Anyone else feel like the days are blending together? This is what week into lock down/social distancing?
There is no better time than the present to review the systems in your clinical department. Take advantage of the time you have to thoroughly review your systems and pinpoint areas that need improvement! Believe it or not, bur management is a biggie! And I am not just talking about how the overstock is organized, I’m talking about how they are deployed and processed.
How many of you keep burs in the operatory - you know - in that big wooden block full of randomly placed burs that you keep on the counter behind you? What happens when the procedure is complete? Do all the loose burs end up on a tray for the dental assistant to process through sterilization?
I remember what a pain it was to process those damn burs. My office was one that had a basket that looked like a tea infuser. I would carry that metal tray from the operatory to sterilization, carefully pick up the burs rolling around and load them into a metal basket, (you know, that tea infuser looking thing) and throw them into the ultrasonic. Throughout the day, I would empty the burs from the basket and into a sterilization bag. If you think you can handle those tiny things with utility gloves, you’re mistaken. By the end of the day, I had a sterilization bag full of burs to run through the autoclave. Quick and easy, right? Not exactly. That bag of clean burs would eventually have to be sorted and restocked on that handmade wooden pegboard in the operatory.
If this is you, don’t worry, you’re not alone.
Now that you have a little time on your hands, let’s talk about what you can do now.
CREATE A BUR BLOCK
For those of you who are currently using bur blocks, you might want to stick around. Creating the most efficient bur system in your practice takes time! Lean teaches us to create systems you can standardize and sustain. But first, we have to sort and simplify. Take a moment and think about the procedures you do 90% of the time, what are they? I’m not here to tell you what burs to use, but rather offer you a lean solution for the burs in your dental practice.
- Gather all the burs and diamonds the entire practice needs.
- Sort them into categories.
- Round, fissure, coarse reduction, fine shoulder, you get it.
- Pair similar burs together.
The next step is more challenging. You’re going to have to take those pairs and decide which one you like better or use more often. For practices with multiple doctors, everyone must be present. You will need the input of your team to get a clear picture of what burs to select.
Reducing the number of burs needed to do dentistry in your practice, allows you to create one standard bur block for all procedures. Your goal should be to have less than 30 implements, but we’ve had some offices get down to 10! If you and your team can’t get it down to 30 burs then return to the beginning and start over! Keep refining. Dr. Ahearn’s Guide to Maximizing Productivity goes into this in greater detail – and shows some example set ups. If you want a copy, let me know!
- Get a bur block with the capacity to contain all 30 or less burs. Frankly, I don’t care who manufactures it.
- Get a bur block that has the ability to close like the Brasseler below.
- Make sure every slot is full – do not leave empty spaces. If you have reduced the number of burs to 26 and your bur block contains 30 slots, duplicate those burs that tend to break or dull faster. That way when you open a block and all slots are full, you will know you have everything you need.
- Take a picture of your bur block
- Print it
- Label it and protect it.
- Finally, post in your central sterilization area as a guide. Remember, before your bur block goes through the autoclave, every slot is should full.
Brasseler Block
CONGRATULATIONS! You have just created a simplified, standard bur block! Processing your burs is now much simpler. There is no need to handle burs individually, but rather, as a single bur block.
NO MORE LOOSE BURS
Now that your bur blocks are efficiently arranged, the next step is organizing your overstock burs. The goal - to make it simple. Different burs must be stored in their own space and the space must be labeled appropriately. Many docs implement a tackle box or a stationary organizer like one you would find in a garage for your screws, nuts and bolts. Both options are good. I like to organize my overstock of burs in clear, tip out bins - not randomly though. I want my overstock burs to reflect my bur block. In other words, if I have three rows of seven burs on my bur block, I want three rows of seven compartments in my bur overstock design. I want anyone, and I mean ANYONE to have the ability to replace a bur on a bur block. If the fourth bur in the second row of your bur block is missing, you will find the replacement bur in the second row, fourth tip out bin across. It really is that simple!
Your investment is minimal. You’re looking at an investment of about $30.00 for a tool chest for small tools you could find at Home Depot and about $20.00 for each 9 - slot small compartment tip out bin. Let me know if you need help with your configuration. Bur blocks could run between $5.00 and $50.00 depending on the manufacturer.
If you have areas in your dental practice that are causing a bottleneck like your bur system, just know - “this can all be easier”
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