The first step is to visualize and get even the minor details on paper. Basically you need to ask yourself a lot of questions and ensure that you have satisfactorily answered all of them. If possible meet a few practicing dentists from the area where you want to start the clinic and get their opinion. Some of the important aspects of planning have been discussed below.

The planning process will involve working parallely on the following activities:

• Finding the right place…

  A minimum requirement of 200 – 225 sq ft for a single chair practice (in a city like Mumbai even 150 sq ft should be OK). Get a property broker to help you find the right place.

• Getting proposals from suppliers for equipment…
  1. Dental Chair

     Choice of the chair depends largely on the budget…a wide range of chairs are available in the market (refer product catalogue on Focusdental.in). Best place is a conference trade exhibition as one can compare the price, deal as well as check out the actual size. Important to check the inlet-outlet points, spittoon size & position.

     Depending on the budget one can mix & match an average chair with good quality unit/trolley. in day to day practice smooth functioning of the air-rotor, air motor etc is far more important than the comfort of the chair.

     Electrical chair is a better option with facility to have additional points, attachments in future.

     Doctor stool’s comfort & height is another important point. Some stools cannot be raised higher & could cause a problem due to the awkward arm/elbow position especially since we nowadays tend to work for a longer period at a time.

  2. Compressor
     1. 2 HP Compressor is advisable if the suction is not motorized (though motorized suction is a better option in the long run)
     2. Care must be taken to avoid/reduce the noise made by the compressor & the position planned along with the chair.
     3. Plug point to be next to the compressor but the switch should be on the chair side panel.
     4. Compressor tubes to be underground.
  3. Ultra Sonic Scalier
  4. X-Ray machine/ RVG
  5. Curing Light
  6. Sterilization
     1. Autoclave
     2. Ultra Sound Cleaner
     3. Glass bead sterilizer - for undo files, burs etc
     4. UV chamber
• Getting budget and time estimates from interior designers…

  One should not compromise on the quality & no. of electrical points, cables etc. Visualize your practice 3-5 yrs down the road & plan.

  The interior cost could be anywhere between 1000 Rs/sq ft to 3000 Rs/sq ft or more.

  If one is likely to have 2 chairs in the near future, better to have plumbing & electrical arrangements made right at the beginning.

• Other activities of the Planning Process would include…
  1. Investigating regarding landlines & broadband in your area for telephone & internet access.
  2. Project feasibility study involving sitting with an accountant and calculating the Cash Flow, Return on Investment, Months required for break-even etc.
  3. If financing from bank take your project report and meet atleast 10 banks so that you can choose the bank that gives you the best rate of interest. Consult your accountant before you finalise with the bank.
  4. Spreading the word around talk about your new venture wherever you go and meet people in your social network. While the interior work is being done, you can have a hoarding informing passers-by about your clinic.

Now that the planning process is over and you are completely aware of how the clinic is going to look like when it shapes up, it’s time to commit and turn your dream into a reality.

Decide the place and complete formalities to take possession of the premises. It’s better to take the services of a good property lawyer and pay him fees so that we are shielded from unscrupulous elements trying to make some quick money from us. Once you have possession of the premises, inspect it properly and if you are going to engage a interior designer then get him/her to inspect the premises.

• Interior Work

  While your architect plans a good design for your clinic – the most important things should be taken care of viz. position of each equipment for ease of use.

• Dental Chair
  1. Position

     Enough space should be left around the chair for movement of the dentist as well as dental assistant. Ideal to have working platform behind the headrest as it allows for easy access to the instrument trays as well as space for other equipment used regularly like the Curing Light, Scaler, Apex Locater, Air motor etc.

     When the platform is behind, chair position can be determined with the cut-out of the chair in the most comfortable (for the dentist) backrest position/ most reclining position . Better to finalize the chair before starting interior work as it allows optimum chair positioning. This will allow for the plumbing, the electrical input / output as well as connection to the compressor to be under ground avoiding a whole lot of wires hanging around the chair.

  2. Plumbing
     1. Drainage line has to be underground & planned well with proper slope, ease of cleaning etc as clogging is one of the most common problems.
     2. In case of an attached toilet, if possible have 2 separate basins : 1 in the operatory, 1 inside/outside the toilet as it allows for separate wash areas : for the dentist & instruments etc. If possible have separate drainage pipes as well.
  3. Electricals

     Try & avoid a clutter of wires around the chair. Have atleast 2 points more than the required no. next to the chair.

     Have atleast 2 5/15 points next to the chair as some of the equipment may require 15 amp points. Compressor plug will be next to the compressor but the switch should be on the chairside panel.

     Extra points at the consultation table & reception area are a must.

• Compressor

  Refer planning section above.

• Ultra Sonic Scaler

  There are three basic types - magnetostrictive, piezo-electric and Odontoson™. Most commonly used is piezo-electric scaler.

  The scaling tip vibrates in the ultrasonic range of 20-45 kHz (i.e. 20,000 to 45,000 times per second), with an optimum frequency between 18 Khz and 32 Khz.

• X-Ray machine/ RVG

  Variety of dental X-Ray machines are available. Price ranges from Rs. 40000 to 80000 /-.

• Curing Light
• Sterilization / Infection Control

  Various viruses and bacteria colonize or infect the oral cavity and respiratory tract. These organisms can be transmitted in dental settings most often through direct contact with blood, oral fluids or other patient materials and indirect contact with contaminated objects (e.g. instruments, equipment, or environmental surfaces)

  Infection Control in the dental practice focuses on the use of sterilization procedures that will be able to eliminate cross-infection from a dental professional to a patient, from a patient to the dental professional and between two patients.

  The use of barriers such as gloves, masks, instrument trays, tray covers, covers of the working surfaces and light handles.

  There are a certain disposable instruments used in the dental practice like gloves, masks syringes etc that control cross-infection efficiently. Those which are meant for repeated use are cleaned through a series of steps such as chemical cleaning, ultrasound cleaning, heat sterilization, using various equipment and applicable cycles followed by proper handling after sterilization.

  Some of the most popular equipment is listed below :

  1. Autoclave - Programmed autoclave machines are better than conventional steel drum type as they have a shorter cycle, need less space & more convenient to use. No doubt they are costlier but are more reliable.
  2. Dry Heat Sterilizers.
  3. Ultra Sound Cleaners are used to remove debris from instruments before putting them through Autoclave or Dry Heat Sterilizers.
  4. Glass Bead Sterilizer - for endo files, burs etc.
  5. UV chamber
  6. Chemical sterilization.

• Tools & Instruments
  1. Dental Instruments (download list)
     • 15-20 sets of mirror, tweezers, probes.
     • 2-3 sets of straight elevator, moon’s probe: best to buy at conferences as one gets a wider choice.
  2. Dental Material (download list)
• Installation & Commissioning

  Is carried out by the respective companies providing the equipment.

  Estimated date of delivery of the Dental Chair & X ray machine have to be co-ordinated with the completion of interior work.

• Helper / Assistant

  A helper / assistant is required with some basic knowledge of English. One has to spend time to train him / her as there is only 1 formal training course available (details are available on request).

• Receptionist

  A receptionist, as practice grows, to give appointments, maintain accounts, records etc.

A Personal Computer is mandatory with Dental Insurance likely to set in.

Record keeping will be extremely important. If it’s out of budget, provision (space, electrical points etc should be made to have it installed in a year or 2).

A no. of Dental Softwares are available in the market. With the dental insurance plans entering the Indian dental scenario, it is going to be extremely important to maintain all patient records. Dental software is necessary for records & also as a patient education tool. Most of these programmes also have an integrated finance / accounts management programme. Spend some time & research before buying.

Would be better to go for the simpler one as you may not have a receptionist to begin with. Always maintain written data until you are certain of the quality of the software.

• Be connected with the latest happenings & technology.
• Browsing on the Internet is a must.
• Continuing Education Programs
• Are available in abundance. In order to stay updated with the latest techniques & materials, it’s necessary to choose the right course. For more information on the same, visit the Education section on www.focusdental.in

• Photography / digital camera

  Photographs capture the shade, shape, texture and characteristics of teeth, gingiva & other oral tissue as well as extra-oral structures like lips & most importantly the smile. Photography is useful as an aid in patient education and is a good marketing tool with case photographs kept in the waiting room. It can also be used for treatment planning, case presentation, case documentation, patient identification. It is also important for evaluation of post treatment result. Digital photographs can be easily used for paper / case presentation in conferences etc.

  Digital camera, 7-8 mega pix, is easily available & can be effectively used to capture anterior teeth & in orthodontics or aesthetic dentistry to capture smile, profile. Though it is advisable to go for digital SLR camera (with a good micro lence & ring flash) for posterior teeth, endodontics, surgical work etc as it is a much better resolution. There are a no. of brands available in the market. My personal recommendation is Nikon or Canon.

  The various attributes of a smile can be captured & favorably altered to give a complete new look to the patient. & can be effectively conveyed to the patient with the help of a camera.

  An intra-oral imaging system / Intra-oral camera is similar to a miniature video camera which may be used as a diagnostic aid, record storage and as a patient education tool.

• Insurance
  1. Professional Indemnity

     A professional liability policy protects dentists against malpractice claims brought against their practices. The policy covers damages for a variety of dental incidents.

  2. Fire & Burglary

     This policy provides cover for Equipment, instruments, cash on the premises as well as property / building etc.

  3. Personal Accident Policy

     This type of policy, often combined in a package with loss of office contents coverage, provides protection against personal injury or injury to others while on the business premises.

  4. Group & individual health plan

     This plan offers comprehensive coverage for preventive care and medically necessary expenses for the dental assistants, receptionist etc

  5. Disability

     This policy is designed to protect the income of a dentist who is no longer able to work because of accident or sickness.