Chapter 6

1 41 dental Office DesignChapter 6:Design TrendsAccording to design professionals, healthcaredesign has evolved dramatically in the past twodecades. dental office design has changed as and trends such as: new advances indentistry; the increased innovations in new ceramicmaterials and high tech dental equipment;Generation X-ers and Baby Boomers wishingto perfect their smiles; and the acceptance ofcosmetic surgery by both men and women, areall having an effect on dentists are demanding more pleasing environ-mentsand dentists are becoming more willing todeliver. Also, many dentists are beginning to realizethat superior office design can be used to markettheir services. According to dental office designexperts, dental office environments are now beingdesigned with an increased awareness and sensitiv-ity to the patient and they project a more spa-likeatmosphere to promote a sense of addition, technology is bringing a new sophis-tication into the dental office both in the clinicaland administrative areas.

2 Currently, the mostpopular technologies are ones that produce dentalimagery, such as intraoral video cameras, digitalstill cameras, and digital radiography. However,other high-tech equipment such as patient education/entertainment systems, curing lights,telescopic loupes, air abrasion, electric handpieces,and other equipment,are integrating quite wellinto treatment areas. Increasingly, electronic dentalrecords, e-mails, advances in digitized imaging,and teledentistry are becoming dentist needs to anticipate the future tech-nology avancements in office designs, anticipatefuture growth and plan , the design of your own dental office needsyour personal one knows more aboutyour desires, philosophies, and goals than you additional information on office design, seethe ADA publication dental Office Design:A Guide to Building,Remodeling and can place an order for the publication bycalling ADA Catalog Sales at , orby visiting the Web site ConsiderationsThe overall function of the dental office shoulddictate the form of its design and layout rather thanadapting function to a prearranged design.

3 Dentaloffices are most effectively designed from new office, built from scratch, should have theinterior functional layout designed first, beforeoverall outside dimensions and walls are , not all offices have the luxury oftotal size and shape determination since remod-eling an existing facility is the presents another design challenge:modifica-tions to existing space to best enhance functionaloffice efficiency. It will help if you begin to lookChecklist C_____number of dentists in the facility_____number of hygienists_____number of assistants_____number of other staff members_____delivery system design_____ancillary equipment needs_____specialty material needs_____number of patients/day_____radiographic requirements_____darkroom processing needs_____number of reception room seats_____business area machines_____filing system_____storage needs_____mechanical room(compressors, vacuum pumps, tanks, etc.)

4 At your plans and traffic flow from eye levelby walking yourself through as a patient , depending upon the patient servicesprovided, your overall form and layout can of the ways for you to start is through aprocess of goal setting and preliminary evalua-tions. Ask yourself a number of questions abouthow you will practice dentistry now and how yousee your practice in the future. How many staffwill you have? How many treatment rooms willyou need? What growth is projected for you andyour community? Will you need more receptionroom space due to the nature of your patientload? What type of ancillary dental equipmentwill you use to support your treatment?Checklist C contains several of the issues that youshould checklist is only a start you need to begin thinking about how you willuse the space and how you plan to run the the use of block diagrams,you can planfor your needs and block diagramscan then be converted into actual plans.

5 Anexample of such a block diagram is shown is important to know your design goals beforedetails can be implemented in an effective officelayout by an architect. Similar to the design of amanufacturing facility, a dental office shouldlook at the production area first, then the sup-port areas for the treatment rooms, and finishwith the administrative and patient receptionareas. For example, location and design consider-ations could be planned in the following order: Treatment rooms; X-rays and digital imaging facilities; Tray and sterilization areas; Reception areas; Business office; Reception room; and Other administrative IssuesA variety of laws will come into play whendesigning and building a dental isimportant that your dental office comply withall applicable said,this introductorychapter cannot,nor does it purport to,fullyaddress every relevant legal requirement.

6 That isamong the many good reasons why it is prudentfor a dentist involved in developing a new orremodeled office to obtain professional advicefrom an attorney, architect, and/or is prudent for adentist involved indeveloping a new orremodeled office toobtain professionaladvice from an attorney, architect,and/or the interplayof these federal, stateand local laws variesfrom city to city, theinformation in thischapter about officedesign should be takenonly as suggestionsuntil they are approvedby local authoritiesand become part ofthe on experts in the know about legalrequirements, and shaping your contracts withthem to protect you and assure compliance, isyour best way for you to proactively address thisimportant aspect of dental office designing your office, there will be a numberof legal matters to consider. At the federal level,you will want to comply with the Americans withDisabilities Act.

7 Patients with disabilities willhave rights under the Americans with DisabilitiesAct and perhaps also state or local law. Forexample, the Americans with Disabilities Actprovides for service animals to stay by the patient sside in the dental office and requires that your officeoffer an interpreter in some cases. The Americanswith Disabilities Actalso imposes minimumdesign requirements (such as restrooms/toilets,curbs and ramps, door widths for wheelchairaccessibility, and handicapped parking, etc.)regarding accessibility for people with disabili-ties. Similar state and local laws may also imposeeven more stringent requirements. If you haveany questions about the Americans withDisabilities Act, the American DentalAssociation has information standards you will need to meet will varydepending on whether you are planning to builda new office, renovate an existing one, or moveinto an office that does not need renovation.

8 Again,in addition to these federal law requirements, youwill need to comply with applicable state and/orlocal accessibility laws and building Department of Justice (DOJ) hasresponsibility for enforcing provisions of theAmericans with Disabilities Act related to publicaccommodations. The Department ofJustice Technical Assistance Program providespublications and free information about theAmericans with Disabilities Act through a toll-free ADA Information Line (TDD).Covered entities under the Health InsurancePortability and Accountability Act (call HIPAAH otline at ADA 800 member number, extension2899) must have in place appropriate safeguardsto protect the privacy and security of protectedhealth information. This standard requires thatcovered entities make reasonable efforts to pre-vent uses and disclosures not permitted by therule. The DOJ does not consider facility restruc-turing to be a requirement under this org/goto/hipaaor answers to specificHIPAA number of other issues affecting dental practicehave the potential to significantly impact dentaloffice design, such as ergonomics and waste man-agement.

9 Have your professional advisors takethese, and all regulatory requirements, into the interplay of these federal, stateand local laws varies from city to city, theinformation in this Chapter about office designshould be taken only as suggestions until theyare approved by local authorities and becomepart of the Division of Legal Affairs of the AmericanDental Association can also answer generalquestions about these issues via the 800 membernumber,at extension 2874. Also,FrequentlyAsked Legal Questionsis available by has a Chapter on dentaloffice ControlInfection control is another important factor intoday s office design considerations. Designersare planning larger and more efficient sterilizationareas,tray preparation concepts, and central storagefacilities. It is also important to have adequateventilation in this area to minimize the buildupof chemical vapor that is associated with disin-fecting solutions, ultrasonic cleaning solutions,and chemical vapor sterilant, if an alcohol-formaldehyde water sterilizer is , floor and environmental surfaces(walls and floors do not need cleaning after eachpatient) in the treatment rooms should be evalu-ated for their cleanability.

10 Surfaces that may becontaminated, including floors, should be easy toclean and if necessary, ADA has many products available regardinginfection control issues. You can place an orderfor the publication by calling ADA Catalog Salesat , or by visiting the Web ConsiderationsConstruction and Remodeling TimeDental office buildings or remodeling projectstake time for design, financing, and who are anticipating office designchanges or construction should adequately prepare and plan , it is estimated that 15 to 16 monthsor longer will often be needed in a new officeconstruction a remodeling project,allow yourself at least 9 LocationDetermining the physical location of your practiceis ultimately a personal, yet important andnever easy decision. It s vital that the locationyou ultimately choose has a local culture andinfrastructure that will support your suggestions to help you make a wisechoice for the location of your dental officeinclude: 1) to explore your wish list for your dream practice ; 2) review your business planand image.