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Better By Design by Joseph Ross

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Categories: Office Design;
Better By Design 

10 common mistakes found in orthodontic office design—and how to fix them

by Joseph Ross

During my four decades of designing orthodontic offices, I’ve often had to redesign the aesthetically lovely but practically unworkable plans and blueprints created by other architects and interior designers who aren’t aware of the many peculiarities and specialties required by the industry.

If you’re thinking about redoing your practice layout, or building a new one from the ground up, here’s your chance to learn from others’ mistakes. Over the next few pages, you’ll see the 10 most common mistakes found in orthodontic office design, as well as the redesigns that make the same space more functional.

 1. Not including a mechanical room

The submitted plan illustrates the lack of experience designing an orthodontic office and not knowing all the standard requirements to operate an office. The missing mechanical room is the No. 1 mistake—without one, you can’t work because it contains your air compressor and vacuum pump. The blueprints need to have air and vacuum lines run to each location when building the office out. Some designers will try to locate the vacuum pump and compressor in the attic or under a counter so they don’t have to rework the plans, neither of which is recommended.

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2. Drawing all the units on the wrong side of the chair

This floor plan is designed with the delivery system on the wrong side of the chair for this doctor. Not catching this early on in the development of the floor plan can cause a good portion of the plan to have to be reworked to allow flow of patients and staff. In this case, we were able to make some minor changes and still maintain the overall design and layout of the plan. Be sure to communicate clearly to your designer that you want the delivery units on either the left side or right side of the patient chairs.
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3. Drawing the delivery units on both sides of the chairs

This floor plan is a follow-up and addition to the previous one. The delivery units were originally on the correct side of the chairs when the designer decided to mirror or “flip” the clinic area, which meant the units were drawn on the opposite side automatically. Designers will sometimes miss this one because it looks symmetrical to the eye, but in reality the second half of the layout will not work. If you’re doing a clinic layout like this, be sure to watch in each revision, because this mistake can show up suddenly.

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4. Not drawing the units and chairs to scale

This designer didn’t understand the requirements for orthodontic office equipment and the extra space needed to work and access the stations. The designer may cramp the chairs too tightly together or, as in this case, space them way too far apart to be efficient. In this same space, one more setup could be added, giving you added production, which in turn adds income. Rule of thumb on spacing: Setups should be on seven-foot centers (from the center of one chair to the center of the next). At minimum, aim for six feet, and at the most, plan for eight feet.

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5. Patient chairs spaced either too close or too far away

This plan illustrates a request for eight chairs in a plan that allows only seven. Chairs and units require additional working space next to them on both sides for the staff and the patient. You also need space to work in front of the unit itself, and additional space to walk by the working zone if the plan requires. Communicate with the designer the want for X number of chairs, but one fewer would be fine if the plan does not work.

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6. Placing the chairs too close to the walls

Access is needed for all chairs—not just the ones in the clinic. Looking over the plan quickly, you may not notice that in the private room, the access to get in the patient chair is only about 12 inches. When working on a plan, always look at all sides of each chair making sure the clearance to access the chair is there: a minimum of 24 inches. This space can be between a chair and a partition, a wall or another unit. If you have any doubts on the space, request the designer give the plan some dimensions.

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7. Not enough counter space in sterilization

Besides the clinic area, the second-most used area by an orthodontic office is sterilization. Your sterile area is a critical component required to run your office. This plan illustrates the designer’s assumption that as long as there’s a sterilization area, it would be covered. Unfortunately, there isn’t enough cabinetry or counter space for all the sterilization equipment and supplies needed. Essentially there are five stations needed in sterilization from dirty to clean: breakdown/ trash, ultrasonic, rinse/wrap, sterilization, and label/storage. All five stations need to be accounted for based on the size of your office and equipment.

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8. Not enough room for the X-ray machine

Communication is key between a designer and the doctor. This plan illustrates the lack of such communication and lack of experience on the designer’s part. The designer had assumed the doctor was going to be using a pan machine only, so that space was all that was accounted for. In reality, the doctor needed room for a pan/ceph, or possibly something different in the future. Relay any dimensional requirements to the designer regarding specific pieces of equipment from the start. Try not to stick with those exact dimensions, because we don’t always know what is coming next.

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9. No sinks in the clinic for the staff

This is one plan of many that we’ve seen illustrating missing clinic sinks. Looking at the plan, the layout appears to be good—nice flow, plenty of room and good spacing—but it lacks any sinks for staff to wash their hands and reglove between patients. Some designers assume the sinks in the sterile, lab or even toothbrush area are enough. We recommend one sink per every three clinical stations, which means staffers aren’t waiting to access a sink. Having the staff just waiting to wash their hands slows down the office and decreases the number of patients that can be seen.

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10. Not having enough waiting room chairs to support the clinic

Waiting rooms in orthodontic offices are different than those in other offices because doctors and team members are seeing a larger number of patients, with shorter treatment times between patients. Also factor in the typical patient rush for appointments immediately before and after school. Rule of thumb here is three waiting room chairs per clinical chair, which allows one chair for the parent of the current patient, as well as the next patient and their parent.
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Author Bio
Joseph Ross Joseph Ross is the president of Ross Orthodontic, an orthodontic equipment manufacturer and office design firm. Ross attended the University of Texas for architecture and interior design, and is an allied member of the American Society of Interior Designers. He has designed more than 1,000 orthodontic offices across the world, and assisted in designing the orthodontic clinics at Louisiana State University, University of Texas Houston, University of Texas San Antonio, Roseman University, the University of Tennessee and the University of Louisville. Since joining his father, Robert Ross, at Ross Orthodontic in 1982, Joseph Ross has hosted roundtable discussions at AAO annual sessions and written articles on office design, equipment, lighting, sterilization, laboratory design and ergonomics, all specifically for orthodontists.

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