All together now

Feb. 1, 2004
In this column, we've discussed computer installation, hardware, and various high-tech instruments.

Paul Feuerstein, DMD

In this column, we've discussed computer installation, hardware, and various high-tech instruments. We've recognized the needs of do-it-yourselfers and given information on installing, upgrading, and integrating these systems.

One ongoing topic is monitor placement. There have been numerous debates about this subject, along with ergonomics and cabling. Even in the best situations (excluding totally new construction), wires and multiple foot pedals can traverse the treatment room floor. Some clever solutions to this problem include wall or floor-mounted electrical conduits. In some offices, these drop down onto a floor, into a wall, or shoot up a corner of the room and into a ceiling. In my office — which is in a constant state of change — foam-pipe insulation has been the best remedy for cables that run along the floor and around corners because it is flexible yet strong.

Wall or ceiling mounts began appearing as adjuncts to various arm configurations, with many prayers said that the bolts would hold under the constant tugging while in use. To be sure, many of these mounts are terrific, but there are some limitations to the points of attachment. In a retrofitted office, there may not have been sufficient "blocking" put in the wall to support the additional weight. As more new devices are added to the treatment room (intraoral cameras, ultrasonic scalers, and power boxes for electric hand pieces), precious countertop space has disappeared, and treatment room floors are littered with the detritus of technology.

Equipment designers have taken notice and are now presenting units with many of these devices either built in or with allowances for integration. Almost all new units come with a monitor solution. Most are pole mounted and may come with an arm that either includes a flat-screen monitor or has the connections built in. Several manufacturers have preinstalled the monitors, while others leave an open end for an optional arm. Some monitors even have the (standard) LCD mounting. In these situations, practitioners can choose what's right for their offices. The monitor can be closer to the patient, as well as allowing the wires to run through the tubing. In some units, this pole mount is on a swivel, allowing it to be positioned circumferentially. As a word of advice, it is helpful if your monitor speakers are either built in or have an allowance for mounting. This is certainly important if the office uses a patient education system, or shows TV or entertainment DVDs.

Other essential tools also can be can be added to the treatment unit. Several manufacturers have incorporated intraoral cameras and put them on one of the active hangers. When the camera is lifted from the unit, it automatically turns on, and, in most cases, activates the monitor. The image capture is done with the unit's foot pedal. When computers are added to the treatment room, most units have matching cabinetry and hidden areas for the CPU, internal wiring, and a place for a behind-the-patient LCD monitor.

When you add items like electric hand pieces, ultrasonic or piezo scalers, again, these new units make all of the extra boxes disappear. There also are newly designed curing lights that are wand shaped, which naturally fit in the hangers. In addition, the new units have sleek, clean lines and look very modern as well as uncluttered. Several now incorporate asepsis features such as individual water supplies and biofilm cleaning systems.

Every unit has ergonomically positioned controls, and they are totally cleanable. Many features beyond the scope of this column have been added in chair design, overhead lighting, and assistant controls. If you are upgrading your office technology, take another look at the core of your treatment areas — the chairs and units. Spend some time at a dental meeting or even at your local supplier's showroom. If you haven't though about upgrading from that foot pumped Ritter chair unit, it may be time to take another look.

Dr. Paul Feuerstein installed one of dentistry's first computers in 1978. For more than 20 years, he has taught courses on technology throughout the country. He is a mainstay at technology sessions, including annual appearances at the Yankee.Dental Congress, and has been a part of the ADA's Technology Day since its inception. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site ( and can be reached by email at [email protected].

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