Jeff Carter, DDS, and Pat Carter, IIDA
For more on this topic, go to www.dentaleconomics.com and search using the following key words: dental office design, dental office technology, Dr. Jeff Carter, Pat Carter.
The mercurial advancements in dental technology have impacted all spaces within the dental facility. Even so, we estimate changes dictated in design of the dental office due to technology advancements to be 15% over the last 20 years. You may be wondering, How can that be? considering the 1,000% change in product design over the same time period — e.g., iPhone or EVO 4G vs. a 1991 rotary-dial, corded, landline phone.
The reason? Effective dental function is still driven by human ergonomics, anthropometrics, and sound practice principles. And those parameters have not changed significantly. A well-designed dental office prioritizes these criteria, and the insertion of technology (large or small) is about identifying size/utility requirements, appropriate application to dentistry, and integration within an ergonomically sound facility.
Significant changes in dental office design due, in part, to technology advancements would be:
Operatory size: We recommend 10’ wide by 12’ deep as the minimum footprint. This assumes partitions between operatories and at the head wall with side cabinets on either side of the chair. This 10’ x 12’ dimension also dictates a minimum clearance between the dental chair and fixed cabinetry of 32”. For those of you who prefer the doctor’s module in the 9 o’clock position (3 o’clock for left-handed operators) and attached to the dental chair, we recommend increasing the width of the operatory to 10’-6”.
CPU cabinets: It is no longer acceptable to place computers on the floor ensnared in cables. Locate computers in base cabinetry with vented cabinet doors. In a 24”-deep base cabinet, the computer cabinet door face is 12” in width, yielding an interior clearance of 24” to 26” H x 10.5” W x 22.5” D — suitable for most workstation computers. In instances of 18”-deep base cabinetry, increase the compartment width by 12” in order to angle the CPU case in the decreased depth.
Server closet: We recommend a space approximately 3’ x 3’ to 4’ x 4’ to receive all related cabling and to house computer networking hardware, stereo system, phone, and entertainment/educational system components. Temperature control is essential and accomplished by providing a vented door, a thermostatically activated ceiling fan (set on 80 degrees), and ceiling mount diffuser connected to your HVAC system. This space is best located off a transition corridor separating operatories and private zone spaces (bulk storage, staff and doctors’ offices).
Monitor mounting solutions: A 15” flat-panel monitor was $1,500 in 1998. Flat-panel monitor mounts were developed for various applications utilizing these “new” tubeless monitors. The articulated mounts used in operatories that provided upright and reclined patient viewing options were priced significantly less than the flat-panel monitors.
The cost of the monitor mounts has risen with inflation while the cost of flat-panel monitors has dropped approximately 750% since 1998. It is now typical to mount $200 monitors on $1,200 to $2,700 articulated mounts in the operatories to provide a “patient viewing” monitor solution. Cable management through articulated joints is problematic and unesthetic. Additionally, the enhanced blocking required to counteract the torque of articulated arms is challenging and adds cost.
Low-profile fixed mounts, in the price range of $50 to $150, hide cables and mounting hardware directly behind the monitor, creating a more esthetic and less costly solution for a patient viewing monitor in the operatory. Consider this two-monitor alternative using fixed mounts vs. the typical one monitor mounted to an articulated arm solution:
• Upright viewing: Mount a 37” to 42” LCD (or LED) monitor on the foot-end wall at 60” above the finished floor.
• Reclined viewing: Mount a 19” to 22” LCD TV monitor directly above the reclined patient head position on the ceiling surface.
Blocking: Wall- and ceiling-mounted monitors used throughout the dental office require blocking in walls or ceilings to ensure stable mount connections. Install ¾” plywood of the approximate size of the monitor to be mounted at framing behind drywall.
Cabling “spaghetti” — computers on the floor and visible network components strewn throughout an office — are viewed negatively by patients and detract from the appeal of a high-tech office. Esthetic and functional technology integration is just the latest design requirement of an ergonomically sound facility and not necessarily the game-changer you may have thought.
Jeff Carter, DDS, and Pat Carter, IIDA, are owners of PDG- Practice Design Group. Located in Buda, Texas, PDG offers a full range of design and consulting services to dentists nationwide. For information, call (800) 511-7110 or visit www.practicedesigngroup.com.