COMMENTARY

What Medical Equipment Does the Dental Office Need?

Marjorie Jeffcoat, DMD

Disclosures

February 14, 2012

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Hello. I am Dr. Marjorie Jeffcoat, speaking to you from the University of Pennsylvania in Philadelphia. Today, we are going to talk to about equipment you should consider having in your dental office that can save lives and will help you better treat your patients. Some of this equipment is for the future, and some of it is what you need to have today. I am not going to talk about drugs.

First of all, you should have a thermometer, an item that is often forgotten. A thermometer is useful when a patient comes in with a possible fever (temperature > 100 ºF), suggesting a systemic infection. If the source is a dental problem, it needs to be treated, and the patient may need to be referred to his or her primary healthcare provider.

The office should have a blood pressure cuff and stethoscope so that you can determine whether the patient's blood pressure is within normal limits. The patient might be nervous from seeing a dentist, so give the patient a few minutes to calm down before taking his or her blood pressure. Patients with chronic high blood pressure need to see their primary healthcare providers.

In my opinion, every dental office should have an automated external defibrillator. Although CPR is useful, it does not save all lives. We all know how to administer CPR. Make sure you are trained in the use of the automated external defibrillator and can use it because it will save more lives than CPR alone.

A simple blood glucose monitor (fingerstick- or armstick-type) is very useful to have in your office, especially for patients with diabetes. This device will provide an instantaneous measurement of the patient's blood glucose.

A relatively new test is the A1c level. This measures how much blood glucose was present over a 3-month period. I keep a A1c testing kit in my office. A single test costs about $25 and is extremely useful. All of my patients tell me that they stick to their diets, they are exercising, and they always take their medications. With the A1c, you can tell whether a patient's diabetes is under control.

A pulse oximeter measures the patient's oxygen saturation. Patients with pulmonary disease should have their bronchodilators in their laps, ready to use, in case their lungs "seize up" during a procedure.

You need to think about your patients who take "blood thinners" (antithrombotic agents). Patients who have had heart attacks or clots are often on these medications. The primary care provider will check the patient's coagulation studies regularly, but you might need to check these studies the day before a surgical procedure. A kit for this purpose, although not necessarily the standard of care for a dental office, is available for approximately $1000, and an additional $5 per test strip. The test is not diagnostic, but it helps in telling patients that they need to see their primary care providers.

You may want to keep a pregnancy test kit in your office. I do so because patients don't always know when they are pregnant, and I wouldn't want to prescribe a tetracycline-based drug to a woman who might be pregnant. Tetracycline is contraindicated during pregnancy, because its use during tooth development (the last half of pregnancy through age 8 years) can cause permanent discoloration of teeth.

One last piece of technology is your staff and the telephone -- 911 will get you expert care at the press of a dial. Have it programmed into your phone.

It has been a pleasure to talk to you today. This is Marjorie Jeffcoat from the University of Pennsylvania.

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