By Cri Boratenski Executive Director at Colorado Family Dentistry

General things to look for in your dental practice

  1. What type of x-rays does the practice use and what other technology do they employ? Digital x-rays have provided dentists with a huge leap forward in diagnostic capability. Film x-rays of the past were little larger than a postage stamp while the digital x-rays of today give the ability to blow up an image of a tooth to fill an entire 27″ computer screen. Which do you think would be better for detecting decay Digital is also faster, is better for the environment because it doesn’t require the disposal of toxic developing fluids, and it significantly reduces the radiation exposure to the patient. The only drawback for a doctor in switching to digital is the cost (up to $13,000 for a single tiny sensor) and the learning curve. Intraoral cameras are also a big one. If your doc tells you that you have a fracture in your tooth ask to see the picture. If the doctor cant produce an image, maybe its time to switch to another practice. We really feel that these technologies should be in every practice and we feel that a doctors willingness to invest in beneficial technologies is a show of their willingness to invest in your health.
  2. How does the practice store patient records? HIPAA (the Health Insurance Portability and Accountability Act) is a set of federal regulations designed to make dental and medical practitioners responsible for ensuring that you’re records are kept safe and out of the hands of people who may utilize your information for malicious purposes. But, just because the regulations exist doesn’t mean that everyone is in compliance and today, the vast majority of practitioners are not in compliance. You’re giving a lot of information to your provider like your name, birthdate, social security number and names of your family members. Your provider needs this information in order to provide a high level of service to you, but they should also ensure that the information is only accessible by people who need access to that information. If you’re dental office has a wall of paper charts containing your personal and medical information, how are those charts secured Do they lock them up at night If not, whats to stop the cleaning crew from taking a peek

Modern offices today are using digital records and HIPAA stipulates that these records must be encrypted and only accessible by personnel who need access to the information. Properly managed, digital records are extremely secure while offering the patient the convenience of easily transferring those records to another office should the need arise to change dentists. Proper security can be huge expense to an office though so if the dentist is unwilling to make the investment, your information could be at risk.

  1. How does the office ensure your personal safety? Similar to HIPAA, OSHA (Occupational Safety and Health Administration) is a set of federal standards designed to ensure that practitioners do not jeopardize the heath of their patients and staff through exposure to harmful pathogens, toxins and other hazards. And, just like HIPAA, just because the regulations exist doesn’t mean they are adhered to.

Our staff members individually average 10+ years of industry experience and all of them have worked at multiple offices across their careers. The stories they tell of offices who don’t properly sterilize equipment are frightening and its unfair to patients who trust in their doctor that the proper steps are being taken. Most issues seem to revolve around some of the larger corporate chain offices where profit is the focus and in order to keep their margins high, instruments are turned over quickly and may not have enough time in the sterilizer to be properly disinfected. Disposable barriers should be placed on areas that clinical staff touch while performing procedures like the handle on the overhead light or the computer mouse. These items should be disposed of after very patients visit is completed.

  1. Take a tour of the office: one of the most important things is just ensuring that you feel comfortable with the office. Are the front office staff and the assistants friendly Do they take the time to show you around the office Does it appear clean and organized If the office is unwilling to spend the time to give you a complete tour of the office and answer any questions you may have, they’re probably also unwilling to spend the time ensuring that your dental work is done properly, your data is secure and precautions are taken to protect your health. Call some offices and schedule a time to stop by and check it out.

An important thing to remember when shopping for a dentist is that you are looking for value (cost relative to benefit) in the office that you choose. All of the items mentioned above have a cost to the practice that implements them, therefore if you’re shopping on price alone you’re probably going to end up with a dentist who either isn’t meeting basic standards or isn’t going to be in business for very long.

Heres a checklist of questions for your next dentist:

  • Technology
    • What type of x-rays do you use Find a dentist using digital x-rays.
    • Do you use a digital intraoral camera
  • Record keeping
    • Do you keep digital or paper records Look for practices using digital.
    • How are the records secured Every office should have a HIPAA manager who should be able to answer these questions:
      • If digital, is the database encrypted All databases should be encrypted.
      • If digital, how is access limited to the files? Access should be limited to people who need access. Each persons access should be password protected.
      • If paper, how are the records locked up at night?
      • How are records backed up? Ideally databases would be backed up daily, but they should be backed up at least weekly.
      • How is your security as a patient protected when transferring records to specialists who may need access to your general dental records? Records should be transferred over SSL (secure socket layer) or specialists should have a portal to login and access patient information.
    • Personal Safety
      • How are instruments sterilized?
        • Instruments should start in an enzymatic rinse and then be moved to a heat/pressure sterilizer
        • Color changing indicators should be used to determine that the proper heat/pressure was achieved to sterilize instruments
        • Sterilizers should be periodically spore tested to verify that the unit is functioning properly. Test results should be logged.
      • Whats in the water that comes out of the dental delivery unit?
        • A single dental office can contain miles of tiny tubing. Water can sit stagnate in these lines and become a breeding ground for bacteria.
        • How are these lines treated and tested?Water lines should be shock treated monthly to kill bacteria and should be tested periodically to ensure bacteria levels are within acceptable levels.
        • A dental practice which has city water plumbed to the dental chairs is probably not going to be able to shock treat their lines because its a closed system. Look for refillable bottles on the delivery units which can easily have antimicrobial tablets or solution added.
      • What barriers are used How often are they changed?
        • Any areas that a practitioner or their assistant would be touching with gloved hands during a procedure should have plastic barriers. Plastic barriers should be used on the head rest, overhead light, air/water syringes
        • A disposable head rest cover should be used on the patient chair
        • Suction tips and air/water syringe tips should be sterilized or disposed of between patient appointments
      • How often are the rooms sprayed down What germicides are used?
        • Each procedure room should be sprayed and wiped down between patients with a germicide capable of killing the Tuberculosis virus.
      • How does the office protect against x-ray radiation? Radiation exposure from dental x-rays is very low especially if the office is using digital x-rays however exposure should be limited whenever possible.
        • Lead aprons have been used as a standard of care for decades and should always be used.
        • A thyroid collar has become the new standard of care to better protect the thyroid gland. The collar wraps around the neck to extend protection above the apron.
      • Does the office provide you with eye protection?
        • Some of the materials used in dentistry can be eye irritants so eyes should be protected with safety glasses. Tinted safety glasses also help reduce the

Yes, good dentistry will cost more upfront, but dental work that lasts longer, doesn’t require re-treatment and doesn’t result in infection or other issues is going to save you time, money and discomfort in the long run and you’ll stay healthier. Most offices today offer financing to spread costs out and make them more manageable. You only get one set of teeth so the additional cost that you might spend on a procedure done right the first time can be looked at similar to an insurance policy because you’ve decreased the likelihood of experiencing further issues and potential tooth loss down the road. At Colorado Family Dentistry our costs are around the fiftieth percentile for the Lakewood, Colorado area but the quality of service we provide ranks among the top offices in the Denver Metro Area according to our patients.

Next up In the coming articles well look at individual procedures and how to ensure that you’re getting the best possible care.

Colorado Family Dentistry is a privately owned and operated dental practice located at 255 Union Boulevard, Lakewood, Colorado 80228. We are currently accepting new patients. Please call us at 303-284-0202 to schedule an appointment.