Mind Three Dangers Before Opening Your Own Dental Office

Bruce Johnstone


Opening a new dental office is an exciting and overwhelming endeavor. Unfortunately, not everyone gets it right. After all, time is money, and poor planning can have a major impact on your bottom line. When opening your dental office, you want to avoid these 3 key pitfalls to success.

Failing to Plan for Future Growth

You know what your dental practice needs today. But have you fully considered its future needs? Odds are, you want your practice to grow. That means taking on new patients and, perhaps, additional doctors, assistants, and technicians. Because the big picture can look very different today than it will tomorrow, the type, location, and square footage—not to mention flow—of your dental office build needs to be considered fully upfront.

That’s where a 10-year plan comes in. It should consider all of your present and future needs, and it should account for potential growth with an eye toward your ultimate goal. Will you also need an x-ray room and storage space? You’ll need to plan for at least 30 square feet for the x-ray room and between 40 and 120 square feet for storage alone.

Beyond that, the “Safety Net Dental Clinic Manual” suggests preparing for a staff lounge of at least 120 square feet, space for lockers to store personal items, and a designated restroom for clinic staff. Further, it suggests a waiting area of at least 120 square feet for a one-to-4 operatory clinic, 180 square feet for a 5-to-7 operatory clinic, and at least 240 square feet for a dental clinic housing 8 to 13 operatories.

You need to know these things now rather than down the line. After all, you want to work in a space that is working effectively for you.

With that in mind, determining the ideal size of your staff, ultimately, is an important consideration. Some dentists simply want to be sole proprietors with a full-time and, possibly, part-time hygienist. Others may want to have a multiprovider clinic, which also requires assistants. Failing to account for the correct number of operatories needed to support your 10-year plan is a pitfall, as it will leave you with limited growth potential or the need to move in the future. 

The ADA’s book, Building or Refreshing Your Dental Practice: A Guide to Dental Office Design, suggests starting by multiplying the number of operatories by the square footage of the operatories. Then, divide that number by 0.275. Also helpful is How to Open a New Dental Office or Relocate Your Current One by Gordon F. Osterhaus Jr, DDS, which can help you decide not only the number of operatories you need, but also office square footage and other initial, integral decisions.

Lack of Compliance

Your dental practice design says a lot about you. It should project comfort, cleanliness, and safety. It should also convey your personality and your brand. However, you can’t simply fall in love with a space (or the idea of one) and forge ahead. Your dental office needs to comply with the Americans with Disabilities Act, a fact that demands certain size, space, and accessibility standards are met. 

The Americans with Disabilities Act establishes baseline standards and technical recommendations for the tools of modern dentistry, from radiographic systems to manual toothbrushes and sealants. It also requires an accessible office, which may include a ramp at its entry, exam rooms with accessible equipment, and an elevator if it is not on the main floor. Everything from the width of doorways to the type of exam tables you choose must be fully considered. The US Department of Justice provides a helpful resource online.

Your dental office also needs to analyze how it will adhere to Health Insurance Portability and Accountability Act (HIPAA) requirements so you can mitigate noncompliance risks. That starts with accounting for private spaces from the get-go. This way, conversations and consultations with sensitive information won’t be overheard, whether it’s patients asking to change their records or inquiring about billing. Further, the HIPAA Security Rule requires a dental practice to conduct a written risk assessment and develop safeguards to protect electronic patient information. Current HIPAA privacy and security laws change regularly and can be obtained online.

Underestimating the Timeline

Getting your practice up and running as quickly and efficiently as possible is one of the top concerns when opening a dental office. That said, you must not underestimate the timeline for doing so. While construction takes, on average, 8 to 16 weeks, permit approval and pre-construction can take 4 to 12 weeks and design 6 to 12 weeks before that.

The complexity of your project has everything to do with how long building your dental office will take. What’s more, securing lending, finalizing the transaction, getting permits, architectural and interior design, and construction all take time. Add that to the fact that running out of time is one of the fastest ways costs mount since the power of negotiation is not on your side. In short, be realistic about your timeline before construction begins. Then, stick as closely to the timeline as possible.

Usually, banks are hesitant to extend 100% of financing to professionals with limited experience and large finance needs. Work with lenders that specialize in and therefore understand the rigors of running a dental practice. They’re more likely to have flexible lending options to suit your individual circumstances. Be prepared to show lenders how you plan to manage and grow the practice. And, meet with at least 3 lenders so you can compare and contrast your options. At the very least, find the best deal by shopping interest and terms for a practice loan before settling on your lender. 

The Next Step

At the end of the day, taking a big picture approach to opening a dental practice can save you stress and money. Plus, it will land you in a space where you’ll happily foster your practice for years to come.   

Mr. Johnstone is a project consultant at APEX Design Build. He studied business and communications at Cambridge University and then naturally moved into the architecture and construction firm that his great-grandfather founded in the early 1900s. Continuing the family legacy in healthcare design and construction was his ambition from childhood. Today the 4-generation firm works with doctors nationwide to deliver a uniquely integrated approach to the office design and construction process. He can be reached at brucej@apexdesignbuild.net

Disclosure: Mr. Johnstone holds a salaried position at APEX Design Build.

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