Practice

Management in
Dentistry

Successful Dentist should

Establish his practice in a desirable conditions

Establish good relationship with the patients
Has a good practice team.
Has reasonable income to maintain reasonable
standard.
Be competent (having good knowledge, skill,
and experience) in his profession.
Respect time.

Dentist may be employed in

1- Academic field (full time or part time)
a- teaching
b- research
2- Hospital (full time or part time)
3- General dental practice.
4- Specialist dental practice.
5- Participant in commercial promotion.
6- writing (journalist)
7- Organizations (WHO).
8- Public relation.
9- Armed services.

Practice management can be defined as

the
organization,
administration,
and
direction of a professional practice in a style
that facilitate quality client care, efficient
use of time and personnel, reduced stress to
staff and finance.
To establish a good dental practice:
1- First step is to establish a dental office.
2- The second step to manage the dental office
(personnel management, patient management, and
record management).

I- Establishment of Dental Office

1- selection of place
2- selection of location
3- selection of building
4- financial assistance
5- selection of equipments and instruments
6- designing of dental office

1- Selection of Place
It is a personal choice of dentist depends on;
- Population demography of the area.
- Population density.
- Age distribution and average salaries of the residents.
- Number of dentists practicing in the place.
- Whether dentist know local language or not.
- Place which is well linked by road, rail, air is good for
practice.
- Good facilities for living.

2- Selection of Location
May be at:
-The heart of the city as it is accessible for people from all areas
of city
- Location with good public transport facility.
- Location close to government commercial offices, corporate
and business houses.
*In that areas it is good to practice at morning and evening time.
As office goers can get treatment before going to office or after
office time. Also, it is convenient for old peoples and
housewives.
*The question of how far away the place from dentist home is
important in travelling time and emergencies even at weekends.

Special considerations for women

dentist
Prejudice against women dentists from both
public and dentist themselves exist.
Many patients however, question if the dentist
women can extract a tooth!
Women dentist can do all dental procedures
which can be done by male dentist.

Another point is the instability in women's

career:
She may have to take more days vacations for
sick reason.
She may leave a job to have children.
If married, and here husband transferred to
another area, may leave here work to leave
with him.

3-Selection of Building
Building should be well ventilated, has proper water and drainage
system as well as power connection.
It is preferred to be at ground floor and has parking facility for both
dentist and patients.
Select place where more area is available than present requirement so
that it can be expanded if required.
It is also possible to practice at home by making some alterations.
It is better to own dental office rather than taking it on rent.

4- Financial Assistance
For a new graduate dentist in private clinics, there are
two main situations:
1- working at another's clinic.
2- beginning on his own clinic.
Many nationalized banks, private sector banks can
give help to establish professional career for a new
graduate.

1- Working at another's clinics:

- It affords a reasonable number of patients
- The new dentist can build up his own patients.
- You must be patient and understand the situation.
- It may need the existing practice team to get the patient's
initial approval for the change to another doctor.
- Once the referral has taken place the decision within the
hand of the new dentist to prove himself.

 His personality and relationship with patients must be

pleasing, he must show compassion and be gentle.
He must not compete or degrade his boss.
He must show the advantage of using the new and
latest methods and techniques in dentistry.
He should speak at language clearly understandable to
the patients.

2- Starting your own practice

A- patient sources:
- Family
- Friends
- Referral of emergencies
- Referral by doctors and dentists
- Recommendations by those patients already seen.

B- Basic furnishing & equipment:

- Buy only what is needed in the expected
immediate future.
- If offered some new devices a careful critical
appraisal should be made of its properties and
report and evaluation by other dentists can be
made.

C- Ergonomics:
It concern with the relation between workers and their energy
and environment.
In dentistry, it is concerned with the study of unnecessary
movement and wasted energy, saving time, lessening fatigue.
Dentistry is physically demanding professionals to stand long
hours in one position.
Standing for a long period of time will cause varicose and
strain in musculoskeletal system.

 Considerations should start with the positioning of

dental chair in relation to the door and patient
pathway.
Another parameter is the entrance of light position.
Once the chair position is established planning for
wash basin is arranged near to the dentist.
Base cabinet should has tops at comfortable height
to the dentist to work.

Equipments

1- Dental Chairs
Most patients do not like:
- one arm chair
- flat head rest
- chairs with noisy mechanisms or with type stimulated
leather that make noises as patients move.
- Recent chairs are computerized, they are supplied with
new accessories that you need (non-touchable light,
light cure applicator, ultrasonic scaler's, intraoral
camera).
- A programmed position is set at any desirable position.

2- Dental stool
Requirements are:
Comfort at all positions
Support for the back
Easily adjustable for height
Should be stable
Should be movable when required

3- The Suction/Spittoon
Some clinics are supplied central
suction

to

place

the

motor

in

distance from the clinics

At most today clinics the suction and
spittoon built within the dental unit.

4- Compressor
It need to be:
Powerful in performing the desired pressure
with either low speed or high speed hand
piece.
Quite and friendly with much noises.
Time of regular check up important for air and
oil.

5- Autoclave
An essential item in the dental clinic, may
assure the quality of standards the dentist
aiming at.
It should be big enough to accommodate all
items.
In the contract at least 2 years maintenance is
advised.

6- Other items

Sphygmomanometer, Stethoscope
Amalgam mixer
Digital timer
Pulp tester
Root canal depth indicator
Panoramic X-ray
Oxygen unit
General anesthesia equipment

Laboratory equipments
Although the dentist is sending dentures and
bridges to a commercial lab, sometimes some
preliminary technician gob and corrections
have to be made at the clinic

Water Distillation
Dirty water may damage the water circuit in
the dental unit, filter or water distiller is
important item.

The Waiting Room

It is better to call it the reception
room
You need to implement your own
personality into it.
The waiting time should be brief
Furniture of the waiting room to be
cleansable
The bathroom must be kept clean all
the time.

The business office

It consists of the following items:
1- Computer: new software for dental
practice management designed for clinics
according to their need.
2- Copying machine: it is used for copying
daily appointment schedule and instruction
to be given to the patient.
3- Telephone and answering machine: used
to make patient able to cancel or change
his appointment.

The Appointment Book

A general plan of appointment book:
Extraction is better to be done early in the day,
that by the end of the day freedom from excessive
discomfort or hemorrhage assured
It is often recommended that children seen early in
the day.
It is good idea to leave new patients requiring
examination, consultation, x-ray.. To the end of
the day.
Emergencies should ideally be seen in two selected
periods during the day, the 1st hour is left open.

Staff

The Dental team may consist of:

The Senior dentist
Dentist Assisstant
Dental hygienist
Secretary/receptionist
Dental technician

Hazard to dental team

Mercury
Posture problem
Electrical
Injury from instruments
X-rays
Infection
Anesthetic gases
Allergies skin reaction
Inhalation of aerosols

Continuing Education
Through:
Regular reading of dental journals
Enrolling in courses
Attending dental meetings
Part-time teaching at dental school
Evidence based learning.

Management of dental practice

Three ways of private practice are:
1- Solo dentist practice Dentist alone manages
all types of cases according to his capacity
2- Group practice-dentist specialized in various
specialties work together in same office.
3- Single dentist with call facility for specialist- in
this type, dentist alone manage the clinical work
but calls for a specialist when required.
Whatever the type of practice, dentist should be
able to manage the practice well.

Personnel management
Daily communication and regular staff meetings to
encourage the participation of all the personnel.
Appoint a full time receptionist, dental assistant and a
person to clean dental office.
The clinic should open much before the scheduled
appointment of the patient and the assistant should
the required instruments autoclaved and ready.
Have sufficient amount of stock of materials and
dental staff should know how to make economical use
of materials.
Should have business association with a good dental
laboratory which delivers work in time.

Patient management
Dentist should have good communication with
patients to ensure quality oral health care
services and patient motivation.
Appointments should be scheduled for patient for
effective time management in the practice.
Dentist
should
explain
about
diagnosis,
investigation, different treatment plans available,
cost of treatment and mode of payment.
Instruction regarding care after extraction,
maintenance of artificial dentures, oral health
education.. May be given written.

Record management
Records should be systematically maintained
Written records include dental and periodontal charts,

case

history,

record

of

examination,

diagnosis,

informed consent and treatment rendered.

Non-written records include photographs, radiographs,

models and cephalometric tracing.

Receptionist should maintain book of account of all bills

of purchase of equipment, instruments, materials.

Accounting and other financial

aspects of dental practice
Maintain patient records along with
fees charged on day to day basis.
Maintain records of all expenses on a
day to day basis.
Start to fill tax returns from first year
of practice itself as it would help in
being law compliant and also in
obtaining loans in future and
avoiding
enquiries
from
tax
authorities.

Factors influence dental practice

Legal: each dentist must respect and be well aware of the law.
Frequent review of the practice acts and or regulations is
recommended to keep the dentist up to date.
Ethical: dentist are ethically and morally responsible for
providing dental care to all patients, including those who have
been or may have been exposed to infectious disease.
Personal: factors such as general physical health, oral health
and mental health should be given consideration. Dentist
should go for routine physical examination at least annually