A New Clinic, A New Experience

Since childhood, Crystal Harris has been afraid of the dentist. “I really didn’t want to go because I knew I’d get a needle and feel pain,” says the 49-year-old Washington Heights resident. Just sitting in the waiting room triggered her anxiety.   A loyal patient at the College of Dental Medicine for the past 20 years, Harris has gotten used to her dental anxiety, but recently something changed. Harris walked into CDM’s new Center for Precision Dental Medicine, a recent addition to its clinical offerings. Entering the clinic, she felt noticeably calmer.

“It’s bright, it’s spacious, it’s clean, it’s friendly,” she says. “It doesn’t look like a dentist’s office, so when you walk in, you’re not terrified.”

In the Center, where dental students and residents treat patients under faculty supervision, CDM is working to revolutionize the teaching and practice of dentistry, and for the patient, the environment transforms the experience. The cutting edge technology and layout aimed to increase efficiency have the added effect of enhancing the patient experience, says Richard M. Lichtenthal, DDS, associate professor of operative dentistry.

“Patients are impressed as soon as they come in,” he says. “When they see an office that is neat and clean, and with modern equipment, they know that the dentistry they’re getting will be the same: modern, efficient, and well organized.”

The center’s soft white light and open design is part of what makes it comforting to patients like Harris. Translucent glass partitions separate its operatories, which are the work-stations where patients are treated. This provides patient privacy without blocking natural light. A subtle curve of the partitions offers a sense of spaciousness, as do the high vaulted ceiling, designed with a reclined patient in mind. “You don’t feel locked in,” Dr. Lichtenthal said. And a careful layout, which includes two wings, each with their own waiting room and registration area, has reduced patient waiting time, and in turn, anxiety. “Access to a doctor is faster,” Dr. Lichtenthal says. “It’s a much smoother operation.

Smart Technology Personalizes Care

What you see is streamlined and open space with modern equipment. But what you don’t see is even more important—first-of-its kind technology that smoothes the flow of operations and enable continuous improvement through

data collection and analysis. Dental chairs, dental instruments, and soon even ID bracelets “talk” to each other, tracking subtle details to ensure quality care. Technology logs the date and time of instrument sterilization and even captures the delicate movements of a clinician’s hand while performing a procedure. This helps students get fine-tuned feedback so they can learn with a level of precision not possible before.

Because this is a teaching clinic, faculty are always accessible to help with any procedure. But in the new facility, they are unobtrusive. Each operatory contains a camera that allows faculty to observe their students from a desk nearby.  So rather than tower over a patient while instructing a dental student at work, faculty can keep a watchful eye as students work independently but also step in when guidance is needed, often catching problems before they happen. Dr. Licthenthal says. “Patients feel safe because they know someone’s always watching.”

This summer, video (but not audio) will be captured for careful but confidential review of students’ work. And in the future, the school expects to analyze video with machine learning algorithms to help researchers determine what makes for the best care and the best patient experience.

Simulation Learning Without a Simulation Lab

 As in other dental teaching clinics, third and fourth year predoctoral students care for patients as part of their clinical training. But unlike in other teaching clinics, the operatories double as classrooms where first-year dental students practice on mannequins in the very space and with the same equipment they will someday use as clinicians. This makes a huge difference in the learning experience, says Megan Cloidt, a third-year student. “By the time students reach their third year, they will have already used a real dental chair and they’ll know how to use an operatory,” Cloidt says.

The result is greater student confidence, which translates into greater patient care. Says Dr. Lichtenthal, “Patients feel more comfortable because it’s obvious that students already know what they’re doing.”

In the coming months, new technologies will continue rolling out, including devices to improve not just the quality of care, but the experience of it. Continuous heart rate and blood oxygen level monitoring will help monitor stress—a sudden spike in heart rate or a decrease in oxygenation could indicate that the patient is uncomfortable or nervous. Also in the works, an overhead camera in the lighthead of the chair will offer a close-up view so faculty can see not how a procedure is being performed but also how a patient is responding. If a faculty member spots a furrowed brow, that might mean it’s time to check in to make sure everything is going okay.

Also down the road, dental records will be integrated with patient’s medical records, helping all clinicians who treat a patient to share valuable insights, such as conditions like diabetes or other disease that affect oral health. As Cloidt notes, “All of this will heighten our ability to individualize patient care.”

Individualized care is key to patient satisfaction, Dr. Lichtenthal says. “If patients feel that they’re getting good care, then they’ll be eager to come back, and to refer their friends and family.”

CDM has long been the go-to place for Harris’ patient care. Although she still considers herself “the biggest chicken” when it comes to her regular six-month check-ups, the new clinic makes it easier to go. “You have to get check-ups,” she says, “and it’s easier to do that if you’re in a calmer environment.”