Size doesn't matter

01 September 2010
Volume 26 · Issue 8

Pete Higson dispels the old myth.

With the publication of the new and updated HTM 01-05 last December, it’s no wonder so many dentists and practice managers are concerned about how the document’s complex and detailed contents can be applied to their practices. With the backing of the law, all dental practices in England are required to have achieved ‘essential’ standards within 12 months of the document’s publication. The guidance, or rather, instruction, is unforgiving.  If these standards have not been met, the dentist will no longer be able to practice. The guidance now also requires written proof of how, and when, each dental business expects to conform to the recommended ‘best practice’ standards. 

It’s inevitable that certain thoughts will cross many a concerned principal’s mind, and that they are likely to contain the words ‘cost’ and ‘time’, and perhaps be peppered with a few expletives.

The problem will be further compounded if space is at a premium. The requirement that all practices should have a designated decontamination area will require some rearrangements, and the necessity for the implementation of a dedicated hand-washing sink will have to be considered. Perhaps the most pressing issue will be that even after satisfying the essential standards, dentists still have to demonstrate their dedication to striving towards best practice. Here, the bone of contention is likely to be the issue of the dedicated decontamination and storage room, which must be kept separate from patient accessed or treatment areas. 

However, before the builders are called in to start demolishing inner walls, all is not lost. The good news is that there are dedicated companies who work closely with spatially challenged dental practices to ensure they meet all the stringent infection control guidelines. Such companies are specialists in designing the necessary cabinetry and workspaces for each individual dentist’s needs.

Good design and layout are the basis for competent decontamination and infection control. Dust and debris collect in inaccessible places, particularly corners and joins in work surfaces. Most dentists will work in a practice that is already set up and cannot influence the design. However, if the possibility does arise for the practitioner to take control over the refurbishment of an existing facility, they should definitely grasp the opportunity with both hands. 

There are several issues to be taken into consideration when thinking of a refurbishment. Ease of use is of the utmost importance and goes hand-in-hand with operational efficiency. There should be room for staff to work in optimum positions, and there should be enough space for mobile equipment to be moved around and used easily. This will be influenced by certain factors, including: the size and shape of the surgery; the types and positions of fixtures; any pre-existing dental chair and unit and any other equipment. The implementation of infection control procedures should also be a major priority. Lack of space is no excuse for sub-standard infection control procedures. Efficient design can create space, ensuring staff can meet their responsibilities and fully comply with present and foreseeable regulations.

The health department’s HTM 01-05 decontamination guidelines state that work surfaces should be impervious, smooth, easy to clean and disinfect. Ideally, they should be continuous, free from damage and abrasion, dust and visible dirt. Where there are joints, a sealant must be used to stop debris from collecting inside. This also prevents damage due to water ingress under the flooring. All junctions should be curved or rounded to allow effective cleaning. Work surfaces made of glass or Corian (composed of acrylic polymer and alumina trihydrate) are highly durable, easy to clean and maintain their aesthetically pleasing look. Corian is non-porous and particularly robust, and is fast becoming the standard at the top end of the healthcare industry. 

The most effective cabinetry to have in your practice is metal medical cabinetry, which is made from galvanised, or stainless steel. It is the ideal material for the environment and conforms entirely to the new updated guidelines. Many companies are still creating LDU rooms from high-density chipboard or MDF carcase. These materials are not always fit for this purpose because of their reactions to extreme heat, steam and water conditions. Wooden cabinets aren’t an option where there is a strong emphasis on cleanliness and hygiene. Professional kitchens, hospital operating theatres and dental laboratories won’t entertain the idea of wooden cabinetry because it doesn’t always provide the confidence that is needed when hygiene, decontamination and professional care is involved.

Once the practitioner has decided what they need, the next stage is to consult a representative. The best suppliers of technical furniture will tailor the work to meet the dentist’s requirements. Each practice will have a different set of physical factors to take into account, perhaps even limitations within the structure of the building itself. A thorough consultation should stand the dentist or practice manager in good stead for the initial designs to be drawn up.

With limitations of space in mind, the latest in computer aided design technology will offer the dentist the chance to turn initial drawings and plans into a reality before an engineer even steps foot in the practice. This allows the principal to visualise their future surgery in all its glory on screen, and to make those all-important tweaks and changes before they commit to one particular layout. 

The best manufacturers of dental cabinetry and worktops will offer a wide range of adaptable, modern and functional designs to choose from to maximise space available to them, all the while complying with stringent cross contamination regulations.

For further information call Tavom UK on 0870 752 1121 or visit www.tavom.com