Design and Sterilizations

Orthodontic office design, sterilization, and patient flow are well integrated in a carefully planned orthodontic office. Whether undertaking a new construction project, a remodel, or simply an evaluation of present design flow, the sterilization and operatory areas of a practice need a system in place to maintain proper instrument processing and patient flow. Many orthodontists make the mistake of underestimating the importance of a well-designed and constructed sterilization center. Proper design of this area will result in a more efficient and productive office.

Many factors are involved when determining how this flow will be most effective for each individual practice. An evaluation of each procedure, instruments, staffing, as well as sterilization units is necessary for designing an efficient system.

The implementation of different bracket systems, bonding systems, and procedures will determine the instruments necessary for each procedure. After each procedure is evaluated and streamlined for efficiency an individual procedural set-up will be developed. This will allow the clinicians to have all necessary instruments and products chairside prior to starting a procedure. This will also allow for faster set up and tear down, and for faster cleaning and reprocessing of instruments.

The scheduling templates in ViewPoint will determine how many of each procedure will be scheduled in a day. Once we have this information we can determine how many instruments and setups will be needed to maintain patient flow for the day. The use of a sterilization technician may allow the practice to process instruments more quickly and may possibly reduce the total number of instruments needed to maintain patient flow. If immediate processing is not available the instruments should be placed in a holding solution so debris does not harden on their surfaces.

An effective option to handle a greater number of trays and/or cassettes is tray storage pass-through areas. Many offices now design a pass-through into their sterilization design to allow for a more efficient drop-off of a "dirty" tray or cassette, and retrieval of a "clean" tray or cassette already set up for the next procedure. This pass-through displays the sterilized setups and is a great visual for patients to see during the initial exam tour of the office.

The sterilization unit (size and processing time) dictates the speed at which instruments can be processed and be returned into the rotation for use by the clinicians. There are three types of sterilization processes used in orthodontics today — steam autoclave, dry heat, and chemical vapor sterilizers. Type of sterilizer, unit size, and processing time will determine which unit is best suited for your practice.

Remember to plan for where the office will be in the future, not necessarily where it is today. Will you eventually need an additional sterilizer? Increasing the size of the sterilizer or the addition of another unit may be necessary for the office to maintain instrument flow. The use of tray setups versus cassettes will also determine which unit will be most efficient for the practice.

In order to maintain their longevity, anytime a new piece of equipment is introduced into the practice it is important to be instructed on proper maintenance. This is for all sterilization units, hand-pieces, water lines, air/water syringes, as well as curing lights and chairside equipment.