7 minute read
Revolutionizing Dental Operatories
Revolutionizing Dental Operatories
How Do We Do More Using Less?
Michael Zidile, D.D.S.; Brian Choi, D.D.S.
ABSTRACT
The authors present a transformative approach to modernizing dental operatories as part of their practice’s recent expansion. Aimed at enhancing efficiency and patient-centered care, the project reimagines traditional operatory design by eliminating ergonomic and hygienic barriers, notably, the use of keyboards and mice. Key innovations include the implementation of touchscreen PC displays, high-power PCs with graphics cards, magnetic USB cables for rapid data transfer, omnidirectional microphones linked to AI scribes and wireless intraoral scanning.
The design prioritizes a standardized, clutterfree layout across eight operatories, utilizing A-Dec Inspire Series cabinets for ergonomic supply management. By removing countertops and pullout trays, the approach fosters a seamless workflow, reduces contamination risks and supports clinician mobility. Early results indicate significant improvements in clinical speed, documentation accuracy and patient engagement. This model offers a blueprint for dental practices seeking to optimize technology and space.
The expansion of our periodontal practice required us to rethink traditional approaches. One goal was to create a patient-centered environment that redefines how our periodontal team uses operatory technology. We needed to transform each of the operatories into highly efficient
spaces that eliminate traditional barriers to workflow. One such barrier is the computer keyboard and mouse, which we found to be ergonomically difficult to use in an operatory setting. This article outlines this new thought process, along with others, including:
• Implementation of touchscreen PC displays
• High-power PCs in each operatory
• Magnetic style USB cables for quick data transfer
• Omnidirectional microphones linked to AI scribes
• Wireless intraoral scanning
• More efficient operatory supplies management
Where’s the Mouse?
The project aimed to greatly improve clinical speed and efficiency. Traditional dental operatories often rely on standard interfaces typically used in a seated, desk-oriented position. The dental operatory is not like a traditional office, and often the staff are in a standing position when interacting with the PC. Keyboards and mice are cumbersome to use when standing and are prone to contamination. We envisioned a keyboard- and mouse-free environment where technology integrates more seamlessly, allowing clinicians to focus on face-to-face interaction.
The operatories needed to be functional, hygienic and aesthetically modern, aligning with the expectations of today’s patients. Standardizing workflows across eight dental chairs was critical. Of high importance was ensuring each operatory was identical. This would enable staff to move effortlessly between rooms, reducing training time and ensuring consistency. The challenge was to design an intuitive system that supports advanced dental technologies while maintaining a sleek, uncluttered aesthetic.
Stuck on the Countertop
A cornerstone of the design was for the clinician to avoid using a countertop or pullout trays. Mice and keyboards are notoriously difficult to adequately clean, and they use up precious operatory real estate. In addition, they are difficult to use while standing without undergoing various uncomfortable and unhealthy contortions. This is due to the fixed height of the pullout shelves or countertop surfaces, which are designed for use in a seated position.
To Touch, or Not to Touch?
We all use our phones and tablets, which have touchscreens; however, most desktop monitors lack native touch input capabilities. To properly implement this design, it is, therefore, necessary to invest in dedicated touchscreen monitors.
The authors found one commercially available monitor (Dell 24 P2424HT 23.8” Multi-Touch Monitor) to be the right size for most dental applications. To use these monitors in the operatory, additional cabling is required. An HDMI and power cable are usually enough to operate properly. For touchscreens, we need one more data cable.
Wiring this additional (USB) cable from the monitor to the PC is needed to transmit “touch” inputs back to the computer. Once a computer is already installed in an existing operatory, it can be difficult to retrofit another USB cable from a touchscreen monitor back to the PC. Pre-installing these cables during the initial installation is, therefore, usually required.
We’ve found that the closest and most intuitive location for these touchscreen displays is both on the side of the patient and behind the patient. The first monitor, positioned for patient interaction, is on the side and serves as the primary monitor for case presentation and treatment plans. This side placement ensures patients can view imaging comfortably, fostering transparency and improving case acceptance.
The second touchscreen monitor is located behind the patient and allows clinicians to interact with digital records and scanning software in real time without turning away from the patient, maintaining a personal connection. It’s also important that each monitor be fixed to a monitor arm that can be moved easily into the best viewing position.
Do You Need Pen and Paper?
To further reduce use of a keyboard, each operatory is also equipped with an omnidirectional microphone connected to AI scribe technology. Commercially available AI software automatically transcribes patient visits in real time, capturing patient interactions and producing HIPAA-compliant clinical summaries without manual typing. The AI scribe enhances efficiency by drastically reducing documentation time, ensuring accurate and timely chart records. AI-enhanced periodontal charting is also now available without expensive custom software purchases. The authors have some early experience AI scribes like Bola.ai and Denti.ai. There are many others currently available as well.
Will Any PC Work?
To improve efficiency, it is the authors’ opinion that each operatory should be powered by a PC with its own graphics card. The term “integrated graphics” used by PC manufacturers is the industry code word for underpowered. PCs with a graphics card are capable of handling more demanding imaging and intraoral scanner software.
For intraoral photography, digital SLR cameras capture the best high-resolution images. Quick disconnect magnetic USB-C cables were implemented specifically for the DSLR cameras, allowing rapid connection and disconnection to speed up image transfer compared to manually removing a native SD card. The magnetic cable design ensures durability and ease of use, enabling auxiliary staff to upload images to the PCs for immediate review in front of the patient.
Ergonomic Design and Supply Management
To further optimize the operatories, we collaborated with Design Ergonomics (www.designergonomics.com) for room layout and supply management. Their expertise ensured ergonomic placement of equipment and supplies, minimizing clinician movement and fatigue by stocking each operatory with a week’s worth of the most common dental supplies. The A-Dec Inspire Series cabinets were selected for their modular design and narrow footprint, accommodating the PCs while providing ample storage, nitrous integration and an automatic vacuum line cleaning system.
Future Trends
This article details the renovation and expansion of our periodontal and implant practice and how transforming eight new operatories allowed us to significantly speed up routine tasks and save the doctors, hygienists and assistants in the practice valuable time. As we rely more heavily on hardware design to speed daily operations, other technology will further improve how we interact with patients. Smart glasses, AI radiologic software and simple robotic systems will further shorten appointment times and eliminate the time spent looking for the keyboard and mouse.
The authors declare no financial interests or conflicts of interest related to this work. This research was conducted independently, and no external funding was received. The views expressed in this article are those of the authors only. The authors extend special thanks to Chris Schramm of Masserano Development and Charlie Vota of Pemco Dental for their invaluable support and contributions to this work. Queries about this article can be sent to Dr. Zidile at michaelzidile@gmail.com.
Michael Zidile, D.D.S., and Brian Choi, D.D.S., are proprietors of Brooklyn Periodontics & Implant Dentistry, PC, in Brooklyn, NY.
