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Safety Net Dental Clinic Manual

Welcome to Safety Net Dental Clinic Manual, which is designed to help safety net dental

clinic staff with all aspects of clinic development and ongoing operations.

Chapter 1: Partnerships & Planning

Chapter 2: Facility Design & Staffing

Chapter 3: Finances

Chapter 4: Clinic Operations

Chapter 5: Quality Improvement

Chapter 6: Program Sustainability

National

Maternal and

Child Oral

Health

Resource

Center

Ohio

Department

of Health

Safety Net

Solutions

Indian Health

Service

Association of

State &

Territorial

Dental

Directors

National

Network for

Oral Health

Access

How will you use this manual?

Experienced clinic director? New clinic administrator? Either way, you've

come to the right place. You may view the chapters as a series of steps to

follow when launching a dental clinic or focus on particular topics of

interest. The manual is presented in an easy-to-use format, and includes

tools and resources like clinic policies, efficiency tips, professional

standards, supply lists, floor plans, design tips, photos of equipment,

customizable budget worksheets, funding strategies, quality improvement

plans, fact sheets, and Web sites.

Who needs this manual?

Perhaps you are a safety net dental clinic director facing major challenges.

Your clinic has a long waiting list and has been mired in red ink for years.

You want to make the clinic efficient and sustainable. You don't know

whether the solution lies in improved staffing patterns, revised clinic policies, or facility design. Or is the problem that

you lack a business plan? This manual discusses the pros and cons of various options and links to other resources to

help you make decisions.

What is the dental care safety net?

The dental care safety net is where people go

When they don't have a regular dentist

Because they know their Medicaid card will be accepted

Because they won't be turned away when they are in pain and can't afford care

Because the clinic is close to home and linked to their other health care providers

The Institute of Medicine's report, America's Health Care Safety Net (2000), defines safety net providers as

those who "organize and deliver a significant level of health care and other health-related services to uninsured,

Medicaid, and other vulnerable patients." Safety net clinics may be operated by federally qualified health centers,

local health departments, neighborhood health centers that are private not-for-profit agencies, rural health

centers, Indian Health Service or tribal units, institutions, schools, hospitals, or other entities.

Why do we need a dental care safety net?

The Surgeon General's Report, Oral Health in America (2000), provides a thorough review of the nation's oral

health and the need for both community-based and individual approaches to prevention and treatment of oral

conditions. It also emphasizes that oral health is essential to general health and that systemic conditions influence

oral health. Despite advances in technology and the scientific understanding of oral diseases, significant disparities

exist in oral disease rates and access to dental care among subgroups of the population. The dental safety net

attempts to bridge the gap for these disenfranchised groups.
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Safety Net Dental Clinic Manual

Chapter 2. Facilities and Staffing

Facility

Design and

Construction

Equipment

and Supplies

Staffing

Facility Design and Construction

What are basic costs for a fixed dental clinic, a mobile clinic, and a clinic using portable equipment?

Use the following chart to "quickly" compare costs for fixed clinics depending on size and staffing issues. Cost figures

for mobile clinics and clinics using portable equipment are also included. Main topics in the chart are discussed

separately and linked to more detailed information. Reviewing this chart should enable you to determine what size

facility you can afford to build and staff.

Dental Clinic Comparison Chart: Capacity and Costs for Fixed Clinics, Mobile Clinics and Clinics Using

Portable Equipment

Fixed* Mobile Portable

Size

3-chair

(1800 sq ft)

6-chair

(2925 sq

ft)

9-chair

(3490 sq ft)

12-chair

(3970 sq ft)

2-chair 2-chair

Patients Treated/Year 1000-1800 1801-3600 3601-5400 5401-7200 500-800 500-800

Visits/Year (DDS+DH) 3000-3400 6400-6600 9500-10000 12800-32000 1400-2000 1200-1800

Start-up Costs

Remodeling ($148/sq ft)

Construction ($215/sq ft) $387,000 $628,875 $750,370 $853,550 $405,198 N/A

Large Equipment $185,234 $287,193 $370,500 $501,025

$21,813

Most equipment is

built into unit

$20,982

Supplies, Instruments and Small

Equipment

$52,218 $100,149 $147,480 $194,963 $26,319 $26,319

Annual Operating Costs

Staff

Dentists' Average Salary

Director $140,568

Staff $106,037

1

$140,658

2

$246,695

3

$352,732

4

$458,769

1

$106,037

1

$106,037

Dental Assistants'

Average Salary $33,985

2

$67,970

4

$135,942

6

$203,912

8

$271,855

2

$67,970

2

$67,970

Dental Hygienists'

Average Salary $65,436

0.5

$32,718

1

$65,436

1.5

$98,154

2

$130,872

N/A N/A

Clerical/Receptionists'

Average Salary $37,135

0

1

$37,135

1

$37,135

1

$37,135

N/A N/A

Utilities Average

$9,467 to $12,924

$9,467 $10,619 $11,723 $12,924

Varies

$0 to $4,000

N/A

Rent or Mortgage Payment

Average $31,212

$29,238 $30,408 $33,000 $34,083 N/A N/A

Dental Supplies

$7,649/operatory

$22,947 $45,892 $68,839 $91,786 $15,298 $15,298

Other

(charts, office supplies, etc.)

$2,611 to $5,762

$2,611 $3,986 $4,856 $5,726 $2,611 $2,611

Total Start-Up Costs $624,452 $1,016,217 $1,268,330 $1,549,538 $453,330 $ 47,301

Total Annual Operating Costs $305,609 $ 576,113 $ 810,351 $1,043,180 $195,528 $191,916

Total First-Year Costs $930,061 $1,592,330 $2,078,681 $2,592,718 $648,858 $239,217

* Fixed locations may include a free-standing facility, community health center, hospital, school or other location.

** Cost is based on 2004 salaries in the Southwest and 2004 equipment/supply costs adjusted for inflation for 2010.
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Dental Chair 15 years

Operating Stool 15 years

Dental Handpiece (drill) 3 years

X-ray unit 5 years

Ultrasonic cleaner 10 years

Autoclave 10 years

Cabinets 15 years

Dental Units 10 years

Air Compressor 12 years

Vacuum System 10 years

Safety Net Dental Clinic Manual

Chapter 2. Facilities and Staffing

Facility Design and

Construction

Equipment and Supplies

Staffing

Equipment and Supplies

What is the useful life of dental equipment?

Even with the best preventive maintenance dental equipment will wear out. In order to aid in planning

for replacing equipment the following estimates of useful life of equipment are provided.

The estimates were developed by the Veterans Administration and the US Army.

© 2011 National Maternal and Child Oral Health Resource Center

Site Credits | Disclaimer and Copyright
From: skolo@ncemch.org [mailto:skolo@ncemch.org] On Behalf Of Sarah Kolo

Sent: Monday, May 23, 2011 12:38 PM

To: Robert Chew

Subject: Re: Safety Net Dental Clinic Manual Question

Hello, again, Rob,

Thanks for your patience! I reached the original author and he sent information about your 

questions.

(1) I was wondering where the start-up cost information comes from, 

particularly for the “Construction”, “Large Equipment” and “Supplies, 

Instruments and Small Equipment” categories. I see in the footnote that the data 

was collected in 2004 but I was wondering if you had any information about the 

source of the information (is it survey data or were the cost figures determined 

through equipment costs provided by vendors?).

The cost of the equipment was obtained from equipment suppliers Henry Schein 

and ADEC. The equipment list was the one used by the Indian Health Service 

when they construct a new facility. This was for large and small equipment as 

well as supplies. The prices had been adjusted for inflation up until 2010.

(2) Is there information for the “Construction”, “Large Equipment” and 

“Supplies, Instruments and Small Equipment” categories that are broken out into 

more specific line items? For example, do you have information on what 

equipment is included in the “Large Equipment” category and how much each 

piece of equipment cost when the table was put together?

When we were originally designing the site we were going to have all of the 

materials on the attached lists included on the site. But it was decided that this 

was too much information. Attached are various tables that I worked up and they 

include all equipment including dental vacuum system and air compressor. 

Hope this helps, Rob. Let me know if you would like further information.

Sarah Kolo

National Maternal and Child Oral Health Resource Center

Georgetown University

Box 571272

Washington, DC 20057-1272

(202) 784-9553
sk22@georgetown.edu

www.mchoralhealth.org
Equipment Cost Table

6 Chair Clinic: 5- Ops Open Concept, 1 Op

Private Cost from 2003

DESCRIPTION QTY COST COST EXT RETAIL RETAIL EXT

Dental Chairs, Hydraulic Base, Multifunction

Footswitch 5 $4,400.00 $22,000.00 $5,495.00 $27,475.00

Operators Stool 5 $475.00 $2,375.00 $595.00 $2,975.00

Assistants Stool 5 $550.00 $3,300.00 $690.00 $3,450.00

Spirit Duo-Flexible Work Station, Wall Mount 2 $4,925.00 $9,850.00 $6,150.00 $12,300.00

Spirit Duo-Flexible Work Station, Cabinet Mount 3 $4,815.00 $14,445.00 $5,990.00 $17,970.00

Built In Fiber Optic System 5 $299.00 $1,495.00 $390.00 $1,950.00

Fiber Optic Handpiece Tubing (6-pin), 2 per unit 10 $155.00 $1,550.00 $195.00 $1,950.00

Built In Piezo Scaler 5 $1,165.00 $5,825.00 $1,445.00 $7,225.00

Self Contained Water System With QD ( Included) 5

Wall Mounted Operating Light, LFIII 2 $1,999.00 $3,998.00 $2,495.00 $4,990.00

Cabinet Mounted Light, LFIIIcb 3 $1,999.00 $5,997.00 $2,495.00 $7,485.00

Drs Lower Cabinet with Sink Left 3 $1,495.00 $4,485.00 $1,860.00 $5,580.00

Assistants Lower Cabinet, Sink Right 2 $2,110.00 $4,220.00 $2,615.00 $5,230.00

12 O'Clock Cabinet W/ Upper Storage 5 $3,600.00 $18,000.00 $4,500.00 $22,500.00

Central Console With X-Ray Pass Thru 3 $7,998.00 $23,994.00 $9,950.00 $29,850.00

BiFold Doors for X-Ray Pass Thru, (Included) 3

Focus X-Ray Unit, (Digital Ready) 5 $3,895.00 $19,475.00 $4,650.00 $23,250.00

Panoramic X-Ray, Ceph Ready, (Digital

Upgradeable) 1 $23,999.00 $23,999.00 $29,050.00 $29,050.00

Film Processor with Chemistry Replenisher 1 $4,085.00 $4,085.00 $5,365.00 $5,365.00

Daylight Loader for Film Processor 1 $925.00 $925.00 $925.00 $925.00

Air Compressor, Dual Oilless With Cover 1 $5,260.00 $5,260.00 $6,850.00 $6,850.00

Dry Vacuum System Dual Motors 1 $10,500.00 $10,500.00 $13,690.00 $13,690.00

10" Autoclave 1 $3,735.00 $3,735.00 $4,645.00 $4,645.00

Cassette rack for Autoclave 1 $136.00 $136.00 $170.00 $170.00

Statim Quick Cycle Sterilizer 1 $3,715.00 $3,715.00 $4,950.00 $4,950.00

Hydrim Instrument Washer 1 $2,790.00 $2,790.00 $2,995.00 $2,995.00

Sub Total Major Equipment $196,154.00 $242,820.00

Digital Radiography (Optional)

Direct Digital Sensor Kit # 2 Size 1 $8,995.00 $8,995.00 $8,995.00 $8,995.00

Additional #2 Sensors 2 $6,600.00 $13,200.00 $6,600.00 $13,200.00

#1 Direct Sensor 1 $5,545.00 $5,545.00 $5,545.00 $5,545.00

Additional USB Interface Box 5 $2,230.00 $11,150.00 $2,230.00 $11,150.00

NOTE: Prices do not include Computer Hardware

Panoramic Direct Digital Upgrade 1 $29,100.00 $29,100.00 $29,100.00 $29,100.00

NOTE: Panoramic Upgrade includes Computer

Workstation

Sub Total Direct Digital $67,990.00 $67,990.00
Supplies/small equipment/instruments

Table top Amalgamator 6 $398.00 $2,388.00 $425.00 $2,550.00

Dental Laboratory Equipment 1 $3,750.00 $3,750.00 $3,750.00 $3,750.00

Hi Speed Fiber Optic Handpieces (4 per Op) 24 $635.00 $15,240.00 $825.00 $19,800.00

Slow Speed Motors 6 $525.00 $3,150.00 $699.00 $4,194.00

Slow Speed Contra Angle Sheaths 24 $175.00 $4,200.00 $195.00 $4,680.00

Slow Speed Latch Heads 24 $170.00 $4,080.00 $225.00 $5,400.00

Slow Speed Straight Cones 6 $240.00 $1,440.00 $195.00 $1,170.00

Curing Lights 6 $690.00 $4,140.00 $899.00 $5,394.00

Misc Instruments and Supplies 6 $6,000.00 $36,000.00 $7,500.00 $45,000.00

Sub total Supplies/small equipment/instruments $74,388.00 $91,938.00

Total Equipment/Supplies/Instruments $338,532.00 $402,748.00

Note: Total Cost includes Digital X-Ray; substract $67,990 if using standard X-ray.