radiologist will not be able
to discern with the naked eye and conventional film-based
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.
Number and location of
periapical units
It is recommended that each operatory have a periapical unit to
enhance productivity. The unit should be placed behind the head
of the patient. This tube-head placement is a recommendation
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
films will be retaken because of tube-head drift or difficulty in
aligning the patient, film, and tube-head due to the complete
extension of the radiographic unit.
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
to ensure good airflow and temperature control. A properly
planned technology closet can reduce clutter while extending
the life of your equipment and protecting your technology
investment. A 3΄ x 3΄ closet is a perfect space to hold your
technology components for today and tomorrow.
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
example, if the operating light has an intensity of 5,000 lumens
(2500 foot-candles), the ambient (ceiling) lighting above the
patient’s head should yield about 250 foot candles.
• 5000 lumens is the maximum intensity of most operating lights and is
very adequate for the eye with normal accommodation.
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.
Benefit to the Practice: The patient will trust the doctor and staff
that the treatment proposed is appropriate and that the office is
capable of delivering the desired treatment results. Staff attitude
will improve because they will not experience back and neck
pain and their efficiency will increase; the efficient business staff
will have one person for every $50,000 of monthly production.
Types and methods for patient
entertainment and education

• Use the heads-up display for viewing the operating field with The patient experience while at your office can be enhanced

great clarity and magnification. This technological feature with video and audio entertainment in your lobby and in each

promises to be the most significant addition to the operatory operatory. With patient education, music, or cable television, you

since the advent high-speed handpieces. will need to decide how these technologies will be delivered and

Benefit to the Practice: It positively changes the posture of the make sure your lobby and operatory design reflect the integration

doctor to lift the head thereby preventing neck and back strain. of this equipment to ensure a seamless look and feel to your

It dramatically improves the visual clarity of the operating practice. In particular, a lobby TV and overhead music can

field without the need for eyewear that distorts the normal 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 Coordinate the entire
design elements, the Henry Schein Dental Office planning process
Design Group will transform your practice into with architects,
a well-organized business and an efficient public contractors and
space that offers the ultimate in patient care. equipment
specialists.
Henry Schein Dental’s National Design Group has one of
the only full-time, dedicated dental office design teams Design a
in the industry. By working closely with you and your plan that will
Equipment Specialist, we will: enhance the doctors’
image while fostering a
Provide the plans for remodeling an existing office,
stress-free and more efficient
expanding your current office, relocating to a new office
environment for both doctor and staff.
or new construction.

O ffice Design G r o u p Contact your Henry Schein Equipment Specialist at 1-800-645-6594 or officedesign@henryschein.com

M a k e yo u r 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.
BEFORE
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

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
Imaging • Chair time saved in hygiene. The average hygienist saves the
equivalent of one appointment per day. That alone will pay for
Cone Beam CT
your digital pan while dynamically improving your treatment
Cone Beam CT or 3D imaging is the new frontier for digital
plan presentations.
radiography. As with other digital radiography systems, the
• An office with high-quality digital panoramic imaging will
system is significantly more accurate than film based systems
need far fewer sensors and use the ones they have far less.
and can reduce radiation by up to 95%. There are plenty of
• New high-resolution technology virtually eliminates the need
applications for this technology. Implant dentists are some
for FMXs because the image is so clear.
of the early adopters as the technology can greatly aid them
• Images maintain clarity as you magnify to diagnose caries,
in presurgical treatment planning to determine the width
lesions etc. Patients report that they understand their
of the ridge, the quality of the bone, and the location of the
diagnosis better due to the full image of the entire jaw
mandibular nerve.
and dentition.
Cone Beam CT can also be helpful to oral surgeons or any
• Higher level treatment plans and full-mouth reconstruction
dentist who extracts teeth for preparing to remove impacted
case acceptance greatly increases as patients see the full-
third molars. An additional benefit of Cone Beam CT is the
mouth x-ray and understand the cause and effect of their
ability to view both arches simultaneously.
conditions like never before.
Digital Pans
• Only 17 seconds to complete a digital pan, which is a minimal
Many offices find the image quality to be so diagnostic that
amount of time for a patient to remain completely still while
they often take many more pans and in some cases, have
the image is being produced.
replaced their standard full-mouth series with a digital pan and
• No need to worry about damaging expensive intraoral
bitewings, augmenting with PAs as required. These systems
digital sensors.
quickly produce excellent diagnostic images, showing the entire
• Saves chair time, which allows you to see additional patients
mouth, which allows patients to better understand the process.
and increase your production. A digital pan takes about
• Dramatic price decrease over the past five years.
1 minute compared to 10–15 minutes for a film pan.
• Patient comments are very positive about the comfort and
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.
Digital Sensors
The benefits and ROI of digital sensors have been well known
for years. Every office spends more than they probably know on
film, chemicals, processor cleaning supplies, repairs, mounts,
and duplicating film. Another cost that is often forgotten is labor;
such as the time needed to clean the processor and mount the
films. There are many reasons to consider getting digital sensors.
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.
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
practice over an hour each day when a coordinated cassette
system is employed for all instrument setups. And, instrument
management systems utilizing cassettes will require much
less space in sterilization...about a third less counter space is
required to process instruments in cassettes compared to tray
based instrument management.
Handpiece Care/Maintenance Systems
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 Operatory Cabinetry

Cabinetry design in the operatory should be selected based
Delivery Systems
upon the type of delivery system employed. For example, with
Delivery systems have always been at the heart of the operatory,
flexible rear delivery a 12 o’clock cabinet and bilateral assistant
and the new systems yield a new pulse to the rhythm of
side cabinets would be most appropriate to maximize the
movement of the dental team. There is increasing awareness
benefits of the delivery system. However, if operatory width is a
of ergonomics among the dental treatment team and this is
concern in a smaller office, free-standing cabinet “islands” can
reflected in the new delivery system designs; damaging Class IV
be placed between operatories to serve as a pair of opposing
and V movements can be minimized with flexible rear delivery
side cabinets and wall. To maximize practice efficiencies, it is
configurations while offering the added feature of creating an
suggested that operative/crown & bridge tubs be stored in each
ambidextrous operatory for the left- or right-handed doctor or
operatory, but all instrument cassettes or procedure trays should
hygienist. And, the ability to place the delivery system behind
be stored in sterilization; the function of any operatory should
the chair creates a low fear environment for the patient as they
be defined by the instrumentation brought into the operatory
do not see the handpieces.
for a specific procedure.
Dental Chairs
Operatory Lights
Dental chairs have been in the operatory since the dawn of
Good operatory lighting can make the difference between
dental treatment. New designs now allow the doctor and
feeling energetic or exhausted at the end of the workday.
assistant to move closer the patient, dramatically enhancing the
Ophthalmologists suggest that the ratio of (foot-candle)
ergonomics of the operatory. Employing thinner and narrower
intensity of the operating light to the (foot-candle) intensity
designs, dental chairs are reducing the daily physical stress on
of the ambient light over the head of the patient should be
the dental team because the doctor and assistant can minimize
approximately 10:1. As the ratio becomes greater than 10:1, the
trunk flexion (bending) and rotation, as well as arm extension;
risk of eye strain increases. For example, if the operating light
both movements, when repetitive, are very damaging to the
has an intensity of 2500 foot-candles, the ambient lighting above
musculoskeletal system.
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
Dental Handpieces
placement, and the stool is integral to that placement. The stool
The number of choices for dental handpieces is legion and
seat should cant forward to allow the hips to tilt downward and
the reasons for specific selections are highly personal. When
thereby straighten the back, whereas the piston or stem of the
selecting a handpiece, however, consider whether the design of
seat should be tall enough to allow the operator or assistant’s
the handpiece facilitates accessibility to all areas of the dentition.
thighs to be positioned at approximately 10° (in relation
Power is also a major consideration with electric handpieces
to the floor). The assistant’s stool should place the eye level
offering a great deal more cutting effectiveness than their air
approximately
turbine alternatives, but the small variation in effective cutting
6˝–8˝ above the doctor’s eye level. This position affords a clear
technique of the electric handpiece must be addressed to
view of the operating field.
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.
CAD/CAM technology
The E4D Dentist™ system is designed with the patient and
operator in mind. From the very beginning, D4D has involved
dental professionals in the development of the E4D system,
resulting in an easy-to-use product and process that can provide
a significant return on investment. Intuitive and fun to operate,
the E4D empowers you to create beautiful restorations that
provide the form, fit, and function that dental professionals
demand and patients prefer.
• Laser technology captures hundreds of thousands of data
points showing what really exists in the oral environment.
Using multiple images, the E4D avoids interpolating data and
captures more detailed information such as undercuts
and contours. You can even distinguish between hard and
soft tissue.
• 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
permission, a customer support representative can remotely
access the E4D system to diagnose, support, and guide
operations.
• “Same-day dentistry” means in a single appointment, the
dentist can offer a completed procedure to on-the-go patients.
• A natural aesthetic look is achieved because a patient’s
restoration can be custom designed to match the neighboring
teeth as well as polished or stained and glazed with ease.
• E4D has partnered with the best in dentistry. Distribution
and service is provided by Henry Schein Dental. Restorative
materials are provided by 3M ESPE and Ivoclar Vivadent
and diamond burs are provided by Premier Dental
Products Company.
Dental lasers
Laser therapy has been associated with the term, “minimally
invasive dentistry.” Lasers are comfortable for patients and are
considered to be safe and effective.
• Some traditional procedures usually performed under
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.
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 Chapter 3: Clinical Equipment & Technology Benefits
Intraoral cameras
Over 50% of offices have an intraoral camera. Intraoral cameras
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.
Computer network
Dental Computer Network
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
documents for your team.
18 Ask your Sales Consultant about currrent Sect. 179 tax incentives.
Mechanical
Vacuums and Air Compressors
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.
Laboratory
Dust Collection/Evacuation Systems
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.
 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 Pins & Posts
r Evacuation Products r Preventives & Prophy Materials
r Finishing & Polishing r Retraction Materials
r Handpieces & Accessories r Rubber Dam & Accessories
r Impression Materials & Accessories r Sutures & Suture Needles
r Infection Control r Uniforms
r Instruments r Waxes
r Laboratory Products r X-ray Products
r Matrix Materials & Accessories r Stationery & Office Supplies
r Pharmaceuticals r Toys

Large equipment

Operatory room setup Exam room setup Hygiene room setup

r Chairs r Chairs 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

Technology
CAD/CAM & Digital Impressioning X-rays Miscellaneous Technology
r E4D CAD/CAM r Intraoral r Computers (dental network)

Lasers r Sensors r Software

r Hard Tissue

r Panoramic r Patient Education

r Soft Tissue

r Cone Beam CT Radiography r Entertainment

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