Sitting in The Lap of Luxury With the Dental Chair

Discover the hidden meanings about the dental chair you never knew existed.

Play this song as you read along, this is what you usually hear when sitting in the dental chair (provided in Soundcloud by relaxdaily).

The dental chair is something that most people in their lives have sat in at least once. It has become a social norm to receive a card every six months for a dental check-up. Everyone appears to begrudgingly go to the dentist to make sure their pearly whites stay clean and healthy. However, people seem to find the dental chair uncomfortable with the unpleasant sound of drills, small motors, and constant suctioning of saliva. What people sit in when their teeth are being cleaned is drastically taken for granted.

Provided in Flickr by Belmont Dental Supply

Most dental chairs have a nice leather upholstery and have state of the art equipment like the high vacuum evacuator (HVE) and the saliva ejector. The design of the dental chair has evolved tremendously in the past couple centuries. The dental chair can represent how far dental care has come along and the design of the chair is a key factor in the dental field’s advancement. The design of the chair is put into great consideration in ways that people never think about when sitting in the chair.

Personal Connection

The dental chair has a very special place in my heart. I go to the dentist every six months like most of the United States population and listen to the dentist talk to me as they scrape, brush, and suction my mouth. Sitting in a chair for thirty minutes or more isn’t an ideal use of time for people and is usually awkward when you can’t talk back to the dentist. However, sitting in that dental chair and listening to the dentist makes me feel comfortable and confident in the care that’s being provided. I also love going to the dentist and sitting in that dental chair because some day I will be on the other side of the chair providing the care people need. I have a strong connection to the dental chair myself when I tool an introduction to dental assisting class in my senior year of high school and at the Lake Washington Institute of Technology. While learning how to do basic cleaning I also learned about the factors that make the dental field possible that typically sits in the side lines. Regulation bodies like Health Insurance Portability and Accountability Act of 1996 (HIPPA). This act was created to help with regulations of health care that’s provided and to protect any confidential information about an individual. These kind of regulations can also be applied to the design of the dental chair.

Background of Dentistry and The Dental Chair

Before discussing some of the ideas associated with the dental chair’s design; some history of the dental chair’s design must be addressed. There was a time when the profession of dentistry didn’t even exist. The acknowledgement of oral care was recognized in 5000 B.C. where a Sumerian text described cavities as being “tooth worms”. The dental profession wasn’t used until 700 A.D. with China’s use of what they called “silver paste” that’s a form of amalgam. The American Dental Association (ADA) talks about the earliest known dentists being barbers. These barbers were then formed into surgeons that would perform complex procedures. This was very unsafe with the lack of disinfection and having a barber treat teeth with no professional skill caused for a much needed change in dental technology. The creation of the dental chair was one of the largest factors of the dental profession’s evolution.
A dentist named Dan Matthews identified the original dental chair as being,

“a bare wooden chair with no head rest, a stool for the dentist and a rudimentary set of picks and pliers” (Matthews; The History of Dental Chairs)

Provided on Youtube by Audio Productions

This is the noise you would hear if the dental chair is uncomfortable like the first dental chair.

This design was the very first and most uncomfortable dental chair created. This chair was just a wooden chair you would find at your dining room table with no cushions and a straight back. Dentists struggled to perform simple tasks like brushing a person’s teeth. Dentists had no electrical equipment and the angle of the chair made it impossible to see into the patient’s mouth. It wasn’t until the year 1790 that a man named Josiah Flagg created a more comfortable and ergonomic chair. The dental chair he created still used the wooden chair, but with an added head rest to allow the patient’s position to be changed for better operating angles.

Provided in Flickr by GettysGirl4260

This was revolutionary and gave patients more comfort and made the treatment of patients much easier. However, there were still several problems that needed to be remedied. It wasn’t until the year 1832 that a man named James Snell created the first dental chair to be fully adjustable. The features that could be adjusted were minimal but caused a shift in how the dental chair should be designed. At this point in history the chair was making the dental profession safer for the patient and more reliable for dentists to utilize. In the year 1867 the first modern dental chair was created by a man named Dr. James Beall Morrison. This dental chair would appear to be more like what we see today in that it has a footrest, a rotating seat, a foot pedal for dental equipment, and adjustments for the seat to go up and down.

Influence of Design

The design of an object like the dental chair can cause many other factors in life to be influenced by the design of an object. A man named Norman, D.A. explains how design matters to the individual by saying,

“good human-centered design practices are most essential for tasks or situations that are stressful: distractions, bottlenecks, and irritations need to be minimized” (Norman; Emotion & Design: Attractive things work better)

This brings us to the point that the design of objects can greatly effect a person’s emotions. Poor designs can cause an individual to become uncomfortable and more stressed. On the other hand, if the object has a great ergonomic design, the individual will feel less stressed and enjoy the positive parts of the design. Patients can feel this when they sit in a chair that is visually appealing and feels comfortable. The same can be said for the dentists with a great design of the chair making the dentists work manageable.

The other aspect of the design concept is having a sense of balance. Objects in design are usually created for the soul purpose of usability. However, the usability of an object shouldn’t be the only thing accounted for. Most objects are produced to go into the open market to go towards companies or everyday consumers like you and I. Therefore, objects can’t be created just for functional use and need to be appealing to the eye that doesn’t make the consumer dissatisfied and uninterested. Norman also argues in his reading,

“Stressful situations, where the negative affect of the task leads to depth-first processing and, in the extreme case, tunnel vision. Tools that are meant to support serious, concentrated effort, where the task is well specified and the approach relatively well understood are best served by designs that emphasize function and minimize irrelevancies”(Norman; Emotion & Design: Attractive things work better)

Without a good design that balances the factors of function and appeal, the person using the object will become stressed or cause a more serious problem depending on the item and it’s use. Earlier when we were talking about the history of the dental chair being just a wooden chair is a great example. The wooden chair’s design, even if it had a visual appeal, could cause a great amount of stress to the dentist with the chair’s lack of functionality and can cause the patient to be stressed as well.

Conditions of Good Dental Chair Design

There are four conditions that should be considered when designing a dental chair that most people don’t realize. The first condition is that the skull of the patient should be positioned in a way that will allow a clear view of both the mandible (lower jaw) and maxilla (upper jaw). The second condition is that the patient’s skull should be able to rotate with great ease while allowing the dentist to see what they are doing. The third condition is that the procedure that is performed needs to have a dental chair that allows the dentist to treat patients from a vertical upright position or to a full horizontal position. The last condition is that all forms of treatment that need to be performed (sitting and standing) need to be performed with a chair that won’t strain the dentists physical capabilities. These four conditions apply to all dental chairs and provide a new viewpoint of the dental chair. These conditions are very important and if this is not implemented in the design of the chair treatment will be more unsafe and go against regulations that have been placed in the United States.

Economic Influence

The design of the dental chair can have an impact in economics of dental clinics. There are regulations that are created to limit the budget of lighting energy to dental buildings. Some exceptions to the light energy budget would be for the overhead lights that’s attached to the dental chair and are used to look into a patient’s mouth. However, because of the chairs design needing an overhead light there are more restrictions on the use of other lights. In the article “Regulations with SIGNIFICANT design implications” by Jeff Carter, DDS, and Pat Carter, IIDA, the authors bring the maximum amount of power allowed in a clinic with a real world model by saying, “Translation of this to a 2,000 SF, four-operatory dental facility would be 20 100-watt incandescent bulbs of artificial light for the interior. With 15 to 20 individual spaces in a 2,000 SF facility, one 100-watt lightbulb makes for a pretty dismal waiting area” (Jeff and Pat Carter Sec.1). What the authors are saying is that because most of the electricity with lighting goes to the overhead light for the dental chair there is very little lighting for the rest of the dental office. With the overhead light taking up so much of the lighting budget for some chairs, the office will project a negative atmosphere and make sitting in the dental chair uncomfortable. The other regulation that has an economic impact from the dental chair’s design is the use of compressed and vacuum air as a medical gas. Originally compressed and vacuum air wasn’t regulated and the other gases that are used in the clinic are on their own separate machine. Recently, though, a national code standard created by the NFPA expanded medical gas regulation to include the vacuum and compressed air that is found in the HVE tips and air water syringes that are attached to the dental chair. Some additional considerations have to now be implemented to how the air is stored and the best method for easy accessibility. One consideration the authors make is that, “Vacuum and compressed air connections to chair-mount delivery units “may” require removable floor access panels to expose vacuum and compressed air lines plumbed to the J-box under the “toe” of the dental chair” (Jeff and Pat Carter Sec.2). What this means is that there is a higher chance for the air lines to be hanging on the ceiling making the chair look more like a torture device and less welcoming for the patient. The other problem of the regulation that is connected to the dental chair’s design is when they are placed in an open-bay setting. This positioning of the chair can require for something called “sleeving” that create long runs of air lines that provide access points to the lines needed to use the equipment on the chair.

Cultural Impact

The design of the dental chair can also create a cultural impact. Most if not all of the population in the United States has access to some of the best dental care. Citizens of the United States have access to some of the best dental care that is easily accessible to most people. However, the privilege of sitting in a dental chair is only available to people who have dental insurance. There are other places around the world that provide little to no dental care to the country and is usually a problem in underdeveloped countries. The other side of the coin is with countries that has accessibility to the dental chair for all. This is typically found in countries that provide free dental and health care like in several parts of Europe. The problem with people who live in areas that offer free dental care is that the design of the dental chair isn’t as advanced due to the care being funded by the government.

The Royal Throne

There are also dental chairs that are created that are typically beyond the reach of people who are getting standard dental care. These kind of chairs are typically found in dental professions like Oral and Maxillofacial Surgeons and by people who have their own personal dentist. One type of dental chair that’s is of the highest quality comes from the Anthos dental unit series created in Italy (Anthos Brochure).

Provided in Flickr by Ruben Nadador

These chairs are designed to have the greatest comfort and make any task the dentist needs to perform easy. Out of all the dental units the best one Anthos has to offer is the Anthos Classe A9. A brochure from the Anthos website describes the chair having integrated devices that allow for the best dental hygiene care with several features that allow for the chair to respond accordingly to each need. The freedom of movement and features that help the dentist and comfort the patient is something that most people will never have the privilege of sitting in. The dental chair has evolved a long way from being just a wooden chair to something like the Anthos Classe A9 and other dental chairs that are at the peak of dental technological advancements.

The design of a dental chair can cause an emotional, economic, and cultural impact that most people never thought existed. The dental chair can signify the privilege some people have over other cultures and can resemble what kind of dental care is being given. I have a personal connection to the dental chair that goes beyond the basic use of the dental chair and have a passion to be on the other side of that chair someday. However, I believe that we can all say that we have come a long way from having barbers as dentists treating us in standard wooden chairs. Today, we have chairs that change to the dentist’s technique and provide comfort that may cause some patients to fall asleep as their being treated. I don’t know about you, but I can safely say that the dental chair’s design has made us live in the lap of luxury and no time soon will we go back to that unappealing and uncomfortable wooden chair.