Unit 1: Essential Elements
Unit 1: Essential Elements

Section 2. Key Principles

Best Practices

No evidence-based, nationally accepted benchmarks are available that cover all types of safety net dental clinics. However, based on the results of systematic reviews of multiple safety net dental clinics by several organizations, including the National Network for Oral Health Access, the Health Resources and Services Administration, the Indian Health Service, DentaQuest Partnership for Oral Health Advancement, Safety Net Solutions, the California Healthcare Foundation, and the Ohio Oral Health Capacity Building Project, the following recommendations can be made:

  • Schedule 1,000–1,200 visits per operatory per year.
  • Provide 2.4–4 procedures per patient per visit, depending on age.
  • Have 300–600 unduplicated patients per operatory per year.
  • Eliminate double booking.
  • Schedule no more than 3 weeks to 30 days in advance.
  • Schedule individual appointments as opposed to a series of appointments for each patient, with some exceptions.
  • Manage emergency care (palliative vs. definitive treatment).
  • Block out protected times for care that cannot wait.
  • Assign standard lengths for procedures, with additional 10 to 15 minute increments for complex appointments.
  • Schedule by patient/payer mix to improve bottom line.
  • Manage broken appointments.
  • Have less than 15 percent broken appointments.
  • Establish appointment and broken-appointment policies.
    • Inform patients of appointment and broken-appointment policies/patient contract.
    • Enforce broken-appointment policy universally.
  • Practice quadrant dentistry whenever possible.
  • Offer risk-based care and recall instead of standard treatment and recall intervals.
  • Use practice-management software to manage appointment book, and make sure that the software allows adequate data reporting to support management of the program.
  • Document and verify eligibility before each visit.
  • Monitor and actively manage accounts receivable (suggested benchmark of 55 to 65 days in accounts receivable).
  • Use digital radiography.
  • Ensure optimal clinical staffing of minimum two dental assistants per dentist (2.5 is better, three with expanded function dental assistants) and minimum two chairs per dentist (2.5 is better, three with expanded function dental assistants).

Until uniform benchmarks come along, establish practice-specific benchmarks, and track these to measure performance in relation to history.