Historically, dental practitioners have been limited to three essential methods of delivery:

• Rear, delivering at the 12 o’clock position
• Over-the-Patient, which delivers at 5 to 7 o’clock, and
• Side, delivering between 8 and 9 o’clock

While each of these methods may carry some benefit, all have significant disadvantages, which may include a limited access to materials, the tendency to enforce poor ergonomic positioning, and a patient experience that contributes to apprehension and limits the opportunity for in-room consultation and checkout.

A design company that started with dental delivery systems

The dental industry – from Dentistry Today to DentalTown – mostly knows our company, Design Ergonomics, as a dental office design firm focused on optimizing dental practice productivity and performance. It’s what brought you here, right? The funny thing is, that’s not how it all started. Thirty years ago, I began building more efficient delivery systems because I hated everything the market had to offer. I gathered some great people around me, we did a LOT of research … and patented our first Universal Workstation in 2000. The company got some great acknowledgement that we’d created something new and important - a style of dental delivery which was later recognized by the ADA in 2004 as “Over-The-Head”.

I spoke with Dr. Claudio Levato, DDS at an ADA annual meeting way back in 2012 about Over-The-Head delivery and our Universal Workstation and I still think that this video is a great overview, although the workstation has been continuously improved in the 13 years since then.

Five different dental delivery options

I'm proud to say that our clients who have embraced "Over-The-Head" delivery, along with our design philosophies, are the most productive dentists on the planet. And with our systems, the patient view and experience is absolutely serene. But, we're biased here ... and there are several other options for dental delivery for you to consider, including "Over-The-Patient" which was the method you probably had in dental school and that places utilities directly in front of the patient. The figures below break down the five distinct dental delivery methods, highlighting the benefits and drawbacks of each. Hopefully this will help to clarify your equipping choices as you plan your new or improved office. Just know that you'll benefit greatly from our practice designs no matter which delivery style or equipment you use.

1. Rear dental delivery

Illustration of doctor and assistant positioning with dental delivery from the rear

Benefits

• Assistant is free to circulate
• Space available for specialty equipment via mobile carts
• Patients not threatened by the sight of handpieces
• Good for dentistry from 7 o’clock position, O.K. from 11 o’clock position
• Potential for fair-to-good right/left hand convertibility

Drawbacks

• Disinfection and cleaning of treatment space is labor intensive
• Dr. and Assistant must work with greater than 180° range of motion
• Room must be heavily stocked for efficiency
• Doctor and dental assistant cannot individually reach all supplies
• Expensive to equip
• Damaging functional ergonomics

2. Side dental delivery

Illustration of doctor and assistant positioning with dental delivery from the side

Benefits

• Possible smaller room size
• Patients less threatened by handpieces in their visual/personal space than with OTP
• Handpieces positioned at doctor's dominant hand

Drawbacks

• Disinfection and cleaning of treatment space is labor intensive
• Doctor and dental assistant must work with greater than 180° range of motion
• Room must be heavily stocked for efficiency
• Poor/no right/left hand convertibility
• Doctor and dental assistant cannot individually reach all supplies
• Constricted space prevents specialty equipment from being deployed on mobile carts

3. Over-The-Patient dental delivery

Illustration of doctor and assistant positioning with over-the-patient dental delivery

Benefits

• Smaller room size and relatively inexpensive to equip (this is the reason that dental schools use this deployment)
• Space available for specialty equipment via mobile carts
• Handpieces at fingertips from the 12 o’clock position

Drawbacks

• Disinfection and cleaning of treatment space is labor intensive
• Doctor and dental assistant must work with greater than 180° range of motion
• Assistant trapped in room during procedures
• Dental equipment highly intrusive to patient’s visual/personal space
• Room must be heavily stocked for efficiency
• Right/left hand convertibility fair to poor
• Doctor and dental assistant cannot individually reach all supplies
• Inefficient when working from the 7 o’clock position

4. Over-The-Patient (hybrid) dental delivery

Illustration of doctor and assistant positioning with hybrid over-the-patient dental delivery

Benefits

• Smaller room size and relatively inexpensive to equip
• Consolidated supply cart reduces range of motion
• Space available for specialty equipment via mobile carts
• Handpieces at fingertips from the 12 o’clock position
• Assistant is free to circulate
• Some reduction to surface area requiring disinfection
• Right/left hand convertibility is greatly improved

Drawbacks

• Disinfection and cleaning of treatment space is labor intensive
• Dental equipment highly intrusive to patient’s visual/personal space
• Inefficient when working from the 7 o’clock position

5. Over-The-Head dental delivery

Illustration of doctor and assistant positioning with over-the-head dental delivery

Benefits

• Smaller sized rooms that are substantially less expensive to equip
• Comprehensive supply consolidation
• Space available for specialty equipment via mobile carts
• Handpieces are at your fingertips from the 12 o’clock position
• Assistant is free to circulate
• Great for dentistry from the 7 o’clock to 12 o’clock positions
• Doctor and dental assistant range of motion is less than 90°
• Fast and easy to disinfect
• Patients are not threatened by the sight of handpieces

• Right/left hand convertibility is excellent

Drawbacks

• Handpieces at doctor’s non-dominant hand. You'll see in the video below at about 1:12 how the right-handed doctor easily moves a utility from left to right during a procedure. It's not difficult, but it's worth being aware of as you plan your clinical workflow.

At Design Ergonomics, we know dentistry because we do dentistry. No matter what your desired plan is for designing your new or improved practice, we can translate your needs into the most productive, comfortable, and cost-effective success possible.

Performance Without Compromise.

For some inspiration, take a look at our recent dental office operatory design work. If you have any questions, please reach out to my team at Design Ergonomics.

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