Safety Net Dental Clinic Manual

Site Index

Use the site index below to locate specific topics in the manual, or visit the search page. A complete download of this site is available as a PDF file. The site may have updates that are more current than the PDF download, which is generated quarterly.

Section 1. Facility Design and Construction

Capacity and Cost Estimates
Location, Size, and Floor Space Considerations
             Floor Space
Design Principles
Design Options and Floor Plans
Open or Enclosed Operatories
Operatory Layout
Compliance Requirements for Facility Design
Construction Options
Ergonomic Design

Section 2. Equipment and Supplies

Delivery Systems
             Over-the-Patient Delivery
             Rear Delivery
             Side Delivery
Major Equipment
             Patient Chairs
             Dental Units
             Dental Handpieces
             Operator and Assistant Stools
             X-Ray Units
             Conventional vs. Dental X-Rays
             Dental Operating Lights
             Communications Systems
Pre-Owned Equipment
Electronic Dental Systems
             What Can Be Integrated
             Implications for Facility Design
Key Features of Electronic Dental Systems
Wireless Technology
Supplies and Small Equipment
Maintenance and Repair
            General Maintenance
            Preventive Maintenance
            Equipment Repair
Service Life

Section 3. Staffing

Staffing Configurations
Staffing Decisions
            Dental Assistants
            Dental Hygienists in Alternative Practice
            Expanded Function Dental Auxiliaries


Section 1. Financial Viability

Balancing Access and Sustainability
Interactive Budget-Planning Workbook
Patient Care Revenue
            Public Programs
            Commercial Insurance
            Self-Pay Patients       
Estimating Patient-Care Revenue
            Number of Patient Visits or Encounters
            Average Reimbursement per Visit or Encounter
            Factors That Affect Patient-Care Revenue
Determining Appropriate Clinic Fees
            Relative Value Units
            Developing a Relative Value Units Conversion Factor

Sliding Fee Schedule
            Implement a Sliding Fee Schedule
Other Sources of Revenue
Compensation Packages
            Typical Fringe Benefits
Dental Equipment and Supply Costs
Other Expenses
            Bad Debt
            Equipment Depreciation
            Lab Fees
            Administrative Expenses

Section 2. Clinic Finances

Managing Clinic Finances
            Assistance with Financial Management
            Developing a Budget
Financial Reporting for Program Planning and Management
Assessing Financial Performance and Sustainability
Business Plans
            Business Plan Success Factors
            Safety Net Dental Clinic Business Plan Model
Independent Audits

Section 3. Grants and Fundraising
            Grants Management 
Sources of Grants
            Government Funding
            Foundation Funding
            Corporate Funding 


Section 1: Policies and Procedures

Policies and Procedures Manual
Format and Topics
Evidence-Based Clinical Care Guidelines
Time-Out Policy
Oral Surgical Procedures Policy

Section 2: Human Resources

Employee Handbook
Professional Standards of Conduct
Position Descriptions
Salaried Employees, Contractors, And Volunteers
Credentialing and Privileging
            Sample Dental Provider Privileging Procedures
Credentialing and Privileging Details
            Additional Considerations
National Practitioner Data Bank
Training and Continuing Dental Education
Disciplining or Terminating Employees

Section 3: Liability Protection

Malpractice Insurance
Risk Management
Common Risk Management Issues
Incident Reports
Required Insurance
Federal Tort Claims Act (FTCA)

Section 4: Scheduling

Appointment System
Strategies for Scheduling Appointments
Scheduling in Advance
Broken Appointments
            Preventing Broken Appointments
            Compensating for Broken Appointments
Emergency Appointments
            Considerations for Dental Emergency Patients
Wrongful Termination or Abandonment
Recall/Re-care Appointments
Continuum of Care
            Tips for Managing Referrals
Patient Rights and Responsibilities
Informed Consent
            Withdrawal of Consent
Informed Consent Policies and Procedures
Consent for Minors
            Minors Under Age 14
            Adolescents Age 14-18
Informed Refusal
Written Follow-Up Instructions
Interpretation Services

Section 5: Billing and Collections

Establishing a Billing and Collections System
Electronic Dental Record
Superbills, Charge Slips, And Encounter Forms
Responsibilities for Billing and Collections Process

Section 6: Inventory Management

Purchasing and Stocking Supplies
Tracking and Managing Inventory
Dental Suppliers
Stocking a Formulary

Section 1. The Vision for Quality

Health Care Quality
Quality Assurance
Quality Improvement
Quality Improvement Process
Quality Control
Adopting an Approach
Developing Your Quality Vision
            Quality Vision Statement
            Prioritizing the Quality Vision
            Health Resources and Services Administration Requirements for Federally Qualified Health Centers
            Oral Health Quality Improvement Committee vs. Health Center Quality Improvement Committee
            Standards of Care and Guidelines

Section 2. Setting the Stage for Quality


Section 3. Measuring to Improve Quality

Applying Quality Assurance/Quality Improvement Principles in the Dental Clinic
Clinic Administration
            Patient Registration
            Billing and Collections
            Purchasing/Inventory Management
            Referrals and the Continuum of Care
            Appointment System, Including Broken Appointments
            Incident Reporting. Processing Patient Complaints, Treatment Issues, and Safety Events
            Access and Its Effect on Quality
            Retention of Staff
            Onboarding of Staff
            Electronic Dental Record and Chart Notes
Patient-Satisfaction Surveys
Staff-Satisfaction Surveys     
Clinical Services
Methods of Measuring Clinical Quality
Quality Metrics
Quality-Based Reimbursement
Incident-Driven Peer Review
Initiating Peer Review
            Peer Review Through Existing Components of Local Dental Societies
            Peer Review Within the Dental Office
            The Review Process
Clinical Quality Control
            Curing-Light Intensity
            Emergency Kit Expiration Dates
            Emergency Oxygen Canisters
            Post-Operative Calls
            Preventive Maintenance
            X-Ray Developer
            Monitor Logs
Acting on Findings

Section 4. Data Collection and Analysis

Collecting Data
Analyzing Data
            Flow Chart
            Cause-and-Effect Diagram
            Pareto Diagram
            Scatter Diagram
            Run Chart
            Control Chart
Sharing Results of Quality-Assurance/Quality-Improvement Activities
Developing a Patient-Satisfaction Survey
Administering Patient-Satisfaction Surveys
Analyzing Patient-Satisfaction Surveys


Section 1: Health Records

Health Record
            Electronic Templates and Clinic Forms
Elements of the Health Record
            Guidelines for Records Maintenance
            Health Insurance Portability and Accountability Act

Section 2: Infection Control, Environmental Health, and Safety

Infection Control and Regulation
Organizations That Support Infection Control and Safety
            Centers for Disease Control and Prevention
            Occupational Safety and Health Administration
            Dental Evaluation and Consultation Service
            Organization for Safety, Asepsis and Prevention
            American Dental Assocation
Bloodborne Pathogens and Needlestick Prevention
            Post-Exposure Management
Products and Devices for Infection Prevention and Control
Waterline Maintenance
Monitoring and Evaluating Compliance
Regulation of Hazardous Materials
Nitrous Oxide
Medical Emergencies
Life Safety Code
Work-Related Accident Documentation
Emergency Preparedness
Clinic Security
Other Clinic Safety Issues
            Eye Protection
            Emergency Treatment of Eye Injuries
            Noise Control

Section 3: Clinical Topics

Clinical and Prevention Issues
            Treating Medically Complex Patients
            Clinical and Community-Based Prevention Strategies
            Clinical Diagnosis and Clinical Technique
            Treating Patients with Special Health Care Needs
Behavior Management
Conscious Sedation

Section 4: Dental Office Technology

Information and Clinical Technology
Information Systems and Information Management
Computer Hardware and Software Selection
Technology Integration
Digital Radiography
Other Technical Equipment
            Intraoral Camera
            Air Abrasion
            Dental Lasers
            Apex Locators and Rotary Endodontics
            CAD/CAM Milling System
            3D Printers

DentaQuest Partnership for Oral Health Advancement’s Safety Net Solutions and the National Maternal and Child Oral Health Resource Center have created this revised edition, in collaboration with several author/reviewers. The original manual was produced by the Ohio Department of Health’s Bureau of Oral Health Services in collaboration with the Association of State and Territorial Dental Directors and Indian Health Services. We gratefully acknowledge the expertise and effort of all collaborators over the span of the manual's lifetime.