Common Questions

Common Questions

We are ready to help - today and throughout your project!

Our team understands that responsiveness throughout the design process is crucial to your success. We treat our client communication the same way we treat communication with a friend. We will communicate in whatever way is most convenient for you (email, text, chat, phone call, Zoom, FaceTime) and make our team available as much as possible. If you think that you have found a great piece of land or existing space for your new practice, you need answers quickly to determine if the location fits your needs. And you need that fast.

Our initial concept designs will be completed in 5 to 7 days, regardless of how many people are required to put on your design assignment. That means that you will know what you will be able to do with that space and will have a good idea about how you can do it. Fast.

After that, the length of the design process largely depends on your schedule, and the size of the project. We have had offices designed and renovated in 10 weeks. Of course, we have many more completed in 10 months. Again, much of this will depend on you, your needs, and your schedule. Just know that, if you choose to work with us, we have been doing this work for over 20 years and our team is very experienced and will be responsive to your needs.

If you are building from the ground up, administrative constraints will commonly require more time and management. But they often result in a much more dramatic, flexible, and scalable office that is free from the constraints of adjacent tenants.

Construction to rehabilitate an existing office can often be done in 6 to 8 weeks and perhaps be split into two segments so that you can always remain open. Our founder, Dr. Ahearn, for example, always tries to do this with his own practices.

A full redo of a shell can take 10 months, although with proper planning it shouldn’t take that long. We have seen this accomplished in as little as 12 weeks - but that requires very careful planning. If you have such a need, we have contractors that can accomplish this.

New construction varies considerably because of local governmental considerations. It is not uncommon for a ground up construction project to take 2 years to completion in areas with varied and complex state and local governmental regulations.

One of the greatest misconceptions about our design philosophy is that since we are able to create more treatment rooms in less space than any other design firm, that we must do one of two things … or both.

  1. We must make smaller treatment rooms. Nope. We don’t. We actually INCREASE the open floor space of the typical treatment room design while eliminating unnecessary expense.
  2. That we couldn’t possibly have enough storage because we don’t design in storage closets. OK, that’s true about no closet closets, but not the part about not having enough storage.

So, here’s the crazy secret … at least about supplies. You want to put the supplies - of any sort - where you will actually USE them!

That means you need to understand a lot of LITTLE things:

  1. What supplies you need this week.
  2. What you need for the next month.
  3. How to put those supplies where you will use them or stage them.
  4. And just maybe …how much extra supply volume you want to keep to satisfy any paranoia you still have about supplies. Our system of supply management will allow you to both serve the supplies you need every minute ... and protect against outtages.

Once you have this volume calculated, you can embrace the concept of visual restocking. You’ll be able to buy whatever you want without wasting, always have what you need, without searching, and greatly reduce the volume of space that you need to use, purchase, or lease, saving you - in many instances - MILLIONS of dollars in mortgage or lease payments … and wasted supplies … over the life of the practice. Yes. MILLIONS. Contact us. We’d be happy to let you know how we make this all happen. Watch this video for more information about visual restocking:


Honestly, it’s not because you want to see the stuff from your past history that might be dated or even something you might consider embarrassing about your dental office. Just know that we’ve seen everything in over 20 years of designing dental offices. We strongly suggest a video because, with a camera, magical things happen. You see things in a different light than your day-to-day view. There’s actually a science behind this. So as you walk and record you get to tell the story. “I love this, better have this in the next office! and “Oh my I really hate this, but I’ve never figured out what to do about it!” Tell the story and we'll work on your ideal future practice together.

We consider these videos like game film. We study them at work together to catch little unforeseen areas that we can impact the design and performance of your office in significant ways, and can be remedied often with little to no additional cost in your project.

So please, take your time (generally less than 10 minutes) and tell your story. Walk around your office with your phone or have an assistant with a phone. We're not looking for anything fancy. A shaky phone camera is the standard for these videos. We just want to hear your story about your office "before" so that we can make the perfect recommendations for your "after."

Even though you may not love, or even like, a proposed floor plan (often "free") you received from your dealer, there is generally some useful takeaway from the process that got you to that plan. There may be something that you can point us to in the floor plan that you like ... or don't like. In any event, it often helps us understand you better as we explain alternatives that will get you to the office of your dreams. Having the context of that initial plan can help us quickly understand what is most important to you.

Here’s a funny fact. If we wanted to win awards for designing, the best way to do it is to design big waiting rooms. Rooms that look like high-end hotel lobbies. They look great in photographs.

So here’s the first question, why do they have those big lobbies in the hotels?

They do this to impress you visually with multi-thousand dollar floral arrangements. But I’m betting that you’re not going to do that. In addition hotels actually have some purpose for these lobbies. They need to have the ability to absorb a large influx of people, for example from a shuttle bus or tour group. This number of new visitors plus luggage can absorb a great deal of floorspace. We don’t have that problem in dentistry.

So what’s a dental waiting room actually for? There are only a couple of choices.

  1. Big dental office waiting rooms are useful when you aren't doing what you're supposed to do, which is to stay on time. That extra space is useful for stacking people up so they can ... wait. Just understand that you're wasting the valuable time of your patients, and they, like all of us, hate that. Especially the ones who can afford to choose you or any other dental office. Everything that we are going to teach you will make it possible to largely eliminate this profitless and painful waiting time.
  2. The other reason for a bigger waiting room is to accommodate relatives in a pediatric or orthodontic practice. These are legitimate reasons and need to be accommodated in your plan. That’s why we will spend a good bit of time discussing your practice model with you before we begin the design process. Most GP offices do not have a significant element of this specialist component and even in ortho/pedo practices the parents seem to muscle their way into the treatment rooms these days! As a result we’re actually more concerned about waiting rooms that are too big and appear empty than those that are too small. Have you ever gone to a restaurant that was recommended but when you entered the place it was almost empty? Did you feel confident that this was a great place for dinner?  I am generally second-guessing the recommendation at that point.

Take a look at some our beautiful, efficient, and high-flow dental office waiting rooms and reach out to our team if you have any questions.

This one seems counterintuitive. Perhaps your practice is overflowing and there’s nowhere to put anyone. You’ve decided to build a new office and you have a property selected.

Guess what? It’s time to start marketing! You’re undoubtedly thinking that you will have a surplus of patients forever, but if you were planning right, you probably should be doubling your number of treatment rooms in this new office. With the proper staffing, you’ll burn down your surplus faster than you might imagine. So, the time to market is now. Brag on your business promise - that this great new future will be wonderful for existing patients…because it will be. Brag on scarcity. Promise your patients that you’ll make room for their friends.  Set the stage for your future. Contact us for thoughts on how to execute this plan.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

We will show you where you might want computers and make recommendations. But, we strongly suggest that the cabling, product selection, installation and servicing be done by local IT professionals. If you don't have somebody already, we probably have a great recommendation.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

Yes. While our focus had been on GP practices, we have felt that the specialty market has been underserved. We have only recently provided specific dental office design services to the dental specialties. Our emphasis has been GP practices, because we wanted to make sure that we had completed our mission to supply all of the needs for high-performance GP practice before committing to doing the same for specialists. Having said that, we have designed specialty sections within GP offices for years and now, having developed new advanced technology designed for the future of specialty practice (where there has been very little in the way of advances in core components for decades), we are now making our design services available to all. Take a look, I think that you’ll be excited at what you see.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

Every year we receive a handful of requests from doctors to have their office manager or assistant be the person to handle the management of the design of a new dental office. In all due respect to your office manager or assistant, we have to say that this is generally a bad idea. While it is true that you probably haven’t designed an office before, unless your employee has done so, and especially of the size that you will now be creating, the consequences can be catastrophic to you and your success in practice.

Would you have this manage the business after it is designed? Maybe. Design it? Probably not. To abdicate the design of the machine that produces all of your income is a pretty horrible idea.

But there’s more to the story. You very much need front office feedback. You need clinical people to understand the important decisions about sterilization. You need to make sure that your hygiene team is on board. Often we are enlisted to help in this process either by working with you at one of our regional Over the Shoulder events or by in-office consultation with your team personally. So to be clear, your new larger office is a very different animal. It functions differently! If done properly, it can be more intimate and relaxing than the smaller office! But it needs careful planning and execution.

In any event, the best way that we know of to do this is to invest in a bit of your time. We have extraordinary Spotlight offices across the nation. Successful dentists that will share their journey and all that they have learned about what becomes possible with a re-thinking of process and flow. The Spotlight clients are special clients who represent what we are about – great success in private practice – and are also are willing to share with other doctors the discoveries they’ve gained through using our systems.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

A family member may be able to source furniture and finish selections, but our interior designers will help add a more comprehensive level of services which include, but are not limited to the following:

  • Incorporate sound control into your design
  • Ensure that the entire space is aesthetically cohesive
  • Source items that are durable and commercial grade - important considerations in a dental office
  • Provide useful visualization tools to help you see the proposed space as they consider design options
  • Ensure that all products sourced are sized appropriately to fit in the space
  • Maintain proper ADA compliance clearances
  • Bridge the gap between any consultants and stakeholders involved in order to achieve your clients overall vision
  • Maintain a targeted budget
  • Provide the GC with a documentation set and specifications of all approved materials and their locations
  • Work hand-in-hand with the GC to tie up loose ends on site

These activities are all incredibly vital and none of them can be overlooked.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

The number one risk factor in any office remodel is downtime! Contractors want to work when patients want to be seen. The reality is that it is almost impossible to make up the lost income related to fully shutting down your office! Ever. A lengthily shut down, in addition to lost income, will often cause a loss of patients and staff. In many ways the lost revenue is the smallest part of your problem!

So if it seems clear that a complete shut down is a pretty horrible idea, what alternatives do you have?

The first option is to find a construction crew that will work around your schedule. For example, if it is summer and your staff is amenable to a reduced work week, you might consider a longer three or four day work week, leaving almost a full week available for your contractor who will themselves presumably work longer days.

Many doctors actually learn during this time that they can be just as productive with one fewer day of practice simply by increasing their focus and, if the renovation is an expansion, this can pave the way for additional doctors being able to join the practice and cover the open days that are created.

The second strategy is actually a subset of the first in that you want to employ phasing in all but the simplest of renovations. Successful project phasing is an extremely important part of almost any office renovation. It needs to be very carefully planned and, when done properly, will often allow contractors to work during open office hours with a minimum amount of disruption.

Here are the most important aspects of phasing:

  1. You do not want room count to drop by more than one or two rooms for longer than one week. It is pretty easy to create one week of longer appointments in fewer rooms. Filling up your days with single column procedures like Endo and bigger crown and bridge cases. On the other hand, most offices find it difficult to avoid short, multi column procedures beyond a weeks time.
  2. Temporarily repurpose existing spaces. We have had offices that successfully converted the existing staff lounge into a temporary waiting room while reworking and expanding the front desk area. They then use the new but unfinished treatment rooms as an interim staff lounge as renovation is completed in that space. The same could be done with creative swaps of sterilization areas, labs and the new treatment spaces. These examples bring up an important point. It is much easier to phase a renovation during an office expansion than it is with an office that wishes to remain its existing size! With the expansion you create additional capacity.

A word of caution: we have offices that have utilized as many as five phases in making these moves. It's something that must be carefully planned and executed. Most contractors do not work out the details to the level that will ensure your smooth workflow during this time (they don't realize that our patients really don't want to hear jackhammers during treatment!).

We've helped doctors through this process hundreds of times. Don't hesitate to reach out to us for our help with this aspect of your design.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

Finally – before undertaking a full remodel of your office, you might consider upgrading your systems first. Design Ergonomics offers three proven dental office training programs to optimize the flow and productivity of your dental practice.

The first, Dental Reboot, addresses bottlenecks in sterilization, resupply and clinical support at the root level. In this 2-day, on-site training we take a hands-on approach to reorganize those systems and get your team working more efficiently. These improvements might buy you some time by increasing the productivity of your existing space. They’ll also make challenges of an eventual remodel much easier to manage.

The dental office design process is about objectives: determining what’s important to your personal practice model, and creating a plan that fulfills your goals in the most efficient and cost effective way possible. The plan should focus on workflow and systems for delivery of care rather than the hardware that you have to buy. While we can’t speak for all of the professional dental office designers out there – we know from experience that many lose sight of these objectives, especially in the dealer world.

The dealers’ design departments fail in keeping focused on your goals simply because the only way that they get paid is with the sale of equipment! As a result, the design process becomes one of how many treatment rooms they can fill with expensive cabinetry and equipment. It’s really not their fault that they do it this way – you were the one that wanted a free design. Invariably, the unfortunate result is a higher build-cost and more space occupied than is necessary.

Another difference that you will find with a custom design firm is the ability to speak directly with the designer. This gives you the opportunity to discuss and develop a broader picture to satisfy long-term goals. Using phased equipping, and smarter design geared to future expansion, you can establish the details needed for today’s success - and tomorrow’s growth.

The best custom designers will have one other factor that differentiates them from the dealers; they’re trained by actual practitioners, dental professionals with first-hand experience in the real-world challenges of running an efficient dental practice. There’s every probability that a challenge you’re encountering has been overcome hundreds of times (if not thousands) in the past by an experienced design team.

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

Many offices desperately need additional treatment rooms, but the challenge of creating additional space is huge. Nonetheless, by using specialized layouts, it is entirely possible to create fantastic treatment rooms in extremely compact spaces. Rooms can be shortened by using specialized chairs. Width can be narrowed for special hygiene function. We even have an unlisted series of designs referred to as SRS (Small Room Solutions) for incredibly challenging space constraints. In addition, in order to make super-efficient, smaller doctor rooms, we frequently use what we refer to as "room pairs" as space saving and efficient layouts. We also frequently trim room dimensions considerably, by recommending Ergonomic Products' Inwall® cabinetry. Watch the video above for more detail on this concept.

When you understand that hygiene treatment rooms do not need to be 9 or 10 feet wide, you'll start to see opportunities for increased operatory count. Wasted dimensions will only trigger a waste in motion, and consequently a waste of time and money. Compact hygiene rooms are also much easier to work in and will make your team super-productive!

A successful construction project is no accident. It is the result of meticulous planning and, more importantly- control. It's easy for a contractor as the gatekeeper to control your project. Design Ergonomics' experience in construction planning and our attention to process can help you make and follow through on the decisions that will lead to successful completion of your office building - on time and on budget. We will work with you from the onset to control costs in the design of your new office so that changes that you or your contractor make during the process, do not push you over budget.

Think of Design Ergonomics as a performance brand. We do and make only what other people won’t or can’t! You’ll want us for the most efficient conceptual layout (a Blocking Diagram) of your space so you maximize the potential of that space. And, quite honestly, we are the best at translating that conceptual layout into a floor plan that will ensure that small, but essential, details get designed in at this stage. It’s an important part of how we squeeze more value from less space.

After that however, there are really two questions to consider in your decision-making process. The first is who will be building the project? We are firm believers in what is referred to as design build. It is an open book method of construction that simply has the contractor charge a stated percentage markup. Then, together you work to get the project in budget. This is very different from the bid process, where are you really can’t tell who may be lying, who’s hiding something, or who intends to find and charge for cost overruns.  With the bid process, builders are forced to guess how low they need to make the bid number appear to be in order to win the work, and successfully capture the bid.

On the other hand, if you are choosing design build, you can let the design build firm prepare the construction drawings and permit plans. That way they’re fully responsible for what is created and do not have the opportunity for markups regarding errors and omissions. Design builders also tend to be quicker than outside engineering firms because they are motivated to get your work done.

Beyond the floor plan and building, the next piece that you need to decide is interior design. Interior design is critical because it's what your patient actually sees and it becomes your de facto brand. It also has a strong influence on the reflected ceiling plan layer of your design. This design element is also vital for the feel of the space and spaciousness, your visual acuity and eyestrain protection, and the energy consumption of your office.

We love being given the responsibility for your dental office interior design. We have a great department committed to just doing amazing interior design work for dental offices. They aren’t decorating a pizza parlor one day and a funeral home or a bar the next.  Those are important places to design - please don’t get us wrong. But the knowledge gained for the designers of those experiences is not really what you need. You need a group dedicated to dental office interior design that understands the needs of doctors and dental staff, and the patients they serve every day.

Note of caution: We often have more interior design business than we can accommodate so if you think that you might be considering us for this aspect of your project please let one of our Practice Liaisons know at your earliest opportunity so that we can set aside time in our schedule for your project.


There are a multitude of opinions about clinician position and, as is commonly the case when there are differing opinions, that usually means that there is no single answer. However, we can give you some background and a method of deciding how to make positioning ideal for your style of practice.

First, here's a bit of history. The quest for "ideal" clinician positioning comes from the studies of industrial hygiene (factories not dentistry!) at the middle of the past century. The whole idea was to make man part of the machinery - a tool with a dental degree.

Here's the problem:

Our patients vary; we have obese patients and tiny patients and patients that can't lie flat. This isn't an assembly line. If you break the machine (the doctor) you can't just buy a new one! So we have to create an environment that is best for the "machine" not just for the task. Therefore, we need to split the process into basic principles and flexible options.

Basic (and incorrect) principles - these are the ones that you probably learned in school:

  • Back upright
  • Minimal head tilt
  • Thighs parallel to the floor (not really -- more on this later)
  • Feet flat on the floor (which can't really happen because of the foot control)
  • Patient low to the legs (there are reasons why this is probably wrong too)
  • These principles are easier to adhere to from the 10° to 12° position, but that doesn't mean much in reality.

This brings us to a flexible view of posture and positioning.

Spines get nourishment through motion. Motion is good! If you convert to a fixed focal length, for example with a microscope, you do so at great personal risk, especially if you perform long detailed procedures such as endo or crown and bridge. (There are solutions coming for this but they are still a ways off).

If it is true that bodies are healthiest when in motion (it is), the goal should be to comfortably accommodate the range of postures required to provide care, so that it is not a big deal when Mrs. "I-can't-lie-back-beyond-45°" comes in for endo on an upper molar crown.

To accomplish this you need flexible equipment-- and most equipment isn't very flexible.

What are the requirements for equipment flexibility?

Flexible Equipment:

  • Allows the assistant and to a lesser extent the clinician to sit, stand or sit-stand in function
  • Permits work from 7° to 1° for right handed clinician (11° to 5° for left handers)

A flexible equipment layout should not place dynamic instruments to the side or rear of the clinician or assistant except in very special situations (but please don't do it -- you don't need to) Equipment flexibility is most easily accomplished with Over-the-Patient or Over-the-Head equipment.

Our studies have shown that, even in successful practices, significant time and energy are spent every day on unproductive effort, which delivers no benefit to the patient and no profit to the practice. We have found that careful planning and organization can free up this time and energy, which you can then use to increase your income, spend more time with your family, or could you imagine, play more. Offices frequently experience an immediate 30% increase in productivity once the new workflow is complete. Improvements continue well beyond this level as the operator becomes more adept at the system capabilities, often 2, 3, or even 4 times their existing level of productivity.

There are many metrics for office productivity but the two that we would consider most useful are production per patient chair and production per provider hour.

Production per treatment chair (sometimes referenced as production per op) is a useful measure of facility utilization. It is based upon a more industrial measurement that is used by factory managers. It is a very helpful way to look at productivity when facility costs are extremely high as, for example, in high rent locations like Manhattan or San Francisco.

What will increase the apparent production score is primarily hours of operation. Want a big number? Be open seven days a week. Steel mills want to measure this way because you don’t want to ever shut the blast furnaces down! For most dental practices this is simply not the primary problem. Staffing is.

Which leads us to our second method of measurement: Production per Hour, or “PPH”. To determine PPH, simply divide the monthly production of a provider by the number of hours they spent in treatment. This can be done by individual doctors – a helpful metric when bringing on new staff – or aggregated for teams. (Doctors/associates only - keep a separate measurement for Hygiene teams.) We are sad to say that the average PPH of doctors in the US is currently not much above $400. The result of this is lower doctor incomes, longer wait-times for patients, inadequate access to care and a lot of unnecessary waste.

Increasing the PPH of our clients is one of our primary goals. From clinical support to chairside, our systems are engineered to allow you do more dentistry in less time (and with less stress!). PPH numbers of 3 and even 4 times the national average are common for our clients.

Ergonomics is critical to the day-to-day practice of dentistry. Dentistry is a complex process involving many elements (including diagnosis, communication, management, etc.) but, when you come down to it, it's fundamentally a manufacturing process. When viewed in this light, it just makes sense that the best manufacturer must have the best equipment in the best work environment. And that best is not just a pretty picture, it requires a very carefully planned and executed facility. Ergonomics serves as the foundation for this work.

Watch the Make Your Dental Office a Fun, Easy, and Productive Place to Work video series on our YouTube channel to learn more about how our revolutionary system for dental delivery will improve your practice.

Learn more about how our delivery system layouts:

Delivery systems
Delivery Systems Layouts

Our focus on critical range of motion will help you maximize productivity while reducing operator and staff fatigue and discomfort:

Critical range of motion
Critical Range of Motion

There are many, many factors involved in determining absolute productivity and many ways to influence productivity without adding treatment rooms... but that is another question!

We know that, in general practice, one doctor and proper support staff are, without question, best served by three operatories per doctor – not including hygiene rooms. Note that this does not mean that you have to schedule 3 columns! But rather that you have a 3rd absolutely equal room to allow for room turnaround and emergencies.

Most practitioners are unwilling to do this and, as a consequence, suffer economically and via increased stress. If a practice is unable to afford the space or expense of providing this volume, it is best to stagger office hours between practitioners in order to make it possible in as many hours as can be made available.

Now, here is the real answer – You can do this:

  • Operatories don't have to be big.
  • They don't have to be expensive.
  • They do have to multifunctional.

If you are smart about your operatory design and implementation, you can have it all – room number, productivity and affordability.

No reason at all, if it's working for you - great. However, if you're moving or need to replace your existing equipment, then you owe it to yourself to look seriously at a centralized method of organization. Take the time to investigate our system carefully. If you're looking to find more time, more income, or more professional success in your practice... make the change. If you are satisfied with the way things are, quite frankly, you're better off staying with what you have.

Chair conversion is, in dental practice, a part of what in industry is known as "zero changeover". Zero changeover studies, particularly as part of the Toyota production system, teach techniques that markedly reduce the time required to convert from procedure to procedure. The results of designing for zero changeover alone can increase your practice results dramatically.

Working with your local dental supply company may seem like your simplest and cheapest design alternative – especially when they throw out an offer for a free design. However, it is said that, there is no such thing as a free lunch and, when it comes to design plans, someone has to pay for that meal – that someone is you. You'll often pay in lost productivity, poor space utilization, increased cabinet and equipment costs, inadequate design documentation, and a lack of esthetic plan – just to name a few.

You can't really blame the supply company. First, they make their big money on supplies – hence the name. Equipment is a headache for them, but they've got to sell it, if not – they might lose your account to a catalog. (Hmmm... If you don't need them for equipment. If you can use anyone for service...) Second, chances are that they didn't charge you up front for your "design", which means they have to make money somewhere.


a) They design for what is easiest and more importantly, safest and most profitable, for them. They don't really know how to increase your productivity through careful layout and they probably couldn't care less about meeting your personal goals and expectations. The person drawing the plan has never even spoken to you! The faster and simpler the job is for them, the better, because doing the job right just costs them more... much more. Remember, they don't do dentistry for a living. Why should we expect an equipment salesman to understand peak performance when most dentists don't?

b) They make sure to use a bunch of cabinets and accessories you don't need in order to get paid back for the design. You'll never hear a supply company telling you to simplify your supply cabinets or to streamline on the variety of products you need – that's where they make money! In fact, they probably hope your cabinets are a mess-then you'll buy more supplies when you can't find the ones you already own. (No, that's probably not true. It just seems like it, doesn't it?)

Save yourself a bunch of money and pay for your office design. You could hire our firm or someone else – just make sure they truly understand dentistry! You'll save your money in the long run. Don't worry, when it is time to purchase supplies, your supplier will still be there.

Most operatories are both too large and too cramped! Dentists are only human – we tend to take a space, and then fill it up until there is absolutely no room left to budge. Imagine how that feels for the patient, to lie amidst a clutter of dental objects. Also, think about what it is doing to your performance! Working in a cramped and inefficiently organized environment is like trying to change your clothes in a broom closet! You can do it, sure, but it won't be fun or productive.

Normally, we recommend one primary design objective for your treatment rooms – maximized throughput. Frequently, we create symmetrical cross function space (doctor and hygiene). We commonly will set these rooms at 8' 4" x 10' 6". Since room length is rarely the constraint, even in a crowded space, we'll frequently go to 11' in length when the extra overall space is available. This extra length allows the room to feel less medical, as it's more inviting and certainly more spacious. Patients don't see width and less is generally better for wall use (X-rays, bulk storage, patient amenities, etc.).

We can also redefine how you use your space in general. In order to increase your treatment room count, you may not want to simply shrink each room space, but instead consider... room pairs.

The doctor and assistant team work very, very differently than hygienists or even hygienists with hygiene assistants. Dedicated hygiene rooms should be narrower. How wide is a hygienist's wingspan? 5 1/2 feet? Why would you put walls and shelves for your dental equipment out where you have to stand up and walk to get it? Why create an 8 - 10' wide room for a 5 1/2' wide operator wingspan? In this situation, the place for width is at the toe end of the room where the patient sees and feels its spaciousness.

Room pairs allow two rooms in a width of as little as 14 feet. That's right, f o u r t e e n feet. That means that if you thought that you had room for four operatories, two pairs of rooms will leave you with space for a fifth operatory. And, you can accomplish all this for about the same cost as creating the four initial conventional rooms.

A thoughtful design can make almost any room highly functional. In actuality, size doesn't limit most doctors or their practices. Rather, it's a lack of adequate room numbers that can be stifling. For example, you need space for overflow, emergencies, increasing hygiene or, you need extra room in the event of equipment failure, or to allow a slightly slower staff member the time to learn and improve new skills and techniques.

We recommend that you slow down for the design process. Simplify. Condense. Organize. We want to help you create space for an adequate number of treatment rooms. You'll spend less, you'll get more, and you'll enjoy the benefits of a more productive office after having completed the process.

If you are a recent dental school graduate and you are trying to figure out how to make it in the real world, in order to make the transition productively, you basically have three choices:

1. Become a specialist so that you can have higher fees to make up for your inefficiency... not a bad choice... but obviously not the one that most of us make... and you really don't have to become a specialist in order to make a great living ... I'd get bored doing Endo all day, but that's just me ...

2. Practice in a place where you can do primarily high-end cosmetics (essentially you're becoming a specialist and will do the same thing as in #1, but remember you won't be getting referrals from other dentists!) To do this, you need to spend most of your time and attention on marketing and training. Do note that there are less of these opportunities available than you may think.

3. Get efficient. This is what most of us can do today in order to make a successful practice. To do this, you've got to think outside the box... (okay, outside the cubicle really). Here are a few of the basic requirements:

a. You should learn how to schedule and thereby work at least two equal treatment rooms (with additional rooms for hygiene). That means trained assistants that can actually do things not just suck saliva. This doesn't mean that you'll be running around. Quite the contrary. It means that you can comfortably transition from patient to patient without tremendous stress placed on your in procedure on-time performance.

b. Except for a very few practices, hygiene is where your next treatment comes from – grow it. Hire great hygienists, be ready to pay for that and make sure that they are highly motivated. You need to help with their peak efficiency because they aren't going to come cheaply and, like you, they won't have learned efficiency in school!

c. Create a system whereby all instruments and supplies can be obtained by both doctor and assistant from the seated position. Visit our sister company, Ergonomic Products, for ideas about equipping your treatment environment. They have some very unique and innovative solutions to outfitting your treatment rooms for peak performance.

​We have great financing partners for both office construction and for equipment purchase or lease. Our lenders appreciate the 100% success rate of our clients - unheard of in our industry - and thus are able to offer financing that is generally more affordable for construction and at lower rates for equipment. We can recommend lenders that will help you benefit from the extraordinary success of our previous clients as you work to create your new office.

Financing partners that we work with include:

Financing Partners

The short answer is to start with a conceptual drawing called a Blocking Diagram before you create a Floor Plan. The more detailed answer is in the video above and the information below:

You need to consider 4 key questions

As dentists, we’re visual. We have a picture in our minds of what we want our dental office to look like. Or a dream of what we hope that someday it could be. But working on the dream part is actually not the way to start the process of planning to achieve that dental practice! To do that you need to start on the much more boring and practical side ... and then work to determine what is necessary to meet your dreams. I refer to this as "The 2 Lists" - "Have To" and "Want To." The conclusions that you arrive at once you create these lists may even mean that you can’t build the entire dream now. That’s OK. But you need a plan.

Here are 4 questions to consider as you plan for your dream dental practice:

1. What KIND of dental practice do you want to create? That means – who do you want to be? Are you creating a place to make a living because you think that a certain kind of practice is a great business plan, or do you have a specific vision for the kind of work that you want to do? These can be very different practices!

2. Do you know of any location (town, or neighborhood) where you can do this kind of work? If not, how will you figure that out? To get you started with thinking about this, take a look at these resources that will help you start thinking about site selection:

- Make sure that you're selecting the right location for your investment (pdf)

- Dental Office Site Selection Services: An exceptional dental practice starts with an exceptional location

3. How many treatment rooms will you need to accomplish your goal? Do you know how to calculate this? Are you guessing? You really should minimize the guessing - that’s risky! We can help with that. If you would like, one of our Practice Liaisons would be happy to walk you through our Dental Office Construction Cost Calculator using your numbers to see if you’re on track to building the office of your dreams. Just contact us or give our team a call (1-800-275-2547) at your convenience. There's no charge or obligation for this service.

The Dental Office Construction Cost Calculator is a great resource, and it helps organize the various costs of a project based on dental operatory count. You just pick how many ops you want, whether you want to rent or own, and some basic cost/loan info. Then we can tell you how much the project will cost, and what your cash flow needs will be at opening. Remember, if this is a new practice, you’ll probably be losing money at first! The magic is to minimize that time, yet not stifle growth!

4. And the 4th and final question is: What size space will you need to design an office that will support this room count and practice vision?

Once these basic questions are addressed THEN you actually get to begin designing! Again, we can walk you through these big decisions – and we’re happy to talk to you at absolutely no cost. We’ve done this thousands of times!

What drawing do I do first?

So, as I’ve just mentioned, for virtually every office, the first design decision that you make is that you need to see if the requirements of your dream can be fitted to your potential space or onto the plot of land that you are considering! It is a waste of time and money to do this with a Floor Plan drawing! To do this we'll use a Blocking Diagram. This is the quickest, most reliable, least expensive, way to match your needs with a given space, and it is rapidly changeable so that together we can try as many options as possible.

At Design Ergonomics, we get doctors coming to us all the time with Dental Office Floor Plans that were the first drawing of a space and it will have fit in the required number of treatment rooms but the result will, for example, have 10 treatment rooms and a staff lounge with seating for 6 or a front desk for 2 or a lab that will only handle 20 lab cases! The designer gave you the thing you said you wanted (a certain number of treatment rooms) and they fit it in the space you’re looking at, but they left out half of the space you need to support those rooms! And the result will be a stressful, underperforming office!

These issues should all have been handled long before the drawing of any Floor Plan!

By using a Blocking Diagram first, you are able to avoid all of these mistakes and rapidly decide on the potential of a space.

It’s incredibly fulfilling for us to help our clients build dental practices that they are proud to own, and that allow them to give back to their communities and provide for their families. If you have any questions, please don’t hesitate to contact my team or call us at 1-800-275-2547.

So, the first, and perhaps obvious answer to this question is that the dollar amount that your new dental office will cost is likely more than you want to hear! And worse than that, more expensive tomorrow than it was yesterday! But ... the good news starts now, with a change in how you think about the investment you are making in a new dental office.

Instead of focusing on the dollar amount for building a new dental office, you w to focus first on two things:

1. What will my PERCENTAGE of production cost be once I am up and running - 6 to 12 months from the start? You shouldn’t have your amortized monthly cost be more than 10% of production. So a good starting point is to work backwards from there.

Focusing on what your production number will be needs to be the starting point

At Design Ergonomics, we have a large number of client offices where this percentage is actually 5%. So, at that point, the cost of the building is just noise. In fact, in our one year post-completion surveys, far too many offices report that they should’ve listened to us and actually made space available for more treatment rooms. To learn more about how to right size your office, refer to our Math of Growth article.

Make the right investments in your dental office

Let me get to directly to the second, and most important, question to focus on:

2. There is a concept referred to as competitive strategy. People that understand real business understand this. We dentists don’t. In the mindset of competitive strategy your understanding would be that you CAN’T control the average construction cost in your area. What you CAN control are the performance results that your new office will have.

And so, the far more important question instead of “What is the cost?” would be:

“What can I get of income producing VALUE for every dollar that I spend?”

When you focus on THAT question, you become laser focused on your design! Your focus changes from dollar cost to:

- Efficiency of construction
- The effectiveness of space planning
- The productive results of the equipment you plan to use

All of this is with the end goal of being more productive - by design - than anyone else in your region! The rest of the cost; of leaseholds, the cost of land in your area, construction costs, permitting delays, you largely can’t control! And no past, present, or future competitor can either.

Bad planning is therefore your biggest expense!

So, if your area is one of those places where the cost to build is $450 a square foot (OMG) then that is what every competitor has to spend too! But the focus stays the same: How much production can I comfortably get per square foot?

So, here is what we would suggest. Figure out how you can create that great practice design, but with a need for one-third less space to get the same amount of treatment rooms.

Do that with a layout plan that is twice as productive.

Do that with dental equipment that costs less but gets much better results.

What results from this - as understood by the rest of the business world, but apparently not to us dentists - is referred to as Sustainable Competitive Advantage. Every other dentist that has NOT done what YOU do to create this advantage will have a very difficult barrier to compete. Forever! They can buy new technology or spend more on marketing, and do anything to train people ... but they will always have higher costs! Which, for example, means that you’ll always be able to pay higher wages for better people.

If you’ve done this correctly, you’ll have clear and simple systems - by design - so your staff will be able to get up to speed faster. Training will take less time. Room turnaround will be faster and cost you less. In each and every aspect of what you do YOU simply pull further and further ahead.

Build a dental office with a "forever advantage"

So how much does it cost to build a dental office in 2022? I discuss a range of numbers for both a tenant improvement and a ground-up build in my YouTube video at 3:42. I've also put the numbers in the images below.

Tenant ImprovementBut it's important that you understand that these numbers are just estimates from April, 2022 and they would need to be updated constantly as market conditions change. And there’s your challenge. There's a wide variation in cost - sometimes over double - in range. And this range is not just because of material costs. Labor is also a huge factor. So, while this may not precisely answer your question about how much it costs to build a new dental office, I hope it also illustrates the point that you shouldn't focus on the cost to build your dental office. What you should focus on is what you can control - spending your money in a very deliberate way that creates a sustainable competitive advantage that will also keep you ahead of the competition ... forever.

Ground-up BuildSo here we are. You probably have more questions at this point than you have answers. I suspect that I just have told you some things that may stretch your understanding of what is possible. But, simply stated, in over twenty years we have NEVER had a dentist take our advice and fail. EVER! We design dental offices that create a forever advantage.

If you have more questions, feel free to contact my Design Ergonomics team. We probably know great builders in your area and more importantly, we know how to get you what you really need - that forever advantage - and the knowledge that with it nobody can catch you!

There is a problem with real estate assessment for dental offices, which is most often that the process does not serve the client. The process often looks something like this:

Realtors and listing agents often have a stack of rentable/sellable properties that they are trying to offload, sorted by region and square footage. When asking for help from a realtor, more often than not, dentists are given listings from this stack in hopes that they will pick their favorite. The disconnect is that, in order for this to work, a dentist must know the exact parameters and specifications for their vision in order to make sure the property is a good fit.

And it’s not just square footage! Many things can dramatically impact a space’s value when assessing its convertibility into a dental office:

  • Is it visible to my patients?
  • Does it capture the demographics I’m targeting?
  • Is it easily accessed?
  • Do the traffic numbers support my new patient goals?
  • Can I put a sign out front? And what kind of sign, and how big can it be?
  • Does it give me potential for expansion in the future?
  • Do I have enough parking for patients and staff given the number of ops I’m building?

These are only some of the questions a dentist should ask about a potential property, but there are many more. And if there aren’t clear answers, there is a huge risk of investing in a property that does not return. Who’s job is it to know? The client? The realtor? The listing agent?

By doing this, we’ve taken the task of knowing these answers and made it into an easy-to-use, safe, and secure service. By using our site selection program, Design Ergonomics offers you all the data you really need to make an informed decision on your investment, and clarity on the return. For us, this is the best way to safely value any listing and rank it relative to any other site (including your existing office).

Take a look at some our beautiful, efficient, and high-flow dental office design examples from our client portfolio and reach out to our team if you have any questions.

Start your design today!

Design Ergonomics

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