Organization of a surgical dental office

Levels of care and room zoning

Surgical dental care is provided at three levels:

1. Qualified care — provided in mixed-practice offices (educational and sports institutions, enterprises, private practice).
2. Specialized care — provided in the surgical office of a dental clinic.
3. Highly specialized care — provided in large centers and hospitals.

For full outpatient operations, the surgical office must consist of at least three separate rooms:

• Waiting and relaxation area — for patients and their companions before the appointment or after surgery.
• Preoperative room (sterilization room) — a room of at least 10 m² with a fume hood. Here, staff change clothes and wash their hands, and instruments are sterilized.
• Operating room — the surgeon's workspace. The baseline area is from 14 m² for a single dental unit, with an additional 7 m² for each extra unit installed.

Sanitary-hygienic standards and microclimate

The office rooms must have a ceiling height of at least 3 m and a depth of no more than 6 m. It is advisable to locate them on upper floors, providing the dental units with natural daylight from windows. Supply and exhaust ventilation and shadowless lamps for illuminating the surgical field are mandatory.

Finishing requirements:

• Walls in the office are tiled with ceramic tiles up to a height of at least 1.8 m, and in the operating room — up to the full height of the room.
• Floors in the office are covered with linoleum or tiles; polymer-cement mastic is acceptable in the operating room.

Sanitary and epidemiological regimen includes:

• Routine wet cleaning with hot soapy water — 2 times a day (between shifts and in the evening).
• Air disinfection with bactericidal lamps (UV or ozone) — daily.
• General cleaning — 1 time per week.
• Bacteriological monitoring to assess the sanitary condition.

Staff workstation equipment

The office space is clearly divided among the personnel:

• Dentist-surgeon's workstation: dental unit, screw-lift stools for the doctor and assistant, medication table.
• Nurse's workstation: instrument sorting table, ultrasonic cleaner, dry-heat sterilizer, glass-bead sterilizer for small instruments, handpiece lubrication device (e.g., Assistina), and sterile table (or UV shelf).
• Cleaning staff workstation: sink and table for sorting used instruments.

Medicines are stored in general cabinets. Special drugs require strict conditions: cabinet “A” is used for toxic substances, cabinet “B” — for potent drugs.

Dental unit configuration

Modern dental equipment is multifunctional. The basic module includes:

• Automated patient chair with armrests and headrest.
• Dental drill (mechanical and turbine handpieces).
• Water and air supply unit.
• Shadowless light.
• Evacuation system (high-volume evacuator and saliva ejector).
• Ultrasonic scaler and cuspidor.

Optionally, the unit can be equipped with additional devices: a radiovisiograph (for X-ray control), apex locator, negatoscope, pulp tester, curing light, and electrosurgical unit.

Medical documentation and patient routing

The primary document of medical, scientific, and legal significance is the case history (medical record). It records:

• Patient complaints;
• Anamnesis vitae (history of life) and anamnesis morbi (history of present illness);
• Examination data and diagnosis;
• Rationale for treatment tactics and surgical stages;
• Complications, treatment, and recommendations.

Patients not requiring emergency care are referred for elective surgery. If the clinical case is complex, the doctor refers the patient to a hospital.

Class and exam questions

What else to study on this topic

• Organization of work in the clinic's surgical department (5 mandatory rooms)
• Purpose of optional dental unit equipment (apex locator, radiovisiograph)
• Rules for taking anamnesis and maintaining the dental patient's medical record
• Methodology for bacteriological monitoring in the office

Other topics in "Chapter 2. Organization and Equipment of the Dental Surgery Office (M.M. Pozharitskaya)"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.