May 14, 2019 | Equipment, TX Rooms, Weekly

What is the optimal dental delivery system layout?

It just goes to show...you don’t know what you don’t know! Boy, that sounds like a song. In fact, it’s a sentence I rattle off a lot. There are several ways to deliver dentistry, and while each has some positive benefit, they are NOT all equally effective - or equally beneficial to your long-term health and well-being.

There’s no question, the topic of ergonomics in the workplace is a growing concern, especially in dentistry. Watch this dental ballet.  

I don’t have to rewrite what has already been written in publications like Dentaltown Magazine, Dental Products Report or Dentistry Today, but I will. The ADA recognizes 4 dental delivery systems. Each have benefits, but considering Ergonomics, one stands out. Here’s a breakdown.

Delivery Pros/Cons

Side

- PROS -

  • Positioned close to operator

- CONS -

  • Assistant cannot access instruments
  • Limits resale and potential associate whose dominant hand is opposite
  • Gets in the way of Mobilized technology

Rear

- PROS -

  • Equipment located behind the patient which frees up space in op
  • Less intimidating to patient
  • Great 4-handed dentistry
  • Less expensive

- CONS -

  • Poor two handed function
  • Cannot easily convert right/left hand
  • Limited access to care
  • Requires more op depth
  • Does not consolidate Dental Assistant range of motion

Over-the-Patient

- PROS -

  • Accessible to operator (doctor and hygienist)  and assistant
  • Most expensive

- CONS -

  • Equipment on top of patient
  • Intimidating to patient
  • Requires more op width
  • Complicates instrument passing
  • Increases time for room turnover.

Over-the-Head
Recognized by the ADA in 2004 as the newest method of dental delivery.

- PROS -

  • Combines benefits of rear and over the patient.
  • Rapid right/left convertibility
  • Supplies at a ideal location for assistant
  • Easily converts from 4-handed to 2-handed
  • If set up correctly, allows you to do any type of dentistry, anytime, anywhere

- CONS -

  • Handpiece placement is located at the hip of non-dominant hand

 

In an article published March 16, 2017 in DPR  by Dr. Bethany Valachi, expert in dental ergonomics, writes “Combining many of the benefits of over-the-patient and rear-delivery systems, over-the-head systems allow the operator the ability to practice from the 7 o’clock to 1 o’clock positions. Supplies are in an ideal position for assistant access, while handpieces are more accessible than rear-delivery layouts, reducing the ergonomic challenges when in two-hand function. Additionally, over-the-head layouts, when properly configured, convert from right- to left-hand function rapidly.”

Dr. Valachi is an internationally recognized expert in Dental Ergonomics.  I had the pleasure of speaking with her a couple of weeks ago. Among other evidence-based ergonomic dental office solutions, she likes over-the-head type delivery systems, specifically Ergonomic Products Workstations, because they fully utilize the dental assistant in a four-handed position. Please check out her website: www.posturedontics.com.  

It’s about reach, and work-surface. Position all clinical materials and extensive work surface within reach of doctor and assistant. Remember - You Can’t USE What You Can’t REACH. If you have to get up to get something, or reach behind you to get everything, you’re not doing your body, your patient or your practice any favors.

There is a learning curve when improving the way you work; in this case, ergonomics. I always tell my clients, “Muscles have memory.”  Your body and muscles have conformed to less ergonomic ways of doing things which has caused you to make endless trips to the chiropractor. When you are positioned properly, you may briefly experience sore muscles as your body gets used to the new position. It’s like exercise. If you haven’t gone to the gym for a year, then get a hankering to one day because it’s almost bathing suit season, you’re likely to be sore the next day. But this soreness goes away the more consistent you are.

 

So - if you are a start-up making equipment decisions or ready to update (upgrade) your equipment, please do a little research. Whether you are left handed or right handed or appreciate the opportunity by having both in your practice, make it easy. The way your body is going to move and do its job for the next decade or three will have a lasting impact on your overall health. Make the job fit the person - not vise versa. YOU are the machine that gets dentistry done in a productive practice: take care of your machine!! Both Over-the-Head and Over-the-Patient delivery will keep you healthy, while providing the greatest level of 2- and 4-hand procedure flexibility - a critical element of a successful practice!

Of course - you know I’m going to recommend the Workstations from Ergonomic Products. Why wouldn’t I? They provide the best of everything: suction utilities, air/water, curing light, operative supplies, consumables, scalers, assistant’s entire work surface and sharps are all within inches of the point-of-use. And they do all that “behind the scenes” so to speak - outside the view of your timid patients. They just make sense.

When I was hired at Ergonomic Products, I made it clear, I couldn’t sell something I didn’t believe in. For a period of time before entering the EP salesforce, I wanted to work chairside and assist the doctors in our dental practices. The “how to” place a composite filling was the same as I had known, but the speed and accuracy of the process was remarkable!  

Ultimately, though, I don’t care where your handpieces are - just please deliver dentistry ergonomically!!  I don’t want you all to break… the work you do is too important.  

Ergonomic Intervention anyone?  

 

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