Section 1. Facility Design and Construction

Open or Enclosed Operatories

When designing a dental clinic, decide if you want to have each operatory as a separate room (enclosed concept) or have a large room with the operatories divided by modular cabinetry (open concept). Before making a decision, visit clinics that use these models, and talk to the oral health professionals working in each to learn about advantages and disadvantages. The major issues are as follows:

• Walls offer more patient privacy and better compliance with the Health Insurance Portability and Accountability Act (HIPAA).
• Walls reduce the noise level in the clinic, which is important when treating young children. 
• Operatories with walls are slightly less expensive, as less cabinetry is needed.
• Walls do not allow the sharing of X-ray heads, which increases the cost of equipment if the ability to take X-rays is provided to each operatory. A pass-through for the X-ray head can be done, but you lose privacy and noise control. Make sure the pass-through is compliant with state law.
• Walls decrease mobility between operatories, which can decrease efficiency.

You can either purchase manufactured cabinetry or have the cabinetry custom built. Page 51 of The Patient-Centered Dental-Health Home: An Essential Guide for Planning the CHC Dental Facility Expansion presents the advantages and disadvantages of each.