Dental Offices Moving Away From Clinical Look

When the Prosthodontic Dental Group first envisioned a new office, they did not want the 2,900 square foot space to look like a typical dental office. Since many of their cases involve complex restorations that have been referred by other dentists, their patients can be more nervous than most.

Creating a calming environment was at the top of their wish list. The finished design does just that.

A slate and pebble waterfall in the lobby immediately puts patients at ease.

"The sound of running water creates a very soothing environment," said Barry Hoffman, one of the three partners. The 6-x-4-foot water feature that sits on a cabinet also hides banks of charts. "We didn’t want the patients to see the files."

By hiding the computers and workspace, the extra-wide granite reception counter keeps the illusion that the lobby could be an upscale living room instead of an office.

"You can’t see the work area," Hoffman added. "All you can see is the receptionist and the staff. The patient isn’t immediately reminded that they are in a dental office by seeing files, computers and clutter on the desk."

Curved corners with banks of glass blocks and extra-wide halls give a sense of openness to the area. "People don’t want to feel closed in," Hoffman said. "We wanted a feeling of spaciousness throughout the office, so patients wouldn’t feel hemmed in. We wanted the design to be as people-friendly as possible."

In moving away from the clinical look of dental offices, the Sacramento prosthodontic group is part of the latest trend.

"These days, the further away you can get from the look of a dental office, the better," said Jeanne Maloney, CID, and principal of Design Directions. A designer of dental and medical offices for the more than 20 years, Maloney has her finger on the pulse of what’s happening.

Having an office that resembles a spa or an upscale home is one of the biggest changes she has seen in the field in the past few years. "Dentists are creating a different ambience in their lobbies. They want people to feel like they’re being pampered, even waited on," Maloney said.

For someone who is fearful of visiting the dentist, this approach is just what the doctored ordered.

Waterfalls are the hallmark of patient comfort. "We’ve done a lot of water treatments this year," Maloney said. As a result of this growing trend, "we’ve found companies who will custom-design wonderful water features."

Table lamps with shades, hardback books instead of magazines, and soft lighting all create a "homey" atmosphere. Being served gourmet coffee or herbal tea also makes the patient feel as if he or she is at a friend’s home rather than a business. Even simple touches like rounded-back chairs and radius wall corners take away from a hard-edged look that subtly adds to the tension a patient feels.

According to Maloney, design can add to or detract from that sense of a trusted relationship dentists want their patients to have. "Every detail of the design can help the patient feel that they are in good hands," Maloney said.

Attention to detail is the hallmark of Craig Wada’s Rocklin office. From the scent of eucalyptus and rosemary in the lobby to the eye gels and cashmere neck wraps during treatment, the prosthodontist has created an office that is closer to a spa than most.

"When you walk in, there is a Zen sense of calm," said Carey Wada, Craig’s dental-consultant wife. When they built the office in 1999, Carey Wada admits they did the opposite of the "space is money" mantra often taught by consultants. "We devoted everything to patient comfort," Wada said.

As a result, patients relax in leather recliners in the lobby or in a soundproof "quiet room" before seeing the dentist. Through two glass walls of the quiet room, they can watch birds in a garden full of birdhouses and birdbaths. Significant others can also set up computers and work if they want to accompany a nervous patient to the office.

The calming atmosphere helps overcome what Carey Wada calls the psychological impact of having unstable teeth from years of "something always going on."

"The public has a real distrust of dentists," Carey Wada said. "The mouth is such a highly private part of the body, it is so personal that many people feel uncomfortable having their teeth worked on."

As such, Craig Wada meets with the patient the first time in the quiet room instead of the dental chair. Appointments in the operatory come later. Although it usually takes more time, Carey Wada says that their approach is based on a solid clinical foundation of examination, diagnosis and planning treatment that "deals with fear on a therapeutic level."

Whether the look is that of home or spa, the trend in dental offices is not only away from a traditional clinical design, but toward a more patient-friendly approach that helps put every patient at ease.

Dell Richards is the owner of the Sacramento public relations firm Dell Richards Publicity. She specializes in health care clients.

Fellowship Created to Encourage Perio Teaching

A new fellowship has been created by the American Academy of Periodontology Foundation to encourage periodontal students to enter teaching.

The Abram and Sylvia Chasens Teaching and Research Fellowship will provide $30,000 per year to fund two fellowships awarded to students who have a stated career goal of periodontal education and who are in their third year of an accredited periodontal residence program.

"The Foundation is extremely appreciative of the fellowship and the spirit with which it was created," notes L.K. Croft, DDS, president of the AAP Foundation. "As an educator, researcher, and practitioner, Dr. Chasens had had a profound impact on the profession. He and his wife, Sylvia, understand the importance of attracting and retaining high-quality educators in periodontology. The Chasens Fellowship will benefit periodontal education and the profession for years to come."

The fellowship will be funded with an annual gift from the Chasens throughout their lives. To ensure the continuance of the fellowship, the Chasens have provided for the future in their estate plan. The award will be funded by a series of three gift annuities established by the Chasens. "The profession has been good to me and I want to give something back. A gift annuity program is an idea vehicle for doing this because it produces an income for me and my wife, while providing the funds we want the Foundation to have," Abram Chasens said.

Racial, Ethnic Health Disparities Improve

A new report shows significant improvements in the health of racial and ethnic minorities, but also indicates that important disparities in health persist among different populations.

The Department of Health and Human Services report presents national trends in racial- and ethnic-specific rates for 17 health status indicators during the 1990s. All racial and ethnic groups experienced improvements in rates for 10 of the 17 indicators. At the same time, the report also shows that despite these overall improvements, in some areas the disparities for ethnic and racial minorities remained the same or even increased.

"Our goal is to eliminate disparities in health among all population groups by 2010," Health and Human Services Secretary Tommy G. Thompson said. "While we are making progress, this report shows how far we still have to go."

The report is part of Healthy People 2000, an effort to set health goals for each decade and then measure progress toward achieving them. One of the goals of the Healthy People Initiative is to reduce disparities in health. Notable progress was made in reducing the gap in syphilis case rates and stroke death rates. However, for about half of the indicators, the disparities improved only slightly; and disparities actually widened substantially for work-related injury deaths, motor vehicle crash deaths, and suicide.

"In many ways, Americans of all ages and in every racial and ethnic group have better health today," Surgeon General David Satcher said. "But our work isn’t done until all infants have the same chance to thrive, all mothers have equal access to prenatal care, and all Americans are equally protected from cancer, heart disease, and stroke."

* All racial and ethnic groups experienced improvement in rates for 10 of the indicators: prenatal care; infant mortality; teen births; death rates for heart disease, homicide, motor vehicle crashes, and work-related injuries; the tuberculosis case rate; syphilis case rate; and poor air quality.

* For five more indicators -- total death rate and death rates for stroke, lung cancer, breast cancer, and suicide -- there was improvement in rates for all groups except American Indians or Alaska Natives.

* The percent of children under 18 years old living in poverty improved for all groups except Asians or Pacific Islanders, and the percent of low birthweight infants improved only for black non-Hispanics.

"A clear lesson for public health is that efforts to achieve progress for all must be targeted and tailored to the needs of specific groups," said Dr. Jeffrey P. Koplan, director of the Centers for Disease Control and Prevention, which prepared the report. "For example, the drop in the syphilis rate followed an intensive campaign to eradicate syphilis community by community."

The report, "Trends in Racial and Ethnic-Specific Rates for the Health Status Indicators: United States, 1990-1998," can be viewed or downloaded at http://www.cdc.gov/nchs. Information on Healthy People 2010 is available at http://www.health.gov/healthypeople/.

New Models Being Created for University-Industry Research

Intellectual partnerships and virtual research organizations are among innovative models aimed at maximizing the upsides and minimizing the downsides of university-industry research collaboration, according to an article in the Jan. 2 issue of the Journal of the American Medical Association.

Annetine C. Gelijns, PhD, of Columbia University, New York, and Samuel O. Thier, MD, of the Partners Health Care System and Harvard Medical School, Boston, write that interactions between the industrial and academic communities have had important public health benefits.

"Yet, there is a risk to the university-industry relationship if the cultural and ethical principles of one partner overwhelm those of the other," they cautioned.

"Concerns center on blurring lines between academic research and the commercial world, closer ties between universities and business, and the implications of universities’ newfound readiness to behave as profit-seeking entities," they wrote.

Beyond internal organizational changes, several experiments are under way with newer models of university-industry collaboration.

"Scientists in academia and industry who share complementary and overlapping knowledge can form an intellectual partnership," the authors wrote. "These joint efforts aim to speed knowledge transfer, enhance the problem-solving capacity of each side, and expand and accelerate new applications."

"The virtual research organization is another option. If each party has distinct intellectual and technical assets that would be prohibitively expensive or impossible for the other to duplicate, they could collaborate to expand their capabilities," they suggested.

"The for-profit and not-for-profit sectors differ deeply in their missions, cultures, resources, and incentives; and these differences deserve respect. That respect is best demonstrated not by offering prescriptions based on one-sided images of institutional dynamics but by recognizing that creative bridging of traditional divisions of labor is vital to medical innovation, and that this deeply felt practical need is generating exciting ventures in organizational collaboration that deserve close and dispassionate scrutiny," the authors concluded.

Safeguards Offered to Prevent Conflicts of Interest in Clinical Trials

More safeguards are needed to account for the potential for conflict of interest in the conduct of clinical medical trials in both academic and community-based settings, according to an article in the Jan. 2 issue of the Journal of the American Medical Association.

"As the biotechnology and pharmaceutical industries continue to expand research activities and funding of clinical trials, and as increasing numbers of physicians both within and outside academic health centers become involved in partnerships with industry to perform these activities, greater safeguards against conflicts of interest are needed to ensure the integrity of research and to protect the welfare of human subjects," wrote Karine Morin, LLM, and colleagues from the AMA’s Council on Ethical and Judicial Affairs.

"Physicians should be mindful of the conflicting roles of the investigator and clinician and of the financial conflicts of interest that can arise from incentives to conduct trials and to recruit subjects," they wrote.

They recommended the following guidelines:

* Physicians should agree to participate as investigators in clinical trials only when it relates to their scope of practice and area of medical expertise.

* Physicians should be familiar with the ethics of research and should agree to participate in trials only if they are satisfied that an institutional review board has reviewed the protocol, the research does not impose undue risks on research subjects, and the research conforms to government regulations.

* When a physician has treated or continues to treat a patient who is eligible to enroll as a subject in a clinical trial that the physician is conducting, the informed consent process must differentiate between the physician’s roles as clinician and investigator.

* Any financial compensation received from trial sponsors must be commensurate with the efforts of the physician performing the research.

* Physicians should ensure that protocols include provisions for the funding of subjects’ medical care in the event of complications associated with the research.

* The nature and source of funding and financial incentives offered to the investigators must be disclosed to a potential participant as part of the informed consent process.

* When entering into a contract to perform research, physicians should assure themselves that the presentation or publication of results will not be unduly delayed or otherwise obstructed by the sponsoring company.

Honors

Ginger P. Glayzer, a dental student at the University of California at San Francisco, won First Place in the Basic Science and Research Category of the 2001 American Dental Association/Dentsply Student Clinician Program. Her entry was "Proper Enamel Formation Requires the Presence of Functional SATB1 Protein." PHOTO

Douglas Kaylor, DDS, of Needles, has been awarded a fellowship by the American Endodontic Society.

Upcoming Meetings

2002

March 13-16 Academy of Laser Dentistry Annual Conference & Exhibition, San Diego, (954) 346-3776, www.laserdentistry.org

April 4-7 CDA Scientific Session, Anaheim, (916) 443-3382, Ext. 4470

April 12-14 International Dental Exhibition and Meeting, Singapore, 212 -974-8835, www.idem2002.com

May 2-4 British and Irish Dental Associations Annual Conference, Belfast, Northern Ireland, (+44) (0)020-7563-4590, events@bda-dentistry.org.uk

May 7-12 American Academy of Cosmetic Dentistry Annual Session, Honolulu, (800) 543-9220, www.aacdhawaii.com

May 16-19 Organization for Safety and Asepsis Procedures Symposium, Nashville, (800) 298-OSAP, www.osap.org

Sept. 27-29 CDA Scientific Session, San Francisco, (916) 443-3382, Ext. 4470.

Oct. 11-13 National Association of Filipino Dentists in America Annual Meeting, San Francisco, (818) 988-3910.

Oct. 19-23 ADA Annual Session, New Orleans, (312) 440-2500.

To have a meeting included on this list, please send the information to Upcoming Meetings, CDA Journal, P.O. Box 13749, Sacramento, CA 95853 or fax the information to (916) 443-2943.