In a recent post, we proudly displayed photos of our newly remodeled, state of the art practice in Plano.
When patients choose a dentist to entrust their oral health to, they typically read reviews or get recommendations from friends. But few think about all the many dozens or hundreds of little factors that a dental practice and its staff care about in order to make an experience good enough to get all those recommendations and great 5 star reviews.
Top notch patient interaction, a caring staff, a sterling record treatments executed flawlessly in the least amount of time stuck in the dental chair or repeat visits possible, and transparent treatment cost are all common things that we strive to be the very best at in all of Dallas.
But what about the unspoken details? Things like lighting? Yes, even lighting can play a major role in top quality dental. Here are a few things we thought about when designing and outfitting the new clinic:
Proper Treatment Lighting
A territory rep for a major dental equipment supplier once mentioned that he overheard another dental consultant tell a doctor that he didn’t need an overhead light if he had the right headlight. He referred to this comment as a good example of an “uninformed and unhealthy” piece of misinformation. Clinics like ours that offer surgical procedures must have a high standard for operatory lighting. There can be a huge difference in the lighting needed to help ensure that critical details during both exams and procedures are not missed. For example, the light needed for proper clinical dental needs are over 150 TIMES(!) more output than the average lighting built into a dental office’s ceiling.
During exams and treatments, we use 3 different types of lighting: Overhead, hand-piece, and headlight.
Our overhead units put out a powerful uniform lighting. The reflectors around the specialized bulbs are similar small scale versions of floodlights used in stadiums. The light from the bulb is reflected in 8 different directions to cover the subject evenly. To emphasize how much light is needed to do perfect work in a dark mouth, even with all that light from the overhead unit flooding in, the doctor supplements with hand-piece lights. Often these are built in to a dental device being used by the dentist or can be a stand alone unit that goes into the mouth with the doctor’s hands and shines a spot on the area being worked on. A headlight, worn by the doctor or hygienist is the third light in the mix which compliments the overhead light. The headlight can fill shadows caused by obstructions to the main overhead light. Sometimes the overhead light can likewise fill shadows caused by obstructions to the doctor’s headlamp as well.
Shadows cast by an assistant’s hands, instruments, or anything else can be a serious liability during a treatment. In some cases, dental staff suffer from poor ergonomics because of straining to work around poor lighting direction. For example, when working on the mandible (lower jaw), dentists are often observed unconsciously tilting their head in order to shine more light from their headlight into a difficult to reach area. This can lead to neck fatigue and eye strain which in turn can lead to mistakes. After a long week of patient after patient, the strain can add up. Proper overhead lighting and having staff trained to pay attention to these details with little to no involvement from the doctor makes a big difference. Yes, the little details matter when our goal is the best dental care possible.
The Importance of Light Accuracy
Healthy tissues look different than unhealthy ones. Sometimes the difference can be subtle. Have you ever purchased a shirt in a store and then gotten it outside and realized that it was a different shade of color than you thought? This is because of the color accuracy of artificial lights. Color accuracy is measured by something called “Color Rendering Index” or CRI. The scale a number from 0 to 100 with the sun being a perfect 100. Most common household bulbs have a very poor CRI of about 85. Essentially no artificial light sources score a perfect 100 like the sun, but our dental lights need to score 94 or better to allow the doctor’s trained eye to see subtle color variations in oral tissues and teeth.
Good Lighting Ratios
Sometimes treatment lighting can seem inadequate even when the subject is fully illuminated. This can be caused by high power lights like dental overhead lights causing excessive contrast between the target treatment area and the surroundings which reflect light as well such as the patient’s face. High contrast levels between the treatment area and other areas within the doctor’s field of view can make it difficult for him to see needed detail even when there is adequate lighting. It can also lead to unnecessary eye strain. To prevent this, we try to work with contrast levels of no more than about 3 to 1. A dental headlamp can put out as much as 75,000 lux of light output. That spot compared to the surrounding reflection of the face can be an 80 to 1 contrast difference. Not good. So we balance the light output between headlamps and overhead lights. This usually just takes a second to dial in the overhead light’s power and distance from the subject balanced with the doctor’s overhead lamp. Just another way think about the little things.
Dental Practice Ambiance
According to Franz Müller, a lighting design consultant, lighting is the single biggest factor to ambiance that “everyone feels but no one consciously notices”. In other words, most of us don’t consciously notice lighting but do feel significantly different in different types of lighting environments. This is why people in industries where ambiance plays a big role such as restaurateurs spend so much on lighting design. A dental clinic is a place that carries a lot of resistant feelings for most people. Müller, quoted above suggests that dental clinics pay at least some attention to how their office is lit. For example, he says that florescent fixtures with old buzzing ballasts and warm-balanced tubes tend to evoke a slight old and run down feeling. He reiterates, “Most people wouldn’t even have a consciousness of the feeling, but it would be there, perhaps in a slight unease. Since a dental office is a clinical setting, there is an expectation of a very professional ambiance. Modern florescent fixtures – especially those that have been converted to LED tubes with a more neutral or slightly cooler color temperature are fine for this setting.”
At Dr. Jivnani’s we complemented the ambient light with subtle washes of green light near the tops of the walls. This addition has had a marked effect on balancing and offsetting the somewhat stark and professional ambiance from the ceiling fixtures with a color closely associated with soothing feelings.
We believe that when you love what you do, then every nuance of your job no matter how mundane, becomes something that is easy to care about. At Dr. Jivnani’s new dental practice in Plano, there’s nothing we care more about than our patients and their experience when they visit us and afterward. By paying attention to every nuance of that experience, we hope to bring the same top patient satisfaction to Plano that we enjoyed for decades in Richardson.