1. Chapter 32 The Dental Office 1
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2. Chapter 32 Lesson 32.1
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3. Learning Objectives Pronounce, define, and spell the Key Terms.
Describe the six areas of the dental environment in a professional office.
Discuss the important qualities of the reception area.
Describe the goals in designing the dental treatment area.
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4. Introduction
Patients often judge the quality of care by the appearance of the dental office!
The patient’s first perception of a dental office will remain with that patient during future appointments.
What are factors to consider when creating a positive experience for the patient? (Details, organization, the manner in which you receive, treat, and dismiss the patient.)
All aspects of the dental office must be professional.
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5. Office Environment Temperature Lighting Reception area 72° F
Clinical area 68° to 70° F
Constant air exchange
Lighting
Reception area: table and floor lamps
Business area: fluorescent lighting
Clinical area: fluorescent and clinical lighting
(Cont’d)
Why do you think the temperature in the clinical area is higher? (Usually the clinical area is a smaller area and has an overhead dental light, which generates heat.)
What is a common statement from patients when air exchange is poor?
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6. Office Environment Wall and floor coverings Traffic control
(Cont’d)
Wall and floor coverings
Calming colors
Floor covering
Durable carpet in reception, business, and private office areas
Vinyl in clinical and laboratory areas
Traffic control
Smooth transition to all areas of the office
Separate areas for business, clinical, and private functions.
The wall covering should not be too “busy.” Wallpaper or paint is recommended.
Why is a vinyl floor covering recommended for clinical and laboratory areas instead of carpeting? (Infection control. Vinyl flooring can be washed and disinfected.)
Why are separate areas recommended for the patients when they are checking out? (Privacy, which is mandated under the federal Health Insurance Portability and Accountability Act [HIPAA] of 1996.)
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7. Office Environment Sound control Privacy
(Cont’d)
Sound control
Minimizing the sound of the dental equipment
Provide distraction from dental sounds with the use of music
Privacy
Administrative area
Dentist’s office
Staff lounge
Why is it important to keep specific sounds associated with the dental office from carrying throughout the office?
Privacy: HIPAA took effect on April 14, All patient accounts, billing, and medical records must comply with the law.
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8. Specific Areas of the Dental Office
Reception area
Administrative/business office
Clinical-treatment area
Sterilization center
Dental laboratory
Dentist’s private office
Dental staff lounge
Dental practices vary in size. However, certain critical components are found in all dental offices.
The design of a dental office must follow guidelines set forth by the American Dental Association and the Americans with Disabilities Act.
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9. Reception Area
Patients are received, greeted pleasantly, and made to feel welcome. The reception area is not a waiting room!
Things to remember:
Keep the area clean.
Ensure adequate seating.
Maintain up-to-date reading material.
Provide place for coats and umbrellas.
Offer a children's corner.
What is one of the ways to ensure that the reception area is not a waiting room ?
If the reception room is dirty or outdated, what impression will patients take away with them? (That the dental office and treatment procedures are also dirty and out-of-date.)
Choose reading materials that will interest patients.
Provide a place in the reception area where children can play with safe (plastic or soft) toys or read books. The toys should be kept away from traffic areas.
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10. Fig. 32-1 Design of the dental office, incorporating calming colors.
What are the positive aspects of the reception room pictured here?
What are the negative aspects of the reception room? (Light-colored carpet may be hard to maintain.)
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11. Administrative Area
Hub for the management or the business side of the practice.
Equipment
Desk
Telephone system
Computers
Photocopier
Fax machine
Storage area for patient records
The administrative area should be separate from the reception and clinical areas to provide adequate patient privacy.
No patient charts or information should be in plain sight or where other patients might have access to them.
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12. Fig. 32-4 Organization and design of the business area.
What are the positive aspects of the administrative area pictured here?
What are the negative aspects of the administrative area?
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13. Treatment Area
Also referred to as the dental operatory; all clinical treatment is provided here.
Design goals
Providing comfort and mobility for the dental team
Providing privacy and comfort for the dental patient
Enhancement in the use of dental equipment through good time management and efficient techniques              
The treatment area is the control center of the clinical area.
Most dental offices have two or more dental treatment areas per dentist and one operatory for the dental hygienist.
What is the purpose of having more then one operatory for each dentist? (Increases efficiency.)
Arrangements of the operatories should be similar in design. Why? (For easier access to items that may be kept in each room.)
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14. Fig. 32-5 Dental treatment area. (Courtesy of A-dec.)
What are the positive aspects of the treatment area pictured here?
What is one negative aspect of the treatment area?
Is this treatment room adequately equipped?
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15. Patient Dental Chair Specific features
Full support to knees, bottom, back and head
Comfortable, movable arms
Easy to maintain and clean
Controls for adjusting the patient
Upright position: The back of the chair is upright at a 90-degree angle.
Supine position: The patient is lying down and his or her head and knees are at approximately the same level.
Subsupine position: The patient's head is lower than his or her feet.
Dental chairs are available in different sizes for adult and pediatric practices.
The headrest, which can be adjusted to the patient’s height, is used to support the patient’s head securely.
Chair arms can be moved aside when the patient is being seated or dismissed.
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16. Fig. 32-6 Patient dental chair. (Courtesy of A-dec.)
Why should the dental chair have smooth, seamless surfaces and flat, smooth controls or buttons?
Why are foot controls a positive design feature?
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17. Operator’s Stool
Type of stool designed to support the body for a prolonged period in a fixed muscular activity
Specific features
Large seat and back
Easy adjustment for back support
A seat that is easy to lower and raise
Casters to make it easy to move around the patient
What features of the operator’s stool are important in reducing body and eye fatigue? (Adjustment up and down and ease of movement around the patient’s chair.)
The minimum number of casters for adequate support and maneuverability on the operator’s stool is five.
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18. Dental Assistant’s Stool
Type of stool that must provide stability, mobility, and comfort, allowing a proper fatigue-reducing posture
Specific features
Twists and turns to help the assistant reach countertops and shelves
Provides an adjustable foot platform or foot ring
Firm, secure cushioning in the seat
Abdominal bar positioned for support
Casters on which move the chair easily
Regardless of the assistant’s height or stature, the stool should allow the assistant to twist and turn to easily reach countertops and shelves.
What is the purpose of the abdominal bar? (To help the assistant avoid lower-back pain caused by leaning over during the dental procedure.)
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19. Fig. 32-11 Left, dental assistants’ stool. Right, operators’ stool
Fig Left, dental assistants’ stool. Right, operators’ stool. (Courtesy of A-dec.)
Notice the multiple casters on both the operator’s and the assistant’s stools. They add stability and maneuverability.
Notice the footrest on the assistant’s stool. It allows the assistant to raise the stool above the operator to increase visibility while supporting the assistant’s weight. The feet are placed on the footrest so that the assistant’s thighs remain parallel to the floor for proper spine support.
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20. Chapter 32 Lesson 32.2
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21. Learning Objectives
Prepare the dental treatment area for patient care in the morning before seeing patients.
Prepare the dental treatment area for patient care the next day.
Discuss the basic functions of the dental unit.
List the clinical equipment most commonly found in dental treatment areas.
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22. Dental Unit
Provides the necessary electrical and air-operated mechanics to the hoses, attachments, and working parts of the unit.
Dental-unit delivery systems
Front delivery: positioned over the patient's lap
Side delivery: positioned at either side of the patient's chair
Rear delivery: positioned behind the dental chair
What factors determine the type of dental unit placed in each operatory?
Front delivery provides the operator with easy access to dental instruments and handpieces without the need for stretching or twisting.
Side delivery allows the dental unit to be easily positioned for a left-handed or right-handed clinician.
Rear delivery keeps dental instruments and handpieces out of the patient’s sight.
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23. Fig. 32-12 Dental unit. (Courtesy of A-dec.)
The dental unit pictured, depending on where it is attached at the base of the chair, may swing to provide front, side, or rear delivery.
Notice the smooth design and limited number of crevices to facilitate cleaning.
Multiple attachments can be prepared and made readily available during the dental procedures.
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24. Additional Clinical Equipment
Rheostat
A foot-controlled device placed on the floor near the operator to control the function of the dental handpieces
Dental unit waterlines
Supplies water through hoses or waterlines into the dental handpieces
Air-water syringe
Handheld instrument attached to the dental unit
Functions
Delivers a stream of water
Delivers a stream of air
Delivers a combined spray of air and water
(Cont’d)
The amount of pressure placed on the rheostat by the clinician’s foot will determine the speed at which the handpiece revolves.
The air-water syringe is necessary for every procedure. Often a dental unit will contain two air-water syringes, one close to the dentist and one close to the dental assistant.
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25. Additional Clinical Equipment
(Cont’d)
Operating light
Used to illuminate the oral cavity during a dental procedure
Oral evacuation system
A means of removing water, saliva, blood, and other fragments during a dental procedure
Types
Saliva ejector
High-volume evacuator (HVE)
Halogen bulbs are used in most operating lights. The light is attached to a flexible arm that is either track-mounted from the ceiling or attached to the wall or dental chair.
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26. Additional Clinical Equipment
(Cont’d)
Disposable traps
Filtering mechanisms for the saliva ejector and HVE
Curing light
Used to “harden” or light-cure dental materials
Amalgamator
Used to triturate dental materials by means of vigorous shaking of the ingredients
Disposable traps collect large debris, tooth structure, and old restorative materials that may loosen during tooth preparation and keeps them from becoming trapped in the plumbing pipes or expensive vacuum systems.
The amalgamator and curing light can be mounted in a cabinet or under a countertop for easy access. However, the light cord must be able to reach to chair during dental procedures.
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27. Additional Clinical Equipment
(Cont’d)
Central vacuum compressor
Provides the suction needed for the oral evacuation systems
Central air compressor
Provides compressed air for the air-water syringe and air-driven handpieces
The central vacuum compressor has two parts: (1) a compressor that creates airflow and (2) a vacuum tank that screens the flow of air to create suction.
The central air compressor must be subjected to routine maintenance to avoid the buildup of condensation, which will result in the formation of algae and sediment in the air lines and waterlines.
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28. Care of Clinical Areas Morning routine
Arrive 30 minutes before the first scheduled patient of the day.
Turn on the master switches for the central air compressor and vacuum units.
Ready the dental treatment rooms for patient care.
Recheck the appointment schedule.
Set up the treatment room for the first patient.
(Cont’d)
Who is responsible for the care of the clinical areas before and after the scheduled patients? (The dental assistant.)
Careful completion of the morning steps ensures the smooth flow of patient care throughout the day.
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29. Care of Clinical Areas Evening routine
(Cont’d)
Evening routine
Complete the operatory exposure-control cleanup and preparation protocols.
Turn off all equipment.
Ensure that treatment rooms are adequately stocked for the next day.
Post appointment schedules for the next workday.
Ensure that instruments, patient records, and laboratory work are ready for the next day.
Ensure that the sterilization center has been cleaned.
Ensure that the treatment rooms are ready for use.
Place any soiled protective clothing in the appropriate container.
Careful completion of the evening steps ensures that the equipment will be maintained and the team will be prepared for the next day.
Turning off dental equipment before closing the office each day will minimize overnight equipment problems or possible damage to the dental office resulting from water leakage or fire.
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30. Central Sterilization
Specific area for:
Cleaning, sterilizing, and storing instruments
Divided into a “contaminated area” and a “clean area”
Provides extra storage for supplies
Should be kept organized and clean at all times
The sterilization area is a crucial component of day-to-day operations.
Step-by-step procedures and protocol must be followed to eliminate cross-contamination or infection-control problems that can injure a dental worker or patient.
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31. Dental Laboratory
Organized area away from patient care where the dentist and dental assistant perform laboratory procedures.
Specific items found
Workbenches
Storage cabinets
Model trimmer
Dental lathe
Laboratory materials
What are some of the procedures performed in the dental laboratory? (Pouring of impressions, preparation of diagnostic models, and creation of custom impression trays.)
All contaminated materials (alginate impressions, removable appliances, etc.) should be disinfected before being handled in the lab.
Personal protective equipment (PPE) should be worn during laboratory procedures.
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32. Dentist’s Private Office
For use only by the dentist
Can also be used as a consultation room with patients
Specific items found
Desk
Telephone
Computer
Extra chairs
What is a consultation room? (A room where the dentist discusses diagnosis and treatment plans with the patient.)
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33. Dental Staff Lounge
Designated private area for clinical and business staff
Specific items found:
Table and chairs
Small refrigerator
Microwave
Locker or locked cabinet for personal belongings
Coffee or food
This area may be used by the staff during personal time or for staff meetings.
It is customary for the dentist to financially support a coffee service and food vendor.
PPE should not be worn or taken into the staff lounge.
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