Seminar pedodontic dental set up

PEDODONTIC CLINIC SET UP
Presented by
Dr Assjad Ansari

Contents
• Introduction
• Factors to consider in preparing a practice.
• Pedodontic clinic designing
• Planning the clinic
• Waiting Room/Reception Area
• Business Office/ front office

• Operatories
• Operatory Delivery Systems
• Tray Setups
• Sterilizing Area/Laboratory
• Private Office/Consultation Room
• Attire And Presentation Of The Clinic Staff
• Colors, Smells And Sounds:
• The five parts of a successful dental practice

Introduction
• The child’s dental anxiety has been of concern for many years and
it is still a barrier to dental care.
• There are many factors that cause the dental anxiety in children.
• They develop anxiety directly (by conditioning) or via indirect
learning (by modeling or from information).

• The child’s perception of the dental environment is also a
significant factor causing the anxiety.
• The changing expectations of children encourage pediatric dentists
to develop a more child-friendly atmosphere in their dental clinics.
• Environmental elements that produce positive feelings can reduce
anxiety.

• Dental anxiety and fear of dental treatment in children are
recognized in many countries as a public health dilemma.
• Despite the advances in technology, dental materials, and increased
oral health awareness, a significant percentage of people suffer
from dental anxiety. It is ranked fourth among common fears and
nine among intense fears

• The term dental fear and dental anxiety are often used
synonymously and are considered to be the main reason for
behavior management problems and avoidance of dental care.
• Environmental elements that produce positive feelings can
reduce anxiety.

• In fact, the attractiveness of the physical environment in the
dental operatory has been shown to be significantly associated
with higher perceived quality and satisfaction, higher reported
positive interaction with staff and reduction in patient anxiety.

• The indoctrination to dentistry is primarily teaching the child to
meet a new situation and to follow the instructions of the dental
personnel. The process may be accomplished if the dentist will
allow the child to survey the dental office and the environment
casually but at the same time attempt to impress the child with
the necessity and the importance of the occasion.

• Factors to consider in preparing a practice.
1.Choosing a dental practice arrangement
2. Selecting and planning a solo practice
3. Choosing an area
4. Choosing a practice facility

5. Finding support services
6. Getting a practice off the ground
7.Looking at alternate delivery systems
8. Finding information sources.

Choice of Dental Practice Arrangement
• The type of practice chosen and the success achieved will depend
on your lifestyle and future goals.
• All dental practices are different and you must seek the type of
practice with which you are comfortable -- not one proposed by
someone else.

• Avenues of practices available
1. Self-employed private practice – ownership
2. Employment by other practitioner – non ownership; partnership or
shareholder possible

3. Group practice -- combined general and multispecialty group,
pedodontic group, capitation group, large advertiser or retail
dentistry group
4. Employment by a corporation to provide services to employees and
dependents
5. Institutional practice -- schools and clinics on a full-. or part-time
basis

6. Government employment -- armed forces, public health service,
state and local government
7. Faculty position -- combination of full- or part-time teaching and
practice
8. Research -- usually in combination with a full-time appointment
in a dental school or hospital.

Selecting and Planning the Solo Practice
• The input of a spouse is extremely important in planning a lifetime
occupation.
• Several questions must be considered in planning the practice.
1. What type of patient do you wish to treat (handicapped,
adolescents, welfare)?

2. Will you perform orthodontic and endodontic services or refer
children to other specialists?
3. Will you have a fee for service, a capitation program, insurance
participation, and the inclusion of welfare patients in your practice?
4. Will you have room to expand your office facilities?

5.Will you eventually establish satellite offices?
6. Are you willing to offer weekend or evening hours?
7. Will you offer flexible terms?

• The type of practice you will have has to be determined.
1. If limited to pedodontics, what age children will you treat?
2. If pedodontics and orthodontics are combined, what are your
training limitations? Will you associate with an orthodontist to
provide orthodontic services?

3. Will handicapped patients be treated as part of your normal office
routine or will you take them to a hospital or clinic where you are
affiliated? Will homebound care be provided to the handicapped?
Will you use general anesthesia or sedation in your office?
4. Will you be associated with a dental school or hospital permitting
you to teach residents and graduate students?

5. What are the long-range opportunities for expansion? You must
realize that a successful practice will outgrow the first facility in
five to seven years. What will your goals be -- to move and
expand either into or another facility or to have multiple offices?

Choosing the Area
• The location is critical to growth and patient satisfaction.
• Use a marketing research approach to get as much information as
possible about the potential patient population in a given area.

• First find out if other pedodontists are located in the general area
in which you are interested, and determine if that area can support
another practice.
• Dividing the population of the area into the number of
pedodontists will give you a rough ratio to determine how much
competition there will be from other dentists.

• Local industrial planning commissions can provide updated
information on population statistics (ages of home owners, level of
income) as well as detail maps, health related data (hospitals,
physicians, births, deaths) and projected community growth.

• Other local sources that can provide information on health-related
demographics are chambers of commerce and health systems
agencies.
• Marketing research firms also can be retained to conduct patient
need surveys. so that a practice can be targeted to meet those
needs.

• Factors critical to choose location
(1) Facility characteristics,
(2) Economic status, and
(3) Projected lifestyle.

Practice Facility Choice
• After choosing your practice area, the next step is to find the correct
facility.
• Dental supply companies often have lists of buildings that would
make good dental offices.

• By visiting one or two companies you can evaluate their ability to
help you find a location and set up practice.
• After choosing an intercity, suburban, or rural area, look for the
correct building. One choice is a professional building that houses
other medical and dental offices.

• These are usually in large suburbs or intercity areas, often associated
with a nearby hospital.
• Such buildings can have services useful to the dentist such as central
compressed air, pharmacies, and other practitioners who can be good
referral sources.
• There are many arrangements in these buildings for leases and even
condominium ownership.

• Other possible sites include:
• (1) individual buildings owned or leased and converted to an
office,
• (2) storefronts and gas stations converted to office space in a busy
location,
• (3) indoor mall locations -- usually with retail dental practices,

(4) home-office combinations.
• Each choice has advantages and disadvantages to consider.
• The site should offer some flexibility for growth and
improvement.

Support Services
• Now that an area and location have been selected, we need help in
getting the office open. There are many services available that can
facilitate this process.
- Local dental supply firms
- Specialty dental supply firms
• - Commercial exhibits at dental meetings give a broad
view of what is available.

- Local banks
- An accountant will be needed to do taxes,
- An attorney will be needed to check documents that need signatures
- Insurance has to be considered.
- Practice management consultants are helpful.
- Decorators and dental office designers or architects are helpful in
planning color schemes and decor for reception and treatment areas

Getting the Practice off the Ground
• After the practice is ready for patients, the next step is to let the
public know you are open -- this will be your main concern for
several years.
• Public relations can take many forms; the AAP has a great deal of
information on public relations campaigns for pedodontists.

• Early in your practice you will have openings in your appointment
book; use this time to meet pediatricians, area dentists, and their
staffs.
• Be sure to leave your business card.
• Even if there are other pedodontists in the area, put your best foot
forward.
• You may be surprised to find that many general dentists and
pediatricians are ready for a change in referral sources -- your
appearance may be timely.

• Some may be interested in new concepts learned in your recent
specialty training.
• Since more than 50 per cent of new pedodontic patients come from
satisfied parents of current patients and friends, concentrate your
efforts in that area.
• Another 30-40 per cent of new patients come from pediatricians;
the remainder will be referred by general dentists or dental
specialists.

• A specialist should meet his colleagues.
• You can accomplish this by attending local dental society meetings and
volunteering to serve on a committee.
• Most dental societies need someone to head the ADA-sponsored National
Children’s Dental Health Month activities; this is a natural for a
pedodontist and a great way to promote your philosophy on preventive
dentistry to the public.

• You also can invite area dentists to an open house in your office,
many specialists start or join study clubs with colleagues to
exchange philosophies of treatment planning and patient
management.
• It is important to be visible in community activities.
• Join as many service clubs and organizations as you can.
• These service clubs always have speakers -- you can present
material on pedodontics to the group luncheons or dinners.

• You and your family should try to be active participants in these
groups so that people will get to know you and seek your
professional services.
• Besides service organizations, activity in religious groups, local
schools, and fraternal or civic groups is important.
• Invite your local nursery and grade schools to visit your offices, or
speak to their classes.

Alternate Delivery Systems
• Besides the traditional private practice, other types of dental
delivery systems increasing their influence in the dental
marketplace are:
(1) health maintenance organizations (HMOs),
(2) retail store dentistry,
(3) corporate dentistry, and
(4)capitation dentistry (closed panel).

Initial Considerations- designing
• In the beginning stages of design, the designer must determine
whether the dentist wishes to remodel an existing office, rent
space in a complex of offices, or build his own clinic.
• In doing this the designer must learn as much as possible about the
dentist's business operations.

• The decision to build a new facility, the first step when making this
decision is hiring an architect to conduct a feasibility study to
determine the maximum size building that could be constructed on
the chosen site, allowing for adequate parking.
• Then an interior designer should develop space plans to determine
the basic dimensions required for the building.

• At this point the architect should adapt the proposed design of the
building to conform to the special interior requirements and to fit the
dimensions of the site, again allowing for adequate parking.

• He must determine how large the office should be and ascertain
whether space will be available for expansion if the need should
arise, whether existing plumbing and electrical conduits are
sufficient, and whether existing conditions are flexible enough to
meet the requirements of the client.

• Generally, each pediatric dental clinic should be equipped with eleven
completely separate spaces.
• a) Receptions area and File archive
• b) Waiting room for parents
• c) Management room
• d) Play room
• e) Dentist’s private office

• f) Examination room
• g) Treatment room
• h) Radiography room
• i) Central Sterilization center
• j) Dental lab
• k) Supporting department

The Role of the Designer
• A good design is based upon a number of complex factors .
• The total plan of the clinic is related to the architectural shape
and form of the building.

• Other factors include the budget, the construction materials, the
type of practice , the philosophy of the dentist and his staff, and the
desired image.
• Other considerations are the location or neighborhood, the type of
clientele-including its social status--and the number of patients
treated per day.

• The achievement of a well - designed plan includes proper size
and space allotments for each function; the correct placement of
operatories, business and support areas; a smooth traffic flow; and
an aesthetic relationship of the forms created within the office.

Waiting Room/Reception Area
• A pediatric waiting room is the first impression children and their
parents receive of a dental surgery and its services
• Once a child is comfortable in the dental environment, coping
with certain anxiety-producing stimuli becomes easier, and this
helps in delivering effective and efficient treatment (da Silva
Pedro et al. 2007;Eisen et al. 2008).

• Studies have shown that the quality of waiting environment influences
the perception of quality of care and caregivers, that the perception of
waiting time is a better indicator of patient satisfaction than actual
waiting time, and that the waiting environment contributes to the
perception of wait time (Becker and Douglass 2008; Pati and Nanda
2011).

• The receptionist should have a clear view of the patient as he
enters the clinic.
• The waiting room should be larger than that found in the offices of
other dental specialties since mothers often bring all of their
children and sometimes a grandmother as well when only one
child has a dental appointment

• The room should offer ample scaled seating for both adults and
children.
• Some tables or flat areas should be provided for mothers with infants
or toddlers in carriers

• Children become bored quickly, so the designer faces a challenge
in making the waiting room exciting .
• Children may -also become noisy while playing together, so an
effort should be made to occupy them with some special pastime .
• A play unit to climb on may appeal to children .

• A fish tank, a toy box, or a table and chairs for reading or games
might be provided.
• It is wise to place carpet on the floor and install upholstered play
units with rounded corners to cushion possible falls .
• Other design ideas might include a tack
board, a chalk board, or a magnetic
tic-tac-toeboard.

• Sound-absorbing wall coverings as well as carpeting should be used in
the waiting room to muffle the noise of the drill in the operatory that
might make waiting patients apprehensive.
• Textured wall surfaces, luxurious carpet, pleasant music, comfortable
furniture, and interesting art work will help patients to pass the time as
pleasantly as possible

• It is the duty of the receptionist to keep a record of new
magazines as they are received and to discard those that are old
or worn.
• A neat reception area will make a good first impression upon
patients as they enter the dental clinic.

• The Snoezelen environment, which consists of a multisensory
adapted environment coupled with client centered therapy,
provides a soothing atmosphere for patients with cognitive
impairment
Merrick J, Cahana C, Lotan M, Kandel I, Carmeli E. Snoezelen or controlled multisensory
stimulation. Treatment aspects from Israel. ScientificWorld J. 2004;4:307–14.

• McCarthy et al.,[1999] who reported that the majority of children
favored a decorated clinic over a plain clinic.
• This finding may be attributed to the comfort a decorated clinic
generates or the distraction it causes in the child’s mind during the
dental treatment.
McCarthy JJ, McCarthy MC, Eilert RE. Children’s and parents’ visual perception of physicians. Clin
Pediatr (Phila) 1999;38:145-52.

Play area:
• Parents and children both chose a play area which would be
separate from the waiting room.
• A novel idea which is followed, is that of a cave for children to
play.
• This gives children a sense of
privacy and fun .

• In medical literature it has been found that, pre-operative anxiety
is reduced when children participate in playful activities in the
waiting area, helping the child to become relaxed, besides acting
as a facilitator for interaction and communication among health
professionals, children and their companions.
• A study by Panda et al, supports this, wherein the participants
preferred to play in the dental waiting area.

Methods
• A questionnaire designed to evaluate children’s preferences regarding
the waiting room was distributed to new paediatric patients, aged
between 6 and 11 years of age, attending an outpatient dental facility
and was completed by 212 children (127 males, 85 females).
Panda A, Garg I, Shah M. Children’s preferences concerning
ambiance of dental waiting rooms. Eur Arch Paediatr Dent
2015;16:27-33.

Statistics
• The analyses were carried out on cross-tables using Phi (for 2 9 2
tables) or Cramer’s V (for larger than 2 9 2 tables) to assess
responses to the questionnaire items across age groups and
gender.

• Results :A majority of children preferred music and the ability to
play in a waiting room. They also preferred natural light and walls
with pictures.
• They preferred looking at an aquarium or a television and sitting
on beanbags and chairs and also preferred plants and oral
hygiene posters.

Business Office/ front office
• The business office, frequently referred to as the "front office,"
should be located adjacent to the reception area.
• This office is the center of a great deal of activity :
scheduling of appointments
preparation of bills
.

storage of medical records
greeting of patients
occasionally, insurance and bookkeeping duties
• Some large clinics separate the front office into two areas , one for
the receptionist who greets patients and schedules appoint ments
and the other for the staff in charge of bookkeeping , filing of
medical records, and insurance processing

• The front office should be located so that patients must pass
through this area when leaving the clinic .
• It should be designed to give patients privacy for the discussion of
finances and other confidential matters .

• Design elements for the business office should incorporate a
custom-made work surface with an adequate sized counter for
clients to attend to paperwork such as writing checks or making
new appointments; this counter should be wide enough to support
an infant in a carrier while the client carries out these operations.

• Well designed desks for the receptionist and secretaries should be
placed on the inner side of the raised counter to house records,
appointment books, office materials, stationery, telephone books,
and the like.
• Some desks include built-in compartments and niches designed
below the writing shelf to store many forms used in the dental
practice
• The appointment book should not be visible to the patients.

Operatories
• Pedodontists use the term "bay" to designate dental chairs installed in
a communal space
• Dentists who employ this type of arrangement have found that it
tends to keep the crying of children to a minimum as it places them
in a peer group situation.
• Children learn from one another, and the presence of other children
in the bay seems to ease the pressure of going to the dentist for new
and younger patients.

• Some larger clinics may have two communal bays, one for the
hygienist and the other for operatory work. The size, shape, and
arrangement of the two areas will depend on the dentist's
philosophy .
• Placing one operatory in a closed area referred to by dentists as
the "quiet room"

• This is place is used for children ~who are known to be
exceptionally nervous or emotional .
• This room is only used when necessary to prevent an epidemic of
crying or unhappy patients
• Near the hygienist's area a space should be provided with facilities
scaled for children's use to enable them to brush and floss their
teeth.

• Since prevention is a primary concern of pedodontics, this space
is very important and should be designed with the child patient in
mind.
• Mirrors should be placed over the sinks to allow the children to
practice what they have been taught about brushing and flossing

Operatory Delivery Systems
• The term "delivery system" refers to the placement of the dentist
and the assistant during the treatment of a patient.
• The placement which the dentist prefers should be established in
the beginning stages of the design process.

Rear Delivery System
• In a rear delivery system the dentist's and assistant's instruments are
delivered from a portable or stationary cabinet behind the patient's
head .
• This concept is most effective when employed in seated, four-handed
dentistry.
• It is less efficient and more difficult to use in two - handed dentistry .

• One of the advantages of rear delivery is that the instruments are
out of the patient's view.
• It allows good traffic flow in the treatment room

Over- the -Patient Delivery System
• In an over-the-patient delivery system the instruments and utilities
are delivered from an area near the patient's left or right elbow or
over the patient ' s chest.
• In this delivery system the doctor's unit is usually attached to the
chair or mounted on an arm which is in turn mounted on a post .

• Over-the-patient delivery provides direct access to the patient's
oral cavity and can be used for two- or four-handed operation,
either sitting or standing. In this delivery the instruments may be
in full view of the patient, and patient access to the chair may be
somewhat restricted.

Side Delivery System
• In a side delivery system the instruments are presented from the
side of the patient.
• This type o f system is also known as split delivery, in which two
separate carts are used, one by the dentist and on by the assistant,
or a cabinet or wall-mounted doctor's unit is employed with a
separate work station for the assistant

• The side delivery system is very flexible and allows good
instrument access for both two - and four -handed operation,
either sitting or standing .
• The instruments are usually out of the patient's view

Tray Setups
• Instruments that are sterilized and set up in advance on trays for
various procedures should be centrally stored.
• Trays may be stored in a stationary or portable cabinet that is
convenient to both the bay and sterilization area.
• This cabinet should be closed and sheltered from public exposure

Sterilizing Area/Laboratory
• In some clinics the sterilizing area and laboratory may be called the
clean and dirty labs.
• The two may be combined in a single space or they may be situated in
two separate areas

• The sterilizing area, or clean lab, may be located in an alcove
convenient to the operatories or in a separate room adjacent to the
bay area.
• This lab requires ample cabinet space for the cleaning of trays
and instruments and the setting up of trays.
•

• A sink, a trash slot, and an ultrasonic cleaner must be provided
as well as an area with fitted slots for tray storage.
• The steps of the sterilizing sequence are scrubbing of dirty
instruments in the sink, cleaning in the ultrasonic cleaner,
wrapping or bagging, sterilization and placement in storage
trays or cabinets.

• In planning the sterilizing area, it should be noted that certain
sterilizers require separate electrical circuits.

Laboratory
• Lab should comprise a space large enough to accommodate all the
necessary equipment to support the procedures performed in this
area
• The lighting in the lab must be excellent.

• Lights should be placed over individual work stations --
sometimes called benches and these benches should be installed at
a convenient height for personnel to work while sitting .
• Upper cabinets should also be positioned so that they are
accessible to seated technicians without too much stretching
• Proper ventilation should be placed at work stations to remove
heat and fumes effectively

• The air compressor and vacuum may be located in the lab or in a
mechanical room, but a hose should be provided to help recover dust
from lathes and handpiece areas.
• The lab requires gas, compressed air, water, acid-resistant drainage
lines and a sink with a plaster bin, and many electrical outlets.
• The electrical service must be of sufficient capacity to accommodate
the high usage requirements of the various pieces of equipment used
in the lab.

• Sufficient drawers for instruments and supplies should be
provided with adequate counter space for equipment and devices.
• The decor should be light in color with smooth surfaces for easy
maintenance.
• Since the lab tends to be messy ,
it is advisable to place a door between
it and the operatories and patient area.

Private Office/Consultation Room
• A private office is just what the name implies , a place for the
dentist do to paperwork, study, rest, and return telephone calls
without outside interference.

• A consultation room is a necessity in a pedodontic clinic.
• This room or space is used by the dentist and his staff in discussing
treatments with parents and children.
• More than other areas in the clinic it should be out of the line of traffic, and
it should embody the principle of undisturbed privacy.
• The shape or size of the consultation room depends on the practice concept
of the dentist.

• The design should be functional enough to allow for a radiograph
view-box and a slide projector or movie projector and screen if
educational lectures are to be offered in the room.
• Most dentists and staff members use the consultation room to
conduct interviews and to discuss types of treatments that can be
performed , recommended diets for patients, and, occasionally,
their clients' finances.

• This space should include at least three places for people to sit:
one for the dentist or staff member, one for the patient, and one
for the parent.
• Additional chairs should be readily available if both parents
accompany their child to the clinic.

• The appearance of the room may be enhanced by draperies or
shutters, wallpaper, and other accessories, but nothing should be
used that will distract the attention of the child and parent from
what the dentist or staff member is saying.
•
• The decor should be simple with diffuse or indirect lighting to
ensure that the patient sees everything that goes on .

• In some clinics the consultation room is located adjacent to the
operatories for ease of movement to and from the work area; in
others it is placed near the business and exit area for the
convenience of patients and parents.
• This space can also be used as an educational room .

• The consultation room may also be used for staff meetings, the
preparation of reports or appointment schedules during regularly
assigned periods, or the passage of free time by staff members .
• The size and the philosophy of the dentist's practice should
determine whether the consultation and educational rooms should
be combined and how many consultation areas will be needed.

Attire And Presentation Of The Clinic Staff
• 1. children have mostly white coat anxiety so avoid of the a typical
attire of dental staff.
• 2.Make an attempt to meet a child casually in consulting room, take a
brief history and assesses the behavior.
• 3. Finally the child to dental chair after showing around the clinic and
meeting staff.

• McCarthy et al.,[1999] who found that children are not afraid of a
doctor in a white uniform.
• Patir Münevveroglu et al reported that 76.5% of the children
preferred their dentist to wear a colored uniform rather than a
white one.
Patir Münevveroglu A, Balli Akgöl B, Erol T. Assessment of the feelings and attitudes of children
towards their dentist and their association with oral health. ISRN Dent 2014;2014:867234.

Colors, Smells And Sounds:
1. Children imagine and accept bold, bright fresh color like yellow, red,
blue, green, orange, pink and dislike such as grey, black, white and
brown etc
2. Smells of spirit, eugenol, acrylic and waxes are may be irritated to
children.
3.The voice of the air-rotor handpiece, ultrasonic cleaner can be
disturbing too.Hence it is best to mask these sound by use of light
instrumental music.

• The color yellow is associated with happiness, cheerfulness and a
positive emotional state, the color blue is associated with security
calmness and comfort; green is associated with quietness; red is
associated with anger, aggression and excitation; and black is
associated with depression or anxiety.
Birren F, editor. Aspects of light and color bearing on the reactions of living things and the welfare of
human beings. In: Color and Human Response. 1st ed. New York: Van Nostrand
Rein-hold; 1978.

.
• Objective: The purpose of this study was to investigate the value
of color as a component of a healing environment for pediatric
patient rooms. Color preferences from pediatric inpatient,
pediatric outpatient, and healthy children groups were investigated
and compared for group and gender differences.
Park JG. Color perception in pediatric patient room design: Healthy
children vs. pediatric patients. HERD 2009;2:6-28

• Background
• Positive environmental stimulation can promote patient well-being by
reducing stress or negative feelings. If environmental colors can have positive
influences, then those colors will make patients more comfortable, reducing
their stress.
• Although previous color studies are suggestive, none has focused on pediatric
healthcare environments.
• Patients’ health status may affect their reaction to environmental stimulation.
• There was a gap in the body of knowledge regarding the consistency of color
preferences with regard to patient health status.

Methods:
• A simulation method was used because of its reliability and
feasibility. It allowed for investigating the value of color in real
contexts and controlling confounding variables.
• Previous color preference studies typically have been done with
small colored squares of paper, which are visually different from
seeing a color applied on wall surfaces. In addition, they failed to
control confounding variables such as color attributes and light
sources.

Results
• Group differences were not significant. This refuted the hypothesis
that the color preferences of pediatric patients are different from
those of healthy children.
• However, overall color preferences showed that the healthy children
group had higher mean scores of color preferences than both pediatric
outpatients and inpatients groups.
• Gender effects were identified across all three groups.

Conclusions
• All three groups showed similar color preference patterns, except for
yellow.
• Both pediatric outpatients and inpatients preferred yellow less than
healthy children did.
• Healthy children’s mean scores of color preferences were higher than
the pediatric outpatients; the pediatric outpatients group had higher
mean scores of color preferences than the pediatric inpatients group.

• Although this observation was not statistically significant, it raised
the question of whether the sickest pediatric patients respond
differently to color than healthy children do.
• Gender effects indicated that girls preferred red and purple more than
boys do.
• Regardless of gender effects, healthy children and pediatric patients
preferred blue and green the most and white the least.
• These results can help healthcare providers and professionals better
understand appropriate colors for pediatric populations.

Aim:
• To evaluate the association between color and emotions of children in a
pediatric dental set-up.
Design:
• A total of 300 children aged 6-12 years were divided into 2 groups: Younger
children (6-9 years, n = 156) and older children (9-12 years, n = 144).
• All the children were asked to shade two cartoon faces representing happiness
and fear with their most preferred color.
Umamaheshwari N, Asokan S, Kumaran TS. Child friendly colours
in a paediatric dental practice. J Indian Soc Pedod Prev Dent.
2013;31(4):225–8

Results
• For the positive emotion, 44% (n = 132) of the children preferred
yellow, followed by blue 32.67% (n = 98).
• For negative emotion, 56.67% (n = 170) of the children preferred black
and 42.67% (n = 128) preferred red.
• Association between color and emotion was highly significant (P <
0.001).

Conclusion:
• This study has attempted to advance the area of color research to
dental anxiety in children visiting a dental clinic.
• The use of child friendly colors like yellow and blue in the dental
work place could enhance a positive dental attitude in the child’s
mind.

• Objective: This study evaluated the association between colors and
emotions in a pediatric dental population.
• Study design: In this randomized cross-sectional study, 100 children
aged 6-12 years were categorized as non-anxious and anxious using
Corah’s Dental Anxiety Scale–Revised. They were then instructed to
color two cartoon faces, one depicting happiness emotion and the other,
sadness, with any of six colors provided.
• Data obtained were statistically analyzed.
Bubna K , Hegde S, Rao D. Role of Colors in Pediatric Dental
Practices. J Clin Pediatr Dent.2017;41(3):193-198

Results:
• The mean Corah’s Dental Anxiety scores were 11.7 and 4.97 for the anxious
and non-anxious children, respectively. Both groups expressed the highest
preference for the color yellow for happiness emotion. No significant
differences were observed between color choices in either group (p>0.05),
except for black which was not chosen by any child for happiness (p<0.005).
• Children in both groups significantly preferred red for sadness emotion. No
significant differences were observed between color choices in the anxious
group (p>0.05). In the non-anxious group, yellow assumed significant
preference over green (p<0.05)

Conclusions:
• Yellow was the most-preferred color and black, the least-
preferred, for happiness emotion, whereas, for sadness emotion,
red and green were the most- and least-preferred colors,
respectively.
• Color preference was not affected by the presence of dental
anxiety

Aim
• To assess and compare emotional association with color preferences and
anxiety levels in children.
Methodology
• 600 children aged between 6-12 years, were randomly selected from the
patients visiting the department of pediatrics and preventive dentistry in V.S
dental college.
Babu, N. S. V., Niranjana, C. N., & Mahesh, S.. Comparative Assessment of Emotional
Association with Color Preference and Anxiety Levels in Children - A Cross-Sectional
Study. The Journal of Middle East and North Africa Sciences. 2020 ;6(02):21-29

• A specially designed proforma was used to record the personal
information consisting of, Humphris modified dental anxiety scale
and face drawings sheet representing both emotions: Happiness
and sadness.
• The children were provided with 8 crayons and were asked to
color the emoticons with their preferred color of choice. Data
collected was analyzed statistically by applying a chi-square test.

Results
• 70.3% (190) children of the younger age group were graded as
anxious, while 29% (80) children were found to be non-anxious.
41.2% (136) of the older age group were anxious, while 58.8% of
children (194) were non-anxious. 45.9% (126) boys and 41.7%
(136) girls preferred yellow to shade the positive emoticon.
• Black was the preferred color of choice for negative emotion by
41.2% girls (134) and girls (112).

Conclusion.
• From this study, they conclude that adding colors like yellow and
pink to the dental environment could enhance a positive attitude
and make the child at ease, while black, blue, red and green might
impart a negative outlook in their mind

Factors for choosing color and light for a dental clinic
• The use of happy colors is very important for designing the waiting
room.
• In choosing color scheme, we need to be careful about matching
colors.
• The use of bright colors like light blue or cream makes the office
space wider.
• The use of mirrors can also help to make the office larger.
• Mild colors can also affect the patient’s inner peace.

• We can use a colorful background for the waiting room and the
treatment room, and only consider the degree of darkness and
brightness of the color in these two rooms.
• It is better to use the same color for the waiting room and the
treatment room.
• In this situation, patients who got familiar with the reception room
before entering the treatment room will get familiar with the new
environment without any stress.

• Avoid using absolute white or yellow light, to create a light like daylight
by combining these two colors by installing suitable lamps.
• Choosing the tooth color for all types of composites and ceramics is
easier and more accurate in these light conditions.
• Also, the use of natural herbs brings a refreshing effect to clinic and
helps to stimulate relaxation.
• Colors that are commonly used in the design of the clinic environment
are bright colors.
Mohammad K, D.M.D, B.S. A Standard Pediatric Dental Clinic. Mod App Dent Oral Health 3(1)-
2018. MADOHC.MS.ID.000152.

• White is at the top of these colors and is almost the first color that
reminds you of a Treatment room.
• The use of white color in this space cannot be simply attributed to its
conventionality.
• The white color is a color that reflects the light well, while at the
same time special beauty.
• This color is also very effective in making people feel relaxed. So,
the white will be the first color to be offered in the decoration design
of the clinic.

• Aromatherapy has been widely recognized as a stress reduction
technique.
• Jafarzadeh et al investigated the effect of aromatherapy with
natural essential oil of orange on child anxiety during dental
treatments and concluded that its use could reduce salivary
cortisol and pulse rate and hence could be effective in reducing
anxiety.
Jafarzadeh M, Arman S, Pour FF. Effect of aromatherapy with orange essential oil on salivary
cortisol and pulse rate in children during dental treatment: A randomized controlled clinical
trial.Adv Biomed Res 2013;2:10.

• Over the past few decades there has been a growing interest in the
use of music in healthcare to achieve a diverse range of outcomes.
• In the medical setting, studies have found that day-surgery
patients who listen to music during their preoperative wait have
lower levels of anxiety than patients who receive routine care.
Cooke M, Chaboyer W, Schluter P, Hiratos M. The effect of music on preoperative anxiety in
day surgery. J Adv Nurs 2005;52:47-55.

• In pediatric dental patients, there have been conflicting results,
with some studies showing that music used for distraction purpose
did not result in a decrease in pain, anxiety, or uncooperative
behavior during dental treatment.
• When children were asked to choose the type of music in the
dental treatment room, the majority preferred listening to rhymes.
Aitken JC, Wilson S, Coury D, Moursi AM. The effect of music distraction on pain, anxiety and
behavior in pediatric dental patients. Pediatr Dent 2002;24:114-8.

• The aim of this cross-sectional descriptive study was to determine
children’s preferences in a dental clinic so as to reduce anxiety during
dental procedures.
• In this study survey methodology was used.
Jayakaran TG, Rekha CV, Annamalai S, Baghkomeh PN, Sharmin DD.
Preferences and choices of a child concerning the environment in a pediatric
dental operatory. Dent Res J 2017;14:183-7.

Materials and Methods:
• A questionnaire was designed to evaluate the child’s preference in a
dental hospital so as to remove anxiety during a dental procedure.
• This study was carried out on 50 children aged 6–10 years.
• The children were randomly selected based on their first dental visit in a
private dental college.

Results:
• A large number of children preferred listening to rhymes and
watching cartoons while undergoing dental treatment.
• They also preferred the walls painted with cartoons, the dental
chair full of toys, a scented environment, and the presence of
their parents during the treatment.

Audiovisual aids
• Using audiovisual aids for distraction during dental injection can alleviate
dental anxiety by distracting two types of sensations; hearing and seeing.
• Recently, several studies have shown that AV eyeglasses are effective in
distracting pediatric patients during dental procedures.

THE FIVE PARTS OF A SUCCESSFUL DENTAL PRACTICE
• 1. DOCTOR’S VISION FOR THE PRACTICE
• 2. MISSION STATEMENTS: PRACTICE AND TEAM
• 3.FISCAL MANAGEMENT
• 4. TEAM DYNAMICS
• 5. SYSTEMS

DOCTOR’S VISION FOR THE PRACTICE
• A doctor should define what is in his/her head and heart about the
practice to be created and then share that vision with team
members.
• A vision cannot be realized until it is shared.
• When all team members are working toward a common vision
and goal, the probability of success greatly increases.
• The team’s energy becomes synergistic.

MISSION STATEMENTS: PRACTICE AND TEAM
• Team members serve two customers: the parent/ patient and each
other, including the doctor.
• Therefore it is necessary for the team to create two Mission
Statements, one for each customer they serve:
• 1. Patient Mission Statement (for serving patients)
• 2. Team Mission Statement (for serving each other)

FISCAL MANAGEMENT
• Fiscal management concerns the way in which the finances of a
business are managed and includes goal setting, accounts receivable
(money owed to the practice), accounts payable (money owed by
the practice), budgeting, fee structure, and monitoring methods.

TEAM DYNAMICS
DOCTOR LEADERSHIP
• Many doctors do not understand the power their leadership actions
have on their level of stress, job satisfaction and practice profits. At
whatever point a doctor stops being a leader by not performing
important leadership actions, he/she will lower his/her profitability
potential.

• Anyone can be a great leader, regardless of personality type, if
he/she consistently and successfully carries out the following
leadership actions:
• Define Practice Vision
• Provide Strong Fiscal Management
• Monitor Practice Goals and Budget

• EMPLOYEE MANAGEMENT
• A personable, professional staff is vitally important for practice success.
•
• The dentist must invest time, effort, and money to hire, train, and retain quality
individuals who can be developed into a high-performing team.
• A team of committed professionals, working together, focused on the patients
and the practice, can make the difference between an excellent and a mediocre
practice.
• Therefore staff development is a sound investment in any practice.

• Before becoming an employer, the dentist must be aware of state and
federal regulations concerning hiring, employment policies, including
Occupational Safety and Health Administration (OSHA) requirements,
employee records maintenance and retention, employee discipline and
dismissal, and so on.
• All employment applications, other forms and tests used in the hiring
process, and employment policies described in the office manual should be
reviewed by an attorney who is familiar with state and federal laws.

• Job Descriptions
• Office Manager
• Front Desk Systems Coordinator
• Clinical Coordinator
• Front Desk Staff
• Clinical Assistant
• Flow Coordinator
• Sterilization Assistant
• Hygienist
• Hygiene Assistant

SYSTEMS
• Effective Scheduling
• Managing Collections
• Managing Insurance
• Treatment Tracking
• New-Patient

• Marketing
• Technology
• Compliance
• Forms
• Clinical Organization
• Inventory Control

Conclusion
• Children do have strong preferences related to the dental waiting
area.
• Introducing distractions that children prefer in the dental waiting
area, such as books, music, aquarium, etc., can help relax them and
can reduce anxiety related to the upcoming dental visit

• The combination of bright colors, engaging themes, and nature
content is consistently highly rated by pediatric patients.
• Children develop color-emotional concepts and schemas during their
early childhood.

• The anxiety level of children in relation to colors can be analyzed
and child-friendly colors can be identified which could be
incorporated into clinical set up to help reduce the overall anxiety
of children during the dental procedure by reducing the stress level
and further decreasing the time utilized for procedures as well.
• Adding low wavelength colors like yellow and pink to the dental
environment could enhance a positive attitude and make the child
at ease.

References
• Jayakaran TG, Rekha CV, Annamalai S, Baghkomeh PN, Sharmin
DD. Preferences and choices of a child concerning the
environment in a pediatric dental operatory. Dent Res J
2017;14:183-7.
• Umamaheshwari N, Asokan S, Kumaran TS. Child friendly colours
in a paediatric dental practice. J Indian Soc Pedod Prev Dent.
2013;31(4):225–8

• Panda A, Garg I, Shah M. Children’s preferences concerning
ambiance of dental waiting rooms. Eur Arch Paediatr Dent
2015;16:27-33.
• Mohammad K, D.M.D, B.S. A Standard Pediatric Dental Clinic. Mod
App Dent Oral Health 3(1)- 2018. MADOHC.MS.ID.000152.
• Nanda U, Chanaud CM, Brown L, Hart R, Hathorn K. Pediatric art
preferences: Countering the “one-size-fits-all” approach. HERD
2009;2:46-61

• Babu, N. S. V., Niranjana, C. N., & Mahesh, S.. Comparative
Assessment of Emotional Association with Color Preference and
Anxiety Levels in Children - A Cross-Sectional Study. The Journal of
Middle East and North Africa Sciences. 2020 ;6(02):21-29
• Bubna K , Hegde S, Rao D. Role of Colors in Pediatric Dental Practices.
J Clin Pediatr Dent.2017;41(3):193-198
• Bernick M S. Starting a pedodontic practice. Pediatr Dent.1983;
5(4):288-292.

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