The Dentist’s Creed 
TO respect my profession, my reputation and myself. To be 
honest and fair with my patients as I expect my patients to 
be honest and fair with me; to think of Dentistry with loyalty, 
speak of it with praise, and act always as a custodian of its good 
name. To be a man whose word carries weight with my fellow- 
citizens; to be a booster, not a knocker; a pusher, not a kicker; a 
motor, not a clog. 
To base my expectations of reward on a solid foundation of service 
rendered; to be willing to pay the price in honest effort. To look 
upon my work as opportunity to be seized with joy and made the 
most of, and not as painful drudgery to be reluctantly endured. 
To remember that success lies within myself, in my own brain, 
my own ambition, my own courage and determination. To expect 
difficulties and force my way through them; to convert hard 
experience into capital for future struggles. 
To believe in my proposition heart and soul; to carry an air of 
optimism into the presence of possible patients; to dispel ill-temper 
with cheerfulness, kill doubts with strong convictions, and reduce 
active friction with an agreeable personality. 
To make a study of the professional and business sides of Den- 
tistry; to know both sides in every detail from the ground up; to 
mix brains with my efforts, and use system and method in my 
work; to find time to do everything needful by never letting time 
find me doing nothing. To make every hour bring me dividends in 
fees, increased knowledge, or healthful recreation. 
To save money as well as earn it; to cut out expensive amuse- 
ments until I can afford them. 
Finally to take a good grip on the joy of life; to play the game 
like a gentleman; to fight against nothing so hard as my own 
weaknesses; and to endeavor to grow as a dentist, and as a man 
with the passage of every day of time. 
THIS IS MY CREED 
Copies for framing, size 9x14, may be had 
with our compliments, upon application to 
Twitter T)ental <J&anufaduring QoInc, 
Rochester, New York RITTER 
Practice Building Suggestions RITTER 
Practice Building 
Suggestions 
Second Edition 
Revised and Enlarged 
Reprinted April, 1925 
Ritter Dental Manufacturing Co., Inc. 
ROCHESTER, NEW YORK Copyright 1924 
bj 
Ritter Dental Manufacturing Co., Inc. 
Rochester, New York Practice Building Suggestions 
INTRODUCTION 
The Student Graduate 
Obligations to Teachers and Humanity 
THE new graduate in entering upon his life’s work owes 
a debt of gratitude to the teachers who have so unself- 
ishly given their knowledge and time to training men to 
succeed them in the profession. Much of their reward must 
be in the knowledge that the student will, in turn, give an 
unselfish support to matters of public welfare in every way 
that he reasonably can. 
If, while at college, the student has not been impressed with 
the great service he can render humanity rather than with 
the financial gain that he may expect to reap, then some- 
thing has been lacking. 
Starting Out 
Most young men starting out in the practice of dentistry 
with high ideals are handicapped to a great extent by a lack 
of knowledge of business principles that, if possessed and 
used, would make more readily possible the attainment of 
the ideals they were taught at college. The successful com- 
bination of the ethical and the ideal with the practical now 
becomes their problem. A successful application will not only 
enable them to serve humanity to a greater extent, but will 
make possible a reasonable reward for the services rendered. 
An empty pocket-book will not assist them in serving 
humanity nor will their ultimate reward be obtained by 
putting the cart before the horse. Their first aim should not 
be to see how much wealth they can accumulate, but rather 
to carry out the teachings received at school. It will be 
necessary to creep before one can learn to walk. 
The beginner will be obliged to work early and late, and 
probably in a great many instances will be obliged to accept 
whatever fees he can get before he will be able to reach the 
point where he can restrict his practice to a limited number 
of patients daily and base his fees in the manner suggested 
7 Practice Building Suggestions 
under the subject of “How to Establish Fees” in the latter 
part of this publication. When the beginner opens his office 
for business, he will not find patients rushing in to have their 
dental work done by him, but there are ways and means of 
gradually bringing them in and of building a practice on a 
solid foundation. 
School Days Not Over 
Dentistry cannot be learned in four years at school. It 
takes many more years of constant study and painstaking 
effort to become proficient in the practice of dentistry and 
to become a builder of health. The end of the students’ school 
days will not end their study periods. They will continually 
not only need new text-books, but it will be necessary to read 
regularly the dental journals, study new methods, new appli- 
ances and try new medicaments. 
Helping the Children 
In locating in a large city, the beginner should visit the 
officer who has charge of the health department and suggest 
a mouth examination for all school children, in whose welfare 
he should be widely interested, or, if located in a town or 
village, he should take the matter up with the superintendent 
of schools, which, as a beginner, is one method of not only 
donating a certain part of his time in the interest of preven- 
tive dentistry but of bringing himself to the favorable atten- 
tion of the established practitioner and the community in 
which he is located. 
His Associates 
Every graduate should join his local society and study 
club, as well as the district, state and national associations. 
This will enable him to exchange ideas with his fellow-prac- 
titioner and obtain the benefit of the best in the profession. 
If he will cultivate the goodwill and good-fellowship of the 
older practitioners, he will always find them ready and eager 
to assist him. 
Manufacturers and Dealers 
lt is also well to cultivate the acquaintance and confidence 
of dental manufacturers and dealers. The successful practice 
8 Practice Building Suggestions 
of dentistry would not be possible without the co-operation 
of both the dealer and the manufacturer, and neither the 
dealer or manufacturer could exist without the dentist. All 
interests are, therefore, mutual, because the success of all 
depends upon the success of each. Many in the profession 
have a very wrong conception of the problems of manufac- 
turing and distribution. They imagine that both fields are a 
lucrative bed of roses and that the principal work done con- 
sists chiefly of dividing the profits made at the expense of 
the profession. On the other hand, many are not familiar 
with the problems of the dentist, and if each can understand 
the difficulties of the other, greater strides will be made toward 
the common goal we are all working for, namely, to serve 
humanity to the best of our ability and at the same time 
have a reasonable share of the comforts of life. 
Association with representative manufacturers and repre- 
sentative dealers will not only assure the dentist of receiving 
the best in the dental line, but he will also have the oppor- 
tunity of advice that will be helpful, because it will be the 
advice resulting from a successful business experience. 
It is always well to remember that the lowest price is not 
always the cheapest and that those who promise to give you 
something for nothing or something just as good as the recog- 
nized standard are not always real friends. Association with 
successful people and successful concerns is more likely to 
make for success than otherwise. 
The foregoing and what follows is offered by us as an indi- 
cation of a sincere desire to assist the dentist, not only the 
beginner, but the established practitioner, in solving some of 
his problems as we have come into contact with them. 
Ritter Dental Manufacturing CoInc. 
Rochester, New York 
9 Practice Building Suggestions 
Law of Supply and Demand 
and Factors Affecting Demand 
THE value of materials, labor, manufactured products 
and professional services varies directly with the demand 
and inversely with the supply. Twenty years ago dental 
equipment and dental services could be purchased for prices 
and for fees considerably less than today, not only on account 
of lower price levels that prevailed at that time, but because 
at that time dental equipment and dental services were in 
much less demand. Consequently the prices of equipment and 
fees were not only in keeping with the demand, but with 
the quality of equipment then produced and the quality of 
professional service rendered. If the demand for dental 
equipment and dental service had been diminished and finally 
extinguished, there would be no manufacturers or dentists in 
practice today. 
Therefore, it would not be difficult to understand that if 
the public at large were to suddenly double its demand for 
dentistry, the demand would greatly exceed the supply which, 
to a certain extent, would be bound to increase fees. 
Great improvement has been made in the practice of den- 
tistry each year, but it seems that the medium of supply— 
that is, graduating students—increases accordingly, with the 
result that the law of supply and demand rests practically with 
each individual dentist. Those dentists who have large prac- 
tices, and for whose services there is a constant and increasing 
demand to a point where it exceeds the supply, find themselves 
able to bring this situation to a proper balance by regulating 
their fees in keeping with the service rendered and the ability 
of the patient to pay. This procedure limits the practice to 
those who can afford to pay in keeping with the service ren- 
dered, and allows the dentist to not only increase his income, 
but also gives him relief from overtaxing his energies. It also 
gives him opportunities for scientific research, an obligation 
he owes his profession and humanity. Those patients who 
cannot afford to pay for the services of such dentists, the de- 
mand for whom exceeds the supply, make it necessary for 
10 Practice Building Suggestions 
them to seek the services of other dentists, possibly equally as 
capable but for whom the demand is not so great. 
The desire for dental services is not in itself an economic 
demand. No matter how much the public may want dental 
services, the desire for them can have no general effect upon 
the fees of the profession unless the public has the necessary 
means of payment. Desire for dentistry must be accompanied 
by the necessary purchasing power before it can become an 
economic or effective demand. 
The factors of supply and demand affecting the success of 
the individual dentist are: 
1. A sincere desire to serve humanity. 
2. Honesty. 
3. The highest sense of professional ethics. 
4. Advantageous location. 
5. Enthusiasm. 
6. Operative ability—Thoroughness. 
7. Modern environment and equipment. 
8. Cleanliness. 
9. Knowledge of proper management of patients. 
10. Business ability. 
11. Personality. 
12. Diplomacy. 
Honesty 
Honesty is fairness and straightforwardness in conduct, in 
thought and in speech. A dentist is not honest with his patient 
or himself who is not efficient in his daily practice. Honesty 
makes for success, and extends far beyond the plane of patient 
and dentist. It is the basis of all successful business operations, 
and is the foundation of all matters of finance. Honesty is a 
dentist’s capital. It makes for credit, safety and power. 
Advantageous Location 
An analysis of a community may prove that another dental 
office is indicated, but whether the dentist is to be successful 
depends entirely upon his personality and his ability to fit in 
with the general makeup of the community. 
Some dentists are best adapted for establishing practices 
11 Practice Building Suggestions 
in large cities. If so, they must give thought to the various 
city districts which may be classified as follows: 
Residential sections, outlying business districts, 
manufacturing districts; 
and main business section subdivided into: 
Professional buildings, general office buildings, 
and those buildings catering to exclusive retail 
shops or tenants. 
Certain dentists are best adapted to a suburban practice. 
Locations in suburban cities are classified into two and three- 
story office buildings, and dwellings in residential sections. 
There is a third group of dentists who would be most suc- 
cessful in agricultural districts. These districts may be divided 
into small cities and towns whose economic features are 
railroad division points and state institutions such as uni- 
versities, hospitals, county seats, etc. There are also smaller 
cities and towns located in farming and stock-raising com- 
munities, which depend entirely upon the farmer and stock- 
raiser for business contact. Certain types of dentists meet 
with marked success in such communities. 
While distances have been bridged by every modern means 
of communication and transportation, every locality presents 
conditions that are peculiar to it alone. Therefore, before 
deciding upon a location a thorough study of it should be 
made so as to determine its advantages and disadvantages in 
various respects. If these have been intelligently analyzed, 
the dentist is capable of determining in advance what the 
community has to offer, and his prospects for success. 
Enthusiasm 
The majority of big successes, whether in a profession, 
business, art, science or politics, were made possible by en- 
thusiasm. Enthusiasm, earnestness and sincerity carry con- 
viction. The dentist who is enthusiastic simply bubbles over 
with his belief in himself and his profession. Enthusiasm is a 
necessary requisite for those dentists who want to practice 
with full efficiency. Enthusiasm is effective—first, because of 
its psychological effect upon the dentist, and second, because 
this effect reacts in many ways upon patients. 
In generating the driving force of enthusiasm, the first 
12 Practice Building Suggestions 
requisite is for the dentist to enjoy his work and throw himself 
eagerly into his practice. The secret of eagerness and enjoy- 
ment of work lies in interest, and interest is dependent upon 
study. The more the dentist studies the operative and business 
sides of his profession, the more interested will he become in 
his practice, and the more eager will he become to put to prac- 
tical tests the theories he has worked out in his own mind. 
When a dentist practices because he enjoys it, and not merely 
to earn so much per year, failures will never dampen his en- 
thusiasm. He will analyze his failures, study their causes, 
and enthusiastically look out for another opportunity to suc- 
ceed where formerly he failed. The dentist who does not 
enjoy his daily practice works under low pressure, and lacks 
those extra few pounds of steam which help him surmount his 
everyday problems. 
Operative Ability 
Operative dentistry is the science and art of the restoration 
of the natural teeth to a state of health, beauty and useful- 
ness. Operative ability can only be acquired through a thor- 
ough understanding of the fundamentals and the technique 
taught in the colleges. The scope of a dentist’s ability can be 
broadened through a continual study of text books, dental 
magazines, and the inter-change of ideas at dental society 
meetings. Aside from these, and most important of all, practical 
ability is acquired through practice, the technique of which 
is consistent with the teachings. In addition to these it is im- 
portant that a dentist should have a fairly correct idea of not 
only his ability, but also his mental power. He should not 
underestimate his ability, for then he will never do justice to 
himself, being fearful lest a case is too difficult for him. On the 
other hand, he must not overestimate his ability, for then he 
may undertake cases for which, for the time being at least, he 
is not fitted. The ambitious dentist will acquire operative 
ability only so long as he tries to keep pace with the teachings 
of the keenest intellects in the profession. 
Modern Scientific Equipment 
While it is true that modern dental equipment does not make 
a dentist, nevertheless it helps present him to his patients, and 
enables him to do his work more efficiently. Equipment which 
13 Practice Building Suggestions 
is recognized as “standard”, with a gilt-edged reputation for 
quality, service, superior workmanship, beauty, ease of man- 
ipulation and convenience to the operator is a distinct asset. 
The dentist who would make the proper impression on patients 
must choose equipment which will stand out as a monument 
to his ability. It will be his silent salesman, because it will be 
evidence that can be visualized by the patient. A dentist can- 
not tell his patient that he is a good and capable operator. 
These virtues must be left to the patient’s imagination, which 
will be assisted through the evidence at hand—namely, scien- 
tific equipment which not only looks the part but does the part 
during operative procedure. 
It is only natural for a competent, conscientious dentist to 
feel that his ability alone should build up a profitable, loyal 
practice, but it cannot be denied that other factors affect a 
dentist’s success. 
The public little realizes the diversified knowledge and 
consummate skill the dentist must possess to be an able 
operator. Think of the years of application and never-ending 
study that dentists have devoted in order that they might serve 
humanity more effectively. Are they fair to themselves, to 
their hard-won technique, if they use equipment short of the 
best? Mechanical devices should be as flexible, sure and res- 
ponsive as sensitive hands. 
Fine equipment and well-appointed quarters cannot fail 
to have a favorable effect on patients as well. They are in- 
clined to gauge a dentist’s standing by his environment. If 
surroundings are impressively modern, they pay tribute in 
greater respect and greater financial return. Every skilled 
operator deserves a devoted practice and a growing income. 
A well-appointed operating room often makes both possible. 
The dentist’‘s environment should be as modern as his tech- 
nique. 
Cleanliness 
Cleanliness in and about the dental suite, together with 
that of the dentist’s personal appearance, is a first requisite 
toward ability to impress the public. The public expects to 
receive scientific dental service, and is more amenable to these 
services at proper fees than it has been in the past. First 
14 Practice Building Suggestions 
impressions are usually lasting, and for this reason the entire 
suite should be kept scrupulously clean. 
During the average appointment, patients have many oppor- 
tunities to study the details of the dentist’s personal appear- 
ance, as well as the various rooms comprising the suite. It 
does not matter if the dentist’s clothes are inexpensive and 
not particularly stylish, but it does matter if they are not 
in good order and appropriate for the class of patients that 
patronize his office. A dentist who looks clean and well-groomed 
in every detail creates an impression of capability insofar 
as purely outward matters are concerned. 
Management of Patients 
Management of patients involves nothing more nor less than 
talking to them in a way that appeals to them. Kindness, 
gentleness, patience, courtesy, tact, and consideration for 
the patients’ comfort, plus the teachings of the Golden Rule, 
are the necessary requisites for their management in the 
dental suite. 
Business Ability 
If dentists are to enjoy a just and prompt remuneration for 
the services they render to their patients, then it is necessary 
that they study business principles which should be applied to 
any well-regulated practice. The ambition to make money 
as a dentist is honorable only so long as that ambition does 
not outweigh the desire to render a scientific service, one in 
keeping with the fee asked and the ability of the patient to 
pay. Therefore, it is necessary that dentists know something 
about business economics, even if only the fundamentals. 
The dentist who makes a study of the business side of his 
profession will get a double reward. First, his income-producing 
ability will be increased, for he will have a better understanding 
of business conditions, will see more clearly the possibilities of 
his own practice, and will be better prepared to take advantage 
of opportunities. Second, he will be a broader man, and get 
more satisfaction out of his practice and out of life. With a 
better appreciation of the relationship existing between the 
professional and business side of his profession, his own practice 
will begin to possess for him the fascination of a game, and its 
charm will be due not only to his increased earnings, but also 
15 Practice Building Suggestions 
to the consciousness of power which its successful conduct 
gives him. 
Personality 
The dentist whose personality is made up of enthusiasm, 
sincerity, earnestness and tact possesses a great asset. A den- 
tist who is handicapped by physical appearance may greatly 
impress his patients if he has personality. These attributes, 
if developed, will instinctively win the admiration and trust 
of patients. Those dentists who lack these qualities seldom 
meet with more than mediocre success. 
Diplomacy 
Diplomacy is the intellectual quality as courage is the 
moral quality of the successful dentist. It is the lubricant 
which takes the creaks and jars out of critical situations. The 
dentist who lacks diplomacy will find that sand has a way 
of eating into the bearings of his point of contact with his 
patients. Enthusiasm may be working at its very height 
when patients are given health talks on dentistry and scien- 
tific service, and his courage and convictions linked to his 
health talks may form a perfect piece of mechanism. How- 
ever, if he lacks diplomacy arguments will fail, just as a piece 
of machinery however carefully put together fails to act 
without lubrication. 
Diplomacy is that mental alertness which enables the den- 
tist to say and do what is best under seemingly unfavorable 
circumstances. 
Time Element 
The dentist is unlike a merchant, who does not sell his time 
but rather his wares. The dentist really does not sell restora- 
tions, treatments or materials, but good health. The former 
is only a means to an end. The value of the dentist’s time in 
restoring health is determined by the demand for it, plus his 
cost of doing business. Out of twenty-four hours a day not 
more than eight—preferably six—can be economically used as 
income-producing hours. The merchant can increase his stock, 
put on intensive sales drives, and through various means increase 
his business, but the dentist is limited to the sale of his time 
measured basically on an hourly basis. The dentist cannot add 
16 Practice Building Suggestions 
to his time, but he can improve it in various ways by keeping 
hours filled with patient appointments, or if that is not possible, 
by making use of his unfilled hours for research and study so 
that he may live up to his opportunities as they are presented. 
Office Individuality 
By “office individuality” is meant an office distinctively 
different from any other in the community. “Office indi- 
viduality” embodies office planning, color schemes, lighting 
effects, floor coverings, window treatments, picture subjects, 
reception room, retiring room and business office furniture, 
as well as the selection and proper installation of scientific 
dental equipment. Along with the suggestions made to the 
dentist by dental supply salesmen and others, he should try 
to incorporate in his “suite” some of his own ideas which will 
reflect his personality. 
17 Practice Building Suggestions 
SECTION I 
Public Opinion and the Dental Profession 
Twenty Years Ago 
DENTISTS who have been in practice for twenty years 
must be impressed with the rapid strides that the 
profession has made during that time, and with the 
fact that the public has considerably changed its former 
opinion of dentistry. In former years the laity looked upon 
dentistry as something more or less jocular. If one was heard 
to remark that it was necessary to have a “tooth pulled” 
those overhearing it would immediately make light of it. 
The layman’s idea of a cavity was merely a hole to be plugged 
up for the sum of $2.00, including treatments. Dentures were 
known as “plates,” with an established price of $15.00 for an 
upper or lower, or $25.00 for both, the extraction thrown in. 
Children’s teeth were given little or no attention by their 
parents except when necessary to have a “tooth pulled,” due 
to toothache or acute abscessed conditions. The temporary 
teeth were being removed as fast as possible in order to make 
room for the permanent set which was to put in its appearance 
some time, possibly in the near future. When the permanent 
teeth appeared, no attention was given them except in cases of 
suffering. The average orthodontist had difficulty in making 
a living because the laity did not realize what might be accom- 
plished for children, and again, the orthodontist was begrudged 
his fee. Patients who should have had bridge work restorations, 
decided to save the money that bridge work would cost by hav- 
ing the balance of their teeth extracted and “plates” made 
instead, and looked upon'them as being something just as good. 
In those days “better dentistry” was looked upon by the poor 
and middle classes as something only for people of means. 
Through lack of dental education in the public schools and 
other means, the public did not know that health was impaired 
by tooth neglect. The scope of the laity’s understanding of 
dentistry aside from painful extractions was gold, silver and 
cement fillings, crowns, fixed bridge work and plates. These 
18 Practice Building Suggestions 
were considered standard dental commodities, the prepara- 
tions for which were always associated with a maximum of 
distress and pain. 
In previous years the laity as a whole held itself aloof from 
dental offices until driven to them for relief. 
The New Era Thought by the Public 
We want the laity to think so much of dentistry that pro- 
vision for it will be made in the average family budget, the 
same as for rent, light, fuel, food, etc. 
We want the poorer class of the laity to take dentistry ser- 
iously enough so that they will visit a dental office at frequent 
intervals in order to forestall an accumulation of work to be 
done, which, if allowed to remain undone would make them 
feel that they could not afford the type of work indicated. 
If this kind of people will submit to periodical examinations, 
tooth troubles will be detected in their primary development, 
and can than be properly corrected with little expense. 
We want the laity to think so seriously of dentistry that they 
will insist upon the school boards and public health authori- 
ties making mouth hygiene an important study in every public 
and private school in the United States. 
We want parents to think so seriously of dentistry that they 
will become thoroughly familiar with the routine in which 
deciduous teeth are supposed to erupt and after they have 
erupted, how they are to be cared for and why it is of the 
greatest importance to have them retained in the mouth until 
nature herself expels them. We want parents to know in which 
way the health of the child may be impaired throughout life 
because of failure to properly care for these so-called “baby- 
teeth.” 
We want parents to know how the welfare of the child, not 
only from a health viewpoint, but also from that of a social 
and business status, may be very greatly handicapped through 
the parents’ failure to appreciate the importance of having 
teeth regulated by scientific orthodontists when abnormal 
occlusal conditions prevail. Children with receding or pro- 
truding chins, who are considered homely by everyone outside 
of their own family, can be made beautiful, through corrections, 
if placed in the hands of the orthodontist. 
19 Practice Building Suggestions 
lt has been proved time and again through scientific dental 
research that many criminals have been developed only be- 
cause of wilful mouth neglect by the parents, at a certain period 
in childhood. Many of the dwarfed mental conditions now in 
existence can be laid directly at the door of mouth neglect 
during junior life. We want the layman to know through 
proof that dentistry is equally as scientific as medicine. 
We want the laity to think so seriously of dentistry that they 
will not choose their dentist at random or compare dentistry 
with a commodity, placing it on a price basis. The layman 
hesitates to choose a physician without first inquiring as to 
how competent the physician really is. The laity thinks, 
and perhaps justly so, that when choosing a physician or sur- 
geon, their very life is put in his hands. The layman has not 
yet come to know that whenever he seeks the services of a 
dentist, he is also placing his life in the dentist’s hands—and in 
many cases to a greater extent—than with the physician or 
surgeon. We want the laity to realize these things, and to 
bring about this realization it is up to the dental profession, 
hygienists, dental nurses, dental dealers, their salesmen, dental 
manufacturers and their salesmen, through concerted effort to 
bring this thought home to the laity. 
When the masses once begin to realize that 90 per cent of 
all ailments first originate in the mouth because of oral neglect, 
then dentistry will come into its own. The laity knows in a 
general way that in order to be successful in the home, in social 
life and in business, they must be healthy, but they do not yet 
realize that the teachings of oral hygiene, if practiced by 
everyone, are a 90 per cent aid to health success. 
Dentistry is a strictly scientific profession. No two mouths 
nor any two teeth are exactly alike. Each individual requires 
special consideration, which must be based upon years of 
scientific research by not only authorities in dentistry, but 
by every dentist who believes in his profession and who is 
making it his life work. It is all of these things that we want 
the laity to not only know, but also to believe because it is 
the Truth. 
20 Practice Building Suggestions 
SECTION II 
Choosing Right Location and 
Starting the Practice 
Analysis of Communities 
ONE of the most important problems dentists have to 
solve, and particularly among those who are about to 
graduate, is to determine just where to locate. The 
majority of those expecting to locate usually do so in the 
state from whose schools they have graduated. This, then, 
brings before them the question of what type of locality within 
the home state upon which to decide. 
As previously stated under the subject of “Law of Supply 
and Demand and Factors Affecting Demand,” this can be 
best determined after a thorough self-anaylsis. However, this 
in itself will not suffice because there are many communities 
in each state which would come under the same classification, 
and it is therefore of the utmost importance that a dentist 
know how to intelligently decide upon the best one of a group 
for which, upon a self-analysis, he seems most fitted. 
Each year many dentists make the mistake of locating in 
a community which has no possibilities for them beyond that 
of a bare existence, with the result that in a few years these 
dentists seek other locations. When this occurs, some of them 
have profited by their past experiences, and through them 
learn to make a careful analysis of a community before locating 
blindly on their second venture. This entails loss of time, 
effort, and expense in both locations. This waste of time and 
money, with accompanying discouragement, can be diminished 
in the majority of cases if an analysis of the community is 
made in the beginning. 
Communities can be divided into the following groups: 
Small towns and rural districts, cities, and those large enough 
to be known as of metropolitan nature. 
Small Towns and Rural Districts 
By these we refer to towns with a population up to 15,000, 
and by “rural districts” is meant agricultural communities 
21 Practice Building Suggestions 
surrounding these towns for a distance of thirty miles. If a 
dentist has decided to locate in a small town or city which is 
chiefly dependent for business upon its agricultural district, 
it is to his interest to locate in the one which stands out pre- 
eminently above all others as the one offering him the great- 
est number of opportunities. 
To those who do not know how to discover or analyze the 
merits of various cities and communities, the problem of loca- 
tion becomes a most perplexing one, usually resulting in a 
haphazard decision which developes more or less into a game 
of chance. By this method a few dentists are lucky, but most 
of them find at the end of a year that their judgement was 
faulty, due principally to the fact that they allowed them- 
selves to become influenced by surface evidence rather than 
by that brought out through careful analysis and study. 
Dentists who are about to locate should make a preliminary 
analysis through the aid of a questionnaire carefully gotten up 
and sent to the commercial clubs of the city or town in question 
for filling out. So as to guard against the return of the question- 
naire filled out with exaggerated answers from the local club, 
a duplicate should be sent to some well-known commercial 
rating agency located in the nearest large city. The information 
which they will supply on a questionnaire for a small fee can 
usually be accepted as authentic. 
Possibilities of Town or City 
Proportion of American and Foreign-Born? 
The foregoing information is most important, because it 
will bring out the business possibilities of the community. 
Generally speaking, native-born Americans respond in greater 
measure to the teachings of dentistry than the other nation- 
alities. Therefore, if the Americans and those of favorable 
foreign extraction, plus minors of foreigners above twelve 
years of age, are in the majority, then such a population should 
be favorably looked upon. If the make-up of the population 
is reversed in any respect, then unless the dentist is content 
to depend upon volume and small fees, plus continual educa- 
tional efforts, he had best check this part of the questionnaire 
in red so as to determine whether the red marks, indicating 
22 Practice Building Suggestions 
unfavorable conditions, will outnumber those in black indi- 
cating favorable conditions. 
What is the Percentage of Illiterates? 
It is always a serious drawback to any community to have 
among its ranks a high percentage of illiterates. Causes of 
such conditions are varied and should be carefully looked into. 
It perhaps is needless to say that the general purchasing power, 
as well as credit ratings, in such communities are very low. 
What is the Population of the Rural District 
Surrounding the Town or City? 
By adding the totals of both city or town and rural, a grand 
total is determined. The dentist can go a step further in his 
analysis by requesting the population per square mile for the 
rural district. This is important because it will help him de- 
termine to a degree to what extent he can depend upon the 
rural district for support. If the percentage of population 
per square mile is very low, he probably cannot depend, at 
least not for a long time, upon a revenue from it. A sparsely 
populated rural district is as a rule very clannish, aside from 
being averse to seeking the services of a newcomer, while 
a district with a bigger population per square mile is just 
the reverse. 
How many dentists already established? 
Of the total number, how many have modern offices? 
How many have been located less than a period of 
5 years? 
How many have been located from 5 to 10 years? 
How many have been located from 10 to 15 years? 
How many have been located from 15 to 20 years? 
How many of them are advertising dentists? 
Are dental fees in this community small, or medium? 
Do the advertising dentists enjoy a large business? 
All of the foregoing is very important because it will deter- 
mine whether or not the community has more dentists than 
it can support. Usually 1000 people can be allotted for each 
dentist. If it is determined that there are less than this num- 
ber for each dentist in a given community, it would indicate 
too many dentists unless it develops that some of the dentists 
already located are not enjoying their rightful quota due per- 
haps to their unpopularity brought about by various causes, 
23 Practice Building Suggestions 
such as lack of discretion, poor workmanship, non-progres- 
siveness, untidy offices or those completely out-of-date. 
A careful check-up should be made on those dentists com- 
ing under the heading of “advertisers.” These usually locate 
in communities where the population is mostly foreign born. 
Such people are easily misled, and are ready prey for the 
rank advertiser. The ethical dentist has nothing to fear from 
the advertiser, except in such communities where the dental 
society is not harmonious, or where there are more advertisers 
than ethical men, and where it seems the population as a 
whole is satisfied with the service these advertisers render. 
Dental fees in the community should be closely analyzed, 
because they express for the community several very impor- 
tant points. If the average fee is small, it would indicate— 
first, that possibly the buying power per capita is very low; 
second, that perhaps the local dental society is not working 
in harmony; and third, that the advertisers have succeeded 
in placing dentistry for the community on a price basis. If 
the average fee is medium, it would indicate just the opposite. 
How Many Villages and Towns with a Population 
up to joo are within a Radius of jo Miles of the City? 
Farmers and villagers will travel by automobile or rail an 
average distance of 30 miles to obtain good dentistry. If a 
city or town in which a location is being considered has a 
number of villages in close proximity, together with a good 
population of desirable farmer families plus good roads and 
proper railroad facilities, the dentist, if a good mixer, may 
secure as a result of these advantages a goodly number of 
desirable patients aside from his regular city practice. 
How Many Incoming and Outgoing Trains? 
Those cities which have the greatest number of local trains 
during the day naturally act as a drawing power to the sur- 
rounding territory. 
Condition of Roads? 
Good roads leading into a city act as an incentive for vil- 
lagers and farmers to travel to the city by automobile. Good 
roads are more important in many localities than railroad 
facilities. A farmer has to prepare to catch a train, as well as 
24 Practice Building Suggestions 
wait for it. Good roads will bring him to town more frequently 
because he can traverse them at times which suit his conven- 
ience. This is most important, especially at harvest periods. 
How much has Population Increased During 
Last 10 Years? 
To locate in a community whose population is on the increase 
should be of vital interest to every dentist. A gradual, steady 
increase over a ten-year period is a healthy symptom for a 
good location. A phenomenal increase in a short period should 
be looked upon with suspicion. Booms are like balloons. They 
will puncture in due time, and when the puncture occurs 
everything falls flat. There, of course, are exceptions. Rapid 
increases in population brought about by legitimate causes 
should be looked upon with favor. A good, sound manufac- 
turing project will bring about a rapid increase in population, 
and barring national panics the business increases which new 
people bring to a city will remain stable. 
Is the Population Public-spirited? 
A public-spirited community means much to a city. Statis- 
tics prove that where a good public spirit prevails the city 
and surrounding territory, together with its population, are 
very much more up-to-date in almost everything than where 
this spirit is lacking. 
Number of Crop Failures, and how frequently 
during the Past 15 Years? 
If a dentist locates in a community where crop failures are 
a steady diet—that is, every other year—he will be continu- 
ally hampered by having to give long-time credits. Crop fail- 
ures always make for unstable business during the entire year, 
and dentists come in for their share of the burden. 
What is the Value of the Agricultural Crop, and how does 
it compare in quality to that of other communities? 
If the crop values in a given county are to any great extent 
below par of those of adjoining counties, it usually indicates a 
shifting population. This shifting is brought about by farm 
rentals and crop profit-sharing schemes. The people on these 
farms are as a rule disinterested in the community, in addition 
25 Practice Building Suggestions 
to being usually short of funds. Where farm rentals are a 
feature in any community, it usually indicates that values are 
low and that the farms have been neglected. 
What is the Average Value of Farm Land per Acre? 
Farm values have a great influence in the community. High 
values make for a prosperous community, with resultant 
profitable fees for the dentist. Low values reflect just the 
opposite. 
What is the Amount of Total Retail Business 
in the City or Town? 
If the figures show a high average, it means that the popu- 
lation does most of its retail buying with the local merchants. 
If the figures are low, it would indicate that a good portion 
of the buying is done away from the city. The reasons for 
the latter should be carefully looked into. Perhaps the local 
merchants are charging high prices for wares of an average 
quality, or they may be carrying stock which is out of date. 
It should be determined whether the public leaves the city 
in order to do its buying elsewhere. If this is the case, and 
providing their source of retail buying is in close proximity 
to the home city, then it is also likely that most of them 
have their dentistry done in the neighboring city. 
What is the Per Capita Buying Power Per Year? 
If the per capita buying power is low, it also as a rule indi- 
cates that dental fees for this community are low, and that 
the dentist must expect to depend upon volume. If the per 
capita buying power is average or above the average, the den- 
tist can be reasonably sure of a successful limited practice 
with profitable fees. 
What is the Total Number of Automobiles in the County? 
A high percentage of automobiles indicates a progressive 
community, in addition to potential wealth. 
How many Automobiles were Purchased each 
Year Since 1920? 
This is but a step further in determining the wealth of the 
community. Automobile purchases for each year should be 
on the increase, providing the community is progressive. 
26 Practice Building Suggestions 
What is the Status of the Local Banks, and what 
are the Banks' Clearings? 
This information should reveal to what extent the com- 
munity is borrowing money. Normal borrowings indicate 
thrift and expansion. However, a high percentage of borrow- 
ing indicates an inflated condition which is bound to react 
sooner or later. The status of the local banks should be com- 
pared with those in other counties in the state. This will 
give a further insight into the possibilities of the community 
in which a dentist contemplates locating. 
What is the Crop Yield per Acre? 
This will indicate whether full advantage is being taken of 
the soil, and also whether scientific farming is being practiced. 
This should be of interest to the dentist, because scientific 
farming methods mean more money for the community. 
Do the Farmers Engage in Dairying? 
If so, it is further evidence of progressiveness. 
Do the Farmers Engage in Stock Raising, and to what Extent? 
Stock raising, even if only on a small scale, goes hand in 
hand with intensified farming. 
What Manufacturing Plants are there, and What is the 
Total Value of the Manufactured Products? 
Manufacturing in a small city or town is always a healthy 
indication, especially so if the demand for the products is such 
as to keep a full employment the year round. This means 
steady earnings and has a tendency to stabilize conditions, 
at least for the city in which these manufacturing plants are 
located. 
What Percentage of Homes are Owned by Residents? 
If it is found that a large percentage of the homes are 
owned by residents, it indicates further that the community 
as a whole is existing upon a sound financial basis, and that 
the population is thrifty. 
What Percentage of Homes are being Rented? 
Most frequently, if the percentage of homes rented is high, 
it indicates a floating population—that is, people come and 
27 Practice Building Suggestions 
go, remaining in the city perhaps for a year or two, and then 
move elsewhere. If such a condition exists, a steady revenue 
cannot be depended upon over a period of years. If the per- 
centage is low, it would indicate just the opposite. 
What is the Average Wage paid to Wage Earners? 
It is very important that a dentist determine this in ad- 
vance, because it will help him in a measure to find his limi- 
tations so far as fees are concerned. If the average wage is 
low, then his revenue from city patients at least will depend 
almost entirely upon volume. If the average wage is medium 
or high, it would indicate that there are great possibilities for 
him in this community for a limited practice from which he 
may enjoy the proper fees. 
Public Utilities 
If the city enjoys very good service on utilities such as 
water, gas, electricity, street railways, etc., it is always a 
point to the city’s credit, because it would indicate further that 
the community as a whole is progressive. 
If the dentist will carefully investigate all of the foregoing 
features set forth in this questionnaire, he should feel satis- 
fied that he has made a scientific analysis, and if the favorable 
findings outnumber the unfavorable, then the dentist should 
feel secure in knowing that he has a future before him in such 
a community. The following is a summary of all the fore- 
going features to investigate in a given community, in ad- 
dition to which we have added what to look for when only a 
preliminary analysis is being made. 
Population of Town or City 
Proportion of American and Foreign born? 
What is the population of the rural district surrounding 
the town or city? 
How many dentists already established? 
Of the total number, how many have modern offices ? 
How many have been located less than a period of 5 years? 
How many have been located from 5 to 10 years? 
How many have been located from 10 to 15 years? 
How many have been located from 15 to 20 years ? 
How many of them are advertising dentists? 
Are dental fees in this community small, medium or large? 
28 Practice Building Suggestions 
How many villages and towns with a population up to 300 
are within a radius of 30 miles of the city? 
How many incoming and outgoing trains? 
Conditions of roads. 
How much has population increased during last 10 years? 
Is the population public-spirited? 
Number of crop failures, and how frequently during the 
past 15 years. 
What is the value of the agricultural crop, and how does 
it compare in quality to that of other communities? 
What is the average value of farm land per acre? 
What is the amount of total retail business in the city or 
town? 
What is the per capita buying power per year? 
What is the total number of automobiles in the county? 
How many automobiles were purchased each year since 
1920? 
What is the status of the local banks, and what are the 
banks’ clearings? 
What is the crop yield per acre? 
Do the farmers engage in dairying? 
Do the farmers engage in stock raising, and to what extent? 
What manufacturing plants are there, and what is the 
total value of manufactured products? 
What percentage of homes are owned by residents? 
What percentage of homes are being rented? 
What is the average wage paid to wage earners? 
Public Utilities. 
Things to Look for in Connection with a 
Preliminary Analysis 
Up-to-date stores which every progressive community 
should have— 
Agricultural, farm implements, 
machinery 
Grocery Stores 
Jewelry 
Musical instruments, such as 
pianos, phonographs, etc. 
Books 
Wearing Apparel 
Candy and Confections 
Automobiles and Auto Ac- 
cessories 
Drugs 
Printing and Stationery 
Hardware 
29 Practice Building Suggestions 
Home equipment—furniture, 
etc. 
Electrical supplies 
Picture Theatre 
Dry Goods 
Shoes 
Men’s Furnishings 
Millinery- 
Churches 
Newspapers 
Plumbing 
Lumber and other contracting 
materials 
Hospitals and Schools 
Restaurants 
Suburbs 
Every large city has numbers of suburbs which afford ideal lo- 
cations for the dentist. Suburbs can be divided into three classes: 
i. Suburbs whose population is made up chiefly of 
steel workers, packing house employes, railroaders and 
those employed in various manufacturing plants, aside 
from those engaged in conducting retail stores, etc. 
i. Suburbs whose population is made up of those 
whose yearly incomes range from $3000 to $7500 per 
year. This class is usually employed in diversified lines 
in the adjacent large city. 
3. Suburbs whose population is somewhat exclusive 
and those that enjoy yearly incomes above $10,000. 
First Classification of Suburbs 
Almost any dentist can establish a successful practice in 
the first classification given. However, he must be sure that 
his personality is such as to fit in with the people making up 
the various classes as listed. He will do well to first consider 
whether he is willing to put up with inconveniences, such 
as practicing at night. It is not always possible for factory 
workers to leave their posts of duty during the day, and aside 
from this the dentist must remember that the earnings of the 
great majority of male patients cease when time is taken off 
during working hours. This makes it necessary for them to 
patronize those dentists who are willing to make evening 
appointments. 
He should determine whether the industries which make up 
the community afford steady employment to the population 
30 Practice Building Suggestions 
the year round. Very frequently certain plants close down for 
several months at a time. The causes for these shutdowns are 
varied. Some of them are due to lack of business, others to 
seasonal demands, and still others to labor troubles. If these 
shutdowns are of frequent occurrence, then a dentist will do 
well to avoid such a community unless he is satisfied to wait 
for seasonal demands for the commodity being manufactured, 
and again to await settlement of labor disputes. The dentists 
in such communities must bear the burden of depression along 
with the general population. Usually after a period of idleness, 
the very first people who were good enough to extend credit are 
the last to be paid up—that is, the dentist and the physician. 
When everything goes well with the industry, then it is true 
that the dentist will enjoy prosperity along with the rest, be- 
cause under those conditions money is spent freely. However, 
when shutdowns occur, the dentist’s earnings are greatly 
diminished, and it takes considerable time for financial recu- 
peration to take place in these communities. 
Fees above the average are seldom, if ever, attained, and the 
dentist who would locate in such a community must be sat- 
isfied to practice early and late for nominal fees, and must 
depend for his yearly gross income purely upon volume of 
practice rather than phenomenal fees. 
When deciding upon office space in these communities, he 
should do so with the thought of convenience for his patients. 
He should choose a building located on a street which is trav- 
ersed daily by the majority of the population. He will do well 
to choose a building located in the heart of the retail district. 
This makes it convenient for the women and children upon 
whom he will practice during the day, as well as for the men 
upon whom he will practice at night. Aside from the location 
of the building, his office within it should be so situated that 
it can be easily found by the people coming to him. If possible, 
his operating rooms should face the street. His window signs 
should be of such color and size that they can be easily seen. 
In such communities a certain amount of window publicity 
is necessary, because people are attracted by it. 
To locate an office within a dwelling or an apartment house 
in these communities seldom makes for success, especially 
so if the location is away from the retail district. People in this 
31 Practice Building Suggestions 
class of suburb like to traverse the busy streets upon which 
retail stores are located, and are not attracted to the beginner’s 
office if it is located away from the busy section. Successful 
practices have been conducted in residences in these com- 
munities, but usually not until the dentist has become thor- 
oughly acquainted as well as established. 
It is not intended to discourage dentists from locating in 
communities as described in the foregoing. It is true that many 
successful practices are being conducted in them, but only 
by those dentists who know how to fit in, who understand 
the problems of those in the manufacturing localities, who can 
join them in their joys and sorrows, who are willing to act in 
an advisory manner, who can display patience in connection 
with dental education, who are anxious to give their very best 
dental services for a nominal fee, and who are content to 
fraternize sufficiently that these people may know the dentist 
is their friend. The dentist who can fit in such a community 
will secure and enjoy patients right from the start. 
In connection with locating in a suburb of a large city whose 
industries are those listed in Classification No. i, the following 
analysis should be made, the explanations for which can be 
found under duplicate headings as listed under “Small Towns 
and Rural Districts.” 
Proportion of American and Foreign born. 
How many dentists already established? 
Of the total number, how many have modern offices ? 
How many have been located less than a period of 5 years ? 
How many have been located from 5 to 10 years? 
How many have been located from 10 to 15 years? 
How many have been located from 15 to 20 years ? 
How many of them are advertising dentists ? 
Are fees in this community small or medium ? 
How much has population increased during the past 10 
years ? 
Is the population public-spirited? 
What manufacturing plants are there, and what is the total 
value of manufactured products? 
What percentage of homes are owned by residents? 
What percentage of homes are being rented ? 
32 Practice Building Suggestions 
What is the average wage paid to wage earners? 
Public Utilities. 
What is the amount of the average savings account at 
the bank? 
It is not always possible to get this information from banks. 
However, when it is available it will be of assistance to the 
dentist in determining to what extent laborers are practicing 
thrift. A manufacturing district in which a great percentage 
of the population enjoys savings accounts at the banks should 
convince the dentist that his practice will not be impaired to 
any great extent when shutdowns of mills and manufacturing 
plants occur, and again during periods covering labor contro- 
versies. 
How frequently have Shutdowns Occurred during 
the past five years? 
These should be carefully looked into and analyzed sufficient- 
ly so as to determine the causes. If the nature of the commodity 
being manufactured is such that shutdowns are bound to occur 
frequently, even in normal times, then the dentist had best 
avoid such a community unless he is satisfied to have his 
practice fluctuate—that is, to be busy for six months of the 
year, and to be idle for the balance. 
How frequently have Strikes Occurred during the past 
five years, and What were their Causes? 
If your investigation proves that strikes have been fre- 
quent and their causes of such a nature that have never been 
thoroughly settled, then it is reasonable to believe that recur- 
rences will continue. Frequent strikes always make for weaken- 
ed business conditions in a community, and the dentist must 
decide whether he is willing to carry his share of the burden. 
Does the Community Support Public School Dental Clinics? 
If so, it would indicate that the community is being educated 
in mouth hygiene, all of which creates a demand for better 
dentistry. If an investigation proves that public school dental 
clinics are not yet in evidence, it would indicate that the local 
dental society is not progressive, and possibly that it is not 
working in harmony. In the absence of these clinics, the dentist 
should determine whether he can be instrumental in getting 
33 Practice Building Suggestions 
them established, and whether or not he is willing to do his 
share in contributing to the teaching of mouth hygiene in 
the community. 
Things to Look for in Connection with a 
Preliminary Analysis 
Up-to-date stores which the community should have: 
Wearing Apparel 
Candy and Confections 
Automobiles and Auto Ac- 
cessories 
Drugs 
Printing and Stationery 
Hardware 
Home Equipment—Furni- 
ture, etc. 
Electrical Supplies 
Picture Theatre 
Dry Goods 
Shoes 
Men’s Furnishings 
Groceries 
Jewelry 
Musical instruments, such as 
pianos, phonographs, etc. 
Books 
Millinery 
Churches 
Plumbing and supplies 
Lumber and other contracting 
materials 
Hospitals and Schools 
Restaurants 
Second Classification of Suburbs 
The second classification, pertaining to the middle class 
which is located in suburbs, requires a more careful analysis 
than the manufacturing suburb, because the dentist must be 
more particular in the selection of his office space, and further 
because the people in these communities are more exacting 
in selecting a dentist. 
The tendency of the middle class in recent years aside from 
making rapid business progress, is to live up to the limit of 
their incomes. In other words, they want to appear in every 
respect as possessing considerably more than is actually the 
case. In their anxiety for business and social gain, they be- 
come associated with various clubs, fraternities and civic 
organizations, and through these various affiliations patronize 
in a business way those people with whom they become 
acquainted, and who are also interested in the same social 
pursuits. 
Those dentists who would practice upon the middle class in 
the suburbs must therefore depend upon acquaintanceship, 
plus recommendations, if they would establish in short order 
a growing practice. Aside from the actual establishment of 
34 Practice Building Suggestions 
the office, the dentist will make his first step in the right direc- 
tion if he will become affiliated with a fraternal organization 
the majority of whose members will make desirable patients. 
To be taken in by such an organization will in itself not help 
unless the dentist takes an active interest in not only the 
work itself, but also in religiously attending each meeting, 
cheerfully serving on various committees, and making it a 
point to meet each and every member. 
He should become affiliated with civic organizations, espe- 
cially those which are interested in furthering the interests 
of the suburb. He must let it be known that as a citizen he is 
interested in the advancement of the community, and so as 
to give proof he should not only be willing to serve when called 
upon, but should make a study of what the community needs, 
and then be ready to make his suggestions at the proper time. 
Even very small suburbs have their civic organizations such 
as commercial clubs and others known as Rotary, Kiwanis, 
Optimists, Lions, etc. etc., and it is with such that the dentist 
can become quickly established, gaining prestige aside from 
social enjoyment, and through it all gain ethical publicity 
which is so essential to his success. All of this makes for good 
citizenship. 
Becoming established in a suburb whose population is chiefly 
made up of the middle class is far more difficult than becoming 
established in those where the laboring class predominates. 
In them, aside from equipping the office and a month’s rent 
in advance, usually no other capital is necessary. However, 
in the suburb of Class 2 the dentist must have some working 
capital. The middle class does not respond as quickly as the 
laboring class. It sometimes requires months before the 
dentist can make sufficient headway in securing patients. 
Therefore if he decides to locate in such a suburb and to be 
successful in it, he should have sufficient cash on hand to carry 
him over a period of at least three months in the event that 
patients do not come to him from the start. 
Just where in the suburb he is to have his office depends 
entirely upon the makeup of the retail store section. Office 
buildings in these suburbs usually are of three or four stories. 
The dentist should try to locate in the one which not only looks 
modern, but has for its tenants the best dentists, physicians and 
35 Practice Building Suggestions 
lawyers, etc. in the community. Frequently space is not avail- 
able, and if upon investigation it proves that all of the space 
is taken up on long leases, then the dentist will be wise in locat- 
ing in a building of less modern construction, but which is in 
close proximity to the favored one, and also close to the main 
intersection. 
Rather than locate in an office building which is on an 
“off” street and noted for its vacancies, the dentist will fare 
better if he will establish himself in a modern apartment house 
or a residence. Physicians have recognized the value of resi- 
dence offices in suburbs, and usually are interested in sub- 
letting space to a good dentist who will not only help to make 
their office unit complete, but also enhance the neighborhood, 
at least for medical and dental patronage. The physician 
who is willing to sub-let his space to a dentist is naturally 
anxious to see him succeed, and therefore is a valuable aid 
to the dentist in helping him get started in the community. 
In the suburbs whose population is made up of the middle 
class, the dentist cannot expect to get many male patients for 
the reason that a great percentage of them are engaged in 
business activities in the adjacent large city. As a rule, these 
men have their dentistry done away from the suburb only 
because it is more convenient. This would lead one to believe 
that the wives and children of such men also secure their den- 
tistry from the same source. However, it must be remembered 
that as soon as it is known that a good, conscientious dentist 
has become established, the women and children will soon 
patronize him because it is more convenient for them. If the 
dentist’s service to them is pleasing, then in time he will pro- 
bably also enjoy the patronage of the heads of the families. 
In connection with locating in a suburb of a large city whose 
population is made up of the middle classes as listed under 
Classification No. 2, the following analysis should be made, 
the explanation for which can be found under duplicate head- 
ings listed under “Small Towns and Rural Districts:” 
Population of the suburb? 
How many dentists already established? 
Of the total number, how many have modern offices ? 
How many have been located less than a period of 5 years ? 
How many have been located from 5 to 10 years? 
How many have been located for a longer period? 
36 Practice Building Suggestions 
Are dental fees in this community small, medium or large ? 
How much has population increased during the last io years? 
Is the population public-spirited? 
What percentage of homes are owned by residents ? 
What is the average value of residences which are owned by 
the occupants? 
What percentage of the population is renting residences 
and apartments? 
What is the average rental for residences and apartments? 
If the rentals are very high, it is further evidence of the class 
of people living in the suburb, and also gives a further insight 
into their earning power. 
Are there Evidences of many Vacant Residences and 
A-partments? 
If so, it might indicate that real estate values are greatly 
inflated, and that because of it people are not moving into 
the suburb. This in a measure would indicate that its growth 
is being dwarfed. 
Do the Majority of the Residents Dress Fashionably? 
If so, it would be further evidence that it is possible to secure 
dental fees above the average, providing the dental suite 
expresses modernity. On the other hand, if the majority of 
the people seem to dress so fashionably that it becomes sen- 
sational, it might be well, in the event that the dentist decides 
to locate, to watch very carefully his accounts where sensa- 
tional style seems to be in evidence. It is often the case that 
many of these patients which a new dentist might secure have 
poor credit ratings. If the residents are up-to-date but conserv- 
ative in the matter of attire, it would indicate a more desirable 
population. These people will pay a fee commensurate with 
the dental services rendered. 
Condition of Office Buildings, Store Windows, 
Streets, Residences, and Lawns 
If all of these are well-kept and orderly looking, it would 
indicate a prosperous suburb. If the appearance of these 
is contrary to the foregoing, then it would indicate a failing 
suburb. 
37 Practice Building Suggestions 
Is there much Activity in the Business Section at Night? 
If the picture theatres, refreshment shops and restaurants 
seem to be doing a thriving business in the evening hours, it 
would be a further evidence of progressiveness for the commu- 
nity. 
Things to Look for in Connection with a 
Preliminary Analysis 
Up-to-date stores and merchandise, which should be modern 
in every respect: 
Candy and Confections 
Automobile Accessories 
Drugs 
Picture Theatres 
Dry Goods and Notions 
Shoes 
Men’s Furnishings 
Groceries 
Delicatessen 
Books 
Millinery 
Churches and Schools 
Restaurants 
Ladies’ Hairdressing and 
Manicure Establishment 
Barber Shops 
Library 
Exclusive shops specializing 
in children’s apparel, as 
well as apparel for women 
Smoke shops 
Banks 
Florist 
Stationery 
Third Classification of Suburbs 
Some dentists leave college with the thought of immediately- 
securing a practice made up of very exclusive people, and they 
believe that the quickest way to reach this goal is to establish 
an office in a suburb whose population is made up of such 
people. Patronage of the wealthy in such communities is 
only secured after years of establishment. Wealthy patients 
are usually satisfied with their dentists, and it is only occa- 
sionally that a person of wealth will discontinue the service 
of one dentist in favor of another. The dentist who locates in 
a suburb composed of wealthy citizens must be reconciled to 
the fact that he will have a long period of “waiting” ahead 
of him, and he must have sufficient funds not only to carry him 
through such a period, but also to allow him to keep up his 
end socially. 
To serve in a scientific manner, and to give complete satis- 
faction to just one wealthy patient will almost immediately 
bring others, providing the dentist’s personality, his office and 
its surroundings are such as to draw favorable comment from 
38 Practice Building Suggestions 
such patients. The dentist who would draw these patients 
to him must of necessity be located in the best office building 
in the suburb, or in a bungalow office. It has been noted that 
dentists who are most successful in catering to this class of 
patient are usually located in bungalow offices, which are situ- 
ated in an exclusive section of the suburb. 
In connection with making a community analysis of the 
exclusive suburb, we would suggest the same as listed under 
Classification No. 2. 
Large Cities 
Every large city offers to the dentist advantageous locations, 
providing he knows how to recognize the good from the poor. 
This should not be a difficult matter, if a careful analysis is 
made of those which seem the most likely, and through it 
select the one which offers the greatest number of opportu- 
nities. A consideration of the following points will assist in 
making a “scientific analysis.” 
No doubt the middle class residential section offers the 
quickest returns for the dentist, especially the beginner. In it 
acquaintances are more easily formed than in the business 
section, or even in those residential sections made up princi- 
pally of the wealthy. Prestige is more quickly established, 
because the dentist will be drawing patients from a small 
area, which means patients through recommendations provid- 
ing the service he renders is pleasing to those coming to him. 
In these sections, providing dentists are not too numerous, a 
mere window, door or porch sign will create comment in the 
neighborhood. As a result of it he will draw patients from the 
very beginning, especially women and children, principally 
because it is more convenient for them than if they have to 
travel a considerable distance to a dental office. Children need 
not be kept home from school in order to get dentistry, and 
women will patronize the neighborhood dentist because it 
will allow them to return to their homes long before their 
children are expected from school or the head of the family 
returns home for dinner. This convenience is not always 
possible if these patients are obliged to leave the neighbor- 
hood for dentistry. In residential sections a dentist can make 
Residential Section 
39 Practice Building Suggestions 
or break himself in the beginning depending entirely upon 
his personality and the service he renders. 
The class of neighborhood in which a dentist would locate 
will depend entirely upon himself. In some, the population is 
made up of foreigners, plus their American-born children. 
Again the population of foreigners and Americans may be 
evenly divided. If an investigation proves that foreigners 
are in the majority, then it should be determined if they are 
of a nationality which can appreciate good dentistry and are 
willing to pay a fee commensurate with the service rendered, or 
if it is possible through educational measures to bring them, 
in time, up to a proper standard. The fact that foreigners are 
in the majority should not be held against the neighborhood, 
if they are of a nationality known for their thriftiness, interest 
in their families, determination to own their homes, and have 
the qualities which go to make up good American citizens. 
Usually the dental fees in these neighborhoods are at their 
best only nominal, but this is offset by the fact that the dentist’s 
overhead is much lower than in neighborhoods where fees are 
higher. The low fee is further offset because these people 
almost always pay cash in advance for dental services, or as the 
work progresses. This virtue cannot always be claimed for 
those neighborhoods where fees are higher. The neighborhood 
in which Americans are in the majority always makes for a 
good location and practice, because dentistry with these is a 
popular subject. 
The types of buildings in residential sections in which the 
dental office is to be located are store buildings, apartment 
houses and residences. 
These are two or three stories high. The stores are usually 
occupied by druggists, confectioners, milliners, haberdashers, 
hardware merchants, notions, delicatessens and groceries. 
This type of building makes for an ideal location, because 
usually it is centrally located in the community and draws 
people to it. The second floor is the proper office location, 
because the window signs can be easily seen from the street 
and this makes for publicity. The dentist will be wise in hav- 
ing his office located on the street side in preference to having 
it face into a narrow court or overlook an alley. Aside from 
Store Buildings Located on Corners 
40 Practice Building Suggestions 
being narrow and dingy, these courts do not afford proper 
ventilation for the dental suite. Alleys in back of store build- 
ings are usually disorderly, in addition to being noisy, etc. 
In the absence of an elevator, the third floor of the buildings 
described should be avoided. Patients these days do not like 
to climb stairs. However, if the building has an elevator, the 
third floor should be a second choice, providing the dental 
suite can be located overlooking the street. To have it over- 
look an adjoining flat roof upon which may be hung the family 
washing, in addition to being a dumping place for odds and 
ends, detracts from the dignity of the suite. 
Apartment Houses 
Providing it is properly located in the neighborhood, the 
apartment house often makes a desirable location. The rental 
of an apartment for the dentist can be brought to a minimum 
providing he has a family which will use the unused portion 
of the apartment for living quarters. This can be arranged 
after a proper planning of the dental suite has been effected. 
If the dentist is minus a family, it is advisable to sub-let the 
balance of the apartment to a small family of adults. 
The character of the tenants in the apartment house should 
be carefully investigated so as to make sure that they are of 
a calibre beyond reproach. The reputation of the apartment 
house must also be investigated, so that the dentist may be 
sure that its name on his stationery will not besmirch his 
prospects for building a practice made up of reputable patients. 
The apartment house should be located, if possible, in close 
proximity to a store corner, as well as to transportation facili- 
ties, etc. If its location is advantageous, and the investiga- 
tion proves that its name and the character of its tenants 
are reputable, then the dentist should try to locate his suite 
on the first or second floor, facing the street, because he must 
have window signs in addition to a sign in the main entrance 
hall. Many people might not expect to find a dentist in an 
apartment house, and for this reason he should display a 
sign from his windows. If the apartment house affords ele- 
vator service, the third floor would also be desirable. Locat- 
ing above the third floor will depend entirely upon the neigh- 
borhood, and also the size of the apartment house. If apart- 
ment houses in the neighborhood are numerous, as well as 
41 Practice Building Suggestions 
big in size, and providing a telephone operator is located in 
the main vestibule, then in such cases a location on the upper 
floors might prove satisfactory. 
The main entrance vestibule or hall of the apartment house 
should have an attractive and inviting appearance, as well as 
the upper hallways. Noise and odors of cooking should not 
be in evidence. The dentist will do well to note these points 
upon his first visit, because they will help him determine 
the character of the house at first hand. 
Residences 
In certain sections of the country, especially in states located 
along the Atlantic and Pacific coasts, dentists and physicians 
seek a residence in which to establish the office suite. This 
is particularly true in neighborhoods where everything tends 
to exclusiveness. There is no doubt but that the private 
house affords seclusion for the dentist and his patients in a 
greater measure than the office or store building, as well as the 
apartment house. However, the rental of a good looking 
residence is a heavy burden unless the dentist can sublet the 
space not needed to desirable tenants, or if he has a family 
to also make it his home. However, in that event he must 
have an absolute dividing line between his office suite and that 
part used by his family or tenants. By a dividing line we mean 
such an arrangement that will set the dental suite entirely 
apart from the rest of the house. He must have a distinct 
understanding with his tenants or his family not to enter 
the dental suite except on urgent business. To avoid any con- 
fusion along this line, it is best to have a separate entrance 
to the dental suite for patients and a side entrance for members 
of the family. 
It perhaps is needless to say that the house should be kept 
up to best advantage. One sadly in need of a coat of paint 
will not promote a good impression, at least from an outside 
viewpoint. The lawn and shrubbery must not be forgotten. 
In fact, everything must be done to give the house and grounds 
that distinctive touch which not only invites favorable com- 
ment, but also impresses those patients who seek exclusive- 
ness. 
In connection with locating in a given neighborhood of a 
large city, the following analysis should be made, the explana- 
42 Practice Building Suggestions 
tions for which can be found under duplicate headings as listed 
under “Small Towns and Rural Districts” as well as “Suburbs.” 
What is the total population of the neighborhood you 
expect to serve? 
Of the total population, what is the percentage of American 
and foreign born? 
How many dentists are already established in the neighbor- 
hood? 
Of the total number, how many have modern offices ? 
How many have been located less than a period of 5 years? 
How many have been located from 5 to 10 years? 
How many have been located for a longer period? 
When deciding upon a neighborhood, the dentist should 
not be influenced for or against it by the number of dentists 
already established. It might appear in some neighborhoods 
that there are more dentists than the population can support. 
Whether this is true or not can only be determined by an analy- 
sis of each dental office and the quality of service which it 
renders. If all of the dentists have modern offices and their 
services are on a par with them, and providing all things are 
equal with regard to ability, personality, honesty, enthusiasm, 
diplomacy, etc. etc., and it has been proven that about half 
of these dentists are only enjoying a nominal practice, then 
it might be an indication that there are more dentists in the 
neighborhood than can be properly supported by it. 
If the investigation proves that only a few of them have 
modern offices, plus the requisites as mentioned in the fore- 
going paragraph, and that those dentists are enjoying a good 
practice, then it would be a good neighborhood in which to 
locate providing the others already located who are not 
making good have offices other than those expressing modern- 
ity, and lack the necessary requisites already referred to. 
Are dental fees in this community small, medium or large? 
Is the neighborhood public-spirited? 
What percentage of homes are owned by residents ? 
What is the average value of residences which are owned 
by the occupants? 
The average value for homes in the neighborhood will 
depend entirely upon the class of residents. If the neighbor- 
43 Practice Building Suggestions 
hood is made up of laborers, skilled mechanics and such others 
as are employed as clerks in stores, etc. etc., with an average 
yearly income of $2400, then the average value of residences 
owned by the occupants should be not less than $7500. If 
your investigation proves under the foregoing conditions that 
values are less than this amount, it would indicate a failing 
neighborhood. 
If the neighborhood is made up of the middle class, whose 
occupational pursuits are those of skilled artisans, salesmen, 
professional people etc., whose salaries range from $3000 to 
$7500 per year, the average value of residences should be 
about $10,000. If the average proves considerably less, it 
would indicate an unrestricted neighborhood, with the pos- 
sibility of it being on the downward trend. 
What percentage of the population are renting residences 
and apartments? 
Are there evidences of many vacant residences and apart- 
ments? 
Condition of store buildings, store windows, apartment 
houses, residences, streets and lawns. 
Public School 
Is it in close proximity to the neighborhood? 
If so, what is its progressive status—that is, does it have 
a Parent-Teacher Association? 
Are the pupils occasionally addressed upon important 
subjects by members of the Chamber of Commerce, 
Rotary Club, etc., etc.? 
Are socials frequently held within the school building for 
parents of pupils? 
Are the principles of mouth hygiene being taught the pupils? 
All of these things, if in evidence in the public school, would 
indicate an intelligent and progressive neighborhood. 
Things to Look for In Connection with a 
Preliminary Analysis 
Every live neighborhood should have somewhere in close 
proximity to it the following stores. The modernity of the 
stores themselves, together with the merchandise carried, 
will depend entirely upon the class of people predominating. 
44 Practice Building Suggestions 
Candy and Confections. 
Drugs. 
Picture Theatres. 
Notions. 
Groceries. 
Delicatessen. 
Millinery. 
Churches and Schools. 
Library. 
Haberdasher. 
Main Business Sections of Large Cities 
Occasionally we hear of a dentist—perhaps a newcomer 
to a large city, without a friend or patient in it—who has lo- 
cated in a large building in the main business section and has 
made good. Upon investigation we find that such dentists 
usually locate with sufficient funds to carry them over long 
periods while they become acquainted with a select class of 
people. There is nothing secretive about their success. In 
fact, any dentist who is financially able to carry the overhead 
of an office in the main business section over a period of months 
without a penny of revenue can be just as successful, providing 
he is alert to opportunities offered daily in attracting patients. 
Aside from being able to render scientific service in the 
proper environment, and possessing all of the requisites as 
mentioned in the first section on “Law of Supply and Demand 
and Factors Affecting It,” he must bubble over with his 
enthusiasm for dentistry, in addition to being a good mixer. 
He must be able to make friends with every person he meets, 
without first stopping to draw a line of class distinction. 
His method of building a practice should be upon the basis 
that every man, woman, and child is his friend. This must 
not be surface evidence, but must radiate from his heart. 
The cigar clerk, the elevator starter and operator, the barber, 
neighbor tenants to his office, guests at the hotel as well as 
the clerk (if his living quarters are such), or the neighbors in 
the apartment house in which he might live—all of these must 
be attracted by his winning personality, his sincerity and his 
ability to make and give lasting good impressions. 
He must be financially able to go to places where he will 
meet the class of people whom he would desire as patients. 
People must take to him sufficiently to unhesitatingly invite 
him to attend various meetings given by business men’s 
associations, where he will again meet others who will be 
interested in him further. Churches and their social activi- 
ties, as well as fraternal organizations—all of these should 
come under this dentist’s survey. If he is a master in operative 
45 Practice Building Suggestions 
technique, he should let his talents be known to members 
of the dental society, and never miss an opportunity to read 
a paper, if invited, or to enter open discussions, especially 
upon subjects he is thoroughly familiar with. This will im- 
press his confreres, especially those who have a continual 
overflow of patients. Frequently the busy downtown dentist 
will send referred patients to the newcomer, if he has proven 
himself with the dental society, and has given evidence to 
its members of his whole-hearted spirit of co-operation and his 
desire to serve. All of these things go to make up a practice, 
and the dentist who would ignore them had better be satis- 
fied to first locate in a small community or residential section, 
and build a practice sufficiently large so that he may be sure 
some of it will follow him to the main business section when he 
is ready, thus giving him at least some assurance of having 
patients to start on in the presence of a continual heavy 
overhead expense. 
The majority of dentists located in the main business sec- 
tion of a city first established a practice in the residential or 
outlying districts. As a result of a large general practice, 
brought about through years of faithful effort and an ever- 
increasing demand for their services, these dentists come to 
have a yearning for a limited practice, retaining only their best 
patients and eliminating those not so desirable. As the goal 
of a limited practice cannot be attained in the location where 
the dentist established himself in general practice, he must 
locate in the type of building where he cannot be reached or 
called upon by patients during hours other than set aside for 
rendering dental services. Some dentists find that many of 
their best patients have to pass through the main business 
section in order to reach the dental office, which may be located 
on the opposite side of the city from that in which these pa- 
tients live. In such cases, in order to hold these patients, 
dentists find it necessary to locate in the main business sec- 
tion, thus making it more convenient for these patients, in 
addition to giving the dentist an opportunity for a controlled 
practice. 
There are other dentists who find that a majority of their 
patients are employed in the main business section. To expect 
these patients to patronize the dentist located in an outlying 
46 Practice Building Suggestions 
residential district is thrusting a hardship upon them, and so 
as to make it more convenient, aside from the assurance of 
holding these people, such dentists will be wise in locating in 
the business section. 
All dentists appreciate the advisability of locating in the 
main business section when discontinuing a general prac- 
tice in favor of a specialized one. Such dentists have to depend 
to a great extent upon their confreres for referred work, and 
therefore it is necessary for them to locate where it is most 
convenient for these confreres and their patients. In short, 
people from all sections of the city come to the business section 
with some frequency, and this therefore opens a large field 
to the dentist located in'it, providing he has a certain amount 
of established practice to go on. 
Where to Locate in the Main Business Section 
A location should be sought in that section noted for its 
exclusive retail shops. As a rule, professional buildings are 
also located in these districts, which all in all tends to make up 
a genteel retail section, and recognized as such by the city at 
large. 
Any observer will note that the best of various retail lines 
will group together at a given point in a business section. 
This is also true of professional talent, and therefore a dentist 
should try to locate among a group, or in close proximity to 
a group of dentists and physicians noted for their ability, and 
who have succeeded in popularizing that section in which they 
are located as containing the best talent which can be obtained. 
The professional building ofFers advantages which are not 
found in ordinary office buildings. These are genteel environ- 
ment, professional atmosphere, dental and medical libraries, 
professional club rooms, cleanliness, quietness, seclusion, 
desirable neighboring professional tenants, convenient short- 
notice professional consultations, both dental and medical. 
Aside from these, the suites are usually properly planned, 
plus the many requisites which go hand in hand toward proper 
dental office planning. Professional buildings are usually 
attractive, and provide such other impression-making fea- 
tures as efficient and noiseless elevator service, building em- 
ployes dressed in uniforms, light, airy and clean corridors, and 
convenient parking areas for automobiles. 
47 Practice Building Suggestions 
Office Buildings 
Many of them contain desirable office suites for the dentist, 
and may be looked upon with favor providing the building 
is located on a busy corner or street commonly known and 
easily accessible to transportation facilities. Offices in these 
buildings were not originally designed for dentists, and there- 
fore space should be selected with the thought of being able 
to incorporate all of those necessary features which go to make 
up a modern dental suite. The agents for these buildings 
usually balk at the many changes that a dentist requires. 
However, most of them can be made to see the light by sug- 
gesting a five or ten year lease. Before signing a lease covering 
a period of years, however, the dentist had best make a care- 
ful analysis with regard to the trend of the retail business in 
that section in which the building is located, the class of 
people daily passing the building and the status of the tenants 
within it. 
Observation will tell whether the retail stores located within 
a block or two either way from the building are of a class 
attracting the more discerning retail shoppers. This can best 
be proven by not only observing the people who go in and 
out of the stores, but also by the attractiveness of the store 
windows, as well as the quality of goods on display. 
A further step should be taken by entering the various stores 
so as to observe their modernity with regard to display cases, 
stocks and the type of clerks employed. If it appears that the 
best stores in the group seem crowded for space, and if this can 
be brought out through conversation with some of the clerks 
as well as the floor man, then it might be reasonable to believe 
that some time, perhaps in the near future, these merchants 
will vacate to other quarters where they will have an oppor- 
tunity for expansion which might not be possible in their 
present location. If this is true, then there is a possibility that 
the next merchant moving into the store will carry a cheaper 
line of merchandise, which will appeal only to a less desirable 
class and if several of such merchants should succeed in enter- 
ing the business block, it would tend to put the section on the 
downward trend so far as the professional man is concerned. 
The dentist who expects to cater to a genteel class of patients 
should consider that they are not apt to come to a building 
48 Practice Building Suggestions 
located on a street where evidence points to a low standard of 
pedestrians. On the other hand, if it is a mixed class of people 
passing the building throughout the day, it would be a point 
in its favor, although not as promising as when observation 
proves that the majority of the people are of the middle and 
wealthy classes. 
The status of the tenants in the building should be carefully 
defined, and particularly those located on the same floor 
considered by the dentist. If the building is noted for its em- 
ployment agencies, loan offices, justice courts, etc. etc., it will 
probably not be a building to which a dentist would care to 
invite his patients. On the other hand, if the tenants are made 
up of lawyers, physicians, dentists, hair dressing and mani- 
cure parlors and small exclusive shops, then it will probably be 
a good building in which to locate, providing the entrance 
to the building and the corridors, as well as the rooms them- 
selves, are light, airy and clean. It perhaps is needless to say 
that an unattractive entrance, as well as dark and dingy cor- 
ridors, do not make for a pleasant environment for tenants. 
The elevator service should be frequent and efficient, and 
the building employees, such as the elevator starter and oper- 
ators, should be dressed in uniform. The better office buildings, 
catering to a mixed class of tenants such as lawyers, phy- 
sicians, dentists, real estate, osteopaths, oculists, insurance, 
building associations, etc. etc., and exclusive shops under which 
can be listed children’s wearing apparel, ladies’ wearing 
apparel, jewelers, opticians, hair dressing and manicure 
establishments, milliners, etc. etc., usually segregate all of 
these tenants according to class. The first few floors are re- 
served for exclusive shops. A floor is set aside for lawyers, 
real estate, insurance, etc., and the balance of the building 
perhaps for dentists, physicians, osteopaths and oculists. 
If the building which is being considered as a location has this 
arrangement, it would be a point in its favor. However, if 
all of the tenants as listed in the foregoing are scattered 
throughout the building, so that a physician’s office may be 
next to a hair dressing establishment and a dental office im- 
mediately adjacent to a jewelry shop, it would indicate that 
the building is being poorly managed, and that it is anything 
but up-to-date. 
49 Practice Building Suggestions 
SECTION III 
Ethical Publicity 
A DENTIST cannot avail himself of the same publicity 
methods used by those engaged in commercial pur- 
suits. He cannot talk about his ability as a dentist. 
Neither can he sit in a modern dental office and wait for pa- 
tients to come to him. Whether patients come to him or not, 
his expense goes on just the same and it is therefore necessary 
to leave nothing undone in an ethical way that might help 
to bring patients to the office. 
When a patient consents to have a dentist do her work, 
he should be sure to give her a thorough understanding of the 
very high class work which he is about to do for her. She 
should be so enthused with his health talks and what she is 
to get in the way of actual work that she cannot help feeling 
that she is getting the best, and will go out and advertise this 
fact to other people. The mistake most dentists make is doing 
the work for the patient without saying anything about it 
to them. It makes no difference how fine a piece of work a 
dentist places in the patient’s mouth, if he does not tell her 
anything about it, the patient will never know of its virtues, 
except perhaps, that it is giving her satisfaction, from the view- 
point of mastication. This is not enough for her to know 
because otherwise it may be hard for her to reconcile the fee 
with the work performed. 
Perhaps this same patient, if told all about the work and just 
what it will do for her in the way of improving her personal 
appearance as well as her health; increasing her efficiency 
generally and an explanation of minute mechanical refine- 
ments, will enthuse to the extent of going out of her way to 
laud the dentist’s praises. To have a patient make the follow- 
ing remark to her friends is the finest kind of advertising and 
cannot be bought with money, “Dr. Jenkins is my dentist. 
His fee is somewhat higher than other dentists’ fees but his 
work will stand the most rigid kind of inspection. He gives 
his patients minute, close attention and the result is certainly 
worth the fees he charges.” 
50 Practice Building Suggestions 
There is another important subject the dentist must take 
into consideration in the ethical advertising of his practice. 
That is—proper stationery. It is highly important that this 
stationery bear the ear marks of refinement with regard to 
the wording, style of engraving or printing and the quality 
of the paper. Let it be distinctive, which usually invites 
comment. 
When a patient sends one of her friends to the dentist, 
it is important that the dentist write her a letter of gratitude 
stating that Mrs. Smith came to his office at the suggestion 
of Mrs. Jones and that he is glad she came because she has 
proved to be a very remarkable patient. It is also well for 
the dentist to write Mrs. Smith when he has finished the work, 
stating that he hopes the service he has rendered has proved 
up to her expectations and that he has tried very hard to do 
his best for her so that she as well as Mrs. Jones could feel 
that the recommendation was well founded. The one big 
thing that is accomplished through this procedure is that 
when Mrs. Smith and Mrs. Jones get together, they will 
talk about the dentist and both will know that the dentist had 
the interest of each at heart. 
A dentist can secure ethical publicity by becoming a mem- 
ber of a good business organization. This connection, however, 
will not do him much good unless he becomes active in the 
organization and takes an interest in it. If invited to give a 
talk, he should never lose the opportunity to do so. 
If there is a Public School Clinic in his city, he should be 
an ardent worker in it and give every consideration to those 
little patients who are so receptive to kindness and who will 
talk about this kindness in their homes. It must be remembered 
that the parents of these little patients usually have a place 
in their hearts for those who are kind and considerate with 
children. This, too, will be ethical publicity. 
He should be most anxious to meet people and he must 
remember that at each introduction as his name is mentioned, 
it means that much more publicity for him. To meet people 
in a gracious way, so that they will remember him, is one 
of a dentist’s big assets. The dental work in his mouth which 
might be viewed by people when he smiles, should be of the 
very best, for the reason that when he is being introduced as 
51 Practice Building Suggestions 
a dentist, people subconsciously look at his mouth and it 
should be suggestive of good dentistry. Glaring gold crowns, 
discolored fillings, and mismatched porcelain crowns should 
not be in evidence in the dentist’s mouth. 
A certain amount of ethical publicity can be gained through 
cultivating the professional friendship of physicians. A den- 
tist should never lose an opportunity to exchange scientific 
thoughts and ideas with a physician. Even at this late day 
only a very small percentage of the medical profession look 
upon dentists as being able to help them in their problems. 
The medical profession, as a whole, has come to believe that 
they alone are scientific and that the dental profession is only 
following their teachings. Much of this attitude can be grace- 
fully eliminated if dentists will completely co-operate with 
physicians. 
A good physician will enjoy talking along scientific lines to 
the dentist and the dentist in turn can accomplish much good 
for himself with that physician if he is prepared to converse 
in as equally a scientific way. This gains the respect of the 
physician and because of it he will be convinced that he is 
secure in sending this dentist his referred work. 
The right type of dental nurse can also aid the dentist 
in ethical publicity. She should have a good set of teeth. 
She should be not only well groomed in the office but also on 
the street. If she is of the type that her refinement of poise, 
manners and character command attention, people with whom 
she comes in contact socially will naturally inquire as to her 
business or profession. To have her pointed out as the nurse 
for a certain dentist gives him further ethical publicity because 
people will naturally associate her refinement with the dentist 
and the office with the result that they believe that two of such 
a kind naturally go together. They will, because of it, seek the 
dentist’s services believing that these services must be dis- 
tinguished. 
Window Signs, Their Value, Wording and Style of 
Lettering, and Where Indicated. 
In certain communities, and provided a dentist is not 
located above the third floor of a building, window signs 
undoubtedly have an advertising value. If a dentist is located 
52 Practice Building Suggestions 
in the residential section and especially on an intersection 
or transfer point, window signs are of distinct advantage to 
him. If he were located in a congested district with a foreign 
element predominating, then a window sign in different lan- 
guages would be of a distinctive advertising value. If the den- 
tist were located in a small town, window signs would be desir- 
able because they would indicate his location to farmer patients 
who usually find the dentist’s office through the medium of a 
sign. The farmer patients, as a rule, pay no attention to build- 
ing numbers or the names of buildings. They find their way 
about town through the medium of signs, both commercial and 
professional. 
Window signs are always indicated in a residential section. 
However, care must be exercised in selecting a proper window 
sign so that it will be in keeping with the general character of 
the neighborhood. Our suggestions for residential locations 
would be a piece of milk-white glass in about a six-inch width. 
This glass is to extend the full width of the window. It can 
be fastened to the window frame itself or hung on two fine 
chains or silk cords. If the dentist were located on the first 
or second floors this glass might be mounted on the window 
sill extending the full width of the window. In this way it 
would not only act as a sign but also as a means of preventing 
a direct draft on the dentist and patient during such seasons 
of the year when the lower half of the window is raised for 
ventilation. Fastening the sign on the sill would not be prac- 
tical above the second floor because it could not be seen from 
the street. 
The lettering on the milk-white glass should be two-inch 
Gothic in black. In residential sections lettering should not 
be placed directly on the window pane for the reason that this 
procedure usually cheapens the character of the window. 
As a rule, window signs are not indicated above the third 
floor in a business section and this because they cannot be 
seen from the street. However, there are exceptions. If a 
dentist’s windows were facing a large office building, then 
perhaps window signs would have an advertising value. 
However, if there were no large buildings, particularly office 
buildings, on the opposite side of the street, then window signs 
would be contra-indicated regardless of a dentist’s location. 
53 Practice Building Suggestions 
A window sign should always be placed on the lower half of the 
window so that it will not interfere with the angle of natural 
light which is so valuable to the dentist in operative work. 
It can be truthfully said that a gaudy display of window 
signs cheapens a dentist’s practice. Such signs would indicate 
to exacting patients that the dentist no longer appeals to an 
exclusive practice. A gaudy sign or one poorly chosen as a rule, 
attracts undesirable patients. The dentist in making his sign 
selection, should do so with the thought of making it possible 
for the recommended patients to locate the dentist without 
unnecessary inquiry. 
Announcement Cards 
The value of a distinctive announcement card as a patient 
producer can hardly be realized, but increases in practices due 
to their use have proven them an asset to the publicity methods 
of the dental profession. An announcement may be classed as 
a form of publicity but can not be accepted as an advertisement 
because of the fact that it is printed in keeping with professional 
ethics and is not distributed to a mass. 
An announcement card is the means by which a dental 
practitioner brings to certain people the understanding that 
he is engaged in the practice of dentistry. 
The average dentist, when opening an office, usually dis- 
tributes announcement cards promiscuously and therefore 
does not receive the returns or results that he is rightfully 
entitled to. 
It is often possible for the dentist to secure from his patient 
who is not only well pleased with the services rendered, but who 
also is interested in furthering the success of the dentist, the 
names and addresses of the patient’s most intimate friends, to 
whom the dentist can send his announcement cards. But, to 
give the announcement a human touch, the satisfied patient’s 
signature should be procured whenever possible. If asked in a 
diplomatic and tactful manner a patient will gladly autograph 
a few of a dentist’s announcement cards. The prospective 
patient receiving an autographed card has in all probability 
been aware of the fact that he, or she, requires dental service. 
This makes it possible for them to communicate with the friend 
whose name is signed to the announcement. The verbal praise 
54 Practice Building Suggestions 
which they receive of the dentist’s qualifications will naturally 
attract them to him. 
However, when it is not possible to secure prospective 
patients’ names and addresses from satisfied patients we 
advise the careful selection of patients through personal con- 
tact with societies, church functions, clubs, lodges, etc., in 
preference to mailing the cards to a list of names of people 
who are not acquainted in any way with the dentist. Mailing 
announcements to a mass is wasted effort and money to say 
the least, and the results obtained through this haphazard 
method are practically nil. 
The two following reproductions are suggestions for an 
announcement card: 
DR. EDWARD P. STANTON 
ANNOUNCES THAT HE HAS EQUIPPED A 
DENTAL OFFICE IN HIS RESIDENCE, COR- 
NER CHESTNUT ST. AND WEBSTER AVE., 
ROSEDALE PARK. N. J., WHICH HE HAS 
OPENED FOR THE GENERAL PRACTICE 
OF DENTISTRY. 
The style of wording may, of course, be varied to meet 
your particular requirements. 
For the quality of card stock we suggest three-ply Wedding 
Bristol with envelopes of Wedding Vellum. This stock has 
been found to answer all practical purposes and is reasonable 
55 Practice Building Suggestions 
enough in cost to permit its general use. The size of x 5 
inches for the card is generally conceded as the best because 
DR. BERNARD P. SAGE 
FIFTEEN FORTY BROADWAY 
NEW YORK CITY 
PRACTICE OF DENTISTRY 
the envelope can then be purchased from a standard stock 
size which will considerably lower the cost. The engraving 
should be of a plain face and in black ink. 
We have determined through observation that there is one 
size professional card more practical than all others. This 
size is 3 x inches. Our reasons for this are. that when 
given to ladies it is not too large for the small sized vanity 
Professional Cards 
C. A. H. SMITH. D. M. D. 
MURRAY HILL 
2819 
CANADIAN PACIFIC BLDG. 
342 MADISON AVE. 
case often carried, and neither is it too large for the vest pocket 
or the average sized card cases carried by men. 
56 Practice Building Suggestions 
Most of the professional cards which we have seen contain 
unnecessary wording. Small sized cards overloaded with words 
lose their effect and also appear too commercial. All that is 
necessary is the dentist’s name and title, telephone number in 
the lower left-hand corner and the name of the building and 
street address in the lower right-hand corner. When “Dr.” is 
placed before the name it would be considered bad form to 
have the name followed by a title. In this instance, however 
“Dr.” before the name would not indicate whether or not the 
card represents a dentist. Therefore, it would be our suggestion 
to omit “Dr.” before the name, adding instead “D. D. S.” 
after the name. Never spell out the word “Dentist” on a 
professional card. 
The card should be engraved on two ply plate finish Wed- 
ding Bristol in a plain face to permit easy reading. 
Professional cards may be used advantageously when mail- 
ing announcements to prospective patients, by enclosing one 
with an endorsed announcement. The amount of new business 
indirectly attributed to this method justifies the small expen- 
diture which is affected. 
Courtesy Cards 
By a dentist’s “courtesy card” is meant a card properly 
filled out by the nurse and signed by the dentist to be sent 
to a physician or dentist who has referred a patient to him. 
It should be mailed by the nurse on the same day that the 
patient calls at the office and it should be sent regardless of 
whether or not the patient contracts for dental services. 
The following reproduction has answered the requirements 
of a conventional courtesy card, and we recommend it as it is 
concise and to the point, a feature that is a requisite in handling 
professional correspondence. 
For the size of these cards we recommend x 3% inches, 
for the reason that it permits plenty of room for the matter 
going on the card and is a size that can be mailed in regular 
correspondence envelopes. 
Two-ply Oxford Wedding Bristol makes a very pleasing 
courtesy card and it is best to have the card engraved in a 
57 Practice Building Suggestions 
plain letter face, because the receiver may be influenced to a 
large extent by its attractiveness. Engraving in a distinctive 
letter face seems to carry an impression of efficiency and pro- 
DR. 
PERMIT ME TO THANK YOU FOR HAVING REFERRED 
TO ME FOR DENTAL SERVICES, 
VERY TRULY YOURS. 
gressiveness and for reasons previously mentioned in this 
volume, you should endeavor wherever possible to create this 
impression. 
There seems to be a difference of opinion as to whether a 
courtesy card should be sent to patients, who refer their 
friends to a dentist. It is our opinion that the courtesy cards 
spoken of and illustrated above are too formal for patients. 
We suggest sending instead a typewritten letter, using regular 
office stationery and signed by the dentist personally. A sug- 
gestion of such a letter is as follows: 
Courtesy Letters 
Mrs. A. H. Rudger, 
2025 Broadway, 
Rochester, N. Y. 
Dear Mrs. Rudger: 
Permit me to thank you for your courtesy and confi- 
dence in having referred to me for dental services, Mrs. 
J. C. Scott. 
Very sincerely yours, 
58 Practice Building Suggestions 
At the conclusion of the work it would be proper to write 
Mrs. Rudger another letter somewhat as follows: 
Mrs. A. H. Rudger, 
2025 Broadway, 
Rochester, N. Y. 
Dear Mrs. Rudger: 
Permit me to thank you again for having recommended 
my services to Mrs. J. C. Scott. 
I thought you might be interested in knowing that her 
work has been concluded. Mrs. Scott has proved herself 
an admirable patient. 
Very sincerely yours, 
The foregoing procedure is a most inexpensive way to show 
appreciation and, in this instance, the last letter serves two 
purposes, first, that of making final acknowledgement to Mrs. 
Rudger for her confidence in recommending the dentist’s 
ability; second, when the two ladies meet, Mrs. Rudger will 
no doubt tell Mrs. Scott that Dr. Jones wrote her what an 
admirable patient Mrs. Scott proved to be. This assures them 
both of the sincerity of Dr. Jones and acts as an incentive for 
both patients to recommend him further. 
Holding and Cultivating Acquaintances and 
Developing New Friendships 
The dentist who can make acquaintances readily and culti- 
vate the desirable ones into genuine friends is the possessor of 
an invaluable asset. 
The dentist, in his daily life, should recognize the necessity 
of separating his professional duties from social activities. In 
his office he must give the impression of a man who is the pro- 
moter of health, of the high professional ability, and who has 
at hand practical means for the relief of suffering patients. In 
his office he must also be reserved, but not to the point of 
making people feel that he is cold and unsympathetic. His 
reserve and manner of talking directly to the point are brought 
about through concentration of thought, prompted by a sin- 
cere desire to serve his patient in the most scientific manner. 
To do this he cannot engage in varied conversations, aside from 
dentistry, with his patients. To carry himself during office 
hours as a man who has become imbued with the spirit of a 
59 Practice Building Suggestions 
noble profession, brought about through years of intensive 
study and training, will automatically prohibit the unthinking 
patient from trying to take advantage and liberties or asking 
for special favors. Dentists who do not give thought to this 
part of their professional life—namely, office conduct—are 
always hampered with patients who, because of their acquain- 
tance with the dentist socially, feel that he will grant them 
special favors, most of which are unreasonable and unfair not 
only to the dentist, but to his other patients as well. 
It has frequently been noticed that the young dentist, who 
finally locates for practice in his home city, is surrounded with 
many of his old acquaintances who remember him as he was 
prior to attending dental college. If the young dentist does not 
practice reserve and act strictly professional while in his office, 
these old acquaintances are not apt to take him seriously. 
Instead of addressing him as “Doctor,” they will call him by 
his given name or “Doc.” They will never hesitate to make 
his office a rendezvous for gossiping and for killing time. If he 
does not nip these assumed privileges in the bud, it will not be 
long before his male acquaintances will introduce the smoking 
habit in his office, and usually at a time when some good 
prospective, sensitive patient is apt to pay him a visit to talk 
about dentistry. An office conducted on a strictly professional 
basis and in a professional environment commands respect, and 
will not be used as a rendezvous by otherwise unthinking 
associates and friends. 
The young dentist, who locates as a total stranger in a city 
or town, will not at first be handicapped by old acquaintances. 
However, it seems second nature for certain undesirable types 
in every community to seek the friendship of newcomers 
because, as a rule, they have been discarded by those who have 
lived in the community. The new dentist is carefully watched 
by the better element of citizens before they will show a willing- 
ness to patronize him as one of their class. For this reason the 
young dentist’s office conduct must be beyond reproach, and 
he must be careful at all times to impress those who visit his 
office with his high professional ideals, environment and the 
fact that he is on hand to serve in a strictly professional way 
those who come to him. Many of the older practitioners have 
learned these principles only after a long period of innocent 
60 Practice Building Suggestions 
mistakes, which, after they have happened, have only been 
corrected through resolutions for firmness and a housecleaning 
of the undesirables, both professionally and socially. People, 
especially in the smaller communities, do not easily forget even 
innocent mistakes. The strictly professional conduct, which 
also involves a certain reserve, acts as a barrier against those 
who would become unduly familiar or take undue advantage of 
the dentist’s friendship. 
The other side of the dentist’s life involves his conduct away 
from the office or, in other words, his social activities. In them 
he must completely discard his professional reserve, and in 
place of it exhibit gladness and appreciation for opportunities 
to fraternize socially with his fellow citizens. To carry a re- 
served attitude in social life is apt to give people the impression 
that the dentist is egoistic, and this opinion, if generally held, 
is apt to make him a back number and eliminate him from 
many social functions. 
The dentist should never refer during social affairs to his 
profession. Neither should he state that he is a dentist unless 
he is asked to do so. Frequently at these social affairs, when 
people learn they are being introduced to a dentist, they de- 
light in trying to get him to talk about his profession. In such 
cases, and only when there is no alternative, the dentist should 
never hesitate to talk about the achievements of his profession 
as a whole, but never about himself. He should not allow him- 
self to be drawn into a discussion of some one individual case, 
or to comment, except favorably, upon the work which some 
other dentist in the community is doing. If a person deliber- 
ately tries to force him into a diagnosis, or to pin him down 
about specific facts as regards his individual case, he should 
be firm in telling him that he will be pleased to discuss the 
matter in detail and to give a diagnosis if the patient, at some 
future time, will call at his office or phone for an appointment. 
His conduct in public, or in fact anywhere, should always be 
that of a thorough gentleman, never over-indulging in any one 
thing. Socially he should go out of his way to make people 
like him, but he should be cautious about any conduct which 
smatters of being overbearing or patronizing. 
The foregoing principles, if practiced, will make out of old 
acquaintances better friends. They will also draw new acquain- 
61 Practice Building Suggestions 
tances to the dentist that will soon blossom into real friend- 
ships, both socially and professionally. 
Satisfied Patients 
A new patient usually comes to the dentist through the 
recommendation of some friend. However, it must be remem- 
bered that, to most of the laymen, dentistry involves not only 
something mysterious, but is very apt to include unpleasant 
experiences. It is safe to say that every new patient comes to 
the office accompanied by a certain skepticism, which it should 
be the dentist’s first duty to try to dispel. If the dentist is 
fully equipped and prepared to do all classes of work coming 
to a general practitioner, and if these things are apparent to the 
new patient, the skepticism which the patient may have is 
quickly eliminated. However, if the dentist is not fully equipped 
to take care of the patient’s needs, aside from such cases as may 
rightfully be turned to a specialist, then the patient is apt to 
feel misgivings for having accepted a friend’s recommendation. 
Sending patients to a specialist for certain operative work, if 
not really indicated as a specialist’s problem, is rejecting a 
certain percentage of ethical advertising. For instance, with 
the average new patient the first step in the right direction 
would be the taking of radiographs. If the dentist is equipped 
to do this work, the patient is convinced of the modernity of 
the office and of the dentist’s ability to serve. If, however, the 
dentist must request the patient to first go to another office for 
radiographs before an intelligent diagnosis can be given, the 
patient might feel that his time is being belittled, and, in 
addition wonders what the dentist will get in return for the 
money he is causing the patient to spend elsewhere at his bid- 
ding. No doubt other dentists in the community are equipped 
to take x-ray pictures, which the patient in question may 
know about. The impression he will get because of it is that, 
even though the dentist was recommended by a friend, he is 
not equipped to do the work. 
Some dentists take pride in stating that they will not be 
bothered with extractions. The general practitioner makes the 
mistake more frequently than is realized of sending a new pa- 
tient to an exodontist for extractions which are simple in 
nature. The general practitioner should support the exodontist 
62 Practice Building Suggestions 
by referring work involving impactions, or in such cases where 
a number of teeth are to be removed or where the operation 
requires the removal of deep-seated and broken-down roots. 
When the case involves the removal of two or three teeth, 
which the radiograph proves will be a simple and normal oper- 
ation, the dentist should not send such cases out, because the 
patient might believe that, aside from not being equipped to 
do the work, the dentist’s knowledge of it is limited. This 
makes the new patient question whether the recommendation 
given by a friend was well-founded. 
Those dentists who are continually referring patients to 
specialists for work which should really be done by them- 
selves are inviting adverse advertising from new patients. A 
few such patients can undo the advertising which a dozen 
satisfied patients might give the dentist. Most successful 
practices have been built up because of satisfied patients. 
Therefore, a dentist should do everything consistent to gain as 
many satisfied patients as possible, because they will be the 
medium for many more new patients to come. A patient should 
not be allowed to leave the office unless complete satisfaction 
has been given. Sometimes it seems entirely unwarranted to 
the dentist to do over work with which a patient is not satisfied, 
even though it has been worn for some time. The removal of a 
discolored silicate, and its replacement with a new one more 
evenly matched, without charge, seems a hardship to the 
dentist at the time, but he never knows but what that patient 
will be the means of repaying him for it a hundredfold by send- 
ing new patients to him. The dentist may select porcelain 
facings for a bridge with the greatest of care so far as shades 
are concerned. The translucency of some porcelains after they 
have been backed up or cemented to a bridge changes the 
original shade to some extent. Some exacting patients will 
immediately detect even a slight mis-match, and, since some 
patients imagine that what they consider an off shade takes 
away from their appearance, the dentist had better replace 
such facings, even at his own loss, in order to give complete 
satisfaction. It must be remembered that patients with a new 
denture, piece of bridgework or silicate, which has just been 
placed in the mouth where it can be readily seen by friends, are 
going to have the work commented upon, either favorably or 
63 Practice Building Suggestions 
unfavorably. A patient may leave the office entirely satisfied, 
but this state of mind may soon be undone by other 
persons in cases of even slight mis-matches of porcelains. Some- 
times a patient may return with a complaint after the work 
has been in the mouth for several weeks. The dentist will be pro- 
moting favorable ethical advertising for himself if he gives such 
a patient complete satisfaction, even if at a loss to himself. 
The work which the dentist places in a patient’s mouth 
should be a monument of his ability as a dentist. Therefore, 
favorable comment not only from the patient, but also from 
members of the patient’s family and friends, is the best ethical 
advertising that the dentist may enjoy. 
Letters for the Advancement of Dentistry 
Dentists, as a whole, overlook golden opportunities for the 
advancement of dentistry in the letters which they might 
write, at a time when convenience will permit, to patients, 
groups of people and various organizations. 
When a difficult case has been completed, the dentist usually 
concludes it with instructions for mouth hygiene. The patient 
promises to carry out these instructions to the letter. It is not 
long, however, before the patient is apt to forget these instruc- 
tions, and the dentist, between periods of periodical examina- 
tions, could prove his genuine interest in the patient’s welfare 
by writing a letter once every three months, calling attention 
to the instructions which were given to the patient during the 
last appointment. The wording of the letter depends entirely 
upon the educational and social status of the patient. It must 
be written in such a way as to eliminate any possible offense, 
and must not give the patient the impression that the dentist 
is trying to be dictatorial. If professional terms are embodied 
in the text of the letter, they must be such that their meaning 
can be grasped by the patient. This procedure convinces the 
patient that the dentist is interested in wanting his work to 
give complete satisfaction, and also that he is interested in 
his patient aside from financial remuneration. 
The dentist can accomplish much good for his profession and 
himself by writing occasionally to his children patients. The 
average child up to twelve years of age has had rather unpleas- 
ant experiences in the dental chair. Rather than have the 
child feel, through force of circumstances, that the dentist is 
64 Practice Building Suggestions 
his enemy, he should try to cultivate the child’s friendship. 
Children quickly forget the instructions for mouth hygiene 
which the dentist gives them. To help keep the child’s resolu- 
tion revived to care for his mouth, so that he will not have to 
submit to more unpleasant experiences in the dental chair, a 
letter, written so that it is easily understood, will do much 
for the child and the dentist. Children are natural advertisers, 
and they are usually believed by adults because they are 
naturally sincere and give full vent to their impressions. The 
type of letter to be occasionally written to the child depends 
upon his age. If he is very young—that is, five to eight years— 
the letter should be worded in childish terms. If the child is 
older, he will treasure the dentist’s letter if its text is such as 
to convey the impression that the dentist looks upon him, more 
or less, as a rapidly growing up patient. The letters which a 
dentist might write to his children patients will also impress 
the parents. Such letters will convey the impression that the 
dentist is interested in the child from a health viewpoint, and 
because of it they will usually bring pressure to bear for the 
complete carrying out of the dentist’s instructions. Letters 
to children patients should be addressed to the child himself, 
so that they may be likened to important mail which comes to 
adults of the family. This procedure makes the child sit up 
and take notice, and also makes him feel important. 
Every dentist should give unselfish thought in trying to do 
something constructive to call the attention of the laity to the 
subject of dentistry. It is a duty that he owes his profession, 
and it is also a duty which he owes the laity. There are letters 
and papers that he could write, and in terms that the laity can 
understand, which would help dentistry very materially in his 
community, providing these writings were prepared in such a 
way that it would be apparent to the recipients that the 
dentist is not seeking personal publicity. A letter or a paper, 
setting forth the principles of mouth hygiene in its various 
phases, should be addressed to the principals of public schools 
such as grade schools and high schools, with the request that the 
writing be read to the various classes. Such writings, if they are 
really educational, are always welcomed by the heads of 
various schools, particularly so when they are convinced that 
the motive is unselfish and that, if heed is given by the recip- 
65 Practice Building Suggestions 
ients to dental teachings it will prove of profit to them. If the 
dentist wanted to be thorough in his activities as regards 
schools, both public and parochial, his writings could be prepared 
in series so that one could be read before the various classes 
each month which, during the year, would cover a very wide 
educational field upon the subject of dentistry. 
Almost every public school has its Parent-Teacher Associa- 
tion. The parents of the children meet at the school some one 
evening during each month. Sometimes these meetings are 
strictly social, and again, purely educational. The presidents 
of this association will welcome an educational paper on 
dentistry to be read before a gathering of parents. Such a 
paper should involve the proper care of children’s teeth, and 
also those of adults, in addition to the meaning of “mouth 
hygiene.” Educational letters or papers should be sent to the 
heads of orphan asylums. These institutions are very much 
in need of educational papers, and, because of it, would welcome 
such attentions from the dentist. 
In large cities the dentist should appeal to settlement workers 
upon the subject of dentistry. If an instructive letter or paper 
were to be written in terms easily understood by the class of 
people to whom settlement workers have to cater, much good 
could be accomplished. The people sponsoring the settlement 
work would be most grateful to the dentist. The instructions 
which the dentist would write on mouth hygiene would no 
doubt be multigraphed by the association of settlement 
workers, who would probably carry copies and leave them with 
the different families where this type of instruction is most 
needed. 
Most of the large business institutions, such as department 
stores and manufacturing plants, etc., have employees’ welfare 
departments. The duty of these departments is to call to the 
attention of the employees the subject of health and the many 
things which go hand in hand in promoting it. They also 
sponsor the social activities of the company. The dentist can 
do much toward bringing the subject of dentistry to the 
attention of a given company’s employees by addressing a 
letter or a paper to the manager of the welfare department, 
who will always be glad to post it on the bulletin board in either 
the lunchroom or reading room of the institution, or in such a 
66 Practice Building Suggestions 
department where it will be seen and read by the employees. 
This procedure is certainly the first step in the right direction 
toward the possible establishment of an industrial dental clinic 
within a given institution. 
In the smaller cities the local newspapers are always looking 
about for educational writings by local people. The writings 
which a dentist might get up would be a welcome contribution 
to the editor. 
The first thought that the reader of this article will get is how 
all of these things can be done, and yet not exceed the limits of 
what would be considered by the Dental Society “ethical 
publicity.” The dentist who is sincere in writing letters and 
papers for the advancement of dentistry will cheerfully elimi- 
nate his name from such papers, and, when sending them to 
the heads of the various institutions, will request that his 
name be withheld, principally for the interests of the ethics of 
his profession, and will state that the articles are being sub- 
mitted with no thought whatsoever of personal publicity. If 
the dentist is sincere in wanting to promote the interests of his 
profession as outlined, ethical publicity will come to him and 
also new patients, because he will have gained the respect and 
esteem of the heads of those institutions and their associates. 
Such people will be sufficiently appreciative to further the 
interests of the dentist whenever opportunity presents. 
Following are suggestions for letters to be sent to children 
of various ages. These letters should not be copied verbatim 
They are simply illustrative. Each letter that is sent to a child 
must be written to apply to the individual case. 
In each instance, however, regardless of the age of the child, 
the letter should be written with a direct appeal. Much of the 
value of it will be lost if it is not addressed to the child. In such 
cases where children are under six years of age, it will be ex- 
pected, of course, that some member of the family, in most 
cases the Mother, will read the letter to the child. However, 
the letter should not be addressed to anyone except the child 
himself. The smaller children take great pride in receiving letters 
from adults. Even though it is necessary for some member of 
the family to read the letter to the child and explain those 
things which he, perhaps, cannot grasp, good will come of it 
not only because of the impression it will make on the parent, 
67 Practice Building Suggestions 
but also because of the good things the child will have to say 
about his or her dentist. 
Because most parents have trouble in getting the children in 
the habit of brushing their teeth, letters along the lines sug- 
gested will help them in this training problem. The older 
children will also be appreciative of attention given them 
through an individual letter from the dentist. In addition to 
reading it aloud to members of their family, they will also speak 
about it not only at school but among their friends, all of 
which tends toward ethical publicity for the dentist. 
To a Boy or Girl under Six Years of Age 
Letter No. i 
Dear Little Patient: 
A caterpillar, in order to develop into a beautiful butterfly, 
must first spin himself a house made out of silk, and which is 
known as a “cocoon.” The caterpillar must remain in this 
little silk house for a very long time before his wings grow 
large and beautiful enough so that he may leave his house 
and come out into the open where everyone may admire him 
and say how beautiful his wings really are. 
If, while he was staying in his little house, something terri- 
ble had happened to it, he probably could not grow beautiful 
wings. They might be so crooked that he could not be a real 
butterfly. Then everyone would be sorry. 
When God gave you away, he placed way down deep in 
your mouth little, tiny teeth, which were to grow and finally 
come out so that everyone could see them. However, the 
purpose of their growing was to make a straight and smooth 
path for some companion teeth, which are also growing and 
trying to catch up with those baby teeth which you now 
have in your mouth. Pretty soon the companion teeth will 
get caught up, and then the baby teeth will have to make 
room for them. 
Like the butterfly in its little silk house, which must not 
be damaged if the butterfly is to be beautiful, your baby 
teeth are trying to keep their companion teeth from becom- 
ing injured. If you do not brush your baby teeth every morn- 
ing and every night, they will become soft and decay, and 
because of it cannot protect their little companions coming 
up behind them. Should your baby teeth come out before 
it is time, then the companion teeth will become injured and, 
like the butterfly’s wings, will come out crooked and will not 
be so pretty to look upon. 
The new teeth which will, some time soon, come in your 
mouth, are going to be just as beautiful to look upon as the 
68 Practice Building Suggestions 
wings of big butterflies, but only if you will take care of your 
baby teeth which are now protecting and making way for the 
new teeth. Everyone loves to see children with pretty, white, 
shiny teeth. You, too, may have them if you will be very 
careful to brush the teeth which you now have every morn- 
ing before breakfast and every evening before bedtime. 
My good friends are all little children who brush their 
teeth clean, and I want you to be one of my good friends. 
Your dentist friend, 
To a Boy or Girl under Six Years of Age 
Letter No. 2 
Dear Little Patient: 
Your mother will tell you that those children who some- 
times are hurt by the dentist when he fixes their teeth are 
those who do not know how to use a toothbrush, or those who 
forget to brush their teeth. Since I have shown you just 
how to brush your teeth, I know you will not be a careless 
little patient. 
To brush your teeth clean every night before you go to 
bed will help you to sleep well and have pleasant dreams. 
Sound sleep and pleasant dreams seem to make the night pass 
quicker and hasten the coming of the morning which, you 
know, will mean it is again time for play. 
To brush your teeth clean every morning before breakfast 
helps you to start the day right, which means that your 
breakfast will taste so much better and that you will be 
happy at play all day long. Nobody likes to play with little 
boys or girls who are cross. When you do not brush your 
teeth clean, it makes you feel ugly and cross many times. 
If you want to grow and be big and strong, you must keep 
your teeth clean. Otherwise they will get soft and hurt you, 
which will make it necessary for me to take them away from 
you and that will be very bad. You cannot grow strong and 
be big without teeth. 
The next time you come to my office I shall know by 
looking at your teeth just how often you have brushed 
them. Everybody can tell by just looking. 
Your dentist friend, 
To a Boy 8-10 Years of Age 
Dear Bob: 
The last time you paid a visit to my office you promised 
to brush your teeth at least twice a day in the way that I 
69 Practice Building Suggestions 
taught you to do. I am quite sure that you are making 
good your promise to me. 
You will remember the tooth on the left side of your lower 
jaw, known as a “molar,” which gave you and me so much 
trouble in getting it properly restored. It is very important 
that you thoroughly brush this tooth, not only the side next 
the cheek, but also the back and the side next to the tongue. 
If you are careless about keeping this tooth brushed, then I 
am afraid that more unpleasant experiences will be in store 
for you the next time you happen to come to my office. 
Carelessness with regard to brushing the teeth always 
results in toothaches. So far as I am concerned, I dislike to 
hurt my boy patients, because it makes me feel badly too, 
especially so when a thorough brushing of the teeth twice a 
day would have avoided the unpleasantness which usually 
accompanies the sick tooth. 
Perhaps in a few years you will want to join the Boy 
Scouts. One of the first things the Scout Master will ask 
you is whether you have good teeth. It is important for a 
Boy Scout to have good teeth, because when he goes away to 
the summer camp it will be very bad to be away from his 
Mother and Father and have to lie awake nights with a 
toothache, with no dentist close by to stop it. 
Do not forget that tooth on the right side of the upper 
jaw, known as the “first molar.” You will remember it has 
a little place between it and the tooth in front of it where 
food can collect. Aside from brushing that tooth, do not 
forget, whenever you feel that particles of food are lodged in 
the space, to pull a piece of dental floss through the space in 
the way that I showed you. If this is not done occasionally 
you may be bothered with another cavity, which is apt to be 
painful should it get started. 
I know that you will be careful about your teeth so that, 
when vacation time comes, you will not have to be bothered 
with possible unpleasant hours spent in my office, while 
your chums are out playing and having a good time. 
The A B C’s for good teeth and good health, which will 
make you a big happy boy and improve your report cards 
from school, are—first, to carefully brush every part of each 
tooth before breakfast and again before going to bed, and 
second, to chew your food for a long time before swallowing 
it. Sound, healthy teeth will make you happy and give 
you more time for play. 
The next time you are near my office please pay me a visit. 
I shall be glad to chat with you for a few moments, even 
though lam busy. 
Yours very truly, 
70 Practice Building Suggestions 
To a Girl 10-12 Years of Age 
Dear Miss Gwendolyn: 
I am writing you this letter so that you may be reminded 
once more how very important it should be to you to brush 
your teeth regularly every morning before breakfast and 
every evening before retiring. As stated to you during our 
last appointment, the enamel surfaces of your teeth are such 
that it will be an easy matter for cavities to get started, 
should you neglect in any way the instructions I gave yoo. 
Regardless of the many different forms and colors fu 
teeth which nature gave us, they are all beautiful to look 
upon and will enhance a person’s appearance, but only at 
such times when they are kept clean. You appreciate how 
important it is to take a bath so as to promote cleanliness 
about your person. If you neglect to bathe your teeth at 
least twice a day through brushing, then the bathing of 
your person will not be complete because it will not have 
eliminated a possible unpleasant breath. An unpleasant 
breath, due principally to lack of proper tooth brushing, 
will cause real friends, as well as acquaintances, to be distant 
toward you. 
The next time that you go to a party, or happen to be pres- 
ent at a gathering of people, look about you and see how 
many persons there are who would have a winning smile if it 
were not for the condition of their teeth. Whenever you see a 
girl or boy with discolored and ill-kept teeth, you may say to 
yourself that, if you do not brush your teeth regularly, it will 
not be long before you, too, will have a marred personal 
appearance. If you do not thoroughly brush your teeth 
when you are young, they may ruin and spoil your natural 
facial expressions when you have become a grown-up. 
Perhaps you are already thinking of the time when you 
will enter high school. It is very important to have good 
teeth at such a time because, since you will have to do a great 
amount of studying, good teeth will aid your digestion which, 
in turn, will make you healthier, and because of it you will 
be able to study more efficiently and gain marks of honor. 
Clean-looking teeth, exposed through a winning smile, will 
also help you in your high school social activities, and this 
should be important to you, as many lasting friendships are 
made during those years. 
The next time you present yourself at my office for an 
examination I know that I shall take pleasure in giving 
favorable comment on the way you have cared for your 
teeth during the interval between visits. 
“A clean tooth will not decay.” 
With my very best wishes, Yours very truly, 
71 Practice Building Suggestions 
To a Boy Attending High School 
Dear Jack: 
Since you are now actively engaged in your high school 
duties, you probably find the school routine quite different 
from that of the grade schools. You realize that the boy in 
high school is put upon an honor basis. In other words, it is 
up to him as to whether or not he is going to make good, 
not only in his many studies, but also in athletics as well. 
Have you prepared yourself both physically and mentally to 
make good? 
It is not commonly known that good teeth are a first aid to 
those who would be “top-notchers” in high school and 
university life. If the opportunity is given you, try and 
compare the marks of those who are inclined to keep them- 
selves physically fit with those who are not inclined to do so 
and note the difference. The next time that you are in the 
gym or on the athletic field, try and take a squint, if oppor- 
tunity presents, at the teeth of the best athletes. I daresay 
in each instance you will find that the teeth of those who are 
the best athletes are in perfect condition, and because of 
it strong bodies and keen minds have been made possible. 
Tissue-building foods are not much good to the growing 
youth unless he enjoys proper digestion which, in turn, is not 
possible without tne aid of good teeth. This is true because 
preliminary digestion is first brought about in the mouth 
through mastication. Poor teeth make proper mastication 
impossible which, in turn, interferes with the routine of 
digestion. This results in lack of nourishment to the body 
tissues, all of which reflects itself in the study and athletic 
efforts put forth by the student. 
The other side of your school life is a social one. There, 
too, ill-kept teeth plus a foul breath are direct reflections, 
which explains why some of the students areshunnedsocially. 
Your high school career will be just what you make it, from 
the viewpoints of studies, athletics and social activities, 
providing you pay strict attention to hygiene about your 
person, which also includes your teeth. 
During your last series of appointments with me I put your 
mouth in complete repair, in addition to having given you 
prophylaxis. The success of your restorations depends en- 
tirely upon the extent to which you are carrying on the 
prophylaxis which I started for you. In other words, are you 
brushing your teeth two or three times a day, and do you 
apply dental floss three or four times a week in the way that 
I showed you? If you are carrying out these instructions, 
then I know that you are very materially aiding your 
efficiency. 
You have often heard it said that “cleanliness is next to 
72 Practice Building Suggestions 
godliness.” Ordinarily people interpret this quotation as 
applying only to the external parts of the body. If one would 
be godly because of being cleanly and neat, then the oral 
cavity must also be included. To give your teeth a bath 
through proper brushing is as important from the viewpoint 
of appearance as to have clean hands and fingernails. 
Aside from all of the foregoing, it is my sincere desire that 
the restorations which I have placed in your teeth give you 
complete satisfaction from the viewpoint of health service. 
This will not be possible unless you diligently brush your 
teeth. 
Aside from all of these things, your success in life depends, 
in part, upon a healthy mouth. 
With my very best wishes, 
Yours very truly, 
73 Practice Building Suggestions 
SECTION IV 
How to Establish Fees 
HERE are three classes of patients that patronize every 
dental office and there is a corresponding difference in 
their ability to pay for services rendered to them. It is 
therefore desirable that patients should be classified on some 
basis that will make it possible to establish a proper fee. 
A dentist’s fee should be in proportion to the benefit the 
patient receives and in proportion to the financial ability of 
the patient to pay. A plan such as the following may be 
used in making a classification: 
Class i Patient: The limitation is the minimum hourly 
fee. 
Class 2 Patient: One in comfortable circumstances and 
with income sufficient to enjoy some of the luxuries. 
Class 3 Patient: Patient with means. Fees should be 
governed according to the dentist’s ability to render 
and sell that patient “service.” 
It is a known fact that some patients will plead poverty in 
a dental chair and leave the office to invest in some luxury. 
The dentist must be a judge of human nature and always 
remember that there are some patients, especially in Class 3, 
who if not charged a fee that is in keeping with their social 
and financial standing, will not appreciate his services. 
Patients use care and thought in selecting their dentist and 
for the same reason the dentist should select his patients. On 
patients that he does not know he should obtain references, 
which will assist him in making his classification more accurate. 
A well-regulated dental office works by appointment only 
on a basis of about six hours a day, two hundred fifty days a 
year, which will allow for mishaps, sickness, holidays and 
necessary leisure. There should be determined a stipulated 
minimum gross earning and from this the hourly fees may be 
established. For example: 
250 days, 6 hours per day, 1500 hours yearly; average 
hourly fee, $8.00; gross earnings, $12,000.00. 
74 Practice Building Suggestions 
On this basis the fees for the different classes of patients 
would be about as follows: 
Class i Patient: Minimum hourly fee $ 6.00 
Class 2 Patient: Minimum hourly fee 8.00 
Class 3 Patient: Minimum hourly fee 10.00 
The maximum overhead expense of a well-regulated dental 
office should never exceed per cent, which will leave a net 
earning of $8000. If the overhead expense is greater than 3314 
per cent, it will affect the average hourly fee. To bring it down 
to this maximum cost of successfully conducting a dental 
office, the average hourly fee will have to be increased. 
It will be an assistance to any dentist who endeavors to 
classify his patients to remember that he should talk health 
to his patients in preference to talking the mechanical side of 
dentistry. Such a course on the part of the dentist will tend 
to make the patient avoid comparisons of the dentist’s fee 
with an article of merchandise. 
If the dentist in talking to a patient refers to a restoration 
as a gold filling which will cost $10.00, it is very easy for the 
patient to compare the “filling” at $10.00 with some other 
commodity that has just been bought or sold; whereas if the 
patient can be impressed with the point that health cannot 
exist unless the mouth and teeth are kept in good condition, 
the fee for dental services will not appear to be large because 
the patient will understand the real value of the work the 
dentist is doing. 
Psychology in Connection with Giving Health Talks 
and Quoting Fees to Patients 
When discussing a case with a patient in the operating room, 
some dentists do not appreciate a certain earnestness which 
should be maintained by them toward the patient. This short- 
coming is not intentional and if dentists who are lacking in this 
respect were questioned in regard to it, they would admit that 
they are unconscious of the fault. Until their attention is 
called to it dentists do not realize how this surface disinterested- 
ness affects the patient, and that because of it patients postpone 
their decision to have work done. 
Dentists who have acquired this habit proceed in the oper- 
ating room somewhat as follows: 
75 Practice Building Suggestions 
After a diagnosis has been made and the various instru- 
ments used in connection with it have been laid aside, these den- 
tists continue their conversation about the case while they are 
walking back and forth in the operating room. Some will 
give part of the health talk while washing their hands, only to 
finish the talk while leaning up against the dental cabinet and 
drying them. Others, especially with those patients who are 
of the cautious kind, leave them alone in the operating room 
with the thought of giving them a chance to think it over. 
At the conclusion of the health talk some will lower the chair 
and make such movements unconsciously which give the 
patient the impression that so far as the dentist is concerned 
the interview is at an end. Perhaps at just the wrong time 
during the discussion of the case the nurse will enter the oper- 
ating room for the purpose of gathering up the instruments for 
sterilization which have been used in connection with the 
diagnosis. All of these things have a tendency to undermine 
the patient’s decision, or at least to promote a mental uncer- 
tainty. 
When the diagnosis has been completed and the instruments 
have been laid aside on the bracket table, the dentist should 
continue to hold the patient’s undivided attention throughout 
his health talk. He should remain at the operating side of the 
chair sufficiently forward so that he can fully face the patient. 
He should not lean against anything for support, but should 
stand erect with both feet flat on the floor without appearing 
unnatural. This posture will help to carry home to the patient 
his arguments in a more positive way than if he is seeking 
support by leaning against the dental cabinet, chair, window 
seat, etc. It has been demonstrated that these details of 
psychology are absolutely necessary with certain types of 
patients, but are not used with the thought of taking advantage 
of the hesitating patient. There are certain types of people 
who can never come to a decision except through certain 
psychological suggestions. Such patients, if allowed to leave the 
dental office undecided with regard to the case, would perhaps 
go to some other dentist who would secure the patient through 
making the necessary suggestions in a proper manner. 
There are three means of communicating ideas—Words, 
Tones and Movements. Words are the best means, usually, 
76 Practice Building Suggestions 
for communicating bare information but words spoken in a 
monotone and without any accompanying actions are not at 
all likely to stimulate the imagination of the patient. 
Many dentists do not realize the relative importance of 
words, tones and movements in getting health talks across to 
the minds of patients. Too much emphasis is placed now-a-days 
on “a good health talk” which often degenerates into a “patter” 
health talk that sounds purely mechanical and devoid of mean- 
ing to the patient. It is foolish for the dentist to expect the 
patient to believe his words alone. In most cases the patient’s 
adverse attitude is simply the caution of self-defense against 
possible deception. Therefore, mere words, unaccompanied 
with proper warmth of tone or emphasized with certain move- 
ments of the hands, promote an adverse attitude upon the part 
of the patient. 
“Yes” can be said in such a tone as to mean an unequivocal 
“No.” It is not the word that the dentist wants to get across 
to the mind of the patient but the ideas behind the word; 
the image which the word is intended to help build. The 
language we speak would be barren indeed of expressiveness 
if there were not expression added to the words we utter. 
Movements are of even more value than tones in com- 
municating mental images. “Actions speak louder than words,” 
whatsoever the tones used. The patient will credit the sug- 
gestions made to him in actions of the dentist because intui- 
tively the patient will, like all mankind, believe what he sees. 
The dentist will carry home to the patient the meaning of 
his words if the tones he uses express earnestness and sin- 
cerity. The movements we speak of in this paragraph should 
be in the form of gestures; a graceful wave of the hand when 
explaining away a patient’s objection; a graceful raising of 
the fingers, not too emphatic, at a point during the health 
talk which the dentist is trying to drive home; a graceful 
droop of the hand when a certain point has been satisfactorily 
explained. 
For the dentist who uses finished samples of certain types 
of restorative work we suggest that these be handled by the 
dentist as something very precious when trying to explain to 
the slow-grasping patient their mechanical and health-giving 
virtues. Patients can be helped to a decision when words 
77 Practice Building Suggestions 
and tones have apparently seemed ineffective if the dentist 
holds and touches the appliances as something of great value, 
as a connoisseur of pictures would treat a work of art. Through 
a careful study of the value of words, tones and movements, 
dentists who have never given thought to this phase of dental 
psychology will reduce a goodly percentage of their patients 
who want to “think it over and come back some other time.” 
Where in the Office to Discuss Fees with Patients 
It has been stated by dentists that the question of fees 
should be discussed with the patient in the business office. 
It is just as impractical for the dentist to always discuss fees 
with patients in the business office as it would be to discuss 
them in the operating room. It would be most inconvenient 
in the average office, to ask the patient to step into the business 
office for the purpose of discussing fees when only a few mo- 
ments of diagnosis will tell what work has to be done. In such 
instances, time will be saved if the fee is quoted to the patient 
while in the dental chair. Such cases do not require study 
models or a lengthy explanation of the treatments, restora- 
tions, etc. 
The function of the dentist’s business office is to discuss 
all matters of business aside from the actual operative work. 
Its use is truly ideal with patients who have mouths known 
as “wrecks” upon which several hours of study will be required 
before a true diagnosis, together with recommendations for 
correction, can be given. When such cases are presented to the 
dentist it usually requires full-mouth radiograms, study models 
and a complete clinical history of the case. Everything must be 
intelligently recorded, at which time the patient is dismissed 
after another appointment has been made. In some instances 
the dentist waives the appointment procedure by telling the 
patient that he will send a notification when to return to the 
office for further discussion of the case. 
When the dentist has completed his diagnosis through a 
careful study of the radiograms and clinical history, and has 
reached a decision as to the type of restorations indicated and 
these have been traced with pencil on the study models, he 
will then summon the patient, who upon arrival should be 
admitted to the business office by the nurse. The dentist will 
78 Practice Building Suggestions 
then discuss the details of the case with the patient through 
the medium of the radiograms and the study models. It is 
needless to say that the fee question will then come up auto- 
matically. 
It perhaps is unnecessary to add that for all patients who 
wish to discuss fees after the work has been completed, the 
business office is the proper place for such confidences. 
Determining Fees for Large Complicated Cases 
The only assurance against under or over-estimating a fee on 
a case known as a “wreck” is to make a thorough diagnosis, 
and through it determine as nearly as possible the number of 
hours required to carry the work to its successful conclusion. 
To do otherwise is very apt to prove disastrous to the dentist 
with regard to remuneration for the work. The trouble with 
dentists in this respect lies not in a lack of proper diagnosis 
but in snap judgements as to the number of hours which will be 
required for the work. A study of statistics proved to us that 
it is only occasionally that dentists over-estimate their fee. It 
is safe to state that 70 per cent of all cases known as “wrecks” 
are under-estimated. 
Dentists are entitled to a just remuneration, and this can 
be assured not alone through a careful diagnosis at the time 
the first examination of the mouth takes place, but through 
a series of diagnoses at a time when the dentist can uninter- 
ruptedly go over his original findings. He can then determine 
the number of hours which will be required to complete the 
case, and also can take into consideration every possibility of 
complications such as an under-estimated number of treat- 
ments, incorrect bites and impressions (the faults lying with 
the patient), and many other things too numerous to mention 
for which the dentist cannot be responsible. 
There is only one proper procedure for mouths known as 
“wrecks.” That is to make first, a surface examination; 
second, to take a full mouth set of radiograms or lateral 
jaws; third, to take impressions for study models; and fourth, 
if possible at the first sitting to get a complete clinical history 
of the patient’s systematic condition. 
After a study of the radiograms, the dentist can quite 
accurately tell what will be required in the way of treatments. 
79 Practice Building Suggestions 
A careful survey of the study models mounted on an articulator 
will determine what type of restoration is indicated. The 
foregoing—namely, the radiograph interpretation and the type 
of restorative work— will be governed somewhat by the clinical 
history. As the dentist progresses with his findings he should 
estimate as he goes along the number of hours required to do 
the wrork. This then will guide him in his estimate, plus the 
patient’s ability to pay. 
The patient should be impressed by the dentist with the 
importance of this procedure, which should convince the pa- 
tient of the dentist’s desire to serve efficiently. It will be well 
for the dentist not to make a positive appointment for the 
patient’s return because, with a very large case, the dentist 
must first complete his study of it at a time when he can give 
it undivided attention. 
For this reason it is not always possible for the dentist to 
make another appointment after the first examination. There- 
fore, he should tell the patient that when he has concluded his 
diagnosis a notification will be sent, stating the time for the 
next appointment. 
For the second appointment it will be well for the dentist 
to receive the patient in the business office where he will have 
his radiographs, the study models and the clinical history 
before him and where he can best explain his recommendations 
to the patient. 
Determining Fees through Mental Estimates 
When a dentist examines the patient’s mouth it is not fair 
to himself or the patient to make a mental estimate with regard 
to the fee. If he makes his estimate too low, which is not 
apparent until the work draws to its conclusion, it is well- 
nigh impossible to make up the difference by asking the 
patient for it. In all probability, if the dentist puts up a good 
argument the patient will pay him the difference. It is quite 
likely, however, that the patient will not return for additional 
dentistry when needed, and it is also likely that the patient is 
not apt to recommend the dentist to friends. 
On the other hand, if the dentist has over-estimated his 
fee, which only happens in rare instances, he would no doubt 
reimburse his patient with the difference, which in some cases 
80 Practice Building Suggestions 
would be a source of gratification to the patient. However, 
this procedure, while impressing the patient with the dentist’s 
honesty, would certainly also be convincing of a certain loose- 
ness and carelessness in business methods. The over-estimating 
feature happens so rarely that it is not worthy of much con- 
sideration. 
With all cases, regardless of their nature, the dentist should 
record his findings on a chart provided for the purpose. As 
he finds conditions during the examination he may mention 
them to the nurse who will mark and check them on the 
chart, and when completed the dentist can then state his 
estimate with reasonable accuracy. The chart should be kept 
as a permanent record and memorandum of the preliminary 
examination. 
The cases touched upon in the foregoing paragraphs are those 
of a simple nature—namely, treatments and simple restora- 
tions—which require but a few minutes of diagnosis, the 
result of which tempts many dentists to give an offhand esti- 
mate. In the absence of charting the work as they make 
their examination, it has been proven that at the final rendering 
of the bill to the patient the total of it did not coincide with the 
original estimate as given to the patient because of the fact 
that the original fee had been forgotten by the dentist, but not 
by the patient, which usually results in a controversy and a 
suspicious or dissatisfied patient. 
How to Quote Fees when Calculated on 
the Hourly Basis 
The dentist who would change the method of determining 
his fee from that of the time-worn “guessing” contest to the 
“positive” method known as the “hourly basis” will be court- 
ing all sorts of difficulties if he quotes his fee as “so much 
per hour.” 
The layman has not yet come to understand what the den- 
tist’s cost problems are and how these are determined. To 
tell them that the dentist will do their work at so much per 
hour will immediately cause them to make mental impressions 
of fees charged by other professions equally as important to 
them as dentistry. The layman, through comparison, will 
imagine that all sorts of discrepancies exist, and unless he has 
81 Practice Building Suggestions 
great confidence in his dentist the hourly fee will be apt to 
cause him to seek some dentist who will quote him a lump 
fee for the entire case. 
Even though a patient who has been quoted a fee by the 
hour has consented to have the dentist do the work, this 
decision on the patient’s part will often cause misgivings 
while the work is in process, because there are many times 
that the patient will believe that the dentist is not working 
as rapidly as he should, and that the work is being purposely 
slowed up to help accumulate time on it. 
The dentist, who would work on an hourly basis, should 
make an estimate for himself, at'the time of the initial diag- 
nosis of the total number of hours, plus a certain additional 
time for mishaps. Then by multiplying his total estimated 
hours by his set hourly fee, he will arrive at the fee which is 
to be quoted to the patient in a lump sum. Just how this 
fee is arrived at should not concern the patient, because it 
the patient is given a thorough understanding of what the 
dentist is trying to do and is made to enthuse over it, the 
total cost of the case will be of secondary interest. 
Why it is Necessary to Give a Patient an Approximate 
Estimate of the Fee Before the Case is Started 
A dentist should not start to work on a case until he has 
first given the patient a thorough understanding of at least 
an approximate fee. To make this a strict rule will do away 
with all “fee” controversies, and consequently dissatisfied 
patients. 
A dentist may rightfully become suspicious of most patients 
who will consent to his doing the work without asking at the 
beginning for at least a general estimate. Some patients are 
not overly anxious to be told of the fee until the conclusion of 
the work for the express purpose of using the fee as an excuse 
for a controversy, and through it secure their dentistry for 
little or nothing. Usually this type of patient is familiar 
enough with the law to know that “restorations,” when once 
permanently placed in the mouth, become personal property 
which cannot be requisitioned by the dentist through legal 
proceedings. Legal statistics show that the dentist has little 
or no recourse in securing a proper judgement, because in the 
82 Practice Building Suggestions 
past at least it has been a most difficult matter to convince a 
jury that the value of dental services to a patient is practically 
unlimited and that the benefits derived from it by the patient 
cannot be measured in dollars and cents. 
Another phase of this question is that certain patients who 
are not told of the fee until the conclusion of the work, and 
who will pay it under protest, will never cease talking about it 
to their friends, who are always inclined to believe what they 
hear and as a result will not seek the services of the dentist in 
question, not knowing that in all probability the fee was more 
than justified. It only takes, especially in the smaller cities, a 
few patients with an imaginary fee grievance to undo the 
honest efforts of a good dentist to build up a reputable practice. 
To give the patients a thorough understanding of at least 
what the approximate fee will be before the work is started 
will put it up to them to either accept it or not, and will give 
the dentist at least a 90 per cent guarantee from a legal view- 
point. In connection with quoting his fee to the patient 
at the time the case is started, it will also be the logical time 
to acquaint the patient with the payment procedure, t.e. 
whether in installments as the work progresses, or in a lump 
sum at the conclusion of the last sitting, or by the 10th of the 
following month. 
Charging for Diagnoses 
The dentist is entitled to a fee for diagnosis on all cases where 
the time involved exceeds 15 minutes. A glance in some mouths 
will tell instantly what is to be done for that patient, and in 
such instances a diagnostic charge should not be made because 
the fee earned in connection with the work will take care of the 
few minutes required in diagnosis. When the case is one of a 
complicated nature the dentist should include in his fee (at an 
hourly rate) the time involved in making diagnosis. When the 
patient happens to be one known as a “shopper” and who wants 
to think it over, then the dentist should show no hesitancy 
in making it plain that his time given to diagnosis on that 
particular case must be remunerative, and the patient should 
be requested to pay for that time. 
A great percentage of the profession do not take account 
of the many hours spent through the year in diagnoses, par- 
83 Practice Building Suggestions 
ticularly on the complicated cases which require study models, 
etc. 
The principal thing a dentist has to sell is his time, and if 
he is going to give part of it away on free diagnoses, he will 
automatically reduce his productive hours and through it 
his yearly income. Patients go to physicians who will make 
a charge for even the slightest kind of a diagnosis, and this is 
considered proper by patients. If dentists as a whole would 
take physicians as an example in this respect, their services 
would be more greatly appreciated, especially by those people 
known as “shoppers.” 
When a dentist makes an extensive diagnosis on a com- 
plicated case, the fee for diagnosis should be included in the 
lump fee for the case. The dentist must be the judge as to 
whether the patient should be told that the fee for diagnosis 
has been included in the lump fee for the case. There are 
certain types of people who would appreciate a diagnosis 
fee, and there are others who would not. Therefore, this is 
purely a dentist’s problem, but it is one which must be taken 
into consideration in connection with those cases where sev- 
eral productive hours have been spent by the dentist in diag- 
nosing them. 
Should Fees for Children be Less than for Adults? 
The dentist who determines his fee on an hourly basis 
should not deviate from it when estimating and quoting on 
children’s cases. The dentist has a certain number of produc- 
tive hours per year to account for in dollars and cents. If he 
sets his productive hours at 1500 for the year and his average 
hourly basis has been determined at the rate of $10.00 (taking 
into consideration all classes), then his books must show at 
the end of the year that he has taken in $15,000.00 gross. The 
same principle applies to the classification of fees for children 
as for adults. If the dentist deviates from his hourly basis and 
established classification for children or adults by reducing his 
minimum fee, then his gross income will naturally be dim- 
inished. 
The size or the age of the patient should have absolutely 
no bearing upon the fee. Work upon children requires the 
same amount of education, skill, caution and operative tech- 
84 Practice Building Suggestions 
nique as for adults. If this is true, then a deviation from the 
hourly basis for children should not be entertained. It is 
easily understood by those familiar with the idiosyncrasies 
of juvenile patients that, if anything, it requires a great deal 
more patience on the part of the dentist when operating on 
children and performing the work correctly than it does for 
adults. Therefore, to quote a smaller fee for juvenile patients 
than for adults is not in keeping with good, sound principles 
when applied to dentistry. 
Why to Avoid Quoting Fees to Minor Patients 
and How to Proceed 
pFA dentist should never quote fees to juvenile patients or 
those in more mature years such as high school students, 
even though the parents of the child inform the dentist either 
by letter or telephone that they wish him to do whatever is 
necessary for the child. 
The average child is not interested in the dentist’s health 
talk let alone the fee, and when an examination has been 
given by the dentist, together with a diagnosis verdict, the 
child will report back to the parents telling but half the story 
and perhaps elaborating on the fee, which because of improper 
explanation is apt to wrongly impress the parents that the 
dentist is trying to take advantage of the situation. 
Aside from giving the child a mouth hygiene talk, the den- 
tist should impart no information with regard to the nature 
of the work or the amount of the fee. He should remember 
that it is the parent who is going to pay the bill, and who 
for the time being at least is the most vitally interested. The 
dentist will eliminate controversies between himself and the 
child’s parents if he will write them a letter or call them by 
telephone, making an appointment which either can keep for 
the express purpose of intimately informing them of the find- 
ings of his diagnosis, the nature of the restorations, how the 
child is to be benefitted by them, what the fee will be, and 
urging the parents to have the child follow the instructions on 
mouth hygiene given to him. 
The psychology of the foregoing feature is twofold. First, 
it does away with the probability of the parent stretching his 
imagination over the dentist’s fee. Second, it convinces the 
85 Practice Building Suggestions 
parent that the dentist is vitally interested in the welfare of 
the child, which to the careful parent is most gratifying. 
For those Dentists Located in Mining, Railroad, 
Packing House, and Congested Industrial Centers 
who Would Increase their Gross Income. 
The solution of the dentist’s problem in these communities 
lies principally with increased production as a means of in- 
creased income. 
Usually this class of dentist has all the patients that he 
can take care of, so his difficulty does not lie in the lack of 
restoration work. If he has gone the limit in fees for such a 
community, it naturally simmers down to the point of doing a 
greater volume of work without increased operative expense. 
Such a dentist should try to secure the services of a dentist who 
prefers to work for another dentist rather than for himself. 
This dentist’s salary should be based upon a percentage—i. e., 
he should be given an incentive for which to work, so that he 
will have his employer’s and patient’s interest at heart and will 
do everything consistent to turn out good operative work. 
Volume would be the big thing, for an office located in the 
districts as mentioned. Sometimes in these communities four 
or five or even six operating rooms are indicated for two dentists. 
In such an office, the dental nurse plays a very vital and im- 
portant role toward increased production. It is just as possible 
for a dentist to be successful in a congested manufacturing 
district or railroad center as it is for a dentist to be successful 
with a higher standard of patients in more exacting communi- 
ties. If the dentist in the congested district will increase his 
production along scientific lines, he can double and treble his 
net income. 
It is not always big, sensational fees that make for a den- 
tist’s success. The small consistent fees are equally contribu- 
tive. Let us visualize the 5-and-io cent store plan making 
possible the erection of a Woolworth Building. And again, 
the 25-cent weekly insurance plan making possible the con- 
struction of that gigantic building known as the Metropolitan 
Life Insurance Building in New York City. 
86 Practice Building Suggestions 
Guaranteeing Dentistry to Patients and What it Means 
An ethical dentist cannot consistently, in the true sense of 
the word, “guarantee” any branch of dentistry to his patients. 
The human mind and hand cannot make duplications of parts 
of the body and guarantee that these will function as efficiently 
and give the same comfort as Nature intended her work to 
do. It is not only an insult to Mother Nature, but also to 
the profession of dentistry to even intimate that a guarantee, 
as commonly understood by the layman, can be given. Even 
though a restoration may be as perfect as the most skilled and 
trained human hand can make it, there are other factors to 
be taken into consideration which prohibit the much-abused 
term “guarantee,” the most important of which is a lack of 
co-operation on the part of the patient to do certain things, 
in order to facilitate the proper functioning of the work, and 
practice to the letter the teachings of mouth hygiene. 
Dentistry is a science—a very exact one—and is taking its 
place of importance with the surgery of any other part of the 
body. The conscientious dentist is at all times interested to 
serve patients and their interests to the best of his ability. 
One of the requisites of ethics in the profession is that of 
“good character,” and if a dentist has the patient’s interest 
and that of his profession at heart, he will be a strict adherent 
to the duty of making right with the patient anything that is 
wrong for which he might possibly be to blame. 
In commercial circles an article stamped with the word 
“guarantee” is generally looked upon with suspicion. Mer- 
chants appreciate in a greater measure than ever that after 
all it is the character and reputation of the maker of the 
article which is the real guarantee, and not the word itself. 
Radiographic Fees, How to Quote Them in 
Connection with Fees on a General Case. 
Percentage Basis for Estimating. 
Whether the dentist is to include the radiographic work in 
his fee or quote it separately will depend entirely on his com- 
munity. If he is practicing in a locality where patients object 
to a separate fee for radiographs, then it would be advisable 
to include the charge in his lump fee for the case. Many 
dentists located in business sections, and again those enjoying 
87 Practice Building Suggestions 
a high standard of clientele in residential sections include 
radiographs when quoting a fee. Laymen, as a whole, recog- 
nize that diagnosis based on the disclosures of an x-ray is 
valuable service, and therefore the taking of radiographs 
should be entered into as freely as the use of any other appli- 
ance in the modern dental office. 
Inasmuch as it is generally conceded among conscientious 
dentists that an x-ray machine is an absolute requisite to 
the safe-guarding of the patient’s and dentist’s interests, there 
should be no hesitancy on the part of the dentist to inform 
the patient that his fee includes as many x-rays as are neces- 
sary in conjunction with treatments before and after and 
throughout the reconstruction of the mouth. The thinking 
patient cannot but help being impressed through this pro- 
cedure with the fact that the dentist is fully equipped for ren- 
dering intelligent and positive service. 
Inasmuch as the dentist cannot tell the exact number of 
radiographs he will have to take of a case, especially where 
considerable treatment work is indicated, he must have some 
basis for making a mental estimate if he is going to include 
the radiographic fee in the lump fee for the case. A practical 
check among dentists proves that on cases averaging from 
$50.00 to $100.00, 10 per cent added to the estimated amount 
for treatments and restorations will take care of the x-ray 
overhead and still allow the recognized profit margin. In some 
cases the 10 per cent will fall a trifle short, and in others it 
will prove ample. In averaging up for the year the dentist 
will come out on this basis with a profitable margin. 
On a case amounting to $100.00 or over, 15 per cent should 
be added to the estimated fee for treatments and restorative 
work. Frequently on cases of this amount full-mouth radio- 
grams must be taken, and the 15 per cent will fully cover the 
recognized radiographic fee in most localities. 
Charging for Broken Appointments 
Charging for broken appointments should be relative. Some 
patients think nothing of cancelling an appointment with their 
dentist, and to such patients, when an appointment has been 
broken without sufficient notice, it should be stated by the 
dentist or nurse that a charge for the appointment will be made. 
88 Practice Building Suggestions 
This then will immediately bring the matter up to the patient 
for discussion, and with the careless patient the possibility 
of future broken appointments will be eliminated for he will be 
forcibly impressed with the fact that the dentist does not 
relish broken appointments. 
The dentist who regulates his practice by appointment 
must be given ample notice of the patient’s inability to keep 
the appointment, so as to allow him to fill in the time by sum- 
moning another patient who is perhaps anxiously waiting 
for an immediate appointment. If it is impossible to fill in 
the time of a broken appointment with another patient, then 
a charge should be made. 
There are, however, legitimate excuses which form excep- 
tions to the rule, such as a sudden sickness, accidents, etc. 
The dentist must use diplomacy to inspire patients to keep 
their appointments promptly. A dentist must set an example 
by doing his part in keeping his appointments with the patients. 
Collecting Accounts 
A dentist engaged in the practice of his profession is, as a 
matter of fairness to himself, entitled to the following: 
1. Remuneration for his time. 
2. Enough to cover uncalculated losses by bad debts, loss 
in estimates, loss by fire, loss through wear and tear, 
loss through perishable supplies. 
3. A fair return on investment. 
4. The comforts of life in a reasonable proportion. 
5. An extra sum for mishaps. 
6. Protection against old age. 
Note: See Section XV, pages 249, 250, 251. 
Anything less is an injustice to himself and to his family. 
Proper attention to the collection of accounts has an im- 
portant bearing on the income of the office for the year. 
The greater portion of business is done on a credit basis 
because there is not enough money in the world to transact 
it on a cash basis. 
The credit condition affects the dentist just as much as it 
does the merchant or manufacturer, and because granting 
credit necessitates collecting accounts, it is necessary to pro- 
vide some definite and effective method of getting the money 
89 Practice Building Suggestions 
if you do not want your practice to fail because of an excess of 
worthless accounts. If you do extend credit you will never be 
able to collect all of your accounts but you can recover money 
that otherwise would be lost if you will adopt some definite 
plan and adhere to it. 
Uncollectable accounts often make dissatisfied patients from 
many angles. Where work is not paid for, patients are more 
apt to be dissatisfied and faultfinding as regards the service 
they have received. 
You have earned the amounts charged in your books just 
as much as you have earned the cash fees, but you have to 
solve the problem of how you may best accomplish the trans- 
fer of these amounts from your patient’s bank account to your 
own. It is necessary to remember that every patient served 
is a prospect for future business and in the collecting of accounts 
it is necessary to retain the good-will of even the slow payers 
if you can do so and still get your money. 
The key-note of the plan we suggest is definiteness and 
persistence. Adopt a definite plan of action and execute it 
persistently. Draft your collection letters so as not to offend 
the debtor and make the theme of such letters the collection 
of your accounts. It matters not so much what you say if you 
will only say it often enough. We suggest sending these letters 
at short intervals, in the belief that the best results will be 
obtained by keeping the subject warm. 
Provide a 5 x 3 vertical filing cabinet with chronological 
guides and a quantity of horizontally ruled cards, these to 
be used for your follow-up system. Mail statements to each 
patient on the first of the month following completion of the 
case. Enter the name and amount on the card, noting the date 
also, and set this card forward twenty days in the chrono- 
logical file. By having daily reference to the file this card will 
be brought out on the twentieth day. Refer then to the ledger 
account and if the account has been paid, destroy the card. 
If the account has not been paid, send letter No. 1, noting the 
fact and the date and again set the card forward twenty 
days. Repeat the procedure at the end of the second period, 
noting letter No. 2 and forward ten days. After this follow 
up every ten days until amount is paid or until final action is 
taken. 
90 Practice Building Suggestions 
Should the patient promise payment on a certain date, 
make note of the fact on the card and set forward to the 
specified date. If payment is not received promptly, remind 
the patient of the promise and ascertain the reason for non- 
payment. Note the facts on the card and follow-up every ten 
days. In such cases it will be found necessary to vary the 
correspondence from the regular forms. 
This vertical file (the commercial name for which is “Office 
Tickler”) will be of valuable assistance as a Daily Reminder, 
but to be of actual service it must be referred to every day 
and all matters for the day disposed of promptly. This will 
prevent accumulation and promptness in handling such matters 
will impress the patient that you do not forget and will not 
allow him that privilege. 
The efficiency of the collection system lies not so much in 
what you say as how you say it. Diplomacy has won more 
battles than the mailed fist, but when diplomacy fails, it is 
necessary to resort to the mailed fist of the law. Do not con- 
sider legal action until you have exhausted every other means 
and not even then unless your debtor can be made to satisfy 
the judgement. 
After you have sent the first statement and begun the first 
system of letters, further statements would be useless and 
should not be sent. It is advisable, however, to refer to the 
amount of the account in every letter. 
For the first letter we suggest something similar to the 
following: 
January 20, 1924. 
Mr. Thomas Blank, 
City. 
My dear Mr. Blank: 
On the first of this month statement was mailed to you 
for an account of $28.00. As no response has been re- 
ceived, I am led to believe that you have some specified 
date for paying personal accounts. 
Will you please inform me on this point so I may make 
proper notation on your account, and thus make future 
inquiries of this nature unnecessary. 
Sincerely yours, 
DR. SMITH 
91 Practice Building Suggestions 
In the first letter is indicated the desire to accommodate 
him by considering only his wishes in regard to time of pay- 
ment. If no response to this is received, the second letter will 
be a definite request for payment, although still deferring to 
his plans. This should be only twenty days after the first 
letter. 
February 10, 1924. 
Mr. Thomas Blank, 
City. 
My Dear Mr. Blank: 
On the first of last month you received a statement ot 
your account of $28.00 and several weeks later a letter 
inquiring as to your convenience regarding time of pay- 
ment. 
Will it be entirely convenient to let me have check at 
this time? Or have you some definite arrangement to 
ofter in lieu of present settlement? 
Please inform me prompdy. 
Sincerely yours, 
DR. SMITH 
Assuming that no response has been received to either of 
the previous requests, it is advisable to send the third letter 
in ten days. 
February 20, 1924. 
Mr. Thomas Blank, 
City. 
My Dear Mr. Blank: 
Imagine my surprise that I have received no response 
to the several letters regarding your account of $28.00, 
for it has been quite two months since your case was 
finished and statement sent you. 
Did you stop to consider that the impression created 
by your apparent neglect of this matter is very unfavor- 
able? 
Frankness in such matters is always the best policy. 
Therefore if you cannot conveniently settle at this time, 
suppose you come in and see me, for I am sure the matter 
can be arranged satisfactorily. 
I shall expect something definite promptly. 
Sincerely yours, 
DR. SMITH. 
92 Practice Building Suggestions 
Then in ten days follow with the fourth letter: 
March 1, 1924. 
Mr. Thomas Blank, 
City. 
My Dear Mr. Blank: 
Do you believe the services for which I charged you 
$28.00 are worth that amount to you? If you do are you 
willing to destroy the confidence I have in you, and cast 
a reflection upon your integrity and credit reputation by 
further neglect of this obligation ? 
I should prefer to believe that you have some good 
reason for not giving the account attention, but continued 
silence will be practically an invitation to go as far as now 
seems necessary to protect my interests. 
Sincerely yours, 
DR. SMITH. 
The fifth letter in the series is a declaration of intention 
to resort to drastic measures and unless the debtor is a pro- 
fessional deadbeat, will often bring results where all other 
letters fail. 
March io, 1924. 
Mr. Thomas Blank, 
City. 
My Dear Mr. Blank: 
Your account of $28.00 has been due for more than two 
months, and you have not only not paid it, but have given 
me no reason for failure to do so. 
Surely you are not going to force me to adopt legal means 
to collect this account. I very much prefer not to cause you 
this humiliation and additional expense, and hope you will 
see how very much better it will be to dispose of this matter 
agreeably. 
But I shall be compelled to hand the account to my 
attorney unless some satisfactory arrangements are made 
by March 20th. 
Sincerely yours, 
DR. SMITH. 
Do not send this last letter until you have fully determined 
to take legal action and, in considering the advisability of such 
action, believe that a judgement will avail you nothing unless 
93 Practice Building Suggestions 
the debtor has the means to satisfy it. It is advisable to rely 
upon the judgement of your attorney in such cases. 
You may gain the impression from the above that the 
proper execution of such a plan will require too much time, 
but we must emphasize that you will have to be systematic 
to obtain results. However, by devoting a short time each day 
to this work you will get excellent results. In fact, if neces- 
sary it would be well to reduce your operating hours in order 
to give the proper attention to collection, for the collecting of 
accounts is absolutely necessary to a prosperous practice. 
Devoting a definite part of your time to collecting may 
not get you as much on your books, but it is certain to get 
more in your bank account and that is where it will do you 
the most good. 
Split Fees 
Years ago when the dental profession felt the need of a spec- 
ialization for certain branches, and when specialists first 
became established, it was a difficult matter for them to get 
referred work because dentists, as a whole, hesitated to send 
patients to them for the reason that they themselves were very 
much in need of the fees which the cases would involve. It 
was really an innovation, and to most dentists it seemed an 
unnatural thing to have to send a patient to someone else for 
dental work, with a possibility of that patient never returning 
to him for operative work coming under the general practi- 
tioner’s jurisdiction. This also made it exceedingly difficult for 
the specialist to become established, because he was compelled 
to depend to a very great extent upon his brother practitioners 
for a certain support. 
It was at this period in dentistry that the “split fee” was 
first put into effect. If a general practitioner referred a patient 
to a specialist he knew that something would be coming back 
to him in return for his support. The specialist in those days 
always made it a point to charge a maximum fee—at least a fee 
big enough so that he could afford to split it with the dentist 
who referred the patient to him. Because of this situation, the 
layman believed that the specialist was only for the wealthy, 
for it seemed that no one but a wealthy person could afford to 
pay the fee asked by the specialist. This opinion is still clung 
to by the layman at the present time, even though the average 
94 Practice Building Suggestions 
specialist’s fee is but little more than that charged by the 
dentist in general practice. 
When it became apparent that there was plenty of dentistry 
for the specialist and general practitioner, both classes began 
to reason the “split fee” procedure from an ethical viewpoint, 
and found that the practice was not in accordance with the 
dignity and high ethics of the profession. Gradually “split 
fees” were eliminated, and today the profession as a whole 
seldom hears of them, even though they are still being surrep- 
titiously indulged in by a few. 
At the period in dentistry when “split fees” were openly 
indulged in, “split commissions” were also being practiced in 
commercial lines. “Split commissions” at one time almost 
ruined the life insurance business. The practice was so widely 
indulged in that a law was finally passed prohibiting life insur- 
ance companies or their salesmen from dividing commissions 
with anyone who happened to be instrumental in helping them 
gain a new policy-holder. “Splitting” commissions, aside from 
being unfair competition, is a dishonest practice, undermines 
the best interests of a business or a profession, and causes those 
who indulge in it to lose their self-respect. 
Contract Fees 
The use of the term “contract fees” in dentistry has been a 
contributing factor toward promoting the shopping desire with 
patients. It has also been the means of much dentistry having 
been given to patients at fees less than cost. “Contract fees” 
are rapidly being displaced by fees which have been calculated 
on an hourly basis, which is really the only fair basis for the 
dentist and for the patient. 
“Contracting” for a case is usually brought about by patients 
themselves who have cases involving considerable dentistry, 
for which the total fee amounts to a great deal more than the 
average run of cases. Patients, when told of the volume of 
their work, usually want to know just what the case is going to 
cost. The dentist makes a mistake when stating that, if the 
patient will allow him to do all of the work so as to put the 
mouth in a normal condition, he will make a “contract” to do 
this work for a certain sum, and that, regardless of what 
happens, the price will be no more nor less than the stated 
95 Practice Building Suggestions 
amount. The term “contract” should not be used in the prac- 
tice of dentistry, because patients are apt to liken it to the 
contract procedure in commercial lines where the lowest bidder, 
providing all things are “apparently” equal, usually gets the 
job. Dentists who have practiced some years will readily admit 
that patients to whom a “contract fee” has been quoted 
usually leave the office in order to think it over, and that only 
occasionally one of them will return to enter into a “contract 
agreement.” 
A patient, having been told by the dentist that he will make 
a “contract” to do the work for a given amount, goes to some 
other dentist and asks him what he will do certain work for, 
using as a basis for specification the description which was 
given by the first dentist. The second dentist appreciates the 
opportunity for a large case at a time when he may not be 
overburdened with work, and is apt to figure the case very 
close. Under these circumstances he may quote fees which are 
less, unbeknown to himself, than those quoted by the first 
dentist. This promotes competition, and usually results in 
the second, or possibly a third bidder, getting the case on a 
“contract basis.” Because of certain unforeseen conditions 
which have not been taken into account, dentistry is given 
at a loss, which is apt to result in slipshod dentistry. 
The reader of this article will no doubt ask what really is the 
difference between a “contract fee” and an “approximate 
estimate” figured on an hourly basis. If the dentist makes a 
contract fee after a very careful study of the case, and bases 
his fee on the total number of hours that the case will require, 
taking into consideration the possibility of unforeseen condi- 
tions and mishaps, then the only difference is the mental 
equation given the patient through the term “contract.” If a 
competitive dentist figures on the case, it is quite probable that 
he will not take into consideration all of the possible conditions 
which the first dentist did. To quote the patient a fee calculated 
on an hourly basis and eliminate the term “contract” is differ- 
ent in the respect that the patient is given a maximum fee, 
with the possibility that the fee will be less, providing the 
dentist does not encounter certain operative difficulties which 
might consume a considerable number of operative hours. 
This does not signify that the dentist should tell the patient 
96 Practice Building Suggestions 
that he works at so much per hour because, in doing so, it 
might also promote the shopping instinct and prove quite as 
disastrous as the term “contract.” 
$10.00 per hour, or even $5.00, sounds exorbitant to the 
average patient. A dentist quoting a fee at a certain rate per 
hour only invites unfavorable comparison with rates paid to 
mechanics. We have heard women patients make remarks 
similar to the following: “Doctor makes almost 
$100.00 per day—he charges $10.00 per hour. Isn’t it terrible?” 
Some people really think that the average professional man 
is entitled to be continually only two steps from poverty. 
Many business men, who understand overhead expense in 
their own businesses, seldom think of a doctor as having any, 
just the same as many dentists overlook the necessary non- 
productive expense manufacturers and dealers are under, and 
which must go into the cost of the articles used in practice. 
The only scientific way in which to calculate fees is on an 
hourly basis, but we believe it unwise to so inform patients. 
Ask any person who has ever built a house whether he was 
entirely satisfied with its construction and workmanship when 
the “contract” was given to a very low bidder. 90% of the homes 
built on the lowest competitive contract system have been 
most unsatisfactory jobs from the viewpoint of material used 
and also workmanship, the reason for it usually being unfair 
competition. The contractor realizes that, to get the job, he 
must bid low because someone before him has already figured 
very close. He also realizes that to get the job will help him to 
keep busy for the time being, and he will be satisfied with a 
very small profit. In his anxiety to get the contract he over- 
looks certain conditions which involve more materials and 
labor costs than he at first anticipates. He takes the chance, 
thinking that he can somehow get around these costs. When 
the work is under way, he finds that if he carries out his con- 
tract to the letter he will be doing the work at a loss to himself, 
which immediately prompts him to find places where it will be 
possible to cut the corners. This procedure seems to be human 
nature. It all results in a dissatisfied customer and a loss of 
self-respect to the contractor. 
The dentist is no exception to this trick of human nature, 
when he once realizes that his “contract” to do the work at a 
97 Practice Building Suggestions 
set fee is going to result in a loss to himself. Perhaps he has 
failed to take into account, when making the contract, that 
certain teeth might have fine, tortuous canals, that certain 
cavities which appeared simple during the examination might 
become compound in nature; also that a certain twist in the 
occlusion might be discovered, making an additional abutment 
necessary for stabilization. All of these conditions, and many 
others which might prove to be in existence and which the 
dentist has not taken into account at the time he made his 
“contract fee,” will cause him to operate at a loss. Even 
though his intentions are good he might try to cut the corners, 
in the same way that a house contractor might do when he 
realizes he is facing a loss. 
At some time or other the patient is bound to realize that 
certain of the work has not been properly done, all of which, if 
the dentist is not interested, results in a dissatisfied patient, 
or he may be put to a further loss to himself in making the work 
good. The term “contract fee” should be eliminated from the 
practice of dentistry, and in place of it the term “approximate 
fee” should be used. 
Special Fees 
Fees termed as “special” are very uncommon in dentistry, 
because it is only seldom in the average dentist’s practice that 
occasion for them arises. A patient may have to make an ex- 
tended trip abroad, or may be suddenly called upon to do some 
extensive travelling in our country. These calls might occur 
at a time when the mouth is in dire need of repair, and the 
possibility of toothaches while enroute prompts the patient to 
seek the services of a dentist and to demand the majority 
of his entire number of productive hours for the period of a 
week or two, preparatory to making the journey. If the 
dentist desires the case, it is necessary for him to cancel the 
appointments of many of his patients, and perhaps at a 
certain loss to himself. It is for this reason that a new patient, 
demanding the dentist’s entire time for a week or two, should 
be expected to pay a special fee to offset a possible loss through 
the cancellation of appointments of regular patients. 
The amount of the special fee depends entirely upon local 
conditions, and rests with the individual dentist. Some dentists 
98 Practice Building Suggestions 
attach a special fee of fifty percent over and above what they 
would ordinarily get for a similar case, if handled by them in the 
regular way. Whether or not the patient should be told of the 
special fee also rests with the dentist, and depends entirely 
upon the type and class of patient. Some of them would 
expect to pay an additional fee for this special attention. 
Others again would object to it. We believe the best policy to 
be frankness in informing the patient that the intensive service 
will be rendered in a satisfactory manner, but at a fee which 
will reimburse the dentist for a possible loss through the 
cancellation of appointments already made. 
Special fees are occasionally attached to cases where it is 
absolute speculation as to what is really indicated in the way of 
restorative work. These cases, most odd and complicated in 
nature, sometimes require the removal of a certain type of 
denture or bridgework after it has been worn for a short time. 
This procedure involves a mechanical restoration of an entirely 
different type which, in turn, may have to be discarded in favor 
of something which proves itself more practical. In other words, 
a special fee is attached to those cases involving many make- 
overs and adjustments and entailing a series of study models, 
in addition to possible consultations with other dentists. 
Special fees are also attached to heavy surgical cases which 
require dentistry involving a restoration of facial expression, 
due to accidents, etc., and again, in cases of bedridden patients 
where it is necessary for the dentist to do the operative work 
at the home or in the hospital, and spend a considerable number 
of hours going back and forth before the case has been com- 
pleted. For these cases the dentist is entitled to a special fee, 
because they involve considerable risk, not only for the patient 
but for the dentist as well. 
If the dentist is strict in basing his fees on an hourly charge, 
special fees can be dispensed with except in cases where a 
patient requires the dentist’s entire number of productive hours 
over a long period. However, if the dentist is not operating on 
the hourly basis, then it is good policy to quote special fees on 
such cases as are enumerated in this writing, adding anywhere 
from fifty to one hundred percent to what the case might 
amount to under normal conditions. 
99 Practice Building Suggestions 
SECTION V 
Following-up Your Patients 
Periodical Examination Cards 
.4 NY person who has ever been subjected to an extrac- 
tion or to restorative work usually leaves the dental 
office at the conclusion of the last appointment with 
the thought and hope that it will never be necessary to go 
through the same experience again. The patient has listened 
to the dentist’s various health talks and final advice on mouth 
hygiene with the firm conviction that the instructions given 
will be carried out minutely. For a time the resolution for 
mouth hygiene is religiously adhered to, but through the idio- 
syncrasies of the human mind, enthusiasm wanes in the pres- 
ence of new and interesting subjects that clamor to undermine 
the best of resolutions. In addition to this, due to another 
trickery of the mind, the ordeals lived through in the dental 
office are soon forgotten with the result that mouth neglect 
once more holds sway. 
In all mouths where artificial restoration exists certain 
changes are apt to take place, such as a minute shifting of 
the teeth, resulting in separation of certain areas and over- 
crowding of others; again the unforeseen gradual development 
of margins around gold, alloy and silicate restorations. All of 
these things and many others in their development prove 
catch-alls for bacteria, resulting in gradual tooth destruction 
and diseased tissue. This retards the proper functioning of 
artificial restorations, which results in gradual failure. You 
being aware of these possible conditions and dealing with the 
human element, cannot guarantee your work. In order to 
safeguard your reputation as much as possible you are inter- 
ested in keeping a close check on your work so that at the 
first indication of the development of adverse mouth condi- 
tions you can ward off a possible ruination of your efforts, 
which through the lack of understanding by the patient might 
be condemned as poor workmanship. In addition to safe- 
guarding your work you also safeguard the patient’s interests, 
because if given attention by both parties when these gradual 
100 Practice Building Suggestions 
changing conditions first present themselves it minimizes the 
expense as well as saves the patient’s time and the possibility 
of more ordeals. For these reasons the patient should submit 
to periodical examinations once every three months or six 
months at the most. At the conclusion of a series of visits 
to the dentist the patient always promises to return for this 
periodical examination, but for reasons already given this 
promise is soon forgotten. 
The periodical examination card was evolved to help elimi- 
nate as much as possible this shortcoming on the part of the 
patient. Its function is to call the patient’s attention to the 
fact that a certain period has expired since the last dental 
examination and, in accordance with his desire, expressed at 
the time of his last visit, the card has been sent for the purpose 
of reminding him to make a voluntary appointment. No 
patient, no matter how sensitive, can take exception to receiv- 
ing a periodical examination card, providing the dentist has 
done his part in the way of explanation during the patient’s 
last sitting. 
Some dentists in sending these cards even go so far as to 
specify on them the date and hour for the patient to present 
PERIODICAL EXAMINATION AND CARE OF 
THE TEETH IS ECONOMY AND PROMOTES GOOD 
HEALTH AND APPEARANCE. 
IT HAS BEEN SOME TIME SINCE YOUR LAST 
VISIT. MAY I SUGGEST THAT YOU MAKE AN 
APPOINTMENT? 
H. H. HAMILTON, D. D. S. 
2500 JEFFERSON AVE. 
PHONE GEN. 104 ROCHESTER, N. Y. 
himself for an oral examination. This may be offensive to 
some and on the other hand meet with approval from others. 
101 Practice Building Suggestions 
You must be the judge in this respect. We believe the 
most practical way is to send the periodical card minus the 
stated appointment. This puts it up to the patients and if 
they do not telephone for an appointment within a few days 
it should then be the duty of the nurse to get into communi- 
cation with them and attempt to make an appointment. The 
illustration, page ioi, is our suggestion for the wording of the 
card, the size of which should be inches x inches. 
A periodical examination card should be sent to patients 
with normal mouth conditions once every six months. Where 
unhealthy tissue conditions exist, as well as tooth abrasions 
and erosions, once every three months. 
Follow-Up by Letter Because of Added Facilities 
The following letter suggestion may be used by dentists who, 
because of a rapidly growing practice and the lack of a second 
operating room, have not been able to properly follow up their 
patients. The fact that the dentist has found it necessary to 
secure additional space in order to serve his practice more 
efficiently will assure them that he is not encouraging periodical 
examinations because of a lack of patients. 
Letter No. i 
Dear Mr : 
Most of my patients have frequently asked me to commu- 
nicate with them at a time when, in my estimation, a 
periodical examination is necessary. I have not been able 
to comply with these requests because of insufficient office 
space. 
I have been fortunate in securing an additional room 
adjacent to my present suite, which has allowed me to fully 
equip a second operating room. This puts me in a position 
to serve my patients efficiently on periodical examinations. 
These examinations, in most cases, should be given once 
every three to six months. 
Aside from safeguarding your health through a prompt 
detection of dental trouble which might have developed 
since your last visit to my office, I am also interested in re- 
viewing the dentistry which I have given you. With this in 
mind, and because of my added facilities, I have taken the 
liberty to instruct my secretary to communicate with you. 
Yours very truly, 
Some dentists who feel the need of a second operating room 
may secure it through a re-arrangement of the dental suite. 
102 Practice Building Suggestions 
For the same reasons given in the explanatory note accompany- 
ing the previous letter, the following suggestion is offered. 
Letter No. 2 
Dear Mr : 
So as to be of greater service to my patients, I have re- 
arranged my dental suite, which has resulted in an additional 
operating room. This added facility will be devoted exclu- 
sively to periodical examinations of my patients. Such 
examinations should be made at least once every three to 
six months. To do so is a first aid in promptly detecting 
failing teeth and diseases of the mouth. 
Aside from safeguarding your health orally, I am inter- 
ested in making a check-up of the dentistry given you during 
your last appointments so as to determine that it is properly 
functioning for you. With this in mind, and because of my 
added facilities, I should be pleased to have you communicate 
by telephone with my secretary, who will arrange an 
appointment. 
Yours very truly, 
The following letter is suggested for dentists who have in- 
stalled x-ray equipment and who want to call patients’ atten- 
tion to the x-ray service which they are prepared to render. 
Letter No. 3 
Dear Mr : 
The dental x-ray has become of such vast importance 
to the dental profession in disclosing hidden diseases afflict- 
ing the tissue and bone structure of the mouth that it is now 
looked upon as a first aid in diagnosis’ The x-ray reveals 
conditions which the human eye cannot see and of which 
patients are not conscious. 
So that I may serve my patients more efficiently, par- 
ticularly on diagnosis of hidden diseases, I have just installed 
the latest in dental x-ray equipment. This now makes it 
possible for me to check up, through the medium of the 
x-ray, the dentistry which I have given you. This will 
enable me to complete my records on your case, and also 
to get a positive check as to whether or not unhealthy, deep- 
seated conditions exist in your mouth. 
I have instructed my secretary to communicate with you for 
the purpose of arranging an appointment so that your health 
interestsmaybesafeguardedthroughscientificdiagnosis,made 
possible by the x-ray equipment which I have just installed. 
Yours very truly, 
103 Practice Building Suggestions 
Some dentists have certain periods during the year in which 
there is a considerable falling off of appointments. It is at 
such times that the dentist can capitalize on his x-ray equip- 
ment, and through it create other dentistry through diagnostic 
services which would not be brought about if the dentist were 
content to wait for his practice to pick up. The following letter 
suggestion will at least bring patients to the office and make 
possible the elimination of idle office hours. The letter should 
be sent to a carefully selected list of patients. 
Dear Mr : 
I feel that you realize the close relationship between 
healthy mouth conditions and general health, and in order 
to bring about this result a full set of x-ray pictures is 
necessary. 
To permit me to be of the greatest service to my patients 
I need a complete record of the work done, and for this 
purpose may I ask that you come in and allow me to make a 
full set of x-ray pictures of your teeth so that I may com- 
plete my records in your case? 
This service will be rendered without obligation to you. 
You will find an appointment card enclosed, stating the 
time which I have reserved for you. If not convenient, will 
you please notify me so that I may assign this time to some- 
one else ? 
Trusting that you will accept this service in the spirit 
in which it is offered, I am 
Very truly yours, 
Letter No. 4 
The third paragraph of the foregoing letter states that “this 
service will be rendered without obligation to the patient.” 
It must be admitted that the actual cost of taking x-ray pic- 
tures is very small. For this reason the dentist who is idle can 
afford to render this service gratis because of the additional 
dentistry which will be created through the medium of x-ray 
diagnosis. It is better for dentists to try to fill in their idle 
time in this fashion during the dull season than to be content 
to allow their overhead to go on unabated without putting 
forth any efforts to offset it. It is for these reasons that the 
letter should be sent to a carefully selected list of patients, who 
will appreciate the service and who will respond should un- 
healthy mouth conditions be revealed. 
104 Practice Building Suggestions 
SECTION VI 
Forming Partnerships, Working Agreement 
and Legal Forms 
MANY partnerships end disastrously through failure to 
have a thorough understanding in the beginning. We 
will assume that a dentist with a fairly up-to-date 
office, including two operating rooms (one of which is not in 
use) and with a fairly profitable practice, desires to form a 
partnership with another dentist who has a small practice, 
obsolete equipment, etc., but who is a good operator and who 
has accumulated some savings. The latter intends to dismantle 
his office, sell his old equipment, furnishings, etc., with the 
idea of starting into partnership with the first dentist and in 
doing so will purchase a new outfit. With this general under- 
standing, they decide to go into business. 
The first dentist has approximately $10,000 invested, after 
deducting depreciation. The second dentist will buy about 
$2000 worth of new equipment. The first dentist has earned 
more over a period of years than the second dentist. They 
intend to share equally the profits of the business. 
Under the above conditions: 
(a) How much should the second dentist pay the first dentist 
to make the investment of each equal? 
(b) Should the second dentist pay the first dentist any 
further sum, and for what? 
(c) What provisions should be made in a partnership agree- 
ment with respect to 
1. Drawing account at bank 
2. Duties of each 
3. Profits 
4. Deficits 
5. Length of agreement 
6. Renewals of agreement 
7. After all conditions have been agreed upon in a 
preliminary way, what is the final step in com- 
pleting the transaction previous to commencing 
business? 
105 Practice Building Suggestions 
Many partnership agreements are entered into without 
fully considering some of the essentials that are necessary 
for a complete and harmonious undertaking in which the 
welfare and future of each partner should be carefully consid- 
ered and provided for. It would be impossible here to cover all 
of the points that might be embodied in a partnership arrange- 
ment as the details of each agreement will depend somewhat 
upon the circumstances, but there are certain essentials that 
should be covered in every agreement and which are herein 
touched upon. The conditions set forth in the question take 
into consideration that each partner will share equally in the 
profits of the business. Therefore, the preliminary or tenta- 
tive understanding should provide among other things that: 
{a) The second dentist, in this instance, will pay the first 
dentist the sum of $4000 in order to make the investment of 
each partner equal, namely, $6000. 
{b) The first dentist has earned more over a period of years 
than the second dentist, which may be due to either better 
business methods or a more lucrative patronage, or to other 
reasons, which means that he will bring into the partnership 
a greater earning power than that possessed by the second 
dentist. Therefore, the second dentist should pay to the first 
dentist a cash sum (to be agreed upon) to cover this excess 
earning power, or, what is sometimes termed, goodwill. 
(c) 1. A joint account should be arranged for at the bank 
and provision made that all checks drawn must bear the sig- 
nature of both partners. 
2. The specific duties of each partner should be agreed upon 
in order to avoid arguments in the future over which classes 
of work shall be performed by each partner. 
3. Profits should be arrived at after full allowances are made 
for all operating expenses, including amount for salary drawn 
monthly by each partner, proper reserves for depreciation, 
etc., and should not be withdrawn from the business unless 
there is sufficient working capital and cash reserves out of 
which to pay profits. 
4. If profits are to be shared equally then any deficit should 
be made good by each partner equally and promptly. 
5. A partnership agreement should be entered into for not 
more than a year’s time, as many unusual and unforeseen 
106 Practice Building Suggestions 
circumstances may come up and either may wish to withdraw 
which might lead to a disagreeable misunderstanding if entered 
into for a longer period. 
6. Provision for a renewal should be made and the conditions 
in the new agreement may be varied according to past exper- 
iences and circumstances. 
7. After the foregoing points have been agreed upon in a 
preliminary way, the final and most important step to be 
taken is to have the agreement drawn up by an attorney in 
legal form. 
It should be remembered that partners in the actual practice 
of a profession are liable for the independent malpractice of 
either 4 
JHyrne vs. Erwin, 23 S. C. 226. 
Whittaker vs. Collins, 34 Maine 299. 
Hess vs. Lowrey, 112 Ind. 225. 
A standard form of agreement, which of course will be sub- 
ject to changes according to circumstances, follows: 
Form for Partnership Agreement Between Dentists 
AGREEMENT, dated the 
day of 19 , between A., 
of party of the first 
part, and B., of party of the second part. 
Whereas the parties hereto are desirous of entering into a 
partnership agreement for the carrying on of their profession 
as dentists. 
Now, Therefore, in consideration of the premises and the 
mutual agreements hereinafter set forth the parties hereto 
agree as follows: 
1. The partnership shall be carried on under the firm name 
of A. and B. The business of the said firm shall be conducted 
at the offices now occupied by B. at No , City of 
or at such other place within said City 
as the partners shall from time to time agree upon. 
2. The capital of the partnership shall consist of all the 
premises, furniture and equipment of the offices now owned 
by B., the same to be valued at the sum of ($ ), 
and new equipment for the use of A. to be purchased by him 
107 Practice Building Suggestions 
for the sum of ($ ). The good will of the 
business now carried on by both parties is hereby conveyed 
to the firm. 
3. All moneys received by the partners or either of them for 
the account of the partnership shall be immediately deposited 
to the credit of the partnership in the Bank 
and partnership funds shall be drawn only upon checks signed 
in the firm name by both partners. 
4. All rents, repairs in the equipment deemed necessary by 
both parties, wages of nurses, servants and other expenses 
that may be incurred in conducting the business and all losses 
and damages incurred in carrying on the business shall be 
paid out of the earnings of the partnership and if the same 
shall not be sufficient, then the parties hereto agree to share 
in equal parts such expenses, losses or liabilities. 
5. Each partner shall be entitled to withdraw upon the 1st 
day of each month a sum not exceeding ($ ); 
provided always that neither partner shall at any time by such 
withdrawal reduce the funds of the partnership on deposit 
below the sum of ($ ), which sum shall be 
maintained as a reserve fund for depreciation, contingent 
expenses, etc. and the parties hereto agree that in the event 
that by reason of partnership losses, expenses or otherwise, 
said reserve fund shall be reduced below the said sum of 
($ ) that the parties hereto will in equal 
proportion replace moneys in the said reserve fund so that 
it shall always be maintained at the sum of not less than 
($> ). All sums of money withdrawn by either 
of the partners shall be charged against" the profits due the 
partner withdrawing the same. 
6. The partners shall share equally in the profits of the 
business. The profits in excess of the reserve fund above 
provided for remaining in the partnership after the payment 
of the monthly withdrawal allowance above provided for 
shall be distributed to the partners at the end of each year 
or at such other times as may from time to time be agreed 
upon between the partners. 
7. At all times during the continuance of this agreement 
both parties shall give their time and attendance and to the 
108 Practice Building Suggestions 
utmost of their skill and power will exert themselves for 
their joint interest, profit, benefit and advantage. 
8. The division of the work between the partners shall be 
as follows: 
A. will as far as is practicable and consistent with the 
best interests of the partnership devote his time to (here 
describe the class of work which it is intended to be done by A.). 
B. will as far as is practicable and consistent with the best 
interests of the partnership devote his time to (here describe 
the class of work which it is intended to be done by B.). 
9. Neither partner shall hire or dismiss any employe, assis- 
tant or servant without the consent of the other. 
10. Neither partner shall, without such previous consent, 
use any of the moneys or effects of the partnership or pledge 
the credit of the partnership except for the use or account 
thereof. 
11. Neither partner shall, without such previous consent, 
compromise or release any debt or liability to the partnership. 
12. Neither partner shall, without such previous consent, 
enter into any bond or become bail, surety or security with 
or for any person. 
13. Proper books of account shall be kept, and entries made 
therein of all money expended and received by, and debts 
due to and from, and of all other matters and things relating 
to the partnership usually or properly entered in books of 
account kept by dentists, and in particular each partner 
shall enter in proper books all charges for professional business 
transacted by him, with all necessary particulars relating 
thereto. Such books and all papers, letters and writings relat- 
ing to or belonging to the partnership shall be kept and shall 
remain at the offices of the partnership, and each partner 
shall at all times have free access thereto. 
14. This agreement shall continue for a term of one year 
from the date hereof and shall be renewed upon the same 
terms and conditions for another year and thereafter from 
year to year unless one of the partners shall at least thirty 
days before the expiration of the year then current, notify 
the other partner in writing of his intent to dissolve the said 
partnership, in which event the said partnership shall termi- 
nate at the end of the said year then current and the partner- 
109 Practice Building Suggestions 
ship assets after the payment of all of the partnership lia- 
bilities shall be equally distributed between the partners. 
15. In case of the violation of any of the covenants and 
obligations of this agreement by either of the parties hereto, 
the other party may at his option dissolve the partnership by 
giving such other partner written notice of his election so to 
do within days after becoming 
aware of such violation. 
16. If either of the said partners shall die during the con- 
tinuance of this partnership the surviving partner may at his 
option purchase the interest of the deceased partner in the 
partnership at a price to be fixed by some disinterested person 
to be agreed upon between the surviving partner and the 
legal representatives of the deceased partner and in the event 
no such agreement can be made then the price which the 
surviving partner shall pay in order to purchase the interest 
of the deceased partner shall be fixed by three appraisers, one 
of whom shall be designated by the surviving partner and one 
by the legal representatives of the deceased partner and the 
third to be appointed by the two appraisers named as aforesaid. 
In the event that the surviving partner shall exercise his 
option to purchase at the price so fixed, payment therefor 
shall be made by the surviving partner to the legal represen- 
tatives of the deceased partner within 
days from the date of the fixing of the purchase price. 
In Witness Whereof the parties to this agreement have 
hereunto fixed their hands and seals all as of the day and year 
first above written. 
What are the advantages of a “working agreement” between 
two dentists, compared to that of a partnership arrangement? 
What is the most practical and satisfactory basis upon which 
a dentist known as “A,” with an increasing practice, may 
select an associate known as “B,” under the following con- 
ditions: 
110 Practice Building Suggestions 
Dentist “A” has a modern office with a large and growing 
practice and can secure additional space in his present 
location. 
Dentist “B” has his own equipment sufficient for one 
operating room, and will move into “A’s” location. 
Dentist “A” has been doing about twice the amount of 
business done by Dentist “B.” Both have good repu- 
tations. Dentist “A” will provide all reception room 
furniture, etc., Dentist “B” simply moving his equip- 
ment into one of the two operating rooms in Dentist 
“A’s” location. 
Under the above conditions, what should be “B’s” share of 
rent, telephone, dental nurse charges, etc.? What proportion 
of fees collected by “B” from patients turned over to him by 
“A” should be given by “B” to “A” during the time such 
patients continue to have their work done by “B”? 
First year % 
Second year % 
Third year and thereafter % 
The advantages of a “working” agreement between den- 
tists compared to a “partnership” arrangement are many. 
Most agreements are the result of a chain of circumstances 
which are easily affected by changing conditions most of 
which cannot be foreseen. Best results are obtained in an 
office where “one” is master and not “two” as in a “partner- 
ship” agreement. It is a difficult matter to divide the power 
of a practice equally. Most dentists with experience have 
their own ideas and it is sometimes very difficult to readjust 
or reconcile these ideas with those of others. Marked differ- 
ences of opinion are more liable to arise after becoming asso- 
ciated with a partner than can be demonstrated beforehand 
and then it is too late to correct the mistake. It is much 
better for all concerned for one dentist to be in absolute con- 
trol of a practice and employ others on a “working”agree- 
ment basis. Such an arrangement should be initially entered 
into for a relatively short time (three to six months), or if 
for a longer period should include a termination clause on 
three to six months notice by either party, which will give 
each an opportunity of finding himself. 
111 Practice Building Suggestions 
Under the conditions named in the question, an equitable 
“working” agreement would, among other provisions, include 
the following: 
1. On the basis that A has about twice the patronage as 
B, the rent, telephone service, dental-nurse services, light, 
heat, etc., would be divided as follows, which takes into con- 
sideration also B’s share of the depreciation and use of A’s 
reception room furnishings etc: 
A’s share 60 per cent 
B’s share 40 per cent 
2. B. should provide at his own expense all operating 
equipment, materials and supplies used in his practice. As 
his practice increases he should also provide at his own expense, 
the services of a dental nurse, leaving the first nurse free to 
serve A. exclusively. Another phone might also be necessary, 
the expense of both items then being withdrawn from the ori- 
ginal understanding, each dentist paying his own expenses 
in that respect. 
3. For all cases turned over to B. by A., A. should receive 
from B. the following proportion of fees collected by B.: 
During the first year 40 per cent 
During the second year 35 per cent 
During the third year and 
thereafter 30 per cent 
4. Should new patients come to B. voluntarily, he would 
retain the full amount of each fee. This would not only be 
equitable, but an incentive for B. to put forth his best efforts 
in building a future practice for himself, which every ambitious 
dentist working under like conditions should look forward to. 
At the same time, although obliged to give up a large share of 
his fees, he is undoubtedly benefitting by the association and 
influence of usually an older and more experienced practitioner. 
A standard form of agreement, which of course will be 
subject to changes according to circumstances, follows: 
Form for Working Agreement Between Dentists 
AGREEMENT, dated the 
day of 19 , between A., of 
party of the first part and 
B., of party of the second part. 
112 Practice Building Suggestions 
Whereas both parties hereto are dentists practicing in 
the City of and desire to make an 
arrangement whereby B. will move into the offices now occu- 
pied by A. and have the use of an operating room and other 
facilities hereinafter mentioned now included in the offices 
of A. upon mutually satisfactory terms. 
Now, Therefore, in consideration of the premises and of 
the mutual agreements hereinafter set forth, the parties hereto 
agree as follows: 
1. A. is to permit B. during the period of this agreement to 
have the use of one of the operating rooms now included in 
A. offices, such room to be designated by A. 
2. A. agrees to provide complete dental suite facilities and 
furnishings (with the exception of operating equipment), 
telephone and the services of a dental nurse for the joint use 
of both parties and B. agrees to pay to A. for the use of such 
facilities and furnishings, telephone, services of dental nurse 
and other facilities furnished by A. an amount equal to one- 
third of the cost to A. of such services or facilities. It, however, 
being agreed between the parties hereto that B. will at his own 
expense employ a dental nurse when in the opinion of A. the 
joint practice of the parties hereto require the services of 
another dental nurse, in which event B. shall be no longer re- 
quired to pay any part of the compensation payable by A. to 
his dental nurse. 
3. B. agrees to move into the operating room in A.’s office 
to be designated by A. his dental equipment and to furnish 
at his own expense all equipment and materials used by him 
in his practice. 
4. Neither party shall be entitled to receive any share of 
the compensation received by the other party for professional 
services performed by such party for his own patients; it, 
however being agreed that during the first year of this agree- 
ment B. will pay to A. for all cases turned over to him by A. 
40 per cent of the compensation received for services performed 
for patients so assigned to him by A., and that during the sec- 
ond year of the said agreement B. will pay in all such cases 
35 per cent of the fees received from patients assigned to 
him by A. and that during the third year of this agreement 
B. shall pay A. 30 per cent of the fees received from patients 
113 Practice Building Suggestions 
assigned to him by A.; it being understood, however, that 
B. shall not pay to A. any part of his compensation received 
from new patients who come to B. voluntarily. 
5. This agreement is to extend over a period of 
years from the date hereof except that either party shall have 
the right to terminate this agreement upon giving to the other 
party months notice in writing of his intent 
to so terminate the agreement. 
6. It is expressly understood and agreed that this is not 
a partnership agreement and that neither party is the agent 
of the other for any purposes whatsoever and that neither is 
liable in any manner or to any extent for the debts or liabilities 
of the other whether personal or professional. 
In Witness Whereof the parties hereto have hereunto 
set their hands and seal this day of 
19 
114 Practice Building Suggestions 
SECTION VII 
Intimate Hints for the Dentist 
BY talking health we mean that a dentist should first 
give a full explanation to his patient as to what benefits 
will be received from a health standpoint. 
Mechanical features should be kept in the background until 
the subject of health has been thoroughly discussed. Every 
patient improves his health in one way or another through 
good dentistry and the dentist must lay stress upon these 
benefits. Men and women, and even children, know that to 
properly enjoy life they must be healthy. When appealing to 
them from the health viewpoint their attention and under- 
standing is more easily gained than when mechanical principles, 
as involved in dentistry, are made the main subject. 
An appeal by the dentist from a purely mechanical stand- 
point places what he has to sell on a commodity basis and 
usually causes a desire on the part of the patient to shop and 
make strictly price comparisons. 
Patients cannot appreciate the importance of mechanical 
dentistry and are inclined to believe that a crown is a crown 
and a hole in the tooth is one merely to be plugged up. The 
successful health appeal is one which creates the desire for 
the dentist’s health treatment and makes the mechanical 
restoration merely a “means to an end.” If we want the laity 
to know that dentistry is a real science then dentists had 
better not make “mechanical restoration” the prime subject 
of their appeal, until after the patient’s first or second visit. 
After a health talk has been properly given which embraces 
such subjects as immediate health improvement, future health 
benefits, removing mouth offensiveness, personal appearance, 
etc., and the dentist is sure that these points have impressed 
the patient, then is the opportune time to explain, with the aid 
of study models, the mechanical side of the question. Study 
models are a valuable aid in bringing truths home to patients 
because it is second nature for them to believe things that 
they can see. This method of selling health dentistry is very 
Health Hints as a Factor in Selling Your Services 
115 Practice Building Suggestions 
THE DENTIST 
“He profits most who serves best” 
Skill 
Personality 
Location 
Equipment 
Organization 
ESSENTIALS 
FOR A 
SUCCESSFUL 
PRACTICE 
Office Environment 
Study 
Fees 
Records 
Accounts 
Ethical Publicity 
Honesty 
Business Psychology 
Enthusiasm 
REWARDS 
Professional 
Financial 
Social 
Respect 
Savings 
Factor in 
Community 
Investments 
116 Practice Building Suggestions 
effective because the patient is given enlightenment upon the 
subject which is not possible without the aid of study models. 
Patients often have to confer with other members of their 
family as to whether or not is it advisable to enter into a con- 
tract with the dentist, especially if the case is big and the 
fee involves considerable money. In such instances, if the 
dentist has not enthused the patient with the health feature 
of the case, the only side which will be discussed at home is 
the fee involved. However, if the patient goes home enthused 
with the health side of the case the fee will be only a second- 
ary consideration. This again avoids bringing up at home the 
names of other dentists who might do the mechanical work 
for less. Patients who are told only of the mechanical side 
of the question will go home with the fee foremost in their 
minds and tell other members of the family that the dentist 
proposes to give them a denture or a bridge for $150. To 
most people it appears that any dentist can make a bridge 
or denture and usually for considerably less money. To them 
there is no difference in these appliances and they presume 
that all dentists not only use the same material but also work 
alike. They do not know that many dentists might suggest 
certain classes of work which are really contra-indicated in 
their particular case. 
If the dentist has given the patient an intelligent and under- 
standing health talk that patient will carry the story to the 
other members of the family and relate it to them from the 
health viewpoint. The dentist should remember, however, 
that even at its best, the story will only be half told. He will 
do well to display his personal interest in the patient by making 
an appointment for another member of the family who perhaps 
might be interested only in the fee side of the case. The 
purpose of the appointment is to give that person the very same 
health talk which was given the patient. If the patient is 
enthused with what the dentist had to impart, the third party 
no doubt will also enthuse when given the story at first hand. 
All of this procedure, if properly carried out, will make the 
mechanical side of the case a “means to an end” and the fee, 
which ordinarily would be first in thought, will be placed in 
the background. 
People are the same the world over. They question those 
117 Practice Building Suggestions 
things which they do not clearly understand. They do, how- 
ever, want to believe those things which they understand 
sufficiently to know that added comfort and health will be 
gained through them. 
Talking over a Patient’s Head, Its Meaning 
By “talking over a patient’s head” we mean that a dentist 
makes a mistake with the average patient by explaining to 
him in highly technical terms what he proposes to accom- 
plish. The average person knows little or nothing about occlu- 
sal surfaces, inter-proximal spaces, the free margin of the gum 
and many other similar phrases. The patient may appear to 
be listening and in most cases does so out of courtesy, but 
this is not always an indication of his grasping the highly 
technical thoughts which the dentist is giving. Patients as 
a rule are not apt to display their ignorance by requesting a 
further explanation of these things. The result is the pro- 
motion of a question in their minds with regard to the work, 
even though they consent to have it done. This usually results 
in a dissatisfied patient at the conclusion of the work. In some 
instances patients will put the dentist off by stating that they 
want to think it over and that they will come back again, but 
generally do not do so. 
The dentist should couch his explanations in the terms 
most easily grasped by the patient. 
A Nucleus for a Prophylactic Health Talk 
The dental profession has a very noble aspiration—namely, 
to eventually eliminate the necessity of having to make restor- 
ations. This end is to be brought about through teaching by 
the profession, and the gradual evolution of the younger 
generation. This degree of excellence can only be secured 
through preventive dentistry commonly known as prophylaxis. 
Prophylactic treatments are slowly but surely becoming 
popular with the layman, and especially with the younger 
generation to whom it is being taught in all educational institu- 
tions. Ignorance of the virtues of prophylaxis still exists with 
the greater percentage of parents. If this condition is to 
remain, then the progress and ultimate goal of the dental 
profession will be greatly retarded, and the health of the masses 
118 Practice Building Suggestions 
continue to be impaired. Many parents are being reached 
by the dentist through the education given their children on 
mouth hygiene. The greater percentage of them, however, try 
to belittle the efforts of the dental profession as a whole and the 
educators who are making the teaching of mouth hygiene their 
life work. 
If prophylaxis is preventive dentistry, or a stepping stone to 
it, then it should be the purpose of each dentist to not only 
preach prophylaxis, but to get every patient to consent to 
complete prophylactic treatments. Unless the patient is given 
something to visualize, it is difficult for him to differentiate 
between ordinary tooth cleaning and prophylaxis, for this 
reason he believes the average fee asked by the dentist is not 
justifiable for what he is to receive in return. 
Patients have been told many conflicting stories about their 
teeth as causes for tooth destruction. It has been stated to 
some that they are subject to tooth decay, because their teeth 
are naturally soft. Some were told their trouble could be 
attributed to a general salivating condition. Less than a 
decade ago, most of them were told that when the mouth is 
once in complete repair, and providing they brush their teeth 
religiously, further tooth decay would be eliminated. Regard- 
less of these statements and the patient’s efforts, tooth decay 
continued even in the presence of the best restorations. The 
profession, as a whole, has done the best it could, and cannot 
be held to blame because dental research had not discovered 
the cause of tooth destruction which was evident in apparently 
healthy mouths. 
The origin, and nature of plaques, and the fact that they are 
evident in every mouth, which has never been subjected to 
prophylactic treatments should be fully explained to the 
patient. Evidence of their presence should be proven through 
the application of disclosing solution and through the medium 
of a transilluminating room and the aid of a transilluminating 
lamp. The patient should be told that the black specks which 
are only visible through the foregoing procedure are colonies of 
micro-organisms whose ambition it is to energize sufficiently 
to break through the enamel wall, thereby starting rank tooth 
destruction. 
The patient should be told that the only reason plaques can 
119 Practice Building Suggestions 
accumulate in colonies on surfaces of teeth is through the col- 
lection of foreign substances, resulting from the improper 
brushing of the teeth, or because of roughened enamel surfaces, 
or imperfect tooth restorations which afford a harboring place 
for these colonies. Prophylaxis technique should be so fully 
explained that the patient realizes that it requires no little 
effort for the proper removal and elimination of plaques, and 
so there is the understanding that the fee asked by the dentist 
is commensurate with the work. Patients will be surprised to 
learn that a bristle brush or other polishing medium will not 
remove plaques, and that this can only be accomplished through 
the use of steel instruments designed for the purpose. Every 
particle of tooth surface, including the free margin of the gums, 
must be planed with painstaking care. Patients do not know 
that when the plaques have been removed their former loca- 
tions on the tooth are left in a roughened state, and that the 
dentist must go over these surfaces again with effective polish- 
ing material, in order to polish the plaques’ former locations 
and the balance of the tooth to a mirror-like finish. When this 
technique has been minutely followed out, the restorative work 
having been made as perfect as possible, then, providing the 
dentist will educate the patient to properly floss and brush his 
teeth and the patient religiously carries out these instructions 
plus periodical examinations and barring accidents, this indi- 
vidual patient will have preventive dentistry. 
Patients must be made to feel the results of prophylaxis 
in an imaginary way before the treatments take place. They 
must be told that the old rank taste constantly present in 
the mouth will, through these treatments, be eliminated. They 
should be told that the offensive taste will not be evident when 
they wake up from a night’s sleep. A sudden awakening to an 
offensive breath on their part, during close conversation, will 
be absent. It perhaps is needless to say that all patients have 
a desire for the elimination of breath offensiveness, as well as 
to establish in their own mouths preventive dentistry. 
It is not the fee which causes the average patient to stop 
at prophylaxis, but is instead a lack of understanding. It is up 
to the dentist in his prophylactic health talk to patients to 
not only give them an understanding of it, but also to make 
them see it through the medium of the transilluminating room, 
120 Practice Building Suggestions 
and to gauge his talk in such a way that the patient will feel, 
through imagination, the freshness of it in his mouth. The 
dentist who has submitted to complete prophylaxis in his own 
mouth, who practices what he preaches, and who believes in 
it, has no difficulty in giving prophylaxis to his patients at a 
remunerative fee. 
Dentists who can enthuse their patients will have no difficulty 
in making them understand why an average case of complete 
prophylaxis on a full upper and lower set of teeth cannot be 
completed within a total time of less than 6 to 8 hours. Patients 
of average intelligence can then understand the difference 
between prophylaxis and ordinary tooth cleaning. Patients will 
no doubt believe the dentist when he states that, if they want 
an ordinary tooth-cleaning, they can do for themselves just as 
good a job as he can by purchasing a new tooth-brush and a 
can of tooth powder and brushing their own teeth for 20 
minutes at home, thus saving the fee. 
Space will not permit a more detailed treatise on a prophy- 
laxis health talk. We have tried to form a nucleus around 
which to build your story most receptive to it. 
Practising What You Preach 
If you were being introduced to a tailor, who was wearing 
a shabby suit of clothes, you would be inclined to form your 
opinion of him upon several things. The principal one would 
be that the suit of clothes which he had on was made in his 
shop and that it is suggestive of the type of work he does. 
A shabby suit, aside from being out of date, is usually a misfit, 
even though it originally was a model. 
Your next impression would be his lack of enthusiasm for 
his product, which in itself suggests failure. Under the above 
conditions it would be hard for him to convince you that what 
he suggests for your personal apparel and welfare is authentic. 
This tailor would not get your patronage. 
This illustration could be applied to certain dentists in 
exactly the same way. The dentist who owns a shabby office, 
which through obsolete equipment is completely out of date, 
automatically suggests to his patients that he is not pro- 
gressive, and if so is not in a position to care scientifically for 
their welfare. 
121 Practice Building Suggestions 
There is another way that the “tailor” illustration can be 
applied to certain dentists, this being to those whose mouths 
show evidence of neglect. When a dentist is being introduced, 
the new acquaintance unconsciously glances at the dentist’s 
mouth, and if it bears evidence of things contrary to good 
dentistry and the teachings of mouth hygiene, the new acquain- 
tance cannot help but accept this as sure evidence of the den- 
tist’s failure in his profession, as well as his incompetency to 
suggest to his patients what they should have as laid down 
and taught by international authorities upon the subject of 
dentistry. 
Certainly a dentist who does not practice in his own mouth 
what he preaches cannot enjoy that real confidence which not 
only enthuses his patients with his ability, but also causes 
them to go out of their way to tell others of it. Every successful 
man, whether professional, business or tradesman, practices 
what he preaches. 
Correct Office Wearing Apparel and Factors 
Determining It 
The thought that should be foremost in mind when selecting 
office wearing apparel is an attire which will harmonize with 
the dentist’s physical build and also “impress the patient with 
the professional side of dentistry.” Dentist’s office attire 
carefully selected improves the dentist’s personality, and sug- 
gests immaculateness and cleanliness. 
For the dentist who is specializing entirely in oral surgery 
a complete white attire would be correct. His uniform should 
consist of white orthopedic shoes, white socks, white trousers 
and white gown. Whether the gown should be short or long 
will be governed by his stature. 
Those in general practice should also be distinctive in their 
office wearing apparel, but not necessarily to such an extent 
as those specializing in oral surgery. 
The following are suggestions for dentists in general practice 
taking into consideration their physical make-up. 
Short, Stout Operator—Silk pongee coat with buttons 
concealed. 
Tall, Slender Operator—White gown with belt effect in 
small of back, knee length. The bosom of gown should have 
122 Practice Building Suggestions 
a reinforced effect. This style will give a tall slender operator 
a snappy, uniformed appearance, etc. 
Tall, Stout Operator—For such men the smock will be 
most effective. The length should be that of an ordinary coat, 
the collar should be of military design and fastened at the 
back. A belt effect should be given it at the small of the back. 
Short Operator of Slight Build—White gown of knee 
length. This type of operator can wear effectively extreme 
designs, such as form fitting, pinch-backs, complete belt, etc. 
With all of the foregoing suggestions the sleeve lengths 
must be given careful thought. In this connection we might 
state that the full length sleeve is not always practical because 
it readily becomes soiled and will easily catch in hair nets of 
lady patients. Every dentist cannot wear the three-quarter 
length sleeves especially if he has a heavy growth of hair on 
his forearm or if his arm should be poorly formed. For such 
dentists we would suggest a full length sleeve with tie string 
or elastic at the wrist. The sleeves at the wrist must be free 
from buttons or braid so as not to catch in the patient’s hair. 
We would suggest the wearing of white trousers regardless 
of the length of gown, coat or smock. 
We also suggest white shoes of orthopedic type. The busy 
dentist stands on his feet continually and therefore must give 
thought to foot health. Orthopedic shoes insure arch support 
and foot comfort, which is so essential for the dentist’s physi- 
cal welfare. 
How to Dismiss Patients 
A dental office should be so arranged that the patient may 
be dismissed through the business office. 
The psychology of this procedure on the patient when 
leaving the office suite through the business department is 
that the dentist is not only interested in overcoming pain, 
making mechanical restoration and giving the patient a step- 
ping stone to health, but also in the remuneration which he 
will get and that this remuneration is to be paid promptly. 
Passing out through the business office is very similar to 
passing the cashier’s desk in a store and is an impressive 
reminder that dental services are to be paid for either in cash 
or within a reasonable period by those who may have charge 
accounts. 
123 Practice Building Suggestions 
Why the Dentist Should Keep His Main 
Entrance Door Closed 
For a dentist to keep his main entrance door open is to 
extend a silent invitation to every solicitor, canvasser, etc., 
to intrude into his reception room, and compel either himself 
or his nurse to waste productive minutes in listening to their 
visitors’ explanations and reasons for being there, with the 
additional time thrown away in responding to their arguments. 
When one considers the work that might have been accom- 
plished either by the nurse or dentist during the time given 
freely to these non-producing interruptions, it sums up into 
hours and dollars. Real estate offices, employment agencies, 
office building barber shops and beauty parlors keep their 
main entrances open. Surely the profession does not desire 
to have their dental suites placed on a par with this class of 
office. 
The advertising value of an open reception room door is 
absolutely nil. In fact, it is a real drawback in numerous 
instances. For example, let us take the attitude of the 
average tenant and his employes in an office building 
toward a dentist’s reception room devoid of patients, and which 
can be viewed from the hall. Not knowing that the dentist 
works only by appointment and rarely seeing patients waiting 
in the reception room, these people inevitably come to the 
conclusion that this dentist must have a lack of patients and 
does not enjoy a successful practice. This impression you may 
be sure is freely spoken of to others in the building, and thereby 
spreads elsewhere. 
As, naturally, every reputable person should be looked upon 
as a prospect, the dentist by his open-door method has not 
only lost a possible patient, but has created an undesirable 
impression which will react as long as gossip holds sway. 
This is especially applicable in a large office building. In such 
a building there are numerous tenants who would no doubt 
prove desirable patients. These people passing an empty 
reception room several times a day would, through lack of 
understanding, class the dentist a failure, and would hesitate 
to recommend or patronize a dentist if they believed he had 
no established practice. 
124 Practice Building Suggestions 
When and Under What Conditions the Dentist 
Should Keep His Operating Room and 
Retiring Room Doors Closed 
A dentist who employs the services of a dental nurse should 
feel that it is perfectly proper to keep his operating room and 
the retiring room doors closed. For the dentist who strictly 
observes the rules of propriety it would be well to keep his 
operating room and retiring room doors open at such times 
as he is not busy with a patient. This will be added protection 
not only for him but for his nurse as well. 
Dentists located in the smaller cities should be particularly 
careful about observing these rules of propriety. 
The dentist who does not employ the services of a nurse 
should keep his operating room door as well as his retiring 
room door open at all times. There is nothing that will involve 
a dentist and ah innocent patient as quickly as idle gossip by 
people so inclined who are waiting for him in the reception 
room while he is engaged in operative work upon a patient 
behind closed doors. The dentist practicing by himself will 
find the “open door” the best policy. 
For the dentist who is busy enough to employ the services 
of a nurse the patient in the chair should receive his undivided 
attention and therefore he should not be too easily reached. 
If the door leading from the reception room into the operating 
department is kept open it brings about a suggestion of den- 
tistry. Again, to the exacting and fastidious patient, it conveys 
the thought that he is not concentrating. 
To the patient in the chair it brings about a feeling of em- 
barrassment for the reason that when a door is left open con- 
versation which takes place is apt to be overheard by the 
waiting patient. Arrangement for payments, fees quoted, etc. 
are of confidential nature and privacy in the busy office is 
all-important. 
Throughout the year a good many hours are wasted because 
patients take the liberty of walking in upon their dentist in 
response to the silent invitation which the open operating 
room door gives them. 
125 Practice Building Suggestions 
Collection Signs and Effects of Their Display 
It is not good form to display collection signs in any depart- 
ment of the modern dental office. 
A dentist takes pride in having his patients believe that his 
practice is made up of responsible people. When displaying 
collection signs many of his patients are apt to infer that his 
practice is of the doubtful class. 
If the dentist has the proper understanding with his patients 
regarding policies of accounts, etc., before the case is started, 
he will not need a display of these signs. Cash signs do not 
suggest business acumen. They are indicative of the Doc- 
tor’s hesitancy to discuss such matters and are virtually an 
acknowledgement of an apparent weakness—the lack of 
courage to ask for and obtain a proper fee. 
Displaying Dissecting Charts and Skulls in Various 
Departments of the Dental Suite 
It is not proper for a dentist to display dissecting charts 
or human skulls in any part of the office where a patient can 
view them. Most of us in the profession have become hardened 
to these objects and they do not bother us as individuals but 
a sensitive woman cannot view them without a shudder. 
Dissecting charts and human skulls are not pleasant things 
to look upon and they are most apt to leave a disagreeable 
impression. 
Why it is Poor Policy to Give X-Ray 
Films to Patients 
Generally speaking, it is very poor policy to give x-ray 
films to the patient. To do so promotes a desire to shop among 
dentists using the x-ray film as a basis. Patients do not repeat 
accurately the diagnosis given them and often-times, when 
telling one dentist of another’s diagnosis, imagination is brought 
into play and through misrepresentation both dentists involved 
are placed in most embarrassing positions. So far as the patient 
is concerned only one of the two dentists is correct and the 
other, even though he gave a correct diagnosis which perhaps 
was couched in different terms, is frequently spoken of to her 
friends as an unreliable practitioner. 
126 Practice Building Suggestions 
When the dentist gives the finished radiograph to the patient 
as property he parts with the one big authentic record which 
he has of the case. Expensive law-suits have been lost by 
dentists because they could not produce radiographs of the 
case as evidence of conditions as they existed before and after 
the case was finished. 
Patients who have systemic disturbances often request 
that the radiographs be given them to be viewed by their 
physicians. In such instances it is better for the dentist to 
suggest mailing them to the physician, together with a type- 
written diagnosis outlining the oral treatment which he sug- 
gests. Under no conditions should he give the patient a verbal 
diagnosis to be delivered to the physician because there is 
too much opportunity for an incorrect repetition. 
Self-Analysis and Self-Improvement 
The following Self-Analysis Character Chart if seriously 
studied by the dentist, will do much toward helping him find 
his weaknesses and the remedies for their elimination, in addi- 
tion to giving him a certain mental broadening. The dentist 
should not read the negative and positive sides of the chart 
only once and then expect that he has sufficiently covered the 
subject. The proper way to study the character chart is to 
study three negative subjects each day and their respective 
opposites—namely, the positive. After all of the subjects have 
been studied in this manner, then it will be well to start all 
over again, because new avenues of thought will be opened 
each time that the various negative and positive subjects are 
studied. 
Self-Analysis Character Chart 
Negative Positive 
INACCURACY ACCURACY 
EGOISM ALTRUISM 
LOW DESIRE ASPIRATION 
FEAR. COURAGE 
DIFFUSION CONCENTRATION 
MISTRUST CONFIDENCE 
VACILLATION DETERMINATION 
PROCRASTINATION DESPATCH 
127 Practice Building Suggestions 
Negative Positive 
INDECISION DECISION 
EXTRAVAGANCE ECONOMY 
LISTLESSNESS ENTHUSIASM 
DISEASE HEALTH 
DISHONESTY HONESTY 
LAZINESS INDUSTRY 
IGNORANCE KNOWLEDGE 
DISLOYALTY LOYALTY 
FORGETFULNESS MEMORY 
UNTIDINESS NEATNESS 
PESSIMISM OPTIMISM 
IMITATION ORIGINALITY 
FICKLENESS PERSEVERANCE 
WORRY PEACE 
EXCITABILITY POISE 
INEXPEDIENCY TACT 
JEALOUSY TRUSTFULNESS 
Condemning a Brother Practitioner’s Work 
As it is human nature to do good work and also some poor 
work, it will be well to keep this fact foremost in mind at a time 
when tempted to condemn work which some other dentist has 
done. There are certain good points about each dentist’s 
workmanship, even though fault may be found with some of 
it. In most cases where a dentist is guilty of condemning the 
work of a brother practitioner, the patient is usually respon- 
sible for having brought about the criticism. There are some 
patients who, when seeking the services of a dentist, do not 
hesitate to start right out with a conversation about the poor 
work and treatment which a previous dentist has given. If a 
careful checkup is made on such patients, it usually develops 
that most of their complaint is imaginative and due to their 
lack of understanding of dentistry. 
When a patient complains about the work which has been 
done by a former dentist, it will be highly professional to try to 
turn the conversation to some other subject or directly to the 
subject in hand—namely, a diagnosis of the case and a dis- 
cussion of the work which is to be given. Should the dentist 
be pressed for his viewpoint with regard to the work of a pre- 
128 Practice Building Suggestions 
vious dentist, he should try to point out its good features and 
to make light of its poor points. No patient will take offense 
when told that it is not possible for every piece of dental work 
to be 100% perfect. 
There is another viewpoint with regard to condemning the 
work of a brother practitioner, which is that some patients are 
not conscious of poor work which has been given them. If a 
dentist feels that the work should be removed because it is poor 
dentistry, he should study the question of replacement very 
carefully before suggesting it to the patient. When making 
such a suggestion he should bear in mind the Golden Rule with 
regard to the previous dentist. It must be remembered that 
some patients are very difficult to work upon. Poor work is 
often as much the patient’s fault as it is the dentist’s. 
There is such a thing, however, as protecting a brother 
practitioner when he is not entitled to it. When it is evident 
beyond a doubt that the former operator was directly and will- 
fully careless, for which there was no excuse, then the dentist 
should not be too delicate in considering his feelings. The duty 
of the dentist is to conserve the health of his patient, and for 
this reason he must tell truth so as to convince the patient that 
certain work must be done over. 
Proper Records of Cases 
It is very important that dentists keep a proper record of all 
their cases. There are many different types of record cards for 
this purpose sold by various concerns. All work which is done 
for the patient should be carefully charted, and a written record 
should also be kept of the patient’s clinical history and systemic 
condition at the time that the case was accepted. 
Quite frequently, and sometimes years after the case has been 
completed, dentists are called upon by their confreres, physi- 
cians or the patient for certain information about the case 
which existed at the time that it was accepted. To be in a 
position to give the information accurately and on short notice 
not only speaks well for the dentist’s business ability, but also 
protects him at times, when certain discrepancies are claimed 
by the patient and misleading statements are made. 
Sometimes a patient will claim, in good faith, that a certain 
filling was put in by the dentist and that it came out because of 
129 Practice Building Suggestions 
faulty workmanship. If a proper record of the case is kept, 
it is not a difficult matter to determine whether the filling in 
question was put in by the dentist or by a brother practitioner. 
A proper record of the patient’s case will soon prove to the 
patient that some other dentist put in that particular filling, if 
such really was the case. Proper case records, if referred to at 
a time when a patient is making unfounded claims, will go a 
great way toward removing any doubts which the patient 
might have, in addition to avoiding the possibility of the 
patient becoming unjustly suspicious of the dentist. 
Proper case records, maintained and kept even for a lifetime 
of practice, are an iron-clad protection in many respects for the 
dentist. 
Advance Arrangement with Patients for Payment 
It is a good business policy to give the patient a definite 
understanding of what the work will cost before the case is 
started. This is especially true with cases which are not com- 
plicated and for which the dentist may set a definite fee, know- 
ing in advance that he will not run into mishaps requiring ad- 
ditional operative time. This suggestion if followed will eliminate 
arguments which might result between the patient and dentist 
at the time payment is expected. 
When a case for which a definite fee can be set runs into a 
considerable amount, it is good policy to put in writing a 
complete statement of the work to be done and the fee to be 
charged. The original copy is to be given to the patient and 
signed by the dentist. The duplicate is to be signed by the 
patient, and then retained in the dentist’s files for future 
reference should occasion for it arise. We do not suggest that 
this practice be applied to each patient. However, it is an added 
protection for dentists, at least with such patients who are apt 
to become confused with verbal statements or who seem to be 
dense. It can also be successfully applied to those patients 
whose credit rating seems to be doubtful but upon whom the 
dentist may be willing to take a chance. 
As has been pointed out in other sections of this book, it is 
not always possible for the dentist to set a definite fee, espec- 
ially on complicated cases. There are many patients who 
expect some idea of what the work is going to cost them, and 
130 Practice Building Suggestions 
in such cases we would suggest that a minimum and maximum 
fee be quoted—that is, not less than $ or more than 
$ The psychological moment to discuss the method of 
payment is at the time the fee is being quoted. There is no 
time quite so apropos for a discussion of this important subject 
with the patient. To accept the opportunity relieves the 
patient and the dentist of all embarrassment, because the 
subject can be approached easily and naturally. In the absence 
of credit information on new patients, arrangements should be 
made for about one-third down before the work is started, 
one-third when half finished, and the balance upon completion. 
New patients usually seek a dentist’s services through the 
recommendation of a friend and, because of it, have some 
confidence in the dentist and his ability. Usually such patients 
will have no hesitancy about an arrangement of this kind unless 
their financial condition is such that they do not have the 
necessary down payment. This will bring the situation to a 
focus, and will give the dentist an insight into the patient’s 
financial status. 
When credit information on a new patient is insufficient or 
of such a nature as to put him in a doubtful class, it is a good 
plan to request that one-half the amount for the case be paid 
at the time it is started and the balance upon its completion. 
A new patient, if reasonable, will not object to an arrangement 
of this kind. To those who would object it might be well to 
state that up to the completion of half the case the dentist will 
be owing the patient, while during the time that he is working 
on the last half and up to its completion the patient will be 
owing him. One offsets the other. However, there are some, 
usually of a prominent social status, who are extremely sensi- 
tive about being asked to make any payments prior to the 
completion of the work. Such problems must be solved by the 
individual dentist, because he only can be the judge of what it 
is best to do in each case. 
Every dentist has patients come to him who are responsible 
and reliable. With such patients it is not important to enter 
into advance arrangements for payments except, perhaps, at 
the time that the amount of the fee is stated, to infer that 
payment in full will be expected on the first of the month 
following the completion of the work. 
131 Practice Building Suggestions 
For dentists located in manufacturing districts and who have 
a large percentage of the laboring class as patients, it might be 
well to inquire as to how these patients are being paid their 
wages—that is, whether weekly, semi-monthly or monthly. 
A dental fee of over $50.00 frequently works a hardship upon 
such patients if the payment is allowed to fall due in one lump 
sum. Even though such patients are honest and have the best 
of intentions so far as dental services are concerned, the 
dentist’s account sometimes has to wait for quite some time 
before it is paid, due principally to the fact that the patient 
may have a large family and can only save in very small 
amounts. This frequently causes the dentist’s account to be 
set aside for a time until sufficient money has been accumulated 
to make a substantial payment. It might be well, in such cases, 
to try to arrange with the patient regular payments for small 
amounts to fall due on payday. This will give the patient the 
opportunity of making payments while the work is in progress, 
and by the time the case has been completed the balance due 
will not seem such a hardship. All of the foregoing suggestions 
will ordinarily work out satisfactorily and without offense to 
those patients who are honest and with good intentions. 
Therefore, these suggestions should not be regarded as a safe- 
guard against those patients who set out to beat the dentist. 
It must be remembered that, for certain patients, all schemes 
for credit extensions are apt to fall by the wayside when it 
comes to collection. 
Agency Reports on New Patients. Some Rules 
for Extending Credit 
Most all cities, large or small, have listed among their many 
business institutions a rating agency whose business it is to give 
to its subscribers for a nominal monthly or annual fee the credit 
rating of individuals or concerns. These agencies, when making 
reports, take into consideration the individual’s vocation, in- 
come, property, number of people in the family depending 
directly upon him for support, his and the dependents’ standard 
of living, and also his reputation for honesty. They keep a 
record of his credit relations with the local merchants and the 
manner in which he has met his credit obligations. 
Every dentist, unless he is practicing in a very small com- 
132 Practice Building Suggestions 
munity and because of it is intimately acquainted with all the 
people in it, should become a subscriber to a rating agency. 
To do so is a first aid toward eliminating the extension of credit 
to deadbeats, and also the limiting of credit to such patients 
who are doubtful or who are known to take their own time in 
meeting their obligations. Aside from the foregoing, the reports 
of a rating agency will guide the dentist in properly classifying 
a new patient. It cannot be denied that many patients, who 
are comfortably situated financially, will plead poverty to the 
dentist. Such patients are usually entirely ignorant of the value 
of dental services. Nevertheless, they should be asked to pay 
a proper fee. In such cases the rating agency renders a very 
valuable service. To be able to get an accurate report on short 
notice on a majority of new patients is a service not to be 
overlooked. Agency reports will help the dentist to keep his 
overdue accounts to a minimum, and avoid the opening of 
accounts that will eventually be classed as “Uncollectible.” 
It is not always possible for rating agencies to give reports on 
every new patient, especially in cases where the patient is a 
newcomer in the community. However, it must be remembered 
that, in most cases, the new patient has been sent by some friend 
or patient in good standing. This does not mean necessarily 
that the new patient will be a good credit risk. In such cases, 
the dentist should not hesitate to ask the patient for at least 
three credit references. If they are given, the dentist should 
take them seriously enough to make proper investigation. The 
patient who has recommended the dentist is not always in a 
position to know positively whether or not the friend or chance 
acquaintance would be a good credit risk. 
Every dentist, unless he in unethical, must expect to extend 
credit. If he is going to live up to the high ideals of his pro- 
fession in the matter of serving his community and practicing 
the healing art, he cannot have a hard and fast rule which he 
will apply to all those who seek credit. To insist that all persons 
who present themselves must pay according to a set rule is as 
injurious to the dentist as it is good in other instances. There 
are patients who are worthy of long-term credit. They are in 
need of the dentist’s services and seek him because they have 
faith in his ability. If it is determined that they are worthy 
and have honesty of purpose, the dentist should give them 
133 Practice Building Suggestions 
consideration. Perhaps such patients have had sickness or 
financial reverses which, if claimed, can be readily investigated. 
It is not the honest, unfortunate patient for whom should be 
laid down a set of credit rules, but rather for those who live 
beyond their means, or for those who treat their creditors 
lightly and who feel that their patronage should be accepted 
by the dentist as a favor. 
The following are twelve rules to be observed by dentists 
when extending credit: 
i. Know your patient before extending credit. 
i. The time to find out all about the patient is before the 
name goes on the books. 
3. In the absence of agency reports, insist on references and 
investigate them before extending credit. 
4. When the patient who seeks credit hesitates to give 
references, you hesitate to give credit. 
5. Have the courage to say “No” to all those whom you 
consider unworthy. 
6. Insist that it is necessary to have an understanding on 
how the account is to be paid, and to have terms met 
promptly in order that you may be prompt in paying your 
creditors also. 
7. Do not allow a patient to decide as to when he might want 
to pay your bill. The deciding should be done by you. 
8. It should be remembered that the loss of a few patients 
who will not pay their bills will help instead of hurt your 
practice. 
9. In addition to depending entirely upon agency reports 
and the recommendations of friends, learn something 
about human nature, character and moral hazards. 
10. Try to co-operate with your confreres on matters of 
extending credit. 
11. Do not bank too strongly on references. Remember that 
an undesirable will always refer to those he has paid, and 
say nothing about the past-due accounts he is owing. 
12. After extending credit to a patient, the terms of which 
have been agreed to by him, do not hesitate to demand 
what is justly due you. The patient will have more respect 
for you. 
134 Practice Building Suggestions 
The granting of credit should be determined by the following 
three factors: 
ist—Character. 
2nd—Earning Power. 
3rd—Manner in which others have been paid. 
“Credit” is only another name for “confidence.” It is the 
power to obtain services by giving a promise to pay money at a 
specified time in the future. Credit is only as good and as 
strong as the person to whom it is granted. 
Ability to Get the Patient’s Point of View 
The mere fact that a patient comes to the office of a certain 
dentist does not necessarily mean that it is a foregone conclu- 
sion that the patient will consent to have the dentist do the 
work. A patient comes to the office usually through the recom- 
mendation of some friend, or again, through personal selection. 
One thought he may have in mind is that the dentist in ques- 
tion can do the work cheaper, or perhaps better, than some 
other dentist. Frequently the patient believes that the dentist 
can do both—that is, better work at a smaller fee than some 
other dentist. This, then, means that the patient must first 
be satisfied with the dentist’s ability to do the work, and also 
that the fee will be in keeping. It is at this point that some 
dentists lack the ability to get the patient’s point of view. 
While it is true that some patients are half sold when they 
first come to the office, this does not signify that the dentist 
should be less enthusiastic and painstaking in giving the pa- 
tient a health talk and explaining what he proposes to do. It 
must be remembered that some of these patients have not been 
obliged to seek the services of a dentist for years. They remem- 
ber dental fees as they used to be, and it is not such an easy 
matter for them to grasp in a few moments present-day fees for 
scientific restorations. If the dentist can get the patients’ 
point of view, he will argue the fee situation from their side and 
not from his. If he expects such patients to pay increased fees 
he must be ready to spend some time in making his patients 
enthusiastic about the work which he proposes. He must be 
able to convince them that, in the long run, better dentistryds 
the cheaper. 
It must be remembered that when a patient comes with an 
135 Practice Building Suggestions 
upper plate which has been worn for years with complete 
satisfaction, which cost say $15.00, that it requires patience and 
convincing argument to educate that patient to a $150.00 fee 
for a gold plate which is scientifically articulated. The same 
holds true with a $5.00 gold crown which has been worn for 
years, and for the replacement of which the dentist asks $25.00. 
There are many similar illustrations that can be given. How- 
ever, it all resolves itself to one point, that being, that the den- 
tist must be prepared to give health talks and, through them, 
educate his patient, even though such conferences take up a 
considerable amount of time. The dentist must remember, 
when viewing the subject from the patient’s standpoint, not to 
display too much dignity when the patient cannot immediately 
agree that the work which he proposes to do justifies the fee 
which he asks. Certain specimen cases which every dentist 
should have in his office, in addition to radiographs properly 
explained, are a valuable aid in converting patients to his view- 
point. 
The Laity’s Valuation of Dental Services 
Until such a time as the members of the dental profession get 
together and take concerted action, joining hands with the 
dental manufacturer and the dental dealer in bringing the 
subject of dentistry to the attention of the laity in a more 
forceful way, it will be hopeless to expect the laity to place a 
higher valuation on dental services than they do at the present 
time. 
It is only natural, as well as right, that the profession as a 
whole expects the same valuation of its services from the laity 
as that which is given to bankers, artisans and the medical 
profession. There are certain professions and businesses whose 
skill and learning is considerably less than that of the dental 
profession, but which are gaining greater recognition as well as 
greater remuneration than dentists. The reason that the laity 
takes certain professions and businesses more seriously than it 
does the dental profession is principally because of proper or- 
ganization which makes publicity possible. After all, it is the 
public, in the final analysis, that sets a value on all services. 
Dentists may put a high valuation on the work which they do. 
However, if the public is unwilling to pay, principally because 
of lack of understanding, then if dentists want to continue in 
136 Practice Building Suggestions 
practice they must give their services at a remunerative value 
which is within the limits of what the public is willing to pay. 
The consumer (who in this case is the patient) ultimately 
places a value upon everything, and this value is determined 
by the need for the thing in question. If the need is great, the 
value of the article which fulfills the need is great, and vice 
versa if the need and demand by all is not great. Patients 
realize that surgical operations may save limbs, organs of the 
body or even the patient’s life. They place a higher valuation 
on their limbs than on their teeth because they realize that, 
without certain limbs, their chances for success in life are very 
much handicapped. They place a higher valuation on their 
limbs than on their teeth because they do not want to be 
generally looked upon as cripples. From the viewpoint of na- 
ture, a man without teeth may be classed as a cripple to as 
great an extent as a man without his limbs. However, the 
difference lies in the fact that the man without limbs exhibits 
to everyone his crippled condition, while a man whose natural 
teeth have been replaced by artificial ones can, as a rule, get 
by in life without people knowing about it. It must be admitted 
that there are many dental operations which are very much 
more serious than the amputation of an extremity. However, 
the public does not know it, and therefore their valuation of 
these operations is reversed. The public places a very high 
valuation on the services of a surgeon because they realize that, 
through him and his skill, one’s life may be saved. Since life is 
cherished by them more than anything else, they are willing 
to go to extremes to retain it. If the laity realized that retaining 
all one’s natural teeth might add ten years to a person’s life, 
they undoubtedly would place a greater valuation on dental 
services than they do at the present time. 
As it is now, they believe that the loss of all of their teeth is 
not such a serious matter, even though it does inconvenience 
them for a time. There are members of every family who have 
lost some of their teeth and still seem to be successful not only 
in the pursuit of happiness, but also from the viewpoint of 
business. Patients know that, if they lose a leg, they will be 
seriously inconvenienced or should they have a diseased stom- 
ach they might be sick continually. However, if they lose one 
tooth or all of their teeth they feel that they can get along 
137 Practice Building Suggestions 
without them, because the dentist can make new ones which, 
in their opinion, might be better than the natural ones they 
lost. They are willing to pay big fees so as to avoid the first 
mentioned evils, but they cannot see at this time why they 
should give much to avoid the latter.. 
The services of a banker carry a high valuation in the eyes of 
the public, because he deals in money. They realize that one 
must have money to do things with, and that most everything 
hinges on proper financing. The banker is not a complete 
medium from which to secure money. However, he is a very 
important one. The public realizes this, and because of it is 
willing to pay big fees for his services. 
The dental profession will not come into its own until such a 
time as it has given the laity an understanding of what the 
dental profession is, and what it is possible for it to accomplish 
in the maintenance or improvement of health. When this 
understanding has once been given the laity through contin- 
uous concerted ethical publicity, then the laity’s valuation of 
dental services will be such that remuneration will be on a par 
with the earnings of other professions and various lines of 
business. 
Selling Complete Restorations 
The reason that more patients are not sold complete restora- 
tions by dentists is because a certain amount of educational 
effort must be put forth in selling health dentistry. A number 
of dentists feel that, if they must first educate each patient who 
needs complete case work, they may become old men before 
they will profit by their efforts. Dentists who adhere to this 
thought are not only limiting and penalizing themselves, but 
their entire profession as well. 
It is a common and daily occurrence for patients to present 
themselves at the dentist’s office, asking him to fix a certain 
tooth which, unbeknown to the patient, is really less important 
than other work which should be given the preference. The 
majority of such patients are not fully aware of the true con- 
dition which exists, and the real reason they want a certain 
tooth restored is because it is so situated in the mouth and in 
such condition that it detracts from their appearance. This 
causes the patient to have what may be termed “dental 
consciousness.” 
138 Practice Building Suggestions 
When such patients are appealed to from the health view- 
point, they are usually reasonable enough to admit that the 
entire mouth does need attention. When such an admittance 
is once made, then it resolves itself into a question of selling 
the patient health dentistry. If the dentist knows how to sell 
his services, it will not be a difficult matter to get the patient 
to decide to have all the work done. Dentists should make up 
their minds to stop travelling the path of least resistance when 
trying to sell their services to patients. It must be remembered 
that if all patients agreed to have the work done a few moments 
after the dentist started to talk about it, more harm than good 
would result. 
If the dentist would tell those patients who should have 
complete restorations that health is the first consideration, and 
that it is a dentist’s purpose to eliminate unhealthy conditions 
from mouths, then he would be practicing proper psychology 
as a forerunner to gaining a favorable decision from the patient. 
He should strive to create a desire in the mind of the patient to 
preserve health, pointing out that complete restoration will 
give him immunity from constant dental patchwork. It is 
understood, of course, that dentists must make a thorough 
diagnosis of the condition of their patients’ mouths, and show 
them how they can get, through complete case work, the 
greatest comfort and efficiency out of their teeth. The health 
talk on case work must be given so that it will be educational 
as well as interesting, in addition to being easily understood. 
Because of patients’ ignorance of what real dental services 
constitute, dentists should not be too ready to give a patient 
the dentistry for which he originally came to the office. More 
thought should be given to what the patient really needs, and 
more effort put forth to gain from him a favorable decision. 
Dental Societies 
Some dentists are frequently complaining about dental socie- 
ties. They claim that their chief reasons for either not becoming 
members or having discontinued their memberships are mis- 
management and partiality, coupled with unfair politics. A 
dental society may be likened to any other organization which 
has for its purpose the furthering of the interests of its particular 
field of endeavor. In most every instance where complaint is 
139 Practice Building Suggestions 
made about the inner workings of some society, it can usually 
be traced to the fact that the members as a whole have not 
taken the proper interest in the activities of the organization. 
It is true that they attend the meetings, but only for the sake of 
curiosity and not with the thought of contributing in some 
form or another to its welfare. Such procedure, if commonly 
indulged in by a majority of the members, always makes the 
life of the society dependent upon a few members who naturally, 
because of their interest and activity, keep it from passing out. 
This results in a few active members gaining control. 
If every dentist took out a membership in his district, city 
or state dental society with the thought of putting into the 
organization as much and more than he gets out of it, most of 
the evils which it is claimed now exist, would be eliminated. 
The purpose of dental societies, aside from upholding and 
enforcing professional ethics, is to further the interests of the 
dental profession in every direction. The findings of those 
interested in research are given at first hand to the dental 
societies, where the latest and best is discussed with the thought 
of improving, if possible, the new findings. In other words, 
dental societies, while in convention, act as a clearing house for 
the best that is to be had, and through it, its members are 
directly benefitted. Every ethical dentist, regardless of his 
age or years of practice, should become a member of a dental 
society. If he will attend the meetings regularly, with the 
thought of learning instead of criticizing, excepting in a con- 
structive manner, and with a keen desire to take part in the 
discussions instead of sitting back in his seat in order to let the 
other fellow do it, he will gain for himself just as much as he 
gives. To take an active interest in the society’s proceedings 
will contribute just that much toward making dentistry a 
bigger profession, aside from co-operating in bringing dental 
health subjects to the attention of the laity. 
It is up to the young dentist to relieve the older active 
executives of the many society duties which they have engaged 
in over a period of years. The young dentist should be willing 
to serve in committee work, in addition to giving clinics and 
reading papers in return for what he will get as a result of his 
efforts. It is surprising how very frequently older confreres 
will refer their overflow of patients to the active young dentist 
140 Practice Building Suggestions 
who is trying to build a practice, and who, aside from it, is 
proving his sincerity for the dental society’s interests by serving 
in every possible way. It is also interesting to note that the 
more prominent a dentist becomes in his dental society, the 
more patients he seems to gain. 
Never hesitate or be ashamed to let your fellow practitioners 
have the opportunity to judge of your ability, or to try to make 
your ability helpful to them. 
Ability to Analyze a Patient’s Needs 
Aside from practical diagnosis, the ability to analyze a pa- 
tient’s needs depends upon the extent to which the dentist can 
place himself in the position of the patient. 
Is the work which you suggest really indicated ? Patients are 
frequently advised to discard certain dental work which is 
functioning properly, but which does not suit the whims of 
some dentists. Some of this work may have been serving the 
patient efficiently for years, and will continue to give good 
health service for a number of years to come. The mere fact 
that a localized condition needs repair, which does not in any 
way interfere with a previous restoration, should not prompt 
the dentist to suggest an entire housecleaning. 
There are, of course, certain patients of means who do not 
appreciate dentistry except at times when they are compelled 
to spend a lot of money for it. In such cases, a rubber denture 
might be replaced with one of gold, because there isn’t any 
question but that a gold denture, properly fitted, is much more 
pleasant to wear than one of vulcanite. The same thing might 
be said of a fixed bridge, in that it might be replaced with one 
of a removable nature. It is, however, doubtful whether it is 
the right thing, even with patients of means, to suggest new 
restorations to replace old ones, providing they are giving 
satisfactory service. If the dentist feels beyond question of a 
doubt that, by replacing old restorations with those of a more 
modern character, he will be improving the health of the 
patient, then he should be firm and positive in his convictions 
in the event that the patient, who can afford to pay, objects 
to the replacement. 
Can the patient afford the type of restoration which you 
know is indicated and, if not, would an alternative and less 
141 Practice Building Suggestions 
costly restoration last a sufficient time to warrant the substitu- 
tion ? If it will not, then you will be proving your sincerity for 
the patient’s interests by your insistence in doing work which 
will result first, in the greatest benefit to your patient, and 
second, in profit and satisfaction to yourself through the 
knowledge that you have stood by what is right. 
If a patient cannot afford the work which is indicated and 
for which no substitution can be given because of its short 
life, then the dentist should practice some of the ethics laid 
down by his profession. The welfare and interests of the 
dental profession can be safeguarded through the efforts of 
dentists to do only the character of work that is indicated. If 
the patient cannot afford to pay, but is honest and has good 
intentions, the dentist should suggest a convenient deferred 
payment plan, the amount to be secured by and divided into a 
series of interest-bearing notes signed by the patient. If 
certain patients must have dentistry which will safeguard 
their health, and which is to be of a character involving fees 
greater than the patient can pay at one time, there should be 
no objection on their part in proving to the dentist their 
sincerity and honesty of purpose by safeguarding the account 
with interest-bearing notes, in return for what the dentist will 
do for them with regard to health, comfort and improved 
appearance. 
The ability to analyze the needs of a patient, and the sugges- 
tions for restorative work which follow, depend entirely to 
what extent the dentist puts into practice the principle of the 
Golden Rule. 
Professional Courtesy 
By “professional courtesy” is meant complete co-operation 
with a fellow dentist regardless of his professional status— 
that is, whether specialist or general practitioner. It also 
embraces co-operation with physicians, surgeons, oculists, etc. 
Frequently professional courtesy is referred to in connection 
with a reduction in fee when doing work for a member of the 
allied professions. 
When the young dentist, because of his lack of experience in 
certain operative and restorative work, seeks the advice of a 
more experienced brother dentist, it is professional courtesy to 
142 Practice Building Suggestions 
give the advice freely and whole-heartedly. If the older prac- 
titioner seeks from the young dentist enlightenment on tech- 
nique in connection with certain new methods taught at 
college, it will be professional courtesy to not only tell him all 
about it, but also to offer to help him at his office on the case 
in question. When a general practitioner appeals to the 
specialist for guidance in a certain case, the specialist’s response 
should be considered a professional courtesy. 
When certain conditions in the mouth of a patient indicate a 
careful checkup on the patient’s systemic condition, necessi- 
tating a conference between the dentist and the patient’s 
physician, the time and information which the physician gives 
to the dentist should be considered a professional courtesy. 
This will also be true in cases where the dentist seeks informa- 
tion from the patient’s surgeon, oculist, etc. When the condi- 
tions are reversed so that the patient’s physician, surgeon, 
oculist, etc. seeks information from the dentist with regard 
to certain oral conditions, making it necessary for the dentist 
to lay out his records, x-ray films, etc. it will be considered a 
professional courtesy which the dentist gives to these members 
of the allied professions. 
When there is some doubt in the dentist’s mind as to the 
honesty of a new patient, and because of it he communicates 
with some dentist who has previously done work for the 
patient, it will be considered a professional courtesy to give a 
truthful report on the experience which the dentist has had 
with the patient, both from an operative and collection stand- 
point. This will also be true when the dentist is being appealed 
to by members of the allied professions. 
In the smaller cities in which the number of dentists practic- 
ing is small, it is sometimes considered a professional courtesy 
to give personal service to a brother practitioner and members 
of his family at a reduced fee. The brother dentist usually 
reciprocates this professional courtesy with regard to fees when 
conditions are reversed. Sometimes it is good policy in the 
smaller cities to extend this professional courtesy, and vice 
versa, to physicians, surgeons, oculists, etc. The extent of this 
type of professional courtesy depends entirely upon a mutual 
understanding, and also to what extent members of the allied 
professions send new patients to the dentist, and vice versa. 
143 Practice Building Suggestions 
Usually this professional courtesy is limited to just one member 
of each of the professions. 
In the larger cities, professional courtesy with regard to fees 
is rapidly disappearing, because dentists, as well as members of 
the allied professions, realize that a brother practitioner’s 
time must be taken into account, and because of the limited 
number of productive hours during the year it is unfair to 
expect him to work for a fee which involves only operative 
cost or less. If this professional courtesy were given free reign 
in the larger cities, then some dentists would be working ex- 
clusively on personal service to brother practitioners and 
members of the allied professions, which could result only in a 
financial loss at the end of the year. There are many arguments 
for and against this subject, and for this reason its practice 
depends entirely upon the individual and also the local condi- 
tions. 
Gaining the Druggist’s Cooperation 
Druggists are beginning to realize the importance of mouth 
hygiene, as is evidenced by the vast stock of toothbrushes and 
tooth-cleaning preparations which every druggist displays and 
considers an important section of his store. 
If the average druggist or his clerks were questioned, by 
someone who knew, regarding the proper construction of a 
toothbrush, the answer in most cases would indicate that they 
are ignorant of how an ideal toothbrush should be made. An 
examination of the average druggist’s stock of toothbrushes will 
reveal a conglomeration of sizes and styles, a great percentage 
of which are injurious to the mouths of those who purchase 
them. Retailers, as a rule, are content to travel the line of 
least resistance, selling the make of brush requested or the style 
picked. They depend upon the advertising of toothbrush 
manufacturers to create a demand, and let it go at that. 
The foregoing remarks upon toothbrushes also apply to 
tooth-cleaning preparations and various mouth washes. Some 
of these preparations are not only directly injurious to the 
teeth and tissues of the mouth, but are also vile. However, the 
laity will continue to purchase those preparations until such a 
time as dentists will give their patients proper instructions as 
to what to buy, in addition to educating the druggists regarding 
144 Practice Building Suggestions 
those preparations which withstand the scrutiny of the dental 
profession as a whole. There are many druggists who do not 
know that all of the advertised stain removers and bleaching 
agents which they are content to sell to their customers on a 
mere request are responsible for many toothaches and the 
creation of numerous cavities. 
A druggist would resent a dentist’s abrupt criticism of the 
toothbrushes and mouth preparations which he sells to his 
customers. Diplomacy must be exercised in calling his atten- 
tion to all of the foregoing. Informing him on what is best for 
his customers can gradually be brought about through casual 
conversations and suggestions as to what the dentist is anxious 
to have his patients buy. Dentists might antagonize the drug- 
gist if they were instrumental in getting him to stock certain 
makes of toothbrushes and mouth preparations, and then did 
not do their part in helping him dispose of them by recommend- 
ing the druggist and his special stock to their patients. 
Every dentist has found through experimental work that 
certain treatment solutions which he himself has made up for 
various obstinate diseases of the mouth are effective. It should 
not be the aim of the dentist to supply such solutions to his 
patients for home treatment. The average dentist is not 
equipped to make up in a scientific manner medicinal solutions. 
This comes in the realm of the pharmacist. Dentists often 
write prescriptions and instruct their patients to have them 
filled at a certain drugstore, because the druggist is fully ac- 
quainted with how the dentist wishes the medicament made up 
and also has purchased special drugs for the purpose. This 
impresses the patient with the importance of the prescription, 
and also convinces the druggist of the dentist’s ability to 
prescribe scientifically for his patients. Dentists must be sure 
to acquaint their druggist of the solutions for various diseases 
of the mouth which they will prescribe, thereby giving him an 
opportunity to have on hand the proper ingredients. However, 
the dentist must be careful not to write prescriptions for 
nationally advertised preparations. This would not leave a 
good impression because the nationally advertised product can 
be purchased cheaper by the patient in its original container 
than when a prescription for it is written in lesser quantity. 
The tops of showcases and wall cases in most drugstores are 
145 Practice Building Suggestions 
littered with advertising posters which, in most cases, do not 
create goodwill. In the absence of something better, however, 
the druggist is content to continue such displays. Those 
druggists who have an eye to promoting goodwill and who are 
interested in impressing their customers with the health service 
which they are anxious to render would welcome educational 
placards gotten up by the dentist to set in a wallcase containing 
mouth preparations. If real truth is set forth in the wording 
of these placards, most aggressive druggists {would go to the 
expense of having them properly framed so as to make them 
conspicuous as well as attractive. In getting up these placards 
the dentist must bear in mind that the writings must be ethical 
and that his name or the location of his dental suite must not be 
mentioned. The good that will come to him will be through the 
druggist’s enthusiasm for the plan and the fact that, when 
customers ask the druggist to recommend a good dentist, he 
undoubtedly will refer them to the dentist giving him construct- 
ive cooperation. 
The following are a few suggestions which might be put in 
placard form: 
The Teeth 
Most of the microbes penetrate the system through the 
mouth. 
Decayed teeth are centers of infection which poison the 
organism. 
Measles, whooping cough, parotid glands inflammation, 
scarlet fever, diphtheria, influenza, certain eye, ear, nose 
or throat diseases are often the result of the fermentation of 
food sticking to the teeth or on decayed teeth. 
A periodical call on the dentist and a strict observance 
of oral hygienic rules given by him can prevent most of the 
above mentioned diseases. 
The Teeth 
Good habits are very easy to cultivate, when we want 
to. 
The habit of cleanliness is one which we keep throughout 
life because it gives comfort and dignifies the human being. 
Any child who is taught how to take care of itself; 
to wash its hands, face, ears, to clean its teeth and to bathe, 
keeps the habit all its life. 
146 Practice Building Suggestions 
The most lasting habits are those formed during the 
first twelve years of life. Therefore, it is very important to 
start young with regard to the teeth. 
A child’s mouth should be examined every three or six 
months, cavities should be filled and the teeth carefully 
cleaned. 
Mastication becomes irregular and insufficient when the 
child who has bad teeth can only use the frontal teeth. 
If the food is sufficiently masticated and impregnated 
with saliva, it is changed into energy to be used in the 
muscular development of the whole body. 
Children who have good teeth grow up normally and 
will become virile and strong. They remain in a healthy 
condition because they formed the good habit of consulting 
their dentist at least twice a year. 
The Teeth 
Beauty generally depends on the shape of the jaws. 
Jaws, no matter how badly shaped, become normal again 
with the dentist’s care. 
Wonderful improvements were accomplished in that 
respect by the dental profession during the course of the 
World War. 
Thanks to some clever devices temporarily fastened in 
the mouth, practically not disturbing the patient, the 
profession now performs marvels. 
If your child’s teeth are growing badly, if they put his 
mouth out of shape, if they are irregular, dentistry offers 
you its effective assistance to reestablish the normal condi- 
tions. 
Do not delay. Consult your dentist. 
The Importance of the Teeth 
The teeth are of prime importance in alimentation. 
Foods have to be minutely masticated and impregnated 
with saliva to be easily digested. 
If teeth are bad, food cannot be sufficiently masticated, 
which causes digestion troubles more or less serious. But 
there is more to it. Microbes find room in the crease of 
the gums and also in decayed teeth. They produce toxins 
which spread throughout the system and slowly poison it. 
147 Practice Building Suggestions 
Physicians and dentists discovered that this steady 
stream of toxic substances mixed with the blood are often 
the causes of serious diseases whose origin, up to now, was 
unknown. 
A periodical call on the dentist and a strict observance of 
oral hygienic rules given by him can prevent most of the 
above mentioned diseases. 
Those dentists who will follow all of the foregoing suggestions 
will not only be furthering the interests of humanity but the 
dental profession as well and, by educating the community 
through the medium of the drugstore regarding what is right for 
the mouth, will also gain the respect of the druggist and his sales 
people. Through it he will gain ethical publicity and new 
patients. 
The Unprofitable Side of the Dental Practice 
There are certain operative and mechanical phases of many 
dental practices which are unprofitable because dentists do 
not take into account various risks which they are apt to en- 
counter during the work, and also because they do not estimate 
their fees on the time basis. To do this means that the dentist 
operates at a loss. The following ten subjects may be classed 
as unprofitable practice: 
1. Treatments. 
2. Examinations. 
3. Cleaning teeth. 
4. Plates. 
5. Repairing plates. 
6. Extractions. 
7. Anaesthetics. 
8. Silver fillings. 
9. Cement fillings. 
10. Stopping toothaches. 
It, of course, is understood that the foregoing ten subjects 
cannot be eliminated from a dental practice. They are things 
which must be put up with because they are an integral part 
of dentistry. Since that is true, then the dentist is entitled to 
remuneration on a time basis just as in other branches of the 
profession which are considered profitable. 
148 Practice Building Suggestions 
Treatments 
These are unprofitable for many dentists because they do not 
take into account the time consumed in treating teeth when 
quoting fees to the patient. Since it is not always possible to 
determine just how many treatments a tooth' will require 
before it is ready for restorative work, it is best to quote the 
fee minus treatments. This might at first seem strange to 
some patients. However, if the dentist will explain to them 
that it is absolutely impossible to tell at first whether a tooth 
will respond to treatments or whether it will be obstinate the 
patient will understand, even if only in a measure, the den- 
tist’s problem in this direction. When including the treat- 
ment work at the time the fee is quoted the dentist might 
figure on a dozen treatments, only to find at the conclusion of 
the work that half this number was required, and vice versa. 
For the foregoing reasons treatments should be set up as a 
separate charge against the patient. The basis of the charge 
should be the actual time consumed for the total number of 
treatments, and at the conclusion of the work it should be 
added to the charge already set up for the restorative work on 
which it was possible to quote a fee in advance. If patients are 
content to neglect their teeth to a point where treatments are 
necessary, then they must be educated to pay for this neglect 
which is really their grief and not the dentist’s. 
The oculist will remove an eye and supply an artificial one. 
He sets up a fee for the operation and the treatment work in 
connection with it, and then a separate fee for the artificial eye. 
The physician will treat a carbuncle at so much per visit, and 
then set up a separate fee of $5.00 when the carbuncle has 
reached the stage for lancing. The throat specialist will treat 
tonsils at so much per visit, and then set up a separate fee of 
$50.00 for the operation of removing them. The dentist should 
not be an exception to the foregoing illustrations, because the 
principle is as true in his case as it is in those of the allied pro- 
fessions. If the dentist would put his practice on a profitable 
basis he must set up a distinct and separate charge for all 
treatments in addition to the fee for the restorative work. 
Examinations 
The dentist has a certain number of productive hours each 
day which he must take into account if he is going to make his 
149 Practice Building Suggestions 
quota of gross income for the year. Since examinations take up 
productive time, a fee figured on the time consumed basis 
should be charged. In a well-regulated practice this should 
hold good whether the patient consents to have the work done 
or not. If the dentist will adhere to the plan of working strictly 
by appointment, most patients will understand beforehand that 
he is not giving his services gratis. Should the patient decide to 
think it over before consenting to have the work done, the den- 
tist should not hesitate to state that he will make a charge for 
the time consumed in the examination. When quoting a lump 
fee to the patient, the dentist should state that it includes the 
time taken up for the examination. Should the patient fail to 
return to have the work done, the dentist should not hesitate 
to send a statement showing what the charge for the examina- 
tion is. In cases where the dentist does not know the patient 
or when references are lacking, he should endeavor to collect a 
fee for examination before the patient leaves the office. It is 
best to have a definite understanding with such patients before- 
hand. 
When a physician is called upon to make an examination of a 
patient he makes a charge for it, regardless of whether or not an 
operation is involved. When a nose and throat specialist 
makes an examination of the nose and finds diseased adenoids 
he makes a charge for the examination, regardless of whether 
he is given the privilege of removing the adenoids. In both of 
the foregoing illustrations patients may decide to think it over 
or to postpone the operation. However, such decisions by 
patients do not concern the physician or the nose and throat 
specialist because they do not hesitate to make a charge for the 
examination services which they rendered. The dentist should 
not be an exception because the examination services which he 
renders his patients are of as great a value and, in many in- 
stances, more so than those rendered by the physician or the 
throat specialist. For a more detailed writing on this subject 
read Section 4 under the heading “Charging for Diagnosis.” 
Cleaning Teeth 
This phase of dentistry is very much abused because it seems 
that there are many dentists who still feel it necessary to throw 
in “cleaning the teeth” when quoting a fee for restorative work. 
Some dentists have a mental equation and, because of it, are 
150 Practice Building Suggestions 
quite sure that it is necessary to give the patient something for 
nothing as good measure because of the favor they extend the 
dentist in allowing him to do the work. The term “cleaning 
teeth” should be eliminated from dental nomenclature because 
a mere cleaning of the teeth is of little benefit to patients. A 
dentist’s time is too valuable to merely “clean” teeth. Some 
years ago it was a common custom for dentists to throw in a 
“tooth cleaning” at the conclusion of the work. In some cases 
half an hour of time was involved, while in others an hour or 
more. If dentists would keep a careful check on the time con- 
sumed throughout the year for “cleaning teeth” and for which 
they do not collect a fee, it is quite probable that most of this 
“throwing in” evil would be eliminated. If the dentist finds at 
the time that he quotes his fee to the patient that it will be 
necessary to give a prophylactic treatment or a series of them 
before the case is finally completed, he should take into account 
the time consumed by such treatments and include it in the 
minimum or maximum fee which he quotes. When it is evident 
that the prophylactic treatments will consume considerable 
time, it would be a good plan to set up a separate fee in the 
event that the patient is of the type who might go elsewhere 
because the total fee seems too large. In other words, the 
dentist should tell those patients who make price their first 
consideration that he will do the restorative work for a certain 
sum of money and that, when the restorative work has been put 
in place, the patient should, in order to get the greatest good 
out of it, submit to prophylactic treatments which will involve 
an additional sum of about $ In many cases this proced- 
ure will assure the dentist of procuring the case for the restora- 
tive work, and it will then be optional with the patient whether 
or not the prophylactic work will be desired at the conclusion 
of it. For a further illustration of the difference between 
“cleaning the teeth” and “prophylaxis,” read Section 7 under 
the heading “A Nucleus for a Prophylactic Health Talk.” 
Plates 
This branch of dentistry is usually unprofitable because 
patients are led by the dentist to expect too much. The term 
“plate” should be eliminated from dental nomenclature because 
it smatters too much of the dentistry which was given years ago 
and which was always referred to as “plates.” In those days 
151 Practice Building Suggestions 
patients were not educated in dentistry. A “plate” was thought 
to be as efficient and to take the place of the natural teeth. As 
much was expected from a plate in every respect as from natural 
teeth, and in fact most patients had it firmly fixed in their minds 
that a plate, properly made and fitted, was better in its func- 
tioning than the comfort and efficiency which the natural teeth 
afforded. The result was that patients, because of certain 
discomfort and the unsatisfactory functioning of plates, felt 
that they had not been given a good piece of dentistry. This 
resulted in an endless number of visits to the dentist’s office 
who, in turn, was content to cater to the patient’s whims with 
the result that dissatisfaction generally ensued. 
The term “artificial denture” is more appropriate because the 
word “artificial” signifies that it is a substitute for something 
original. The word “denture” eliminates the term “plate” and 
is apt to signify something scientific requiring considerable 
skill. No dentist has the right to tell his patients that an arti- 
ficial denture will give the same service and comfort as the 
natural teeth. Regardless of how scientifically a denture may 
be built and fitted to the individual case, it can never take the 
place and perform the same functions as the natural teeth. 
When these truths are told patients beforehand they will not 
expect too much. This results in more prompt payment for 
this type of work, and eliminates the constant returning of 
patients who have imaginary fault to find with the denture. 
A man who buys an artificial limb is not told that it will be as 
efficient as his natural limb was. A man who must wear an 
artificial eye is not told beforehand that he will be able to see 
with it. The patient who must wear an artificial denture 
should be told that it will only be as efficient as he is willing to 
make it, and that there are certain things which must not be 
expected of it, at least not in as great a measure as was possible 
with the natural teeth. If the dentist will eliminate his denture 
“guarantees” and arrange with the patient for prompt pay- 
ment at the time that the denture is finished, he is quite apt to 
reduce his unprofitable hours, at least in this branch of the 
profession. On the other hand, it must be remembered that if 
a misfit denture is delivered to a patient for which the dentist 
himself is at fault, such work must be made good at the den- 
tist’s own expense, even if an entirely new denture must be 
152 ractice Building Suggestions 
made. Read Section 4 under the heading “Guaranteeing 
Dentistry to Patients and What It Means.” 
Repairing Plates 
This branch of dentistry is unprofitable in many practices 
because dentists are content to repair plates for a fee which 
falls considerably short of the fee which should be set up, 
taking into account the time consumed. The mere fact that a 
plate is repaired in a dentist’s or a commercial laboratory does 
not mean that the dentist is not entitled to his regular profit on 
the transaction. A broken plate is many times presented for 
repair when the dentist’s entire time is taken up with operative 
work. Usually the patient is in a hurry to have the repair work 
done. If the dentist does this work in his own laboratory, it 
usually means that he will either have to do it after his regular 
office hours or that he will have to set aside the time of some 
other patient in order to accommodate the patient with the 
plate. In such instances the regular fee based on time consumed 
should be quoted. 
There is another side to the question of repairing plates, that 
being the risk a dentist assumes when he accepts such work. 
It frequently happens that a plate will warp in the process of 
repair, and when it is returned to the patient it is not satisfac- 
tory. Some dentists feel in such cases that it is their duty to 
make an entire new plate for the patient. This opinion is 
erroneous, and it is for this reason that a dentist should state 
beforehand when consenting to repair a plate that he will 
assume absolutely no risk should anything go wrong with the 
plate during the repair process. When the patient presents a 
plate to be repaired which is so comfortable and efficient that 
the patient cannot do long without it, then the dentist should 
take this into account when basing his fee, especially at a time 
when he must cancel some other patient’s appointment in order 
to accommodate the owner of the broken plate. 
Extracting 
It is not an uncommon occurrence for dentists to find that 
after a long period of treatments the roots of a tooth will not 
respond and that an extraction is necessary. Very frequently 
the dentist extracts the tooth without making a charge for it. 
The lack of charges in such cases is brought about because the 
153 Practice Building Suggestions 
dentist undertook to restore the tooth, plus treatments, for a 
certain fee. The patient has it firmly fixed in mind that the 
tooth will be saved. When it is determined that this cannot be 
accomplished and that the next best thing is an extraction, 
patients frequently refuse to pay not only for the treatments 
which it was necessary for the dentist to give, but also for the 
removal operation. This condition exists in many practices 
because the dentist does not have a definite understanding with 
his patient beforehand. When a tooth requires a number of 
treatments it is impossible to tell in how great a measure the 
tooth will respond, and this should be told to the patient. It is 
for this reason that a separate charge should be set up for 
treatments. The patient should be told in advance that, in the 
event that it is necessary to extract the tooth after heroic 
efforts have been made to save it, the patient must be content 
to pay for such a misfortune. If the patient must lose the 
tooth, the dentist should not be held to blame but rather the 
patient, and this because the patient did not seek the dentist’s 
services at a time when the tooth might have been saved. 
Dentists should not be sympathetic in such cases and feel that 
because the tooth got beyond the saving stage the extraction 
should be given free and the time consumed for treatments 
thrown in as good measure. 
In cases where an artificial denture is being considered, prior 
to which extractions must be made, the dentist should set up 
a separate fee for the surgical work and then quote a separate 
fee for the denture. There are certain patients to whom sepa- 
rate fees—that is, for the extraction and for the denture—should 
not be quoted for the reason that they are interested princi- 
pally in a total fee for all of the work. With such patients it 
will be more practical for the dentist to add to his fee for the 
denture work that occasioned by the surgical work, bearing in 
mind however that if his technique is along surgical lines and 
his surroundings such as to suggest it, he should base his fee 
not only on the time consumed but also by the risk incurred. 
If the preliminaries such as nerve blocking, infiltration or gas 
administrations are not taken into consideration, then the 
dentist will be short of proper remuneration for this type of 
work. A dentist makes a fatal mistake when discussing the 
removal of teeth with patients to refer to them as “extrac- 
154 Practice Building Suggestions 
tions.” They should be referred to as “surgical removals,” 
which in truth they really are. Patients usually think about 
extractions at $1.50 each, while a surgical removal plus proper 
surroundings will raise the value of this branch of operative 
work. 
Anaesthetics 
The dentist is entitled to a separate fee for anaesthetics in 
as great a measure as physicians are in their practices. Ordi- 
nary anaesthesia, administered by a physician, brings a mini- 
mum fee of $5.00. Yet some dentists are content to quote a 
fee on surgical removals and leave the question of anaesthetics 
untouched. In many cases it takes just as long to administer 
an anaesthetic as it does to perform the surgical removal, yet 
the time consumed for anaesthesia is left out of consideration 
entirely. The dental profession has passed the age in dentistry 
when it was supposed to extract the teeth, take an impression 
and make the plate all for $35.00. The dentist should take 
careful account of the actual time consumed in administering 
the anaesthetic and the risk he assumes with some patients. 
Silver Fillings 
When talking about “silver fillings” instead of raising the 
value of such a restoration it is lowered in the minds of patients 
because they associate silver fillings with something cheap. 
Instead of referring to this type of restoration as a “silver 
filling,” the dentist should refer to it as an “alloy restoration.” 
This term will help the dentist to build up value in the eyes of 
the patient on this type of work. “Silver fillings” are always 
thought of as something anywhere from one to three dollars 
each, while an alloy restoration seems to be something quite 
different, at least so far as value and service to the patient are 
concerned. The dentist who bases his fee on the actual time 
consumed in putting in an alloy restoration will be doing this 
work at a profit, while the dentist who still quotes a fee for 
“silver fillings” will usually find his patients quibbling about 
the fee in the event that it happens to be over the regulation 
fee asked by dentists who are still selling materials and the 
finished product instead of their time and skill. So far as the 
dentist is concerned there should be no difference in the value 
of his time, whether it be spent in making alloy restorations or 
155 Practice Building Suggestions 
gold inlays. The only difference there can be is in the value of 
the material itself and this, when based on an average over a 
period of time, can be but slightly more for gold than for alloy. 
So far as the dentist is concerned there are certain mouth condi- 
tions when an alloy will be of greater service to the patient than 
gold, and again vice versa. However, so far as affecting the 
value of the actual time consumed, there should be no differ- 
ence. In other words, if it takes half an hour to make an alloy 
restoration or a gold inlay, the fee for both should be the same 
unless, of course, the dentist is content to sell merchandise 
instead of his time and skill. 
Cement Fillings 
These are looked upon by the average patient as being about 
on a par in value with silver fillings. Therefore the dentist 
should be cautious about emphasizing too much this particular 
material. The patient associates it with something in dentistry 
of which there seems to be a great abundance, and when a fee 
for this work involves an amount of $5.00 the patient is apt to 
think the fee is too great. If the truth be known, it takes con- 
siderable time and skill in most cases to properly prepare a 
cavity for a cement filling, and therefore greater stress should 
be placed on the cavity preparation than on the material itself. 
These various types of restorations involve time, and the den- 
tist who quotes his fee on the time basis will not find a great 
variance in his fees, whether the material used be alloys, 
cements, enamels or silicates. 
Stopping Toothaches 
Those patients who are suffering from toothache and who 
present themselves to the dentist for relief always do so ex- 
pecting to pay. There are a vast number of dentists who are 
content to take care of these emergency cases at the expense 
of other patients and at the expense of their own operative 
time. In other words, an emergency case may come to the 
office at a time when the dentist is right in the midst of a tedious 
cavity preparation. He is taught at college to give these 
emergency cases the preference when it is apparent that the 
patient is suffering, and so he attempts to carry out these 
teachings somewhat along the following lines. 
He stops his cavity preparation and invites the patient al- 
156 Practice Building Suggestions 
ready in the chair to sit in some other department of the dental 
office while he is giving attention to the emergency case. In 
order that he may serve the suffering patient efficiently he 
must remove most of the instruments which are being used at 
the time in the cavity preparation for the patient who has just 
vacated the chair. He must bring out various treatment in- 
struments and also his medicaments, as well as cotton pellets, 
wood applicators, etc., etc. After he has given the suffering 
patient relief he must again remove all of these instruments and 
materials, replacing on his bracket table all of those instruments 
with which he will again resume his cavity preparation in the 
mouth of the patient who is waiting. Aside from all of this, his 
mind has been taken off the technique in connection with the 
cavity preparation and concentrated on the technique to be 
applied to the suffering patient. He again must take the time 
to revert his mind back to the cavity preparation. All of these 
things take considerable time, and the patient who has pre- 
sented himself for the emergency treatment should be the one 
to pay for it. A fifty cent or dollar fee in most cases will not 
repay the dentist. Inasmuch as a suffering patient is willing to 
pay a proper fee for relief, the dentist should have courage to 
ask it, being sure it is based on the time consumed which should 
begin at the moment that the patient already in the chair is 
requested to vacate and end at the time that the dentist can 
once more concentrate on the cavity preparation or whatever 
the work was at the time he left it. 
The majority of time leaks for which no account is made are 
usually brought about by the foregoing ten classes of dentistry. 
So that a dentist may turn the unprofitable operative branches 
of his practice into profitable ones it will be well to watch 
carefully all of the foregoing subjects. It must be understood 
that the unprofitable subjects listed and the suggestions to 
make them profitable should be applied by dentists to those 
patients who can afford to pay. There is certain charity work 
which every dentist expects to do, and therefore things purely 
charitable should be charged off to profit and loss. 
157 Practice Building Suggestions 
SECTION VIII 
Duties of the Dental Nurse 
Why the Title of Nurse is Most Appropriate 
OF ALL titles which have been given to girls working 
for dentists we believe the title of “Nurse” is most 
appropriate. It carries a certain dignity with it which 
the patient will not easily forget. When the nurse is intro- 
duced her name is frequently forgotten by most patients. 
This usually results is some embarrassment to the patient as 
well as to the nurse during future appointments. 
The patient should realize that the dentist is enjoying the 
services of a real nurse. This can be best brought to the 
patient’s attention by addressing the girl as “Nurse” instead 
of “Miss So-and-so.” The patient, too, will get in the habit 
of addressing the girl as “Nurse” after she has heard the 
dentist do so several times. The girl will enjoy this title 
because it certainly is more refined and dignified than those of 
“stenographer”, “assistant” or “office girl.” To the mind of the 
average girl employee, these titles are very common and rather 
meaningless. A dentist’s requests given as follows will help 
to feature the girl and will also do away with undue publicity 
of her name: “Nurse, a glass of warm water, please”; “Nurse, 
please heat some modeling compound”; “Nurse, please mix 
some amalgam”, etc., etc. 
Frequently the patient will have some special request to 
make of the girl. If the patient hears the dentist address the 
girl as “Nurse” she, too, will address her so, all of which will 
do away with embarrassment in the event she has forgotten 
the girl’s name. 
If the dentist employs two girls, one to assist in the operat- 
ing room, the other for the reception room and business office, 
then the last mentioned girl should be given the title of “Sec- 
retary” and she should be featured as such. The dentist 
whenever speaking to her in the presence of a patient should 
address her as “Secretary.” This, too, will be impressive with 
the patient and will add dignity to the girl’s position. 
158 Practice Building Suggestions 
A competent nurse will add prestige to the dental office 
as well as to lend a tone of refinement, quality and indi- 
viduality. 
A Calculation of Time Saved for the Dentist Through 
the Employment of a Competent Nurse 
The following is an interesting tabulation of figures and 
operations showing time saved for the busy dentist by an 
efficient dental nurse, covering the period of a week: 
Time 
Consumed 
Time 
Consumed 
Summoned to reception room 70 times 
Hours 
2 
Minutes 
20 
Patients served (removing wraps, helping on with 
wraps and dismissing patients) 42 times 
3 
30 
Positioning patients in chair, adjusting napkins, 
arranging instruments on bracket table, ad- 
justing saliva ejector, supplying drinking glass, 
etc., 42 times 
1 
45 
Washing, sterlizing and assorting instruments 
60 times 
5 
Mixing impression plaster 4 times 
20 
Heating and manipulating wax for bites 6 times 
. . 
18 
Pouring and separating denture models 6 times 
1 
Keeping accounting system 
6 
Phone calls 36 times 
1 
is 
Taking intra-oral radiographs 18 times 
1 
Developing, fixing, washing and drying radio- 
graphs 
7 
30 
Getting warm water 80 times 
1 
Mixing alloy 10 times 
1 
30 
Mixing cement 15 times 
Investing and casting 10 times 
5 
30 
Banking deposits 6 times 
1 
Drawing cold water 80 times 
. . 
30 
Heating inlay wax 10 times 
30 
Mixing silicate cement 6 times 
25 
Polishing bridges and dentures 
2 
Purchasing dental supplies 
1 
30 
Total 
43 hrs. 
53 min. 
Twelve Requisites to be Looked for when Engaging 
the Services of a Nurse 
There are many dentists who have not yet come to regard 
the dental nurse as an important asset. They do not believe 
159 Practice Building Suggestions 
that it is possible for the nurse to relieve them of not less 
than 30 per cent of the burdens associated with the general 
routine of the average dental office. A good many of the den- 
tists who are of the opinion that a dental nurse is a nuisance, 
base their opinion upon the experiences which they have had 
with girls. With few exceptions the dentist himself is to blame 
for the failure of the nurse, because when engaging her services 
he fails to look for certain fundamental qualities which a nurse 
must have in order to be properly trained so that she will really 
be efficient. Most of these girls have been chosen by dentists 
from the ranks of department store clerks, or from other 
vocations such as stenographers, etc. The mere fact that a 
girl has been waiting upon people in a department store is no 
indication that she is qualified to wait upon people in a dental 
office. 
The following fundamental requisites are the most impor- 
tant for the dentist to look for when engaging the services of 
a nurse: 
Integrity—The one asset that counts above all else in a 
professional office is gilt-edged self-respect. To look every 
patient in the eye and to feel that they can say nothing but 
good for her represents a capital from which the dental nurse 
may draw sufficient strength to enable her to rise above ad- 
verse conditions. 
The dental nurse must have character. A woman who 
becomes the assistant of a dentist must bear in mind that she 
also is aiding in relieving the sufferings of humanity, and 
thus rendering a goodly service. Such service, however, cannot 
be given in its true worth unless it is accompanied by that 
unmistakable quality of “true blue” character. 
Initiative—A woman who is anxious to succeed as a nurse 
in the dental office must have initiative and practice the art 
of visualizing. When a mental picture has once been firmly 
fixed, the next thing is to put it into execution, and it is here 
that many dental nurses fail. If the nurse has an idea, she 
should not be afraid to try it out. Many good ideas perish for 
want of action. When an idea which seems good portrays 
itself and stays with the nurse, she should not allow herself 
to be talked out of it, but should at least try it out. Trying 
out an idea is at first only investigating it. The wise nurse 
160 Practice Building Suggestions 
will first study well her new idea before she attempts to make 
it a permanent feature of the office. If, after application, it 
proves impractical, it can quickly be dropped without any 
damage having been done. If it proves to be practical and an 
asset to the office, the nurse will have proven herself that 
much more valuable to the dentist, and compensation will be 
forthcoming. 
Concentration—As a rule the nurse who ranks as a failure 
has never mastered the art of concentration. Keeping her mind 
fixed on each duty as she performs it, and if possible to improve 
upon it, is concentration. The nurse should not think of a 
dozen things while she is trying to do one, as this method impairs 
her efficiency. Concentration in the dental office means mind 
and muscle working harmoniously together. Success in doing 
things depends largely upon the attention given to them. The 
nurse must never allow her mind to work in one direction while 
her body is working in an entirely different direction, for twice 
as much energy is spent as would ordinarily be required. 
Attention—The nurse must give proper attention to her 
duties in order to get them into thorough harmony with the 
work she has to do. If she is in love with her work, she will 
achieve results that never would be attained by those who are 
performing the same duties perfunctorily. The nurse must 
lose her self-interest in the dental office. Her success will 
depend largely upon the amount of attention and pains which 
she is willing to put into each duty. She must be alert and 
attentive—not sluggish and haphazard. 
Patience—The nurse must not expect that her ambitions 
are to be realized at once. She should be told to observe the 
chronic doubters, and to determine whether these doubters 
are worth while. It takes patience and lots of it in the dental 
office before the nurse becomes proficient. 
Courage—Courage is one of the essentials of success for the 
nurse. If she has courage, she will be strong in performing 
her duties correctly. Courage makes her persistent. Courage 
dispels weakness. Courage will steady her at a time when the 
dentist needs her help most. Courage gains for her respect 
from everyone with whom she comes in contact. The nurse 
should never hurry things through because, if she does, her 
work will not be up to standard. To act deliberately gives 
161 Practice Building Suggestions 
people with whom she comes in contact in the office the idea 
that she is thorough, and a master in her profession. 
Personal Appearance—The appearance of the nurse should 
be one of extreme neatness and refinement. Sensational attire 
must be avoided. To dress in harmony with her environment 
must be her constant aim. She should be told that her pro- 
fessional life in a measure should reflect itself in her social 
activities. Some patients will come to her employer’s office for 
his services because she at some time or place has impressed 
them with her personality—with her way of being different. 
We may not go so far as to assert that it is clothes that make 
the workman, but however generous and charitable we may 
strive to be, we must admit if we are honest, that carelessness 
and slovenliness in the matter of attire invariably leave a most 
unfavorable impression. It is pride that insists that the sleeves 
shall be clean. It is pride that brushes her clothes and polishes 
her shoes. Her hands and finger nails must be well-kept. Her 
mode of hairdressing must be in harmony with her face and her 
height. Her teeth above all things must be clean and the 
dentistry in her mouth, if any, must be the best, because 
she will then be practicing those things preached by the dentist. 
Her mouth and teeth must be the dentist’s silent salesman, not 
only in the office, but also in social life. The right type of 
nurse will draw patients to the office, and as they come her 
earnings will increase proportionately. 
Other qualities which should be looked for, and which will 
manifest themselves during the nurse’s first interview with the 
dentist are ambition, a pleasing voice, courteous manner, order- 
liness, cheerful disposition, tact and self-confidence. 
Dental Equipment a Nurse Should be Competent 
to Operate for the Dentist 
The efficient nurse must not only be able to operate all of 
the equipment as described, but she must also know what care 
is required for its complete maintenance. 
Dental Chair. 
Positioning adults and children. 
162 Practice Building Suggestions 
Units. 
Turning on and off various switches at will of operator. 
Regulating and heating the flow of air for hot air 
syringe. 
Heating and operating sprays. 
Regulating flow of air for sprays in connection with 
cut-off. 
Changing of instrument points for the mouth in 
switch handles. 
Turning on and off water valves on cuspidor. 
Operating water syringe on cuspidor. 
Operating saliva ejector. 
Regulating flow of air for cut-off when chip-blower 
point is used. 
Adjusting current regulators for various instrument 
points. 
Positioning bracket table. 
Operating Bunsen burner on bracket table. 
Positioning engine arm. 
Attaching to handpieces, burrs, cleaning brushes, 
mandrills, disks, polishing cups, etc. 
Attaching handpieces such as contra angle or right 
angle. 
Operating engine foot controller. 
Heating and maintaining water glass in tumbler 
heater. 
Positioning and operating fan and spotlight. 
Tri-Dent. 
Positioning spotlight. 
Positioning bracket table. 
Heating and operating sprays. 
Heating and maintaining water glass in tumbler 
heater. 
Turning on and off water valves on cuspidor. 
Operating water syringe on cuspidor. 
Operating saliva ejector. 
Operating Bunsen burner on bracket table. 
Positioning engine arm. 
Operating foot controller. 
163 Practice Building Suggestions 
Attaching to handpieces, burrs, cleaning brushes, 
mandrills, disks, polishing cups, etc. 
Attaching handpieces such as contra angle or right 
angle. 
Positioning auxiliary table. 
X-Ray Apparatus. 
Positioning patient. 
Positioning films in mouth. 
Positioning x-ray tube. 
Making exposure. 
Developing films. 
Air Compressor. 
Setting it to proper pressure point. 
Draining tank. 
Laboratory Lathe. 
Changing chucks and keeping them clean. 
Mounting on chucks, felt cones, felt wheels, carbor- 
undum stone, bristle wheels, vulcanite burrs, 
cotton wheels, chamois wheels. 
Attaching to lathe, Ritter hand piece attachment. 
Spray Warmers and Tumbler Heaters. 
Maintaining proper heat. 
Keeping spray bottles filled with solutions. 
Attaching cut-off to spray bottles, etc. 
Ionization Equipment. 
Operating current regulator. 
Adjusting electrodes to patient, etc. 
Distributing Panels and Switchboards. 
To be operated by nurse in the same manner as listed 
under Units. 
Electric Engines. 
To be operated by nurse in the same manner as listed 
under Units, etc. 
Dental Cabinet. 
Having a respective place for each instrument and 
being able to locate it at a moment’s notice. 
164 Practice Building Suggestions 
The nurse must be able to recognize each instrument 
by its technical term. 
Keeping working surface of cabinet clean and free 
from bottles, cement slabs, jars, etc. 
Drinking Glass Cabinet. 
Keeping glasses clean and in place. 
Laboratory Bench. 
As with the Dental Cabinet, laboratory instruments 
should have their respective places in the labor- 
atory bench, and the working surface of the bench 
should be kept as free as possible from appliances 
and working materials not in use. 
Many nurses do not appreciate the importance of being 
capable of operating and manipulating the following mis- 
cellaneous equipment and instruments: 
Amalgam mixer, or mortar 
and pestle. 
Alcohol lamp. 
Articulators. 
Blow pipe. 
Casting machine. 
Compound heater. 
Dentimeter (inserting mea- 
suring wire). 
Electric furnace. 
Electric fan. 
Flask presses. 
Gas apparatus (nitrous oxide 
and oxygen). 
Gasoline gas generator. 
Gas furnace. 
Hand mallet. 
Inlay drying oven. 
Inlay wax eliminator. 
Laboratory Bunsen. 
Matrix retainer. 
Novocaine heater. 
Point polishers (inserting 
points). 
Pyrometer. 
Rubber dam holder. 
Rubber dam clamps (insert- 
ing them in the mouth). 
Rubber dam clamp forceps. 
Rubber dam punch (cutting 
rubber dam). 
Sterilizers (electric, all types) 
Tooth separators. 
Tooth stock (keeping facings, 
crowns and vulcanite stocks 
replenished and in order). 
Vulcanizer. 
Vulcanite flasks. 
Water still. 
Water heaters. 
X-ray film illuminators. 
165 Practice Building Suggestions 
The Nurse’s Duties in the Office Prior to the Arrival 
of the First Patient 
The nurse should arrive at the office sufficiently early and 
prior to the dentist’s arrival so that she can accomplish as 
many as possible of her duties before the first appointment 
of the day takes place. It is not always possible for the nurse 
to accomplish each day the duties as listed. If she is system- 
atic in her work, all of the important ones can be finished up 
prior to the first patient’s arrival, and those of less importance 
can be attended to as opportunities present themselves through- 
out the morning hours. 
Reception Room 
Dust, clean and attend to places usually left unfin- 
ished by janitress. 
Complete ventilation, after which maintain tempera- 
ture of 71 degrees. 
Put books, magazines and newspapers in order. 
Position all furniture which has been pushed out of 
place. 
Retiring Room 
Fluff up pad and pillow on couch. 
Fasten clean napkin or doily on pillow of couch. 
Remove from dressing table combs and brushes 
which perhaps were used by last patient the 
day before. 
Replenish stock of powder puffs, pins, hair pins, etc. 
Polish hand mirror. 
Polish dressing table mirror. 
Operating Rooms 
Sterilize the following instruments, together with 
those to be used on the first patient: Mouth 
mirrors, cotton pliers, explorers, etc. 
Thoroughly wipe and polish all equipment, paying 
special attention to all nickeled parts through 
the application of whiting. 
Flush cuspidor and then wipe until all parts are dry. 
166 Practice Building Suggestions 
Remove from working surface of cabinet such items 
as instruments, bottles, cement slabs, glass 
receptacles, etc. 
Wash drinking glasses and replace in drinking glass 
cabinet. 
Remove drinking glass and saliva ejector from cus- 
pidor which perhaps has been left there from pre- 
vious day. 
Wash lavatory with cleaning powder. 
Polish mirror over lavatory. 
Fill spray bottles with the proper solutions. 
Heat up spray bottles when refilled. 
Place clean towels on towel bar over lavatory. 
Fill alcohol lamp. 
Replenish linen stock in cabinet. 
Lay out all work for first patient such as “try-in” 
cases, bridge work, etc. 
Put clean napkin on headrest of dental chair. 
Sterilize all hand brushes. 
Clean and lubricate handpieces. 
Put on bracket table fresh napkin upon which lay 
contra angle handpiece, disk of cotton pellets, 
mirrors, explorer, pliers and dental floss. 
Sharpen dull instruments. 
A certain morning each week should be set aside for 
proper lubrication of all equipment. 
Sterilizing Room 
Wash and polish all glassware. 
Polish sterilizer. 
Replenish sterilizing room supplies. 
Laboratory 
Clean top of laboratory plaster, gold and vulcanizer 
benches. 
Wipe up and polish Air Compressor, Lathe and 
Vulcanizer, etc. 
Wash sink with cleaning powder. 
Place all models not being worked on upon a shelf 
reserved for that purpose. 
167 Practice Building Suggestions 
Clean and polish flasks which have been used the day 
before. 
Clean and polish impression trays which have been 
used the day before. 
Business Office 
Put nurse’s and dentist’s desks in order by filing all 
papers such as invoices, letters, etc. which have 
been given attention. 
Supply clean blotters, fresh ink, pens, etc. 
Assort and open all mail other than personal. 
Make two lists of all appointment schedules for the 
day—one list to be placed in the operating room 
so that the Doctor can refer to it during the day 
for guidance in gauging his operative time; the 
other to be kept in a convenient place in the 
business office so that it can be instantly referred 
to in case of appointment cancellations or emer- 
gency appointments. 
Order supplies for the day by referring to want list. 
Why the Nurse Should Take and Develop 
Radiographs for the Dentist 
There was a time when it was considered very dangerous 
for the nurse to do complete radiographic work for the dentist, 
particularly in the days of the gas tube. With that type of 
apparatus there was much that could happen even with the 
dentist if he did not watch his step very closely. Today, much 
of this danger has been eliminated. There are still certain 
types of x-ray machines being manufactured whose operative 
technique is complicated, and because of overhead wiring and 
many levers to manipulate, certain dangers still exist which, 
if taken seriously, should prohibit the nurse from relieving 
the dentist of the details in connection with taking radiographs. 
Invention has brought about simplicity in x-ray apparatus 
making possible ease of manipulation, absence of overhead 
wiring, elimination of useless and confusing levers. With the 
advantage of standardized technique, there is absolutely no 
excuse for the dental nurse not relieving the dentist of the 
complete radiographic work. By turning the radiographic 
department over to the nurse and making her responsible for 
168 Practice Building Suggestions 
it, this department can be made highly remunerative, not only 
through the fees secured because of the radiographs themselves, 
but also through the additional operativqwork which is disclosed. 
We emphatically state that the nurse should not attempt 
or even be encouraged to give interpretations, as this is only 
possible through study by a degree man. Aside from being 
told by the dentist just what areas to radiograph, the nurse 
should be capable of efficiently serving the dentist and patient 
by doing the following: Positioning the patient in the chair, 
positioning the film in the mouth, positioning of the tube, 
making the exposure, dismissing the patient, developing the 
films and then delivering them to the dentist, in an envelope 
with the patient’s name written on it. 
By taking over the radiographic work as described in the 
foregoing paragraph the nurse will help the dentist to increase 
his actual productive hours, and through it his gross income. 
By following this procedure it will be possible to make the 
x-ray department self-sustaining which by the end of the year 
should produce a revenue to entirely offset its cost, and aside 
from leaving a profit should be sufficiently remunerative so 
that the dental nurse can be paid a salary in keeping with her 
position and which will be justified by service rendered. 
Treatment Solutions the Nurse Should Make Up 
and Have Ready for the Dentist 
Space will not permit the listing of the many treatment 
solutions which the nurse should be competent to make up 
and have ready for the dentist. A few of the important solu- 
tions will suffice. 
Germicidal mouth washes for 
highly infectious conditions 
for use in connection with 
spray bottles or treatment 
syringe. 
Anesthetic solutions for in- 
filtration and nerve block- 
ing. 
Various pyorrhea solutions. 
Various solutions for root 
canal treatments. 
Mouth washes such as nor- 
mal salt solutions and pro- 
fessionally advertised so- 
lutions which require dilu- 
tion before application, 
and to be used in connec- 
tion with spray bottles or 
treatment syringe. 
Aconite and iodine. 
Eucapercha Comp. 
Di-oxygen and water. 
169 Practice Building Suggestions 
Disclosing solution. 
Aromatic ammonia. 
Phenol Comp. 95 per cent. 
Blacks—1, 2, 3. 
Ammoniated silver nitrate. 
Swabbing solution (benzol 
iodine, menthol.) 
Phenol—5 per cent. 
Stain removers. 
Ringer solution. 
Filling Materials the Nurse Should Make Up and 
Have Ready While the Dentist is 
Working on a Patient 
We are only listing the important materials which the nurse 
should have ready for the dentist while he is working on the 
patient. The nurse would not be serving her best interests 
and those of the dentist if she were not fully capable of master- 
ing the mixing technique of the following: 
Temporary cements. 
Crown and bridge cements. 
Copper cements. 
Inlay cements. 
Silicate materials and por- 
celain. 
Zinc cement. 
Alloys. 
Copper amalgam. 
Cavity linings. 
Pulp preservers. 
Temporary stoppings. 
Gutta-percha points. 
Root canal filling materials. 
Gold foil materials, such as 
rolling and cutting sheet 
foil, assorting gold cylin- 
ders and annealing before 
placing in cavity. 
Abscess cures requiring a 
mixing of liquid and pow- 
der. 
Enamels 
Various pastes for pulp treat- 
ments. 
Miscellaneous Materials to be Worked Up 
by the Nurse 
The nurse should be capable of anticipating the wants of 
the dentist for the following materials and of preparing them 
for him just prior to their use: 
Articulating paper. 
Modelling compound. 
Inlay wax. 
Wax for bites. 
Rubber dam cut in proper 
size. 
Cocoa butter. 
Prepared chalk. 
Tooth cleaning preparations. 
Prophylaxis preparations. 
Absorbent pellets. 
Devitalizing fiber. 
170 Practice Building Suggestions 
Gutta-percha for base plates. 
Base plate wax. 
Spunk. 
Varnishes. 
Flour of pumice. 
Orange wood. 
Cotton rolls. 
Gauze. 
Cotton pellets on wood ap- 
plicators. 
Swabs and compresses. 
Laboratory Duties for the Nurse 
It would require a volume of writing to describe in detail, 
together with technique all of the duties that the efficient 
nurse should relieve the dentist of in the laboratory. There- 
fore, we are listing only the important laboratory duties of 
the nurse. 
Keeping bins for plaster and investment materials filled. 
Investing models, such as vulcanite, inlays and bridges. 
Separate, boil out and trim all models. 
Drying out inlays. 
Making plaster mixes for impressions. 
Vulcanizing. 
Mounting models on articulators. 
Keeping laboratory properly supplied with all labora- 
tory materials. 
Boiling flasks after packing and screw down in flask press 
ready for vulcanizer. 
Heating up bridge cases prior to soldering. 
Melting and pouring various kinds of metals. 
Trimming off surplus vulcanized rubber with mechanical 
saw from dentures. 
Making wax base plates on model for try-ins. 
Polishing dentures, crowns, inlays and bridges. 
Application of shellac and sandarac varnish. 
Application of sticky wax. 
Application of separating fluids. 
Piecing together and mending broken plaster impressions 
and models. 
Keeping impression trays cleaned and polished. 
Swageing cusps for crowns and bridges. 
Setting up and waxing vulcanite sets, facings for bridges, 
etc. 
171 Practice Building Suggestions 
Backing up facings. 
Applying tin foil to vulcanite casts. 
Soldering swaged cusps to crowns. 
Repairing dentures. 
Scraping dentures preparatory to polishing. 
Pouring models and casts. 
Packing denture casts. 
Important Duties for the Nurse in the Business Office 
The important duties to be mastered by the nurse in the 
business office are as follows: 
Bookkeeping. 
Sending collection letters to patients. 
Making bank deposits. 
Balancing petty cash. 
Paying all accounts either by check or, when indicated, 
from the petty cash fund. 
Making out and mailing monthly statements. 
Filling out and sending periodical examination cards. 
Keeping perpetual inventory of all supplies used and of 
those on hand. 
Purchasing all supplies for the business office. 
Purchasing all supplies and materials for the operating 
room and laboratory. 
Filing all letters, invoices, record cards and radiographs. 
Reviewing call list. 
Making all appointments and posting them in the appoint- 
ment book. 
Making a typewritten record of all agreements between 
patients and the doctor. 
Keeping cost sheet, and rendering monthly a report of 
the operating expenses, gross and net earnings, cash 
on hand and in the bank. 
Care of Reception Room Literature 
A dentist who is interested in keeping his reception room 
looking neat should keep his periodicals in the business office. 
A table that is cluttered up with magazines and newspapers 
detracts from the appearance of the reception room. If the 
dentist is working strictly by appointment and his patients 
172 Practice Building Suggestions 
are on time, they will really have no opportunity to read. 
Therefore, periodicals should be kept only for those patients who 
are kept waiting. 
The nurse usually knows just how long the patient will 
have to wait before being admitted to the operating depart- 
ment and when she steps into the reception room to inform 
the patient of the number of minutes she will have to wait 
it might be well to take with her a magazine. It would be a 
matter of personal service to ask the patient if she has seen 
this particular magazine for the current month and when the 
patient answers in the negative the nurse should then present 
the magazine to her. When the patient is finally admitted 
to the operating department the nurse will then remove the 
magazine from the reception room and return it to the business 
office. 
Magazines should be placed in flexible binders, viz., that 
of Spanish brown and on which should appear the dentist’s 
monogram, together with the name of the periodical on the 
lower edge. Binders tend to preserve magazines and also add 
to the dentist’s individuality. 
173 Practice Building Suggestions 
SECTION IX 
Relation of Nurse to Patient 
Proper Procedure by Nurse when Receiving 
Telephone Messages 
IN this day of overburdened telephone service it is well to 
come right to the point in answering the phone by stating 
“This is Dr. Smith’s office.” Stating the doctor’s name will 
save the necessity of the party who is calling asking the ques- 
tion. There are many dental nurses who still insist upon open- 
ing a telephone conversation by saying “Hello,” which obliges 
the person calling asking if this is the doctor’s office, all of 
which is a useless and time-wasting conversation in addition to 
being exasperating to a person accustomed to intelligent 
methods. 
The nurse’s voice plays no small part in giving a favorable 
or unfavorable impression of the doctor’s office to patients 
who perhaps have never met the nurse or the doctor. The 
nurse’s conversation over the telephone should be carried on 
in a low modulated tone of voice. Enunciation should be clear 
and distinct and should also carry an impression of cheerfulness. 
After stating that this is Dr. Smith’s office, if the party call- 
ing should reply that she has been given the wrong connection, 
the nurse should never miss the opportunity of saying “We 
are sorry.” This little courtesy over the ’phone impresses the 
party calling with the doctor’s name and the courtesy of the 
nurse, which gives added publicity to the doctor and his 
establishment and may result in attracting a desirable patient 
to the office. 
If the party asks for the doctor, the nurse should explain 
that he is busy with an operation but that she can probably 
take care of the matter. If it is impossible for her to handle 
the situation she should say that she will take the message, 
and at the same time should learn the caller’s name before 
going to the doctor, being sure, however, that the party wants 
to talk about dentistry. The nurse should write the name of 
the party calling and, if possible, the message on a pad pro- 
174 Practice Building Suggestions 
vided for such purposes. The nurse should then take the pad 
to the operating room and at the back of the chair call the 
doctor’s attention to it, holding the pad so that he can read 
the name and the message at a glance. All of this should be 
done in the operating room without any conversation taking 
place between the dentist and the nurse. The doctor will 
then stop at a point in his operative technique where he can 
leave the patient in the chair for a minute or two without 
having the patient know why. 
Imagine yourself in a dental chair being subjected to a 
gingival third cavity preparation, with a large piece of rubber 
dam in position and a cervical clamp in place functioning on 
the retention of gum tissue. During such an operation each 
minute augments itself, together with the irritable side of 
your nature. What would be your opinion of the dentist and 
the nurse if she informed you as well as the doctor that he is 
wanted at the ’phone, and in response to the message the 
dentist would be inconsiderate enough to leave you in this 
condition in order to engage in telephone conversation lasting 
two or three minutes? 
An urgent telephone message must be given attention, and 
if it is impossible for the nurse to give it, the doctor must be 
called but in such a way that the patient will not be conscious 
of it; hence our suggestion for writing the name and, if possible, 
the message on a pad. If this procedure is properly followed 
out the dentist can leave the patient without having to make, 
seemingly, an unreasonable excuse. 
An urgent telephone message for the doctor can frequently 
be postponed if the nurse will explain that the doctor at the 
particular moment is engaged in operative technique of an 
urgent nature, and just as soon as it is concluded she will have 
the doctor call back, provided the name and telephone number 
of the party calling is given her. It perhaps is needless to say 
that the nurse should never open her conversation over the 
telephone, after the doctor’s name is stated, by saying “He 
is busy.” The doctor, of course, always desires persons calling 
on the ’phone to know that he is busy. The impression of being 
continually busy can be given over the ’phone in a much more 
genteel and impressive way than merely stating, and usually 
in monotone, “The doctor is busy?” We put a question mark 
175 Practice Building Suggestions 
after the word “busy” because it has been our experience in 
a thorough check-up on telephone conversations that the 
nurse usually raises her voice in connection with saying “busy,” 
which might indicate to a thinking patient that it depends 
entirely upon which patient it is as to whether or not the 
doctor will condescend to come to the telephone, all of which 
suggests discrimination among patients. 
Conversation Which Should Ensue between Nurse 
and Patient Prior to Extractions 
A patient who has been informed that an extraction is 
necessary immediately, takes on an attitude of fear. The 
patient no doubt has been told by friends of extractions which 
have been gruesome, (mostly imaginary). Because of it the 
patient imagines and expects the same experience and airs 
her imagination to the dental nurse or the dentist. It is good 
policy for the nurse to give every extraction patient reas- 
surance. However, to over-do this will have an adverse effect 
because the patient will then expect that real trouble is brewing. 
The nurse’s reassurance must be gentle but firm, stating that 
before the patient is conscious of it, the tooth will be out and 
that the patient will be well on her way toward health. 
The nurse can do much toward making an extraction a 
success because it is an established fact that when a patient 
enters the extraction room with a calm mental attitude extrac- 
tions are more successful than with patients who have not been 
given proper assurance and who, as a result, are highly nervous. 
She should be accompanied to the retiring room by the nurse 
who should remain until the patient is ready for the operating 
room. The patient should not be allowed to wait in the retir- 
ing room an undue length of time because it will be the undoing 
of the reassurance and courage which the nurse has given her. 
Precautions to be Taken by Nurse with Patients 
Just before Extractions 
lt should be the duty of the dental nurse to see that all 
tight clothing on both men and women extraction patients is 
loosened sufficiently to allow a free circulation and complete 
relaxation. Just a few moments prior to proceeding to the 
operating room extraction patients must be informed of the 
176 Practice Building Suggestions 
necessity of emptying the bladder. Even the most serious 
extractions have been successful due to the proper administer- 
ing of complete anaesthesia, in most cases nitrous oxide and 
oxygen, which would not have been possible if free circulation, 
complete relaxation and an empty bladder had not first been 
assured. 
Nitrous oxide and oxygen acts as a stimulant to circulation, 
also to the bladder, and if the body were encumbered with 
tight clothing and adverse bladder conditions were present 
complete relaxation so essential would not be possible. 
If the patient is a woman the nurse should help her loosen 
all tight clothing. The nurse must be insistent, particularly 
if a heavy extraction is to take place, that the patient remove 
her corsets. If the patient is a man the nurse should send 
him to the retiring room with instructions to remove his collar 
and tie and to unclasp his shirt-band at the neck as well as 
to release his belt. In this connection the nurse should never 
fail to explain to both men and women patients why these 
requests are made. Failure to give this explanation to patients 
will cause them to believe that the dentist expects to run into 
difficulties and this in itself will cause them to come to the 
operating room in an adverse mental attitude. It is very 
important, especially when nitrous oxide and oxygen is to be 
administered, that the patient be kept as calm as possible 
prior to the administration. 
When conductive anaesthesia is given the foregoing instruc- 
tions with regard to tight clothing can be modified because 
the conductive anaesthesia is not as severe and the patient 
is conscious throughout the operation. 
Attentions to be Given by Nurse to Patients 
After Extractions 
When the patient is ready to return to the retiring room 
after the extraction has been effected, the nurse should accom- 
pany the patient and see to it that every comfort has been 
provided for. She should remain until assured that the patient 
is recovering sufficiently so that the nurse’s presence will not 
be required again for some time after leaving the patient alone 
in the retiring room. Special attention must be given patients 
who have been subjected to heavy extractions or prolonged 
177 Practice Building Suggestions 
anaesthesia, because these patients as a rule are finicky after 
the operation has been performed, and being super-sensitive at 
such a time they will not forget the thought which has been 
given to their comfort. 
The well appointed retiring room, if of sufficient size, usually 
has a couch. Extraction patients, aside from those of simple 
extractions, should be requested by the nurse to lie down if 
only for a few moments. This helps to revive the patient and 
stimulates resistance, resultant in giving the unaccompanied 
patient sufficient confidence to leave the office unassisted. 
Sensitive patients, even though they are very ill, will hesitate 
to make use of a recovery couch unless invited to do so. If 
the nurse fails to invite patients to lie down, many of them 
might believe that the couch was not there for practical pur- 
poses, but rather for show. 
Inasmuch as the average retiring room is small and usually 
an inside room, the nurse should pay special attention to cir- 
culation, being sure that the fan which is part of the equip- 
ment of a well appointed retiring room is turned on and in 
just the right direction. The after-effects of anaesthesia with 
certain people are varied. The retiring room may be com- 
fortably warm yet the patient be subject to chills. In such 
an instance the fan must be so adjusted that the draft from 
it will not strike the patient directly, but rather have the draft 
pass over the patient. For such patients it is best to have on 
hand a light-weight wool blanket. With other patients, a 
retiring room with a temperature below normal might seem 
uncomfortably warm, and in these cases it would be best to 
have the draft from the fan strike the patient in an almost 
direct line. 
It is perhaps needless to say that the nurse should see to it 
that the patient is not needlessly disturbed and is kept abso- 
lutely quiet. After all of the necessary comforts have been 
provided the nurse should leave the patient, but with the 
thought of returning to the retiring room every five minutes 
to make sure that the patient is properly recovering. It is 
well to instruct patients to lie on their right side, although 
with certain of them this is not always practical because some 
patients do not feel comfortable in that position. The main 
178 Practice Building Suggestions 
thought is to bring about relaxation which with the conscious 
patient stimulates recovery. 
The following items should be supplied by the nurse after 
the patient has been made comfortable, and the uses of these 
items will be apparent, depending on the condition of the 
patient: 
Glass of warm water. 
Glass of luke-warm salt water. 
Hand pus basin. 
Bottle of smelling salts or aromatic spirits of ammonia. 
Several towels. 
A cold, wet towel to be used as a pack to the forehead 
or the cheek. 
When the patient has fully recovered and is ready to be dis- 
missed, the nurse should help the patient to readjust her 
clothes, being cautious that all evidence of disarrangement 
has been removed. The importance of this phase of the ques- 
tion is not always appreciated by many of the dental nurses. 
The patient may not appreciate at the time this exacting 
attention, but usually after the patient gets home and rehearses 
her experience in the dental office all of these special attentions 
are recalled and doubly appreciated. 
We stated previously that before extractions the patient 
should be given reassurance, but that it must not be overdone, 
and explained fully why. After the extraction the nurse may 
go to the other extreme with the patient in regard to a sym- 
pathetic attitude. The patient will really require this to a 
greater extent after extractions than before, all of which wil 
impress the patient with the human side of the dentist’s office. 
Propriety of Nurse Sympathizing with Patients 
Undergoing Pain 
We believe that it is most proper for the nurse to sympathize 
with patients undergoing pain during an operation. The extent 
of such sympathy, however must be gauged by the nature of 
the patient. Some patients would take advantage of the situa- 
tion if too much sympathy were being given. Sympathy to 
some patients has a tendency to bolster up their courage 
through the painful period, which perhaps is only to continue 
179 Practice Building Suggestions 
for a short time. The doctor should not be expected to give 
sympathy for the reason that he is fully aware of what the 
patient is going through, and because of it is concentrating on 
the operative procedure and is exerting every effort to get it 
over with. Therefore, if he is to give sympathy in addition to 
performing the operation, it is apt to prolong his efforts rather 
than to shorten the operation. 
The efficient nurse should thoroughly understand the various 
classes of operative work with regard to the pain which they 
bring about, and she should at the psychological moment give 
the patient proper encouragement. There is nothing quite so 
irritating to patients who are undergoing pain as to have the 
situation made light of. If the patient shows signs of suffering, 
the dentist as well as the nurse should make an acknowledge- 
ment of it, and under no conditions when it is evident that the 
patient is being subjected to pain should the dentist or nurse 
disagree with the patient in regard to it, or treat the patient 
as though the suffering were purely imaginary. 
Special Attentions to be Given Patients by Nurse 
During Prolonged Painful Operation 
There are certain cutting operations such as gingival third 
cavity preparations, sensitive dentine, especially where a leaky 
filling has existed, and the dressing of sockets after extractions, 
which affect patients in several ways. With some patients 
these operations produce chills, and with others they cause 
flushes resulting in perspiration. At such a time the nurse can 
do much to help the patient through this trying situation when 
perspiration is in evidence by applying a cold, wet towel to the 
forehead or gently wiping the patient’s brow and face with a 
damp cloth. To those patients who are subjected to chills it 
would be most considerate to apply a hot towel to the brow, 
as well as to wipe the face with it. 
These things can be done without interfering in any way 
whatsoever with the dentist’s operative work. It is the least 
that can be done, and will do much to favorably impress the 
patient with the fact that the nurse is thinking of the patient’s 
comfort. Men are particularly susceptible to this type of 
attention, resulting in favorable comment by them to their 
friends about the dentist and his nurse. 
180 Practice Building Suggestions 
It is interesting to note that many in the profession still 
believe that in this day and age there should be no occasion for 
the type of pain spoken of in this answer, and give as their 
reason the solutions on the market for infiltration and nerve 
blocking, as well as desensitizing pastes, etc. Regardless of 
all these preparations there are many types of patients and 
certain areas in all mouths where these pain reducing remedies 
cannot be successfully applied, and it is of these that we state 
the nurse should efficiently do her part in helping the patient 
over the “rough spots.” 
Three Important Steps to be Taken by the Nurse 
When a Patient Telephones an 
Appointment Cancellation 
If a patient telephones that it will be impossible to keep an 
appointment and asks cancellation of it, the first thing for the 
nurse to do is to immediately make another appointment and 
impress the patient with the fact that the new appointment is 
being especially arranged. This will indicate to the patient 
that everything consistent must be done to meet the next 
appointment. 
The next step is to make out an appointment card, sending 
it to the patient by mail. This in itself will once more impress 
the patient with the importance of keeping the appointment. 
The third step is to try and fill in this broken appointment 
by summoning some other patient whose work will require 
the same amount of time as that of the patient who made 
cancellation. 
It is proper for the nurse to greet the patients in the reception 
room soon after they have entered it, but not immediately. 
The dentist who has a nice reception room, which has been 
furnished for the convenience and comfort of his patients is 
naturally as proud of it as he is of other departments in the 
suite. For this reason he would like his patients, especially 
those who have never been to the office before, to become 
familiar with the conveniences which have been provided for 
the comfort of visitors to the office. 
When the annunciator announces that someone has entered 
Proper Reception of Patient by Nurse 
181 Practice Building Suggestions 
the reception room, it should be the thought of the nurse to 
allow the newcomer sufficient time not only to become seated 
in the reception room, but also to look about it. If the nurse 
immediately rushes out to greet the patient, the impression 
which the patient will gain from the reception room is apt to 
be interrupted. It is an old saying but nevertheless true that 
“The first impression is lasting,” and inasmuch as the modern 
reception room is a patient’s first impression of the dentist’s 
establishment, the nurse should take advantage of the oppor- 
tunity for the patient to be indelibly impressed. 
We suggest that when the annunciator indicates the arrival 
of someone in the reception room that the nurse slowly count 
from one to ten before responding to the call. This will give 
the patient an opportunity to stand for a moment after entering 
and then be seated. By the time the nurse counts to ten and 
then enters the reception room to greet the visitor, the visitor 
will have had an opportunity to take in the entire room and its 
furnishings. 
For the visitor to enter a reception room devoid of people 
and then to have the nurse or the dentist respond before the 
newcomer has had an opportunity to catch her breath, is apt 
to give an impression that the dentist or the nurse rushed out 
fearing that the patient might get away before they could 
intervene. 
Psychology plays no small part in the proper conduct of a 
dental office, and it is well to begin to apply it in a place where 
the first impression is gained—namely, the reception room. 
Special Attentions by the Nurse to Sickly Patients 
Special attention must be given to sickly patients such as 
rheumatics, paralytics, and those crippled by neuritis and will 
depend upon how badly the patient is afflicted. These invalids 
are usually supersensitive and if the nurse seems too anxious 
to please, especially in the presence of other patients, it is apt 
to be most irritating to them. When the afflictions of this type 
of invalid are apparent to everyone in and about the office, it 
is best for the nurse to help the patient out of the reception 
room, either into the business office or retiring room—in other 
words, away from the gaze of other people. When the nurse 
has made the patient comfortable in a department other than 
182 Practice Building Suggestions 
the reception room, she should tell the invalid that the added 
privacy will afford more comfort than would be possible in the 
reception room. 
The nurse should help the patient off with wraps, removing 
them if possible after the patient has become seated and also 
remove the rubbers or overshoes. If the affliction is in the 
lower extremities, and providing the patient will have to wait 
some little time before being admitted into the operating room, 
the nurse should provide an extra chair so that the patient’s 
feet or portion of the limb below the knee may be placed on it. 
The nurse should not first stop and ask these afflicted patients 
whether she may do so-and-so for them. She should do what 
seems necessary, and then if the patient states that she does not 
care for it, the nurse should abide by the invalid’s decision in a 
graceful way. Sickly patients as a rule do not like to be asked 
a lot of questions as to whether they would like the nurse to do 
certain things. Invariably when these questions are first put 
to them, minus action, the patient will reject the proposal with 
the thought, however, that the nurse is asking foolish questions 
which she ought to be aware of. 
Depending upon the condition of the patients and provided 
they come to the office unaccompanied, the nurse should not 
be content to leave them by themselves during the waiting 
period. Sickly patients as a rule do not like to be left alone. 
Therefore, when the nurse remains with them during the 
waiting period she must be sure to guide the conversation 
which might ensue, and avoid as much as possible talking 
about the patient’s physical condition. 
When such patients are placed in the dental chair the nurse 
should have foresight enough to know whether the standard 
position of the dental chair will be applicable and practical. 
She should position these patients without thought of ease of 
operation for the dentist, but rather with the thought foremost 
in mind of positioning them in such a manner as will be most 
comfortable. For the time being she must dismiss from her 
mind the maintaining of proper operative angles. The dentist, 
appreciating the invalid’s condition, will for the time being 
consent to operate with considerable discomfort to himself. 
At the time the appointment is made for an invalid patient 
such as described, the dentist and the nurse will be most 
183 Practice Building Suggestions 
thoughtful if they will set the appointment hour at a time 
when they are sure that there will be no other patients in the 
office. This will help to eliminate some of the invalid’s embar- 
rassment. 
When an invalid patient is being dismissed, the nurse should 
be equally as considerate as when the patient first entered 
the office. In other words, she must help the patients with 
their wraps, and if possible these should be put on while they 
are seated. Such a patient should always be dismissed through 
a separate exit rather than through the reception room. 
By properly caring for invalid patients additional new 
patients find their way to the office. 
Procedure by Nurse With Persons Who 
have Something to Sell 
The fact that such people as insurance, stock and bond 
salesmen, solicitors, etc., come to the dental office for purposes 
other than dentistry is no indication that the nurse should be 
abrupt with them or show any discrimination in her procedure 
of giving them attention as compared to regular patients. The 
nurse must be the judge as to whether what they have to offer 
will be of interest to the doctor. If she thinks the doctor will 
be interested in the salesman’s proposition, then she should 
suggest that the salesman return after regular office hours, at 
which time an interview will no doubt be granted. If she is 
quite positive that the proposition will be interesting to the 
doctor, she might suggest to the salesman a certain day and 
make an “after-office-hour appointment.” If she knows before 
hand that the salesman’s proposition will not interest the doc- 
tor, then she should not hesitate to state it. 
If the salesman still persists, she should state the exact office 
hours and be emphatic that the doctor can only be seen after 
them on appointments other than for dental purposes. In this 
connection, however, she should not intimate in any way that 
she will arrange an appointment for any certain day or hour. 
The nurse should receive and dismiss these people in such a 
way that they will entertain only the kindliest of feelings 
toward the doctor and his nurse, because some time, and 
possibly in the immediate future, they might return to the 
office seeking the doctor’s services. 
184 Practice Building Suggestions 
Caps for Lady Patients as an Aid for 
Comfort and Convenience 
In addition to placing upon a lady patient a napkin, bib, 
or apron, we would suggest a patient’s cap made of white linen 
for the winter months and of closely woven net for the summer 
months. In this day of the many different modes of hairdressing 
it is sometimes very difficult for the dentist to operate without 
disarranging the patient’s hair, especially at times when it is 
necessary to support certain materials in the patient’s mouth 
with the fingers of the left hand. A dentist should have a 
sufficient quantity of these caps, so that a clean one can be 
placed on each lady patient. 
A cap will be very impressive to the patient because it 
convinces her of the dentist’s foresight for her comfort and 
appearance, in addition to proving without words, the individ- 
uality and refinement of the office. 
Preparatory Operative Assistance by Nurse 
The nurse should thoroughly understand the proper spray- 
ing of the patient’s mouth before and after operations. She 
should know just what solutions to use, and the proper tem- 
perature for them. Aside from positioning the patient in the 
chair, adjusting the linen cap to the patient’s head and attach- 
ing a napkin she should be able to do the following if it is 
indicated by the nature of the operative work about to take 
place. 
1. Cut, punch and place in the mouth the rubber dam, 
together with the rubber dam clamp. 
2. Very carefully pass ligature between the teeth and 
tie it in support of the rubber dam. 
3. Fasten the rubber dam holder, and place under the 
holder a napkin so as to overcome making an 
impression of it on the patient’s cheek, as well as 
adding to the patient’s comfort. 
4. Place cotton rolls in the mouth. 
There are many other things which a nurse should be able 
to do for the dentist in getting ready for the operative work 
185 Practice Building Suggestions 
in the patient’s mouth. We are only listing a few of the impor- 
tant ones. 
If the nurse has had no experience in accomplishing these 
things, the doctor should at least give her a chance to learn 
by allowing her to first practice these things on him until 
she is competent to do them for the patient. When she has 
learned how to properly accomplish these in addition to 
positioning the patient in the chair, she can then accomplish 
a material saving of the dentist’s productive time. 
186 Practice Building Suggestions 
SECTION X 
Management of Child Patients 
Proper Relationship Between Dentist or Nurse 
and Child Patients 
MUCH of the success in managing children may be 
attained through tact and skill of the nurse. If the 
nurse has a happy disposition and can bring herself 
to a level with the child, she should have no difficulty. At the 
time the appointment is made for the child the nurse should 
obtain the child’s given name, age, if he has ever been to a 
dentist before, and if so whether the dentist had trouble in 
controlling the child and why. The nurse should take the time 
to form an acquaintance with the child, using the information 
gathered at the time the appointment was made as an intro- 
duction to the acquaintance. 
When the child is first presented in the reception room, the 
nurse should converse with him long enough in a childish way 
so as to discover his likes and dislikes, in order to gain absolute 
mental control before any operative work is attempted. 
On the first visit the child should not be forced to submit to 
work under protest unless it is necessary to the health of the 
child. 
H ow the Dentist is to Receive a Child Who is 
Under Eight Years of Age 
The dentist should never meet the child patient in the 
operating room for the first time. The reception room is pre- 
ferable because the child will be in an environment similar to 
that of the living room in his home, and he is more apt to take 
to the dentist in such surroundings than in the operating room 
where things are in evidence which he has never seen before and 
which will seem mysterious as well as suspicious. 
The dentist should not attempt to “rush” the child. In 
other words, to see how quickly he can get the little patient 
into the operating room and have it over with. These hur- 
187 Practice Building Suggestions 
ried tactics usually promote obstinacy and nothing much can 
be accomplished when such a mental condition exists. 
Especially with the child a first impression is a lasting one, 
and the dentist because of it should try and make his first 
introduction to the child as pleasant and agreeable as pos- 
sible. The child’s confidence cannot be gained in any other 
way. 
When the dentist first meets the child in the reception room, 
he should do so in a stooping position so that he will bring his 
eyes on a level with the child. The little tot is more apt to 
respond to the dentist’s questions in this position than if obliged 
to look up to him. There is nothing so pleasing to parents than 
to witness proper considerate attentions being given to their 
child, and it is through these special efforts on the part of the 
dentist that many a good patient is recommended to him by 
parents. 
How the Nurse is to Receive a Child who is Under 
Eight Years of Age 
Even in the present advanced age the first visit of the child 
to the dental office is usually at a time when the visit has been 
forced because of mouth neglect, and 90 per cent of these cases 
are accompanied with toothache. This visit to the dental office, 
being accompanied with the toothache, naturally puts the 
dentist and his office on an unfriendly basis in the eyes of the 
child. He knows beforehand through information imparted to 
him by the parents that a trip to the dental office is necessary. 
The child in turn passes this information on to certain of his 
playmates who perhaps have already had their sad experiences 
in this respect and do not hesitate to enlarge upon them to the 
new recruit. The result is that the suffering child conjures up 
all sorts of mental pictures not only of the dentist, but also of 
the nurse, the office, the instruments and especially the dental 
engine. It is for these reasons that the nurse and the dentist 
should make special efforts to reassure the child when he is first 
presented. 
When the child gets his first glimpse of the nurse dressed in 
uniform in the reception room, he is inclined to hold himself aloof 
because the uniform impresses the child that perhaps there is 
something to the talk he has previously heard about the den- 
188 Practice Building Suggestions 
tist’s establishment. No doubt the child patient has never seen 
a woman dressed in so severe a costume. For the nurse to 
briskly walk up to the child would be contrary to a proper 
reception. The procedure would be to walk slowly to within 
3 or 4 feet of him, and then stoop in as natural a way as possible 
so that the eyes of the nurse are on a level with those of the 
child. The nurse’s elbows should rest on her knees with the 
hands in a drooping position and from then on childish con- 
versation should ensue. If this conversation is natural, the 
child will soon come close enough to the nurse so that he can be 
touched and then, the ice having been broken, confidence is 
established. 
When the child is being escorted to the operating room 
another problem is to be solved, for there the child will see 
some things entirely different from anything he has ever seen, 
and there again he will be reminded of certain things told by 
his playmates. For this reason the conversation between the 
nurse and the child in the reception room should be along 
preparatory lines in regard to what the child will see in the 
operating room, and beforehand such equipment as the dental 
chair, the unit and the instruments for the mouth should be 
talked about in connection with childish illustrations so that 
when the child gets into the operating room he will not be 
startled by what is in evidence, but rather look forward to 
actually seeing a demonstration of this mystery equipment. 
Of all patients coming into the dental office children patients 
are the most difficult to manage. However, managing them 
properly is not so difficult providing the nurse will study 
children and try to realize how different their thoughts are as 
compared to the thoughts of adults. The first lesson then for 
the nurse should be to learn to like children, and to have this 
affection reciprocated by the child. The child is always accom- 
panied and a great mistake most nurses make is to address 
their conversation about the child to the accompanying adult. 
The nurse should always direct her conversation to the little 
tot and try and keep the adult in the background. If this is 
not done the conversation that ensues between the nurse and 
the adult is sure to convince the child that there is something 
unusual brewing. 
Space will not permit the giving of further details in regard 
to this important question such as the exact conversation 
189 Practice Building Suggestions 
which should take place between the nurse and the child in 
the reception and operating rooms and the conversation 
between the dentist and the child. We have only dealt with 
fundamental principles, and depend upon the dentist and nurse 
to build their story upon the substance given. 
Literature for Children 
Literature for children should be selected with infinite care 
and by someone familiar with the subject. Oftentimes the 
child patient will be detained in the reception room for con- 
siderable time before being admitted into the operating room, 
and for this reason proper literature subjects must be provided 
not only for the entertainment of the child but of such charac- 
ter as will help to put the subject of dentistry entirely in the 
background. The child must come to the operating room in 
a proper mental attitude, and this will not be possible if liter- 
ature is given him containing pictures suggesting strife or detail- 
ing stories of ugly fairy tales, war pictures or showing animals 
with snarling open mouths. The subjects should be light, 
pleasing and easily understood by children. The pictures con- 
tained in these books should be flower subjects, or those of 
healthy happy children at play, etc. 
Good books to have on hand for children are as follows: 
“Peter Rabbit” 
‘ ‘ Billy-F orge t-me-no ts 
“Alice’s Adventures in Wonderland” by Lewis Carroll. 
“Friendly Fairies,” by Johnny Gruelle. 
“The Turned-Intos,” by Elizabeth Gordon. 
“My Very Own Fairy Stories,” by Johnny Gruelle. 
“Child’s Garden of Verses,” by Robert Louis Stevenson. 
Copies of the above books with profuse illustrations and in 
pleasing colors should be selected in preference to the plainer 
ones. 
Proper Conversation Between Dentist or Nurse 
and the Child with Regard to Instruments 
Which are Being Used 
The dentist and the nurse must be considerate of children 
patients when engaging in conversation with them in regard 
190 Practice Building Suggestions 
to certain instruments which will be required for the operative 
work. The technical terms of the various instruments should 
be thrown into the discard and in their place such terms 
employed as will be intelligible to the child. Children who are 
being operated upon will look with suspicion upon anything 
which is foreign to their understanding, and as a result stretch 
their imaginations along lines which are apt to make it difficult 
for the nurse or dentist to manage them. The dentist and the 
nurse when holding conversation as to just what will be neces- 
sary in the way of instruments and material should direct 
their conversation to the child instead of to each other. 
If the dentist desires the nurse to get a particular instrument 
he should state to the child that the next instrument he is 
going to use will do a certain thing in the tooth, and the instru- 
ment and operative procedure should be explained through 
childish illustrations. The nurse who is alert will recognize 
the instrument through the explanation given the child by the 
dentist, and before the dentist has finished his story the nurse 
will have presented the instrument. This, then, means that 
the dentist will have to anticipate his wants sufficiently in 
advance so that the nurse can have the instrument ready and 
in place just prior to its use. 
When the operative work has once been started it will be 
best to keep up with it a continual line of childish talk and not 
allow any lagging in the work such as waiting for instruments, 
etc., because it will be found that many children will take 
advantage of the pauses by becoming obstinate. It depends 
a great deal upon the nature of the work whether many of 
these pauses are necessary. Whenever possible, the operative 
work should be continued without a break and childish con- 
versation should ensue. 
The dentist and nurse should avoid using words suggestive 
of things unpleasant as—nerve, hurt, disease, etc., or speaking 
of mouth conditions as being very bad—because the child 
is sure to interpret all of these as being something disagreeable. 
The proper way to visualize the various instruments and 
appliances to the child is to compare them with toys and 
various implements for which children automatically develop 
a liking. The hatchet should be compared to the little toy hat- 
chet used in candy shops in Fairyland for breaking molasses 
candy. The hoe should be likened to the child’s garden hoe; 
191 Practice Building Suggestions 
the burr compared to the bumble bee as described in fairy 
tales. The chisel may be called the rake. The excavator may 
be called the little shovel; the explorer named the fishing 
pole; the mouth examination lamps compared with searchlights 
or likened to those worn by miners on their caps. Regulating 
appliances for very young children should be talked about as 
fences to keep the bad men out. The various sprays should be 
known as a hose with which to wash away bad bugs, etc. etc. 
A childish illustration can be given to practically everything 
in a dental office, and it will do much toward making children 
fond of the dentist and his nurse. 
How to Describe the Dental Chair to a Child 
We have previously stated that the child should be prepared 
in the reception room by the nurse for what he is going to see 
in the operating room. Perhaps the most interesting story 
to the child will be the one about the dental chair. The nurse 
should tell the child that he is going to sit in the queerest kind 
of a chair, one that can be made into a tiny chair and in just 
as short a time into a great big chair. She should also state 
that the chair goes up very much like an elevator except, of 
course, not so high. The child will be quite interested when 
told that the chair can hold two people—namely, the child 
and the nurse—and it can go up with both of them sitting in it. 
When the child is taken to the operating room it will be well 
for the nurse to make good her statement about the chair. 
The nurse should adjust the chair into the child’s position, 
and immediately place the right arm in a position so as to make 
a seat. At the moment that the child is placed in the chair 
the nurse should sit on the arm so as to prove to the little 
patient that she, too, is going to sit in the chair. This pro- 
cedure will put the nurse’s eyes on a line with those of the child 
and realizing that he has company, any preliminary doubts 
that the child might have will be dispensed with. The nurse 
should make good her story to the child about the chair going 
up and down like an elevator, and while seated on the arms 
should raise and lower the chair. The child will notice that the 
nurse is riding in the chair with him and because of this, certain 
fears which he has are done with. At this point it will not 
be difficult for the dentist to take his operative position and 
192 An operating room arranged and equipped in keeping with successful 
present day practice. A dentist operating in such surroundings enjoys 
an atmosphere of harmony and individuality and is able to perform 
his work with a minimum of effort. The positions of equipment and 
fixtures have been carefully considered from the standpoint of space 
economy and to insure the greatest facility. 
Notice the practical manner in which the radiators have been covered, 
thus enhancing the appearance of the room and providing an added 
convenience. Also note the foot valves on the lavatory. 
This is a southern exposed operating room. The walls and ceiling 
have been painted in Lichen gray accordingly. This well arranged business office is of the same suite as the reception 
room shown opposite page 224. Mounted on the wall in the right 
foreground can be seen a signal box which is a part of a system con- 
necting the various rooms of the suite. 
It is just as important to impress patients with the business principles 
of a dental practice in this department of the office as it is to impress 
them with operative skill in the operating room. A properly furnished 
business office provides a place for private interviews between the 
dentist and his patients, and such an office should be included in 
every suite. Practice Building Suggestions 
continue the conversation with the child where the nurse has 
left off. 
When and Under what Conditions Parents should 
be Admitted in the Operating Room and 
Allowed to Remain During the Operation 
The parent, in most instances, should be allowed in the oper- 
ating room with the child and especially so at the time of the 
child’s first visit. If the parent is not wanted in the operating 
room, this in itself frightens the child and is apt to convince 
him that an unusual ordeal is awaiting which requires strict 
discipline not possible for the parent to give. The child immed- 
iately recognizes that this heartless discipline and control, what- 
ever it might be, is being transferred from the parent to another 
—a stranger. 
During the first few visits of the child to the dentist’s operat- 
ing room it is the best policy to admit the parent. As the work 
progresses and as the child comes to know in a more intimate 
way the dentist and his nurse, the parent can be dispensed with 
and usually at a time when it is more desirable to the dentist 
and his nurse than at first. It might be well to state that when 
the parent is admitted to the operating room it should not be 
with the thought of standing in the way of the dentist and his 
nurse, or in any way interfering with the operative work. The 
parent should be kept in a place in the operating room so that 
the child will know at all times that the parent is there with him. 
This gives a moral support to the little tot. 
193 Practice Building Suggestions 
SECTION XI 
The Dental Hygienist as an Asset 
E VERY dentist desires a controlled practice. To dismiss 
a patient after a completed work without planning 
future visits is as inexcusable as a surgeon dismissing 
a patient without arranging for future dressings. To have a 
patient report at stated intervals for prophylactic treatment 
and observation is ideal. The periodic appointment system 
can be made effective by turning it over to a dental hygienist. 
She is the sanitary aid who prepares the field of operation. 
She labors on the plus side of the health line. 
The pressure of work in most dental offices, in meeting the 
demand for treatments and restorations, leaves the dentist too 
busy to meet the newer responsibility of prevention. The 
physician has found the field of prevention covered by the 
sanitary engineer and students of hygiene, with the result that 
he finds himself free to study and find solutions for the higher 
scientific problems existing in his profession. The dentist, too, 
in the same measure should avail himself of the assistance of 
the new professional woman—the trained dental hygienist. 
There are many dentists who still believe that to accept the 
hygienist would be to impair the profession’s rigid code of 
ethics, and that hygienists as a whole will succeed in assuming 
operative responsibilities not sanctioned by the authorities. 
The dentist who has a practice large enough to support the 
services of a hygienist will, in order to protect his own interests, 
see to it that she will not even attempt to do operative work 
for which she has received no training. The various dental 
institutions interested in training the hygienist give courses of 
such an intensive nature that any ambitions the hygienist 
might have to overstep the bounds will be curbed initially. 
Inquiry also reveals the fact that hygienists with ambitions to 
do in private practice those things not sanctioned by law are 
never allowed to become full-fledged graduates. The course of 
training represents one year of very serious work with its 300 
hrs. of lectures, 136 hrs. of manikin practice, and more than 
500 hrs. of actual clinical practice on real patients, all this 
194 Practice Building Suggestions 
aside from detailed service in such departments as surgery and 
radiography. 
This training produces a group of women filled with enthu- 
siasm, competent and ready to do their best in the great 
movement for better health. Some of the curriculums provide 
for practice in public speaking, so that the hygienist may be 
prepared to go into the public schools to not only teach and 
treat the children, but also to speak before parent-teacher 
associations upon the subject of nutrition and mouth hygiene. 
Twenty states have now passed laws outlining the activities 
of the hygienist. Their ethical standards have been set very 
high, and so far the fear that they would overstep their pre- 
scribed bounds has not materialized. Every dentist with a 
gross practice of $8000 or more should be interested in employ- 
ing the services of a hygienist, because with her added activi- 
ties in the office and the ethical publicity she can give him, 
his practice can be greatly augmented, aside from the added 
prestige he will enjoy in his community. 
Those dentists, who are interested in securing the services 
of a dental hygienist, should write to the various schools 
which are conducting courses for them. The proper time 
to correspond with these institutions is just prior to the grad- 
uation month which is June. Most of the graduating hygienists 
make arrangements for positions before they finish their course. 
Schools for hygienists usually have a list of those out of em- 
ployment, as it is natural for hygienists to depend upon faculty 
members of their school to put them in touch with dentists 
who are seeking the services of hygienists. At the time the 
dentist makes application for a hygienist, he should state 
exactly what he expects of her. Some dentists prefer a hygien- 
ist to do not only her work, but assist in the office as well. 
If that is the case, it should be understood at the time the 
hygienist is engaged. 
There are a number of schools which conduct courses for 
hygienists. We are listing only those which are nationally 
known. 
Rochester Dental Dispensary 
Columbia University 
Forsyth Dental Infirmary 
University of California 
195 Practice Building Suggestions 
SECTION XII 
Planning The Dental Suite 
The Value of a Modern Office 
THE average dentist in performing his daily operative 
work little realizes the material savings in both time 
and effort that could be effected by a simple re-arrange- 
ment of his offices. Efficiency in daily operating routine is 
a factor that is receiving much consideration by dentists 
because they realize that it is the means of obtaining from their 
practice an income commensurate with their ability. 
Performing operative work in a haphazard manner, handling 
patients without giving thought to their comfort and conven- 
ience, doing business on a “scratch pad” basis and working 
under an environment that makes success almost impossible, 
causes many of the professional failures yearly. 
Man cannot work under adverse conditions, for the physical 
being fails to respond to opportunities that present themselves 
each day. Your office is your day time home—make it a 
pleasant place in which to work, let it offer efficient ways to 
complete each day’s work and lastly let it be in keeping with 
your professional ability and aspirations. 
Ritter Planning Service 
So that a dentist can enjoy the conveniences and privileges 
of a practically designed office we have established a planning 
department to prepare working plans and blue prints for the 
constructing, decorating and furnishing of modern offices. 
This department is in the charge of men who have spent 
years in the dental equipment and supply business and their 
experiences enter into the making of every plan which passes 
through this department. Appreciation of their efforts is 
voiced daily in letters commenting upon plans they have 
designed and which have been executed to the complete 
satisfaction of dentists for whom they were intended. 
We offer this service without cost only asking that we be 
given complete information concerning your plans, what 
196 Practice Building Suggestions 
equipment, etc. you have and the space secured for your offices. 
For the convenience of those wishing to avail themselves of 
this service we have prepared a questionnaire in booklet form 
which when filled out gives us the desired information to start 
working upon a preliminary sketch which is first submitted for 
your approval. When the sketch has been approved our 
planning department then prepares complete working drawings 
and suggestions as to color schemes, floor coverings, etc. 
Following is a sample of a rough sketch sent to us in a ques- 
tionnaire, showing the space a dentist had, his present arrange- 
ment and new space that he had secured. 
197 Practice Building Suggestions 
The final plan for this space is shown here and these com- 
parative illustrations in detail give you a clear idea as to 
the nature of the service we render. 
198 Practice Building Suggestions 
SECTION XIII 
The Dental Suite, its Construction, 
Decoration and Furnishings 
How to Proportion Small Rooms 
With High Ceilings 
N remodeling an office in which it has been decided to 
have operating rooms of the sizes of 7x9, 8 x 9 or 8 x 10; 
the ceiling 12 or 14 feet high; the upper window sash 11 
feet from the floor, what should be done to properly proportion 
the rooms? 
In remodeling an office care must be exercised regarding the 
ceiling heights. If the ceiling is low or high in the operating 
room the effect can be heightened or lowered by the proper 
placing of picture molding. 
Low ceiling: A picture molding should be placed directly 
against the ceiling. The ceiling is to be treated with a light 
color blending somewhat with the color of the side walls. This 
treatment of the ceiling, together with the picture molding 
will give a heightened effect. 
High ceiling: If the ceiling height is twelve or fourteen feet 
the proper treatment would be to lower the picture molding 
a distance of eighteen inches from the ceiling. This will allow 
for a deep frieze and it should be treated with the same color 
as the finish of the ceiling. This procedure will bring about 
a lowered effect. 
If a low ceiling in the reception room is studded at its joint 
with the side walls by the use of a large cove molding, this 
also will be very effective in giving height to this room. 
If the ceiling in the reception room is very high you can 
produce a lowered effect by carrying out the same depth of 
frieze as suggested for the operating room. In this instance 
a paneled effect would be indicated below the picture molding, 
consisting of a narrow strip wood molding and decorated 
the same as the wall. 
199 Practice Building Suggestions 
If the height of the ceiling is over fourteen feet, it is necessary 
to build a false or suspended ceiling. In other words, a plaster 
Illustratiorij)f False Ceiling as Described in this Section 
Scale V2= Foot 
and lath ceiling is to be run across the entire suite of offices at a 
height of not less than 9 feet 6 inches from the floor. If a false 
ceiling were not built into these rooms to displace the abnor- 
200 Practice Building Suggestions 
mally high ceiling it would make the office seem heavy and 
oppressive. 
Very frequently windows are abnormally high in rooms 
with high ceilings. Therefore, care must be taken that a false 
ceiling which might come directly in the middle of an upper 
window sash be properly finished so that it cannot be viewed 
from the outside. The proper architectural procedure would 
be to build on the inside of the false ceiling, a window heading. 
This will give a finished inside window effect. A roller shade 
should be hung on the upper heading of the old original window 
and drawn down so that the false ceiling line coming in the 
middle of the upper window cannot be seen from the street or 
adjoining buildings. The question of proper ventilation would 
enter at this point, but this has been treated as a separate 
subject. 
Proper Partitions and How to Build Them 
Composition board materials, as a rule, are not desirable 
for the dental office. Regardless of the care exercised in building 
in such partitions they do not give a finished appearance. These 
materials, after they have been installed, are also subject to 
warping and splitting and are easily dented. Under these 
conditions it is practically impossible to properly restore the 
surfaces to their original condition. It is most essential that a 
dentist have sound-proof walls and this cannot be acquired 
with composition board materials. 
Partitions with Florentine or prism glass panels are not 
desirable or practical in the dental office for the reason that 
they lack privacy for the adjoining departments. Even though 
the glass in these partitions is not fully transparent, it is suffi- 
ciently so to make it possible to detect shadows and move- 
ments of persons in adjacent rooms. Glass partitions always 
look bare and cold and destroy the harmony of the office. 
It is a difficult matter to properly conceal the pipes for 
plumbing as well as electric conduits in these partitions. It is 
impossible to properly locate electric outlets at the various 
necessary heights on the walls, neither can pictures be properly 
hung. 
These glass partitions cannot be camouflaged by covering 
the panels with drapery materials. A suggestion of this sort 
201 Practice Building Suggestions 
is a false economy which is not only expensive but causes 
eventual dissatisfaction. 
When advising for or against glass partitions, we take into 
consideration the dentist’s financial limitations. At this period 
glass partitions are somewhat less expensive than those of 
plaster and lath or plaster and tile. When we have determined 
that the dentist must economize in the construction features 
of his office, then we suggest these portable partitions. 
In certain buildings these have already been placed and fre- 
quently such buildings prohibit the removal of them. In such 
instances, and providing the partitions contain glass panels, we 
would suggest that these panels be removed from the partitions 
and wood panels inserted in their place. This procedure would 
do away with the undesirable glass features. When these parti- 
tions are built up to the ceiling it would be advisable to arrange 
the panels at the ceiling line so that every other one can be 
pivoted in order to open for ventilation. 
In such buildings where glass partitions are already in place 
it is not unusual to find them of the height of 7 feet 6 inches 
because they are of a regular stock design. The dentist should 
build these partitions up to the ceiling whenever possible for 
the added privacy that complete partitions will afford both 
himself and his patients. 
Proper Ventilation System and its Installation in 
the Absence of Transoms 
One or two ventilating grills 4 inches by 8 inches or 6 inches 
by 10 inches should be placed in each room just above the 
picture molding and on a line with it. Aside from the height 
their locations should be selected where they will not be in 
direct view. These grills come in various finishes, such as 
black Japan, oxidized copper, brass and nickel. The black 
Japan grills would be best, providing they are installed previous 
to decorating the walls and ceiling because they can then be 
painted the same color which will further help to make them 
inconspicuous. 
If the office has a false or suspended ceiling it would be best 
to place these grills over the door in the ceiling if possible. 
They will hardly be noticed at such a point and ventilation 
202 Practice Building Suggestions 
from the various rooms through the grills into the space above 
the ceiling is most ideal. 
Regardless of whether these grills are in the wall or the sus- 
pended ceiling, they should be countersunk and built flush 
with the surface. 
Proper Size of Wood Trim for Small Rooms 
In many spaces that are being subdivided into small rooms 
for the dentist the original wood trim is usually from inches 
to inches wide and the baseboard is from 10 inches to 14 
inches wide. Such wood trim would not harmonize with small 
rooms. Therefore, wherever possible, a baseboard should be 
installed which is 6 inches to 8 inches wide and a wood trim— 
such as window and door casements and window and door 
headings—should not be over inches in width. This wood 
trim should be of a plain milling and this simplicity of design 
will promote an effect of spaciousness within the rooms. If 
the dental office is to be an institution of health and harmony, 
it must also appear harmonious in design and this would not be 
possible if large size wood trim were used throughout. The 
narrow trim is also less expensive. 
Lavatories and Sinks, Their Proper Fittings, 
Installation, and Location 
Lavatories should be placed at least 36 inches from the floor. 
When hung at this height it will help to eliminate, for the 
average dentist, stooping each time that he washes his hands. 
To have the lavatory mounted high enough so that a dentist 
can stand erect when washing his hands certainly helps to 
eliminate a lame back at the end of the day. If a dentist is 
exceptionally tall the lavatory should be hung at a height of 38 
or 40 inches. 
In determining the height for the lavatory on the wall, 
measure from the floor to the top of the lavatory apron. 
It is important, when submitting your office plans to the 
plumber, to always mark on them the proper height of the 
lavatories and sinks. 
We would suggest fittings controlled by foot pedals. It is 
practically impossible to keep lavatory water cocks or faucets 
sterilized. If a dentist or his nurse has to turn these on and 
203 Practice Building Suggestions 
off by hand there is some danger of contamination to instru- 
ments which have been sterilized. For these reasons hand 
faucets are not in vogue and are considered obsolete in hospitals. 
Inasmuch as the medical profession has positively proven 
that hand faucets are detrimental to sterilized instruments, it 
will be well to bring this thought to the dental profession, in 
view of the fact that sterilization is equally important to them. 
While the knee pedal controls do away with the turning of 
water on and off by hand they are not as desirable as foot pedal 
controls for the reason that the dentist places himself in an 
awkward and tiring position while using them. 
It should be remembered that the best fittings for labora- 
tories are those of brass nickel plates or white metal. The latter 
will not become tarnished. The pantry faucet is most practical 
placed at a height of 8 inches and which gives a soft flow of 
water and also with this sort of spigot it facilitates replenishing 
the water in the sterilizer. 
Vitreous china is more desirable than enameled iron basins 
for the reason that it is easier to keep clean because of its hard 
vitreous surface. 
The procelain glaze on vitreous china is an integral part of the 
article and has been fused in a heat that would melt cast iron. 
The pure ivory color of vitreous china basins is more pleasing 
to the eye than that of the average enameled iron basin. Vitre- 
ous china basins retain their lustre while enameled iron basins 
soon become dull and are easily discolored. 
The enamel used on cast iron is fused to the metal after the 
casting is molded. It is relatively soft in texture, because if a 
heat high enough to vitrify it to the hardness of china were 
used, it would melt the iron. Such an enamel is somewhat 
porous which allows dirt to adhere easily to its surface. Vitreous 
china is much superior not only from the standpoint of beauty 
and durability but sanitation as well. 
The most desirable place to hang a lavatory in the operating 
room is directly in back of the chair. If door space will not 
permit this, then the next best location would be in back and 
to one side of the chair. This location is most practical for the 
dentist and the nurse because, when operating, the dentist and 
nurse usually face that direction and in that case it is a natural 
step toward it from the operating side of the chair. 
Frequently cement slabs and spatulas are placed in lavatories 
204 Practice Building Suggestions 
for cleaning. Because of lack of understanding this usually 
impresses the patient as an untidy procedure. If the lavatory 
is hung at the back of the chair the instruments which might 
be in it are apt to be unnoticed by the patient. 
A very practical lavatory for the operating room is Trenton 
Potteries Plate No. 233-OR. This is of proper proportion for 
the average operating room. A large lavatory breaks up the 
balance of the room, is entirely too conspicuous and occupies 
too much valuable space that could be used for another purpose. 
If at all possible, a sink should be mounted level with the 
laboratory bench. Almost daily a dentist will have occasion to 
move such appliances as a vulcanizer or heavy casting flasks 
into his sink. If it is located higher than the working surface 
of his bench these appliances will have to be lifted into it. On 
the other hand, if the sink is level with the working surface of 
the bench, the appliances can be slid into the sink without 
effort. 
If possible, the laboratory sink should be countersunk in the 
bench itself and in that part of the bench where most of the 
“mussy” work is done. 
This will go hand in hand with cleanliness and orderliness in 
the laboratory department which is virtually the kitchen of the 
dental office. 
A sink located at a distance from the bench hampers labora- 
tory efficiency. Vulcanizers and flasks carried from the bench to 
the sink and back again drip water on the floor as well as 
particles of plaster, etc., and this in itself produces untidiness. 
If it is impossible to countersink a lavatory in the bench 
the next best thing is to place it immediately adjacent and 
level with the top of the bench. 
The size of a sink for the laboratory will depend entirely 
upon the dimensions of the laboratory itself and the number 
of people working in the laboratory at one time. If the sink 
is countersunk in the bench a 12 inch by 12 inch, inside mea- 
surement, would be correct. If it is to be located immediately 
adjacent to the bench one about 15 inches by 20 inches, over 
all, would be desirable. The sink should be just large enough 
to meet the requirements. We want to emphasize this point 
because most dentists have sinks entirely too large for their 
purpose, which means that room is taken up unnecessarily in 
205 Practice Building Suggestions 
the laboratory which is usually the smallest department of the 
dental office. 
Paneled Effects for Walls of Reception Rooms. 
When Indicated, Construction Procedure, etc. 
By “paneling effect” on the walls of a reception room, is 
meant that the large bare spaces have been broken up into 
smaller spaces, giving a decorative effect to the walls and be- 
cause of it, bringing them more nearly in direct proportion to 
the room itself, particularly in such rooms where there are 
abnormally high or low ceilings. 
The advantages, aside from the decorative effect, are to be 
gained in the proper proportioning of the room. If the room 
happens to have a low ceiling the panels are to be narrow and 
run perpendicularly on the walls. If the room has a very high 
ceiling the panels are to be narrow and in proportion to the 
height but are to run horizontally. 
The most inexpensive way to panel the walls of the recep- 
tion room is to order from the mill a f inch plain picture 
molding of No. I grade which is to be free from knots and 
blemishes. When ordering this material be sure to specify that 
it must be delivered with one priming coat on it. If the walls 
are of ordinary plaster, the molding is to be tacked into place 
just before the initial coat of paint is applied. On the other 
hand, if the wall is to be canvassed, the molding is to be tacked 
after the canvas has been placed and just before the initial 
coat of paint is applied to it. The painters are to paint the 
molding the same color as the side walls and when the last 
coat has been applied, the wood molding is then to be glazed, 
which will help to set it off. 
The question of expense is practically nil, when taking into 
consideration the elegance that paneled walls give a room. 
The initial cost of the molding material depends upon the 
number of feet used. It can be purchased from a sash-and-door 
mill or concerns dealing in hardwood floor material, at a price 
ranging from three cents to eleven cents per foot. The plainer 
the design the less will be its cost. 
If a good carpenter or cabinet maker is engaged he can 
complete the panelings within a day, provided the room is not 
larger than io x 12. 
206 Practice Building Suggestions 
Each panel must be built in proportion to the space of the 
wall. It is important that each segregated space be paneled 
and your particular attention is called to the spaces above the 
doors as well as those directly above the baseboard. Pictures 
will show to better advantage when hung on a paneled wall 
because the paneled effect gives them a proper background. 
Even an inexpensive picture which ordinarily would look flat 
and without depth on a plain wall will give just the opposite 
effect if hung in a wall space properly paneled. 
A patient’s first impression of a dentist’s office is gained in 
the reception room and, therefore, it is desirable to make this 
room as near ideal with regard to furnishings and decorations 
as possible. Patients are particularly observant of elegance and 
refinement and talk about it to their friends, which again means 
publicity for the dentist. Most dentists give little or no 
thought to their reception rooms and look upon them more or 
less as non-productive departments. Patients who have become 
accustomed to seeing the ordinary rank and file of dentists’ 
reception rooms will be highly impressed with one that has 
refinements. At this point we want to bring home the thought 
that by elegance and refinement we do not refer to over-done 
decorative effects, lighting fixtures, furnishings, etc. In fact 
we urgently recommend that simplicity be adhered to, but not 
to the point of rank conservatism. It should not be your idea 
to lavish money on the reception room. In fact, your thought 
should be to spend as little as possible but to choose such 
furnishings for the least amount of money which will show 
the room to the best advantage. 
Color Schemes for Northern Exposed 
Operating Rooms 
The correct color scheme for a northern exposed operating 
room is flat old ivory. The next best colors to use are caen 
stone, cream ivory tan and light buff stone ivory tan. Under no 
conditions should stencil work be allowed in operating rooms, 
because this treatment gives an overbearing as well as a ginger- 
bread effect. Simplicity of colors must be adhered to and 
stencil work does not promote simplicity. If the operating 
room is large a finely stippled wall minus brush marks would 
207 Practice Building Suggestions 
be indicated. Such a treatment will add cheerfulness as well 
as proportion. 
A northern light is very intense and while it is the finest light 
for operative work in the mouth, yet the atmospheric effect is 
very cold and oppressive. A northern light should be softened 
but not to such an extent that it will take away the good pierc- 
ing qualities for actual operative work. Flat old ivory is pre- 
ferred because it adds a certain warmth to the room as well as 
cheerfulness. The finish of equipment will have no bearing 
whatsoever on the color scheme. 
For correct wall treatment, it is necessary to finish the wood- 
work in the same color as the side walls but one tone darker. 
In many new buildings the woodwork is finished in mahogany 
or Adams brown. If this finish is in good condition it should 
be left undisturbed. However, if the finish is poor and it is 
necessary to refinish, then the color treatment should be of the 
same general tone as the walls. 
In many northern exposed operating rooms dentists use a 
gray color which makes the room appear very cold and has a 
tendency to make the north light too intense. When a dentist 
complains of ocular irritation we often find that incorrect color 
schemes are directly responsible. 
Color Schemes for Southern Exposed 
Operating Rooms 
Sunlight from the south, because of its brightness, high 
lights and shadows is very confusing to the operator and con- 
sequently must be toned down with an idea of producing, 
through the medium of colors, a north light effect. This can 
be accomplished through certain shades of gray, such as light 
silver gray, pearl gray, lichen gray, oyster gray and a combin- 
ation of silver gray and caen stone. 
In the summer months a southern room will usually appear 
hot and stuffy. Gray color schemes will overcome this because 
they give a cool effect and will also do away with sun glares 
as well as shadows. Glares and shadows are particularly 
bothersome when matching silicates, etc. 
Note: The finish of equipment has no bearing on the color 
scheme, and is not to determine the wall treatment. 
208 Harmony of colors together with simplicity of treatment give the 
pleasing effect showm above as a suggestion for double windows in a 
reception room. 
The valance and overdrapes are of a harmonious and distinctive 
color blending, which produces cheerfulness within the room. 
In properly decorating a window it is important to proportion the 
material according to the size of the window so that a pleasing balance 
may exist. STRIPED KINTBURY 
1441-3 20 
FAIRIE NET 
H1 5'23 1 
The names and numbers of the drapery materials shown on this page 
refer to Orinoka Mills fabrics. These fabrics or others similar in 
design and material may be obtained at most dry goods, depart- 
ment and drapery stores. An effective treatment for double windows in an operating room. 
This color scheme is well suited for western exposures. The use of an 
overdrape of colored material does much to break up the monotony 
of a dull color scheme and enhances the appearance of the room with- 
out affecting the quality of natural daylight. RAYDALE TAFETTA 
1345-590 
RAYHAM GAUZE 
1531-320 
The names and numbers of the drapery materials shown on this page 
refer to Orinoka Mills fabrics. These fabrics or others similar in 
design and material may be obtained at most dry goods, department 
and drapery stores. 1 he proper treatment for a single window in an operating room. The 
curtain rods are fixed to the lower window sash permitting the window 
to be freely raised, carrying the curtain with it. 
The use of a valance or overdrape is avoided for sanitary reasons. SUNGLOW GAUZE I3II-3O3 
SHADE CLOTH 6449-1 
The names and numbers of the drapery materials shown on this page 
refer to Orinoka Mills fabrics. These fabrics or others similar in’ 
design and material may be obtained at most dry goods, department 
and drapery stores. Practice Building Suggestions 
Color Schemes for Eastern Exposed 
Operating Rooms 
The eastern exposed operating room is not a difficult one to 
treat because in most of them we get a combination north light 
the greater part of the day. If the exposure is obstructed by a 
large building or a court cutting off the sunrays then we would 
suggest a light flat old ivory. This color will help to eliminate 
the grayish atmosphere in the room under the above conditions. 
It will also promote cheerfulness within the room. 
If the exposure is not obstructed then it is more advisable, 
because of sunrays, to use gray colors such as lichen gray, 
light pearl gray, oyster gray, light silver gray, etc. A very light 
oyster gray bordering on a dark caen stone color could also be 
used with marked effect. 
Note: The finish of equipment has no bearing on the color 
scheme and is not to determine the wall treatment. 
Color Schemes for Western Exposed 
Operating Rooms 
Dentists, as a rule, if given their choice of exposures, would 
make the western and southern rooms their last choice because 
the sunrays predominate in these rooms for the greater portion 
of the day. There is no doubt that the sunrays do play havoc 
with the dentist during operative work if no thought is given 
to wall treatment. A western exposure room can be made very 
desirable if colors are selected which will diffuse the light and 
help to do away with high-lights and shadows. 
Our choice for wall treatment for a western exposed room is 
light silver gray, pearl gray, lichen gray, oyster gray and caen 
stone. A combination of light silver gray and light pale azure 
will also be very effective in a western room. 
In deciding upon color schemes three important factors 
must be borne in mind: 
1. The reclamation of the natural light. 
2. The toning down of the room. 
3. The avoidance of colors that will cause unnecessary 
high lights or shadows. 
Heavy, depressing colors such as forest green, cocoanut brown, 
209 Practice Building Suggestions 
etc., etc., or shell pinks, old rose or those suggestive of red 
should not be used in any department of the dental suite. 
In such departments as the reception room, business office, 
and hallways stencil work can be used provided a modest 
design is selected. 
Note: The finish of equipment has no bearing on the color 
scheme and is not to determine the wall treatment. 
Color Schemes for Retiring Rooms 
For an inside retiring room, our first choice would be light 
orchid. Our second choice would be antique bright sage and 
ivory tan. If possible, the woodwork and furnishings are to be 
enameled in the same shade. 
An inside retiring room is usually small and unless great care 
is exercised in selecting colors, this room will appear stuffy and 
top-heavy. 
It must also be remembered that frequently patients who are 
ill are obliged to lie down in this room and therefore we must 
have colors which will give a healthy, cool and invigorating 
atmospheric effect. 
The correct color scheme for an outside retiring room would 
be flat old ivory. This lends a tone of cheerfulness to a small 
retiring room in connection with natural light which is hard to 
duplicate with another color. 
Stipple and stencil work should be avoided in a retiring 
room as they make a small room appear “stuffy.” 
Blues, shell pinks, grays, buffs, tans, browns, azures, forest 
greens and old rose should not be used on walls in retiring 
rooms for the reason that the size of the room will not permit 
it and because certain of these shades have a depressing effect 
on patients. 
Why Shades of Red, Maroons, or Old Rose Should be 
Avoided on Furnishings in Retiring Rooms 
All shades of red, maroon and old rose should be avoided in 
a retiring room for the reason that they are too closely asso- 
ciated with the color of blood. 
Frequently after an extraction the patient must lie down in 
the retiring room. This is particularly true when nitrous oxide 
and oxygen have been administered. The resistance of these 
210 Practice Building Suggestions 
patients has been lowered not only physically but also mentally. 
Because of this it is not difficult for them to stretch their 
imaginations in the wrong direction should everything they 
look upon in the retiring room suggest the color of red. Nitrous 
oxide and oxygen patients are easily affected by colors and if 
these are not correct it has a tendency to delay their immediate 
recovery. 
Color Schemes, Floor Coverings, etc., for 
Sterilizing Room 
The correct color scheme for a sterilizing room is flat white 
enamel for ceiling and side walls. 
The floor should be of white tile or linoleum in a pattern to 
harmonize with the general architectural design of the steriliz- 
ing room. If linoleum material is used flowery designs must be 
avoided and square, set patterns strictly adhered to. The 
color scheme of the linoleum should be a two-tone effect, such 
as black and white, gray and white, black and gray with border 
in a darker tone of gray. In these floor color combinations 
white or gray should be the predominating color. We suggest 
light colored floor material for the reason that it helps to pro- 
mote the appearance of the sterilizing room from a viewpoint 
of complete sanitation, which is so essential and which is really 
the purpose of the sterilizing room. 
A cove base of the same material as the floor covering 
should be used in place of a wood baseboard. If a tile floor is 
used a cove base of tile should be included. We suggest cove 
bases for the reason that frequently water is spilt on the floor 
and if a cove base is used the water is easily mopped up which 
would not be so readily accomplished if there was a quarter- 
round and wood baseboard. If this accident happened fre- 
quently it would not only cause warping of the quarter-round 
and wood baseboard but would promote a disagreeable, musty 
odor. 
Tile walls would be appropriate but in this connection it is 
very important that a dull finished tile be installed because it is 
not so apt to detract from the sterilizing room equipment as 
tile with a very high glaze. A flat white enamel is recommended 
in preference to a brilliant white because then there is no 
211 Practice Building Suggestions 
tendency of a clash with the brilliancy of glassware as well as 
the highly nickeled sterilizer, etc. 
The best flat white enamel material is known under the 
trade name of “Dutch Boy.” 
Wall Treatments Under Special Conditions on 
Account of Old or Broken Down Plaster 
Frequently in old buildings, and particularly in buildings in 
the smaller cities, the walls and ceilings are in such condition 
that they will not permit further painting or papering. 
If these walls are to be properly treated the old coats of paint 
or paper will have to be scraped off and in this procedure a 
certain amount of defective plaster would also be removed. 
These places in the walls are then to be “re-pointed,” which 
means that the holes left in the walls, due to the removal of de- 
fective plaster, will have to be filled up with new plaster 
material. Because of the moisture in the new plaster it will 
take time for these spaces to properly dry out. A dentist usually 
cannot put off the decorating of his walls for a long enough 
period to allow these places to dry properly. If the paint is 
applied before the plaster has thoroughly set and dried, these 
different spots, which have been “re-pointed,” will gradually 
dry out under the paint and then they will appear through the 
surface in a lighter color, which would result in a series of spots 
and blotches. 
Rather than go to the expense of removing old paint and 
“re-pointing” the walls and ceilings it would be more econom- 
ical and practical to cover them with what is known as “can- 
vas.” This material is not exactly what its name implies 
because when we think of canvas we think of a heavy fabric. 
The material which we suggest is really a muslin sheeting and 
it comes unbleached. It is known to interior decorators by 
the name of “canvas.” This is placed on the walls in the same 
manner as wall paper. Its function is to give a new surface 
and to bind and hold in place the old imperfect plaster surfaces. 
Canvas gives a finished surface such as cannot be obtained 
with plaster walls where the color has been applied directly 
to the plaster. A wall and ceiling that has canvas for a foun- 
dation and upon which oil paints have been applied can be 
212 Practice Building Suggestions 
washed with soap and water and this will in no way injure 
its surface. 
The expense of a canvas wall is offset by that saved in labor 
for removing paint and wall paper and “re-pointing.” Walls 
and ceilings in the better homes are now being finished with 
canvas and flat oil paints are being applied in preference to 
wall paper. We recommend this practice for the dental office 
for the reason that when walls and ceilings are to be repainted 
it requires only one coat of paint about every three years. 
Taking everything into consideration, the application of can- 
vas to walls in a dental office is most economical in the end 
and avoids crazing and chipping brought about by the careless 
moving of furniture and climatic influences. 
If the ceiling is 9 feet 6 inches high it should be finished in 
exactly the same color as the side walls provided they are of 
light colors such as oyster gray, lichen gray, old ivory, caen 
stone, creams, etc. If the walls are finished in dark colors, 
such as buffs, tans, greens and dark grays, then it would be 
best to finish the ceiling in a light cream or a very mild tint 
of the predominating color of the walls. 
Particularly in inside rooms where the walls are finished 
in light colors and the ceiling in the same color it helps to pro- 
mote lighting effects as well as to give a certain softness, all of 
which creates a restful atmosphere. 
Color Treatments for Low Ceilings 
Cross-lights are produced in an operating room having 
windows facing in two or more directions. These conflicting 
rays of light impair the dentist’s vision and cause ocular irri- 
tation. A dentist’s work is tedious, exacting and nerve-racking 
and therefore carries with it a certain amount of eye strain. 
Cross-lights very often interfere with exact matching of sili- 
cates, cements, procelain crowns, facings, vulcanite teeth, etc. 
To correct the condition of cross-lights we would suggest the 
placing of a cambric shade on the upper half of the window. 
Such a shade, when partly drawn, will diffuse the harshness of 
light entering the window at an angle of 45 degrees. 
Cross Lights and how to Eliminate Them 
213 Practice Building Suggestions 
Sanitary Treatment for Swinging Doors Between 
Operating Rooms 
A touch of cleanliness and refinement can be added to 
swinging doors by mounting at approximately fifty inches 
from the floor a vitrolite or clear glass plate. These plates are 
fastened on the door with small brass or nickel rosettes. A 
twelve-inch length is usually correct and the width should not 
be less than four inches. These plates are easily cleaned and 
enhance the woodwork of such a door. 
Tile Floors, Arguments For and Against 
Even though a great many dentists are using tile floors in 
their operating rooms these floors are not as practical as one 
might believe. 
It must be borne in mind that the feet support the body and 
that a tile or similar floor affects the entire physical mechanism. 
Tired, aching feet, weak arches and foot trouble, can be laid 
directly to this type of floor. There is no resiliency which is 
so essential to foot health. Some dentists try to eliminate the 
hardness of tile floors by placing at the operating side of the 
chair a small rug or rubber mat. These rugs or mats are hardly 
ever heavy enough to accomplish the purpose. There is but 
very little relief through this remedy, and, in addition, a small 
rug placed at the operating side of the chair gives the appear- 
ance of a makeshift. 
Tile floors are, of course, indicated in the specialist’s office, 
such as exodontists and major oral surgeons. There isn’t any 
question but that a tile floor is kept clean very much easier in 
these branches of dentistry. 
Linoleum, Where Indicated, its Advantages, 
Suitable Designs and Colors, and a 
Correct Method for Laying 
It is only of late that we have considered linoleum desirable 
floor covering for operating rooms because now the design, as 
well as the color scheme of it, as it is being manufactured at 
present, is more in keeping with the exacting requirements of 
the modern operating room. Heretofore, linoleum patterns 
have been but cheap imitations of mosaic tile, parquet, etc., 
214 Practice Building Suggestions 
and the color selections of this material were very limited and 
usually of such combinations that their use was prohibited in 
operating rooms. 
Linoleum manufacturers have recently realized that a de- 
mand for their material could be created with dentists, phy- 
sicians, and hospitals provided they incorporated designs which 
would harmonize with the architectural make-up and environ- 
ment of the average operating room. 
The most suitable designs for dentists are those of square 
set patterns in the form of blocks separated from one another 
by narrow stripes of a different color than the blocks them- 
selves. If the operating room is of the size of 8 x io or as large 
as io x 12 then the block should not be more than inches 
by inches square. If the room is 7 x 9 or 8 x 9 then a block 
of not less than 4 inches by 4 inches would be preferable. The 
block design should be so incorporated in the linoleum that 
they lie straight edge to edge and not point to point. The 
stripe separating the larger blocks is one-half inch wide, while 
the stripe separating the smaller blocks is one-quarter inch wide. 
The color combination which is most desirable and which 
will harmonize with the color schemes usually used in operating 
rooms is gray and black, that is, the blocks are to be a light 
gray while the stripes between the blocks are to be a jet black. 
This gives a very distinctive appearance and creates the im- 
pression that it is an out-of-the-ordinary floor covering. There 
are various other combinations, such as dark gray blocks with 
a very light gray separating stripe and again, light gray block 
with a very dark gray separating stripe or one of jet black, etc., 
etc. There are many color combinations in the block design 
of linoleum but care should be exercised in selecting only such 
combinations as will promote the appearance of cleanliness and 
simplicity to the operating room. It stands to reason that 
heavy colors such as browns, tans, forest greens, etc., would 
not be appropriate. 
Linoleum, if properly laid, provides the necessary resiliency. 
The best method for laying is to cement a layer of building felt 
to the floor. The linoleum is then to be cemented on to the 
felts. This method of laying the material has the distinct ad- 
vantage of deadening sounds and noises. It also helps to in- 
crease the durability of the material. Linoleum laid as directed 
215 Practice Building Suggestions 
will not bulge or crack and can be taken up without damage to 
the floor or to the material. 
A neat border tends to improve any linoleum-covered floor 
and where a inch block pattern is used a border of at least 
6 inches would be indicated of the same color as the separat- 
ing stripe. It is advisable to cement or attach the same color 
of border material to the baseboard to safeguard against the 
finish wearing off at that point when the floor is being cleaned. 
This also gives that part of the floor where the baseboard is 
visible a neat and finished appearance. 
Carpets and Rugs for Reception Room, Business 
Office and Retiring Room, How to Lay Them 
If such departments as the reception room, business office 
and retiring room are to be carpeted, the carpet for each room 
should not be of a different color. The same material, design 
and color should be used throughout. 
The placing of a carpet on the floor tends to make a small 
room appear larger. As a suggestion, a taupe colored carpet 
with sand cast makes the room appear spacious and cheerful. 
Therefore, if this material is used throughout it will give a very 
pleasing floor effect, especially when the doors of these different 
departments are left open and a patient is given a view of it 
from the reception room. If each room were to be carpeted in 
a different material, pattern and color, the harmony of the 
entire suite would be destroyed and make the rooms appear 
small and crowded. 
A rug is desirable in a reception room if the color and design 
will harmonize completely with the room itself and provided 
the floor in the room is of a high-grade quality of wood and kept 
properly polished. If a rug was chosen at random without 
keeping in mind the foregoing factors it would not only cheapen 
the general appearance of the reception room but would also 
make the room appear small and stuffy. 
A selection of small rugs in a reception room would be de- 
sirable and would add a certain elegance provided they were real 
Oriental rugs. However, even with such rugs, the dentist has 
to contend with their being continually out of position. If the 
floor is highly polished, there is a certain amount of danger 
to a patient of slipping or tripping. Part of this danger could 
216 Practice Building Suggestions 
be eliminated if the Oriental rugs were sufficiently large but as 
most reception rooms are small, the dentist would have to 
choose small rugs in order to put a selection of them in the 
room. If the price was not prohibitive to the dentist, Oriental 
rugs, if a selection is made up of mild colors and set, square 
patterns, could be used with pronounced decorative effect. 
Very often dentists make an attempt at Oriental rugs, by 
purchasing domestic rugs of Oriental design. Such rugs are 
poor imitations and only have a tendency to cheapen the room. 
Wherever possible, we believe it best to carpet the reception 
room from baseboard to baseboard because it helps to widen 
the room and gives it spaciousness. When a floor is carpeted 
it allows the placing of two layers of double thickness of moth 
proof lining paper which produces that elegance of feeling to 
the step. If the floor happens to be of concrete it can be car- 
peted very much in the same way as the wooden floor. This 
is accomplished by securely fastening the carpet with pins 
and sockets on the floor at the baseboard. When a carpet is 
laid on a wood floor the ends of it should be placed underneath 
the quarter-round. This method does away with bulkiness at 
the baseboard and also eliminates places for dust and fuzz 
which are so much in evidence where carpets have not been 
extended underneath the quarter-round. 
Push Buttons For Main Entrance Doors, and 
Where Indicated 
We would suggest an electric push-button for those dentists 
located in exclusive buildings or residential sections and also 
for those dentists located in less exclusive buildings but who 
are catering to a very high standard of clientele. 
The push-button should be of pearl, countersunk into the 
door casing at a height of about forty-five inches. The button 
itself should be of a size conspicuous enough to be seen. 
Sneak-thieves thrive in office buildings and it is a frequent 
occurrence, especially during the winter months, for patients 
to have fur coats, umbrellas, etc., stolen from the dentist’s 
reception room when his main entrance door is unlocked 
throughout the day. It is needless to say that the push button 
procedure of gaining entrance to the dentist’s reception room 
eliminates for him this expensive hazard. 
217 Practice Building Suggestions 
There is a certain psychology in connection with a locked 
reception room door, inasmuch that it conveys the idea to the 
patient that the office is exclusive and that the dentist does not 
cater to transient or haphazard patients. 
Psychological Effect of a Sterilizing Room, and its 
Proper Location, Construction etc. 
There is no room in the modern dental office which carries 
with it such impressiveness as a sterilizing room. It not only 
favorably impresses the patient with the fact that instruments 
are sterilized but it also automatically conveys the thought 
that the dentist is especially equipped to take care of his pa- 
tients’ needs. All of this immediately dispels the thought from 
the patient’s mind as to whether or not the dentist really does 
sterilize his instruments. 
In dental offices where sterilizing rooms are not in evidence, 
patients frequently ask the dentist how he sterilizes. This 
question is only asked with one thought, that being not how 
he sterilizes his instruments but whether or not he really does. 
In other words, the patient broaches the subject in a tactful 
way. 
In dental offices where a sterilizing room is in evidence 
those questions are seldom if ever, asked by patients because 
the evidence is there. 
The ideal location for it is in that part of the office where 
a patient will see it before entering into either operating 
room. In other words, it should be so located that when the 
patient steps into the operating department from the recep- 
tion room, the sterilizing room will compel attention. If sur- 
rounded by plate glass and if equipped with white vitrolite 
or clear glass shelves with an assortment of glass jars, also an 
impressive sterilizer, it will convey in an instant, an impres- 
sion of cleanliness and a mystery of research. For the better 
patients especially, to know before actually occupying the den- 
tal chair that everything for the mouth has been properly 
sterilized, creates in them a feeling of security and assurance 
that is not possible under other conditions. A sterilizing room 
in a prominent location in the operating department of the 
dentist’s office becomes the best of silent salesmen. 
Very often we hear dentists make the remark that the nurse 
218 Practice Building Suggestions 
frequently slights sterilization or makes light of it and that she 
is careless and continually needs watching in this part of her 
duties. It is just as important for the dentist to give his nurse 
things to work with as it is for the dentist to provide himself 
with working essentials. The nurse is as interested in steriliz- 
ation as is the dentist but if she is to accomplish this thoroughly 
and properly she must be given the equipment as well as 
environment. A sterilizing room acts as an incentive to the 
dental nurse to thoroughly and carefully wash, scrub and 
sterilize instruments and dressings. 
The cost of a sterilizing room is nil as compared with the 
vast amount of efficiency it promotes for the dentist as well as 
advancing big impressions and publicity for him, to the 
patients. 
In an office the ceiling line of which is 9 feet 6 inches above 
the floor, we would build the sill of the sterilizing room not 
higher than 24 inches from the floor. 
The length of the plate glass would be approximately 54 
inches. 
We would extend the upper sill from the ceiling to a depth 
of 36 inches or sufficiently to meet the top of the plate glass. 
By adding all the above dimensions, you will get a total of 
9 feet 6 inches, which is the height of the room. 
There are two ways of enclosing plate glass in the frame of 
a sterilizing room as follows: 
A sterilizing room built in the shape of an octagon requires 
four pieces of plate glass. The top and bottom of the glass is 
set in wood trim in very much the same way as a window is set 
in its sash. Ordinarily it is found that the proper joining of 
the plate glass, one to the other, seems to be little understood. 
To have these four pieces joined together with wood strips 
between is proper from a construction viewpoint but improper 
from the viewpoint of architectural beauty. It is desirable to 
display as much of the plate glass as possible so that the view 
of the patient, when looking at the sterilizing room from a 
distance will not be obstructed by cumbersome wood casing. 
Care should be taken to order the plate glass from the 
manufacturers, with mitered edges. If proper attention is 
given to this, the edges of the glass will be ground one to fit 
the other and the fit will be snug enough to prohibit steam from 
the sterilizer to escape through the joints of the plate glass. 
219 Practice Building Suggestions 
The second procedure for a sterilizing room of octagon shape 
would be to have holes drilled in the plate glass at the mitered 
edges about six inches above the lower sill and the same dis- 
tance below the upper sill. The glass is then fastened with 
very small nickel or brass rosettes, cushioned against the glass 
with a rubber collar or washer. 
Regardless of the shape of a sterilizing room and provided 
more than one piece of plate glass is used, one of the fore- 
going procedures of fastening should be adopted. 
Metal strips, clamps, corners or show case fasteners are not 
practical for fastening either the inside or outside of the plate 
glass fronts for the sterilizing room because they soon become 
tarnished unless constant attention is given them. Anything 
in the way of metal around a sterilizing room which is not 
continually kept polished will soon tarnish because of moisture 
at different times within the room. These metal parts, if 
allowed to tarnish, will naturally detract from the appearance 
of the room and might give the suggestion that the sterilizing 
room is not properly functioning. 
The metal fittings mentioned are usually of an awkward 
design and if used will take away from the neat appearance of 
a properly built sterilizing room. 
Lighting Effect for Sterilizing Room 
The type of electrical fixtures for a sterilizing room would 
depend entirely upon the architecture and size of the room as 
well as the height of the ceiling. 
The reflector type of fixture with tubular bulbs which are 
usually used in the better class of “Silent Salesmen Show 
Cases” are most practical. These fixtures if mounted about 
six inches above the upper plate glass line give a very pleasing 
lighting effect. 
Frosted bulbs should always be used on the fixtures in the 
sterilizing room, as they give a subdued light and do not throw 
shadows which is the case with clear glass bulbs. The equip- 
ment should stand out in an impressive way, all of which is 
possible through proper installation of light fixtures. 
In some sterilizing rooms we find an extended ceiling fixture 
either on a chain or rod. If this fixture is allowed to extend 
220 Practice Building Suggestions 
down from the ceiling below the upper plate glass line so that 
it can be seen by the patient, the lighting effect as well as the 
fixture itself will take away from the appearance of the steriliz- 
ing room. For this reason it is important to select the type of 
fixture which will be most inconspicuous. 
Where a ceiling of a sterilizing room has been built in dome 
fashion, and provided the dome extends far enough above the 
upper plate glass line, flush fixtures can be used to very good 
advantage. 
Sterilizing Room Equipment 
The equipment for a sterilizing room should consist of the 
following: 
Plate glass or vitrolite shelves of 6 inches width and cut in 
length in proportion to the width of the wall space. These 
shelves are to be mounted on adjustable show case brackets. 
An assortment of glass containers for such articles as cotton 
rolls, cotton pledgets, wood applicators, wood tongue depres- 
sors, 6 inch cotton napkins, etc. 
The conductive anaesthesia outfit as well as all material and 
equipment pertaining to it should be kept on one of the shelves. 
High pressure steam sterilizer. 
Water still. 
Small aseptic stand for water still, providing space will 
permit. 
Waste hamper. 
Small lavatory. 
Towel bar. 
Automatic air compressor, in white pyralin finish with glass 
dome. 
Bunsen burner controlled by Gas terminal valve. 
If a high pressure steam sterilizer is used, thought should 
be given to the running of water supply and waste pipes to it. 
Several electric base plugs should be installed in convenient 
locations. 
The sterilizer should be on a separate circuit of No. 6, 8 
or io gauge wire. The gauge of wire depends entirely upon the 
amount of current used by the sterilizer. 
221 Practice Building Suggestions 
DoubleActirg D°vble 
Deer 
vMiditjy Door Inio 
■Partition 
In some offices because of construction problems it is im- 
possible to have regulation sized doors in entrance to sterilizing 
room. The accompanying illustrations will help to solve those 
problems. 
An Ideal Inside Reception Room with Regard to 
Size, Color Scheme, Picture Subjects and 
Lighting Effects 
The first impression a patient gets of the dental office is 
in the reception room. Therefore, this room must of necessity 
be given minute attention with regard to size, color scheme, 
lighting effect and furnishings. It should be so arranged 
that it will inspire confidence and enthuse the patient with the 
dentist before meeting him. This is best brought about by 
harmony of colors with simplicity prevailing. 
The size of an ideal inside reception room in a one-man office 
is io x 12. A room this size will provide for the necessary 
accommodation of patients for the reason that if the dentist’s 
practice is conducted along modern lines patients’ visits are 
regulated by appointments. 
Inasmuch as an inside room is entirely dependent upon 
artificial light, the color scheme must be given careful thought. 
222 Practice Building Suggestions 
Avoid using dark and heavy colors or those which would give 
the room a stuffy atmosphere. Flat old ivory is the most 
desirable because the effect is both airy and cheerful which is 
so essential. 
The dentist is an agent of good health and wherever there 
is good health there is also harmony. It is, therefore, essential 
that the pictures be suggestive of all this. Peaceful landscapes 
or group pictures of people with healthy happy faces and vig- 
orous figures would be appropriate. We have all seen pictures 
in dental offices of wild animals housed in dens and also wild 
creatures in struggle. A patient who has a bouncing toothache 
cannot gaze long upon a picture of strife without feeling in 
a greater measure the toothache which she is experiencing. 
Pictures of thunderstorms, chariot races, Roman arenas, 
athletes in struggle, war pictures, etc., have no place in any 
department of the dental office. They only suggest turmoil 
and strife and do not promote receptiveness. Suggestions of 
dentistry should not be in evidence in the reception room and 
therefore class pictures, State Board diplomas, college diplomas, 
signs and dental magazines should be removed. 
The foregoing will also apply to children. These little 
patients are even more receptive to suggestions than grown-ups. 
A picture of strife will promote fear in the hearts of the little 
tots and make them hard to manage in the operating room. 
Artificial lighting should be studied so as to determine 
whether ceiling or side lights would be appropriate. If side 
lights are to be used their height from the floor must be judged 
somewhat by the height of the ceiling. In any event the base 
of the side wall fixture must not be located lower than sixty 
inches from the floor and not higher than seventy-two inches, 
all of this depending upon the design of the fixture. Side 
lights must of necessity be shaded with a decorative silk or 
parchment shield, the color of which must be in harmony 
with the predominating color scheme of the room. The ceiling 
light must be of such a design that it will give a soft tone 
which will blend completely with the color scheme of the walls 
and ceiling. If an open wrought-iron fixture is to be used care 
must be taken that each bulb is provided with a silk shade 
so as to avoid ocular irritation. If a patient were to sit in a 
223 Practice Building Suggestions 
harsh artificial light the completeness and beauty of the room 
would hardly be appreciated. 
If a table lamp is used care must be taken that the shade of 
this lamp harmonizes with the general color scheme. In many 
dental offices floor lamps are used but they are usually out of 
proportion to the rest of the room. Therefore, large and 
clumsy-looking lamps should be avoided. These should be 
selected according to the size of the reception room. If it is 
small a junior lamp would be correct with a shade propor- 
tionately small. If the room is large then a large floor lamp 
would be proper with a shade of the proper size. A large shade 
on a floor lamp in a small reception room always looks out of 
place and makes the room appear crowded. 
Reception Room Furniture, its Design and Finish 
The community in which the office is located and the size 
of the reception room should be taken into consideration when 
selecting furniture. Large pieces in a small room are not de- 
sirable for the reason that they make the room appear too 
heavy. Furniture purchased in suites or sets of the same design 
and color is considered obsolete. Selection of various period 
designs consisting of an arm chair with a low back, a plain chair 
with a straight narrow medium high back, a small settee never 
to exceed sixty inches in length, and a console table of a design 
that will harmonize, produces a better effect than the usual 
three-piece set. A dentist in general practice displays thought- 
fulness when he includes with his reception room furniture a 
child’s chair. In certain localities mission furniture would not 
only be more serviceable but also quite appropriate and, in 
some instances, reed furniture would lend to the beauty of the 
room. The community has to be taken into consideration. 
In selecting furniture it is well to purchase that of simple 
design on which very little carving appears. If all pieces of 
furniture are alike the effect is monotonous and there will 
be nothing further to enthuse over or admire during succeed- 
ing visits so, therefore, the same care in furniture selection 
should be exercised, viz; remember that conditions are rela- 
tive and certain designs are indicated for the various offices. 
224 In this reception room the decorations and furniture are of a simple 
character, but through the careful selection of colors there has been 
provided an air of warmth and cheerfulness. 
The double French casement window opens into the business office 
and is a time-saving factor as well as a convenience for greeting 
patients in a prompt and courteous manner. 
In a reception room where the floor may be subject to hard usage 
linoleum is sometimes indicated because of its durability and because 
it can be so easily cleaned. The reception room shown above is entered through a small vestibule 
into which there is also a passage from the business office, thus per- 
mitting the dismissal of patients without re-entering the reception 
room. 
Here is displayed a tasteful arrangement of console table, mirror and 
torchierres. Notice the effect achieved through the use of simple and 
inexpensive paneling. 
Being an inside room, the color scheme is light old ivory with car- 
peting of gray taupe. The furnishings lend character and are of 
moderate design and cost. Practice Building Suggestions 
Book and Magazine Subjects for the 
Reception Room 
Book and magazine subjects in a measure, suggest the 
general character of the office and if these are not well chosen, 
detract from the individuality of the office. 
Inasmuch as no two patients think exactly alike, it is also 
reasonable to believe that no two patients care for exactly 
the same books and magazines. Therefore, these should be 
selected with an idea of pleasing the average patient and a 
variety of subjects should be covered through such selection. 
The size of these publications will also enter for discussion 
because if the reception room is small, the table or console 
will also necessarily have to be small and large magazines 
would not look well on it. 
Some people like to read poetry, others like to read about 
music and others again only care for books in which are dis- 
played a goodly selection of illustrations, etc. Books contain- 
ing lengthy stories should not be in evidence. The average 
patient does not care to start a long story and not be able 
to finish it—and if the dentist is working by appointment, 
a patient will have only a few moments to wait before being 
admitted to the operating department. 
The Literary Digest is an excellent publication for the den- 
tist’s reception room where patients do not have to wait long 
before being admitted to the operating department. Books 
with a variety of picture subjects in them would also be 
especially desirable, but, again, these picture subjects must 
not be suggestive of strife and unpleasantness. The music 
magazine known as Etude is exceptionally fine for the den- 
tist’s reception room, as well as the Mentor, which is of small 
size and always has something of interest to offer the reader 
in a short, concise way. 
If the dentist frequently has children patients, he must be 
thoughtful of them, too, with regard to book subjects. He 
should choose several books which are particularly appealing 
to them so that when a child has to wait for any length of 
time, he can become interested in a book that he can under- 
stand. A child who is allowed to wait in the reception room 
for the dentist for perhaps some little time, with nothing to 
do, is apt to think up all the horrible things he has ever heard 
225 Practice Building Suggestions 
about a dentist. The child, as well as the adult, must come 
to the operating room in a receptive mood for the reason that 
the average child is particularly hard to manage in the operat- 
ing chair. The way for the child’s receptiveness can be laid 
in the reception room through the medium of proper literature. 
Where to Keep Periodicals when Reception Room 
is Shared by a Physician 
It is not good policy for the dentist to keep periodicals in 
the reception room for the reason that sensitive patients have 
an aversion to turning over the pages of periodicals if they 
have any suspicion whatever that extremely careless people 
have thumbed these books before them. 
Observation has brought home to us the fact that when a 
patient sees a magazine being laid down by another patient, 
who appears in poor health, this patient will avoid coming in 
contact with the book. 
It is not unusual to see patients who have bandages on 
their hands waiting for dentists. A sensitive patient frequently 
interprets this as an evidence of rank disease and will be 
backward about picking up the books laid down by such a 
patient. 
This is particularly applicable to offices in which the den- 
tist shares a reception room with a physician. 
A dentist who is interested in keeping his reception room 
looking neat should keep his periodicals in the business office. 
A table that is cluttered up with magazines and newspapers 
detracts from the appearance of the reception room. If the 
dentist is working strictly by appointment and his patients 
are on time, they will really have no opportunity to read. 
Therefore, periodicals should be kept only for those patients 
who are kept waiting. 
The nurse usually knows just how long the patient will 
have to wait before being admitted to the operating depart- 
ment and when she steps into the reception room to inform 
the patient of the number of minutes she will have to wait 
it might be well to take with her a magazine. It would be a 
matter of personal service to ask the patient if she has seen 
this particular magazine for the current month and when the 
patient answers in the negative the nurse should then present 
226 Practice Building Suggestions 
the magazine to her. When the patient is finally admitted to 
the operating department the nurse will then remove the 
magazine from the reception room and return it to the busi- 
ness office. 
Magazines should be placed in flexible binders, viz., that of 
Spanish brown leather and on which should appear the den- 
tist’s monogram together with the name of the periodical on 
the lower edge. Binders tend to preserve magazines and also 
add to the dentist’s individuality. 
Floor Lamps for Reception Room. Their Selection 
with Regard to Size, Type and Material of 
Shade, and Lighting Effects 
In a small reception room we would suggest a Junior floor 
lamp for the reason that if a full-sized floor lamp were used 
it would be out of proportion to the room. 
A small shade would be our choice because it would look 
better on a Junior lamp and would allow the lamp to be 
placed in an out of the way corner. On the other hand, if a 
large shade was used on a Junior lamp it would make it appear 
squatty and because of the circumference of the shade the lamp 
could not be placed as closely to the wall or corner. 
This type of lamp should give a soft, subdued illumination 
because a floor lamp was never intended to completely lighten 
a room. Its function is principally decorative. With this in 
mind we use round, frosted bulbs of about 25-watt capacity. 
Aside from a soft illumination a small, frosted bulb is further 
desirable for the reason that there is less danger of its scorch- 
ing a silk shade. A great many expensive silk shades have 
been ruined due to carelessness in selecting too powerful a 
light bulb; we therefore recommend the use of not over 25- 
watt capacity. 
We would choose a silk shade for this lamp in a combina- 
tion of colors to harmonize with the predominating color of 
the room. We would prefer a silk one for the reason that it 
gives a very soft lighting effect and a blending of colors which 
is not possible with shades of other materials. Very often 
dentists make the mistake of selecting parchment shades. 
These shades, no matter how they are decorated, give a harsh, 
cold effect as well as being void of all gracefulness. 
227 Practice Building Suggestions 
Book-ends and Statuary 
Book ends and statuary have their place in the reception 
room. Book ends, if properly selected, can be used for other 
purposes than supporting books. A console table in the recep- 
tion room is usually bare, particularly in the absence of books 
and magazine subjects. A decorative book end will be most 
appropriate to break this monotony. 
Vases and Pottery 
A piece of pottery or a vase displayed in the reception room 
looks incomplete unless certain kinds of artificial or fresh 
flowers are placed in them. If artificial flowers are desired the 
best should be purchased as they should resemble real flowers 
as nearly as possible. Some people object to artificial flowers 
because dust readily adheres to them. This can be removed 
by dipping in gasoline from time to time, which not only 
removes the dust but also restores the flowers to original 
freshness. 
Regardless of whether artificial or fresh flowers are dis- 
played care must be taken not to overstuff the vase. One or 
two flowers in each piece and of a stem length to harmonize 
with the vase will be sufficient. 
Where natural flowers are used they should be purchased 
fresh each day and only those which are in season. When 
purchasing fresh flowers, quantity should not be the prime 
object. Artistic effect as well as a touch of color and quaint- 
ness can be acquired with but a few blossoms and at a small 
cost. 
Sweet peas, pansies, violets, daisies, golden rod, cosmos, 
black eyed susans, and marigolds, or a selection of ordinary 
buds and greens are most appropriate. 
French Doors for Reception and Operating Rooms; 
Their Design and Treatment 
French doors with prism glass panels, architecturally 
known as casement doors, are desirable in the reception room 
as an opening into the department adjacent to it. These doors 
should be made to swing into the reception room because it 
is more convenient for the dentist or the nurse to open them 
when admitting a patient. 
228 Practice Building Suggestions 
French doors are preferable for the reason that they give 
a certain widening effect which is essential from an archi- 
tectural viewpoint as well as one of harmony. 
These doors should be treated with a curtain because it 
takes away a certain bareness which usually exists where 
prism glass panels are in evidence even though the panels are 
small. If curtains were not used with prism glass doors the 
shadows of the dentist and his nurse passing back and forth 
on the other side might prove annoying to a patient who had 
been waiting in the reception room for some little time. This 
treatment will give added privacy, even though prism glass 
is not fully transparent. 
French doors should be treated with casement cloth, or a 
similar material. If the prism glass panels are eight by twelve 
inches, the curtains should be fastened on the dividing rail at 
the bottom of the upper panels. This will preserve the archi- 
tectural effect of the doors. When hanging the curtain in this 
fashion and provided the glass is prism or Florentine, fasten 
the lower end of the curtain with only one hook and brass 
ring on each side to hold it in place. Enough fullness should 
be allowed at the top for shirring to enable it to hang in graceful 
folds. The bottom of it should be scalloped. We would not 
suggest fastening it at the bottom with a rod for the reason 
that when the door is only partly covered a curtain shirred 
at the top and bottom on a rod is apt to give the effect that 
the dentist ran out of curtain material and for this reason 
treated it in this fashion. When the curtain is hung with 
complete fullness, scalloped at the bottom as suggested and 
loosely caught at either end, it does entirely away with the 
skimping effect. The treatment, as outlined for French doors 
with panels of the size as specified, is the very latest creation 
for door decoration. 
If the French door contains very small glass panels we 
would then suggest that the curtain be fastened at top and 
bottom and drawn tightly on rods, allowing a liberal shirring. 
For such treatment a two-inch heading on top and bottom 
will give a neat and finished appearance. 
With both styles of treatments, as outlined, a full fifty-inch 
width is to be used on each door. This will permit the neces- 
sary fullness which is so essential to give the desired effect. 
229 Practice Building Suggestions 
Communicating Windows, Their Function, Location, 
Construction and Treatment 
French or casement windows opening from reception room 
into the business office are a great aid to the dentist and the 
nurse in getting away from lengthy conversations with patients 
and saving many unnecessary steps. 
When the buzzer announces that someone has come in, 
the nurse will take note of the time on the appointment 
barometer and she can generally tell before opening the com- 
municating windows whether it is a patient with whom the 
doctor has an immediate appointment. If so she will ascer- 
tain how long it will be before the doctor can admit this 
patient and when she has this information will then open the 
communicating windows, greet the patient and state just how 
long it will be before being admitted to the operating depart- 
ment. This in itself suggests efficiency. 
If the nurse’s barometer indicates that the dentist has no 
appointment then before opening the communicating win- 
dows she will be prepared with the usual questions when 
greeting such a person. 
It is certain that these windows will save the dental nurse 
the necessity of having to step out into the reception room 
each time the buzzer signals, which means the saving of 
money, and hours of time during the year. When the dentist 
or nurse step into the reception room they automatically 
invite conversation which means time taken from operative 
work. With the communicating window procedure they can 
shut off unnecessary conversation without running the risk 
of offending the patient. 
Casement windows opening from reception room into the 
business office should be panelled either in wood, prism or 
Florentine glass or mirrors. 
If panelled in wood, the panel should be artistically painted. 
Another excellent way of decorating window panels is to place 
in the panel space a zinc etching or water color picture, placing 
over it a picture glass of proper size. This will give a very 
artistic decorative effect. 
The most inexpensive method would be to panel with 
either prism or Florentine glass. In order to take away the 
bareness and cold effect these glass panels should be treated 
230 Practice Building Suggestions 
with curtain and drapery material shirred on rods, top and 
bottom. 
The method of panelling which will be most effective is 
to use small mirrors of the size, 5 inches by 8 inches and leaded 
together. The lead strips are to be bronzed. The size of the 
mirrors will, of course, be determined by the height and 
width of the casements. The mirrored casements help to give 
depth to a small reception room. 
It seems natural for a patient when entering a reception 
room to try and become seated opposite a mirror. When mir- 
rored panels are used on the communicating windows the 
nurse usually finds the patient seated facing her when the 
greeting is given. 
It is not always necessary to panel casement communicat- 
ing windows on both sides. However, should the adjoining 
room be small the mirrored effect on that side would help to 
give it proper proportion. 
When prism or Florentine glass is used the panels would 
naturally be the same on both sides. 
Casement communicating windows should swing inward 
from the reception room. 
If the windows were hung to swing the other way, i.e.y 
into the reception room, a patient sitting in close proximity 
to them might be struck; or a small table with a lamp placed 
on it, could be easily knocked over, should they accidently 
swing out too far. 
In some offices, due to construction problems, it is not 
advisable to hinge these windows. In such instances it would 
be more practical to have a single window to slide into the 
partition. 
Are Rocking Chairs for Reception Rooms Desirable? 
A rocking chair is undesirable for the reason that it occupies 
too much space in the average reception room. A rocking 
chair must have plenty of space around it to allow for the 
rocking motion. If sufficient space is not available the walls 
will soon become marred not only from the top of the chair 
rail but also from the ends of the rockers themselves. 
A person rocking tends to make other people in the same 
room nervous and this is particularly true in the dentist’s 
231 Practice Building Suggestions 
reception room. A patient with a nervous and fidgety mental 
condition is not receptive to the dentist’s attention. Hence, 
everything should be eliminated from the reception room which 
might promote a nervous condition. 
Picture Subjects for the Retiring Room 
The objects in the retiring room or dressing room of the 
dental office are usually more closely scrutinized after an oper- 
ation than before. Previous to the operation the patient 
enters it a few moments before the appointment, removes 
her wraps and then immediately leaves it for the operating 
department. After the operation, provided the patient has 
not become ill, there is usually a fixing of the hair, a brushing 
of clothes, adjustment of hat, wraps, etc. and during this time 
she has an opportunity to view more closely the objects 
placed there for her benefit as well as for decoration. 
When a patient returns to the retiring room in an exhausted 
condition, quite some time is spent there before she has re- 
covered fully enough to leave the office and frequently such 
a patient has to lie down in order to effect recovery. Colors 
of walls as well as picture subjects have an influence upon 
people, particularly those in an exhausted condition and 
especially when resting on a recovery couch. With a patient 
in this condition with nothing to do but to think of herself 
physically and to look at the walls, pictures which do not 
suggest cheerfulness and harmony have not only a depressing 
effect but also because of mental depression, have a tendency 
to prolong recovery. Investigations have proved that patients 
who have become ill in the dental office and who have had 
to rest for some little time in the retiring room where sugges- 
tive strife picture subjects were displayed, have been so 
impressed with such picture subjects that they never think 
of the dentist’s office and their experience in it without these 
pictures immediately coming back to their memories. 
Such picture subjects as war scenes, athletes in struggle, 
thunderstorms, Pharaoh’s horses, wild animals, hunting 
scenes, rushing water or waterfalls, etc. have no place in the 
retiring room, or, for that matter, in any department of the 
dental office. 
Since the retiring room is to be a suggestion of health and 
harmony in as great a measure as other departments of the 
232 Practice Building Suggestions 
office, it would be correct to choose subjects of quiet land- 
scapes, flower gardens or a group of healthy, happy children 
at play. Children subjects are particularly good because 
everyone likes to gaze upon an innocent, happy, healthy child. 
Such pictures, when gazed upon by a patient who is recover- 
ing from an operation in the retiring room, will often be 
stimulating. The coloring in the pictures should be soft and 
subdued with proper blending. Etchings, while often quite 
appropriate in the reception room, should be avoided in the 
retiring room because of their sharpness and extreme contrast. 
Toilet Articles for the Retiring Room and 
Their Proper Care 
The following will aid materially in furnishing a well ap- 
pointed room: 
A ladies’ hat brush with a white ivory or tortoise shell 
handle. If this brush is of proper design it can be used as 
a light clothes brush. The bristles or hair of this brush should 
be white. An ivory or tortoise shell hand mirror; an ivory 
or tortoise shell box containing an assortment of hairpins. 
A small cut glass dish of oblong shape containing an assort- 
ment of pins. We prefer the cut glass dish to one of ivory or 
tortoise shell because it makes a more presentable appear- 
ance for the purpose for which it is intended. A small squatty, 
cut-glass jar with a large opening containing face powder. 
This jar must be accompanied by a glass cover. We prefer 
the glass jar for face powder for the reason that the powder 
will be immediately discernible to the patient, while if one of 
ivory or tortoise shell were used the patient would first have to 
remove the cover to determine its contents. In fact the glass 
jar would be a silent invitation for the patient to make use of 
the powder therein. A large cut glass bowl or jar with a large 
opening, containing individual powder puffs made of Johnson 
& Johnson large size cotton rolls. This jar must also be provided 
with a cover. We suggest the glass jar for the reason that 
the patient will see its contents and will be silently invited to 
use one of these individual powder puffs. 
On the wall next to the dressing table should be hung an 
artistically shaped small decorative waste receptacle to 
receive the hand-made powder puffs which have been used. 
233 Practice Building Suggestions 
A cut-glass bottle containing a solution of smelling salts of 
a pleasing color and one to harmonize with the remainder 
of the room. The dressing table should be covered with a 
plate glass top under which should be laid a doily of a size 
and shape that will harmonize with the architectural design 
of the dressing table top—in other words, if the dressing 
table has a narrow top, the doily should be of an oblong 
shape. On the other hand, if the dressing table has a wide 
top the doily should be of an oval shape. 
The doctor’s monogram is indicated on the various toilet 
conveniences in a color to harmonize with the predominating 
scheme. 
A patient is always more or less skeptical about a comb 
and brush. Therefore, these must be presented in such a way 
that the patient will feel and know that they have been thor- 
oughly cleansed since the last patient used them. For this reason 
we suggest that a comb should not be placed in the retiring 
room at all, and especially so if a dentist has a sterilizing room. 
Immediately after a patient leaves the retiring room, the nurse 
should get the comb and brush and after a thorough cleansing 
should place them in onionskin envelopes which are labeled or 
printed “Sterilized.” These envelopes should then be sealed 
and placed upon the shelf in the sterilizing room. 
When the patient has left the operating room for the retir- 
ing room, the nurse should then get the comb and brush which 
are sealed and present them to the patient with the remark 
“This is your comb and brush for today.” The patient will 
then have to tear the envelopes open and during this procedure 
will know that they have been cleaned. No remark will have 
to be made that these articles have been given proper atten- 
tion because that will be in evidence. There is nothing that 
pleases a patient quite so much as such individual attention. 
It is this personal consideration that helps to promote publicity 
for the dentist. 
Care should be taken that the glass covers for the jars 
containing face powder and individual powder puffs are always 
placed upon the jars. No patient cares to use face powder 
that has been exposed to the air and dust. This will also apply 
to the powder puffs. Therefore, these glass containers should 
be kept scrupulously clean as well as properly filled at all 
times. A patient often places the dentist’s powder puff in 
234 Practice Building Suggestions 
her purse or bag after she has used it because it is unique and 
distinctive. After leaving the dentist’s office she perhaps has 
occasion to use this powder puff in the presence of her friends 
who cannot help remarking upon its oddity. She perhaps will 
state that her dentist supplies these individual powder puffs, 
in the retiring room for his patients, and in this way she in- 
nocently gives him free advertising and publicity. 
The glass tray containing a selection of pins must also 
be kept in order as well as the container for hairpins. There 
is nothing that looks quite so untidy as to see a selection of 
hairpins scattered helter-skelter about the top of a dressing 
table. Therefore, the container for hairpins should be divided 
into three compartments, one for small pins, another for 
medium and another for large. 
Dressing Tables and Chairs for the Small 
Retiring Room 
If the retiring room is too small to permit a regulation 
dressing table, we would suggest a small console table. Con- 
soles come as narrow as six inches and in any length desired. 
The toilet articles should be arranged on the top of the console 
table the same as on a regulation dressing table. 
Since it is desirable to have a dresser-sized mirror in the re- 
tiring room, we would suggest a separate mirror framed to 
harmonize with the other furnishings and hung over the console 
table. This type of furniture can be installed in the smallest 
of dressing rooms. 
We would suggest a small-sized chair with a low back to 
go with the dressing table provided the room is of sufficient 
size. However, inasmuch as most retiring rooms are very 
small, a chair will take up more room than the space will 
permit. In such a room our choice would be a bench with 
a cane top. When this bench is not in use it can be pushed 
underneath the dressing table and out of the way. 
If the room is of such size that a console table were used 
instead of a regulation dressing table we would then suggest 
a square stool with cane top. This stool is to be the same 
height as a bench. The dimensions of the top of such a stool 
are 15 inches by 15 inches. A console table, because of its 
shallow depth, will not permit a stool, bench or chair to be 
235 Practice Building Suggestions 
pushed under it. Therefore, in suggesting a stool, we have 
in mind that it will take up the least amount of room when 
not in use by placing it in a corner of the room. This would 
not be possible with a chair or bench. 
Equipment Finishes for the Dentist 
of a Nervous Temperament 
If a dentist is continually working under high tension, 
mahogany finished equipment would be most desirable for him 
for the reason that mahogany in itself suggests quietness and 
would help to tone down the dentist. Oftentimes a nervous 
condition in the dentist can be traced to operating room 
cross lights playing on the improper wall treatment and this 
effect is intensified in the light finishes of equipment used. 
If you are of a nervous temperament it might be well to 
experiment on yourself by remaining in a room in which all 
of the furniture is of very light finish. You will note that you 
cannot concentrate and are alert to all movements and noises 
within and without this room. In one furnished in mahogany 
you will note that you can concentrate and that you are not 
as conscious of the movements of other people who are in 
the room. A person with a normal set of nerves would not 
be susceptible to this experiment. 
Equipment in the light finishes should not be used by den- 
tists who are afflicted with nerves. 
Equipment Finishes for the Dentist who is Deliberate 
and Always Good Natured 
If such a dentist is neat about his person and about his 
office, then a Pyralin white, Pyralin ivory or Pyralin gray 
equipment would be correct, provided the man is not too big 
in stature and that his operating room is not too small. In 
other words, light special finished equipment will make a tall, 
heavy set operator appear even larger in a small operating 
room. 
However, we will assume that the operator’s physical build 
is somewhat in proportion to the operating room and that he 
is rather slow and deliberate. Light finished equipment will 
have a tendency to give him a certain snap and will set him 
236 Practice Building Suggestions 
off in such a way that his slowness and deliberateness will 
not be so apparent as when mahogany or black enamels 
are used. 
Equipment Finishes for the Dentist of a Small 
Physical Build 
A man of small stature and one who would not be termed 
impressive will always look better in a cut-to-form, tailored 
suit of clothes. A suit built along conservative lines will never 
set such a man oft. This is also true of dental equipment. 
A dentist who is small and not impressive, will appear to 
better advantage when working in an operating room con- 
taining equipment finished in Pyralin white, Pyralin ivory or 
Pyralin gray. 
Advantages of an X-Ray Room 
We would suggest an x-ray room for the dentist provided 
sufficient floor space is available. Such space, through the 
medium of the x-ray, can be made highly productive from 
the viewpoint of earning power. 
If an x-ray was to be installed in a separate room the 
minimum floor space required would be 5 x 5 feet. 
A separate x-ray room is advantageous because radiog- 
raphy can be successfully accomplished without interfering 
with operative work. As a rule, the first appointment with a 
patient is taken up with health talks and general diagnosis. 
The question of radiographing the teeth is also brought up 
during the first appointment and if the case is one of a com- 
plicated nature positive diagnosis cannot be given until after 
the case has been radiographed. 
If radiographs are to be taken during the first appointment 
the nurse, will conduct the patient to the x-ray room and 
radiograph those teeth which are charted by the dentist. 
During this procedure, the dentist can immediately begin or 
continue operative work on another patient. It is needless to 
say that if the dentist was burdened with the actual taking of 
radiographs and his x-ray unit was in his operating room, he 
could not care for as many patients in a day as he could if he 
had a separate x-ray room or second operating room in which 
the x-ray machine was installed. 
237 Practice Building Suggestions 
Certain dentists, might object to having the nurse do the 
radiographing. In that event, by having a separate room, the 
dentist could continue to save time by taking the radiographs 
himself while his nurse was positioning another patient in 
the chair, as well as getting the instruments, etc., in readiness 
for the dentist, so that he would lose no time in getting started 
when he returned to the operating room. The nurse would 
then return to the x-ray room for the purpose of making 
another appointment with the patient. 
When the patient returns for the second appointment, at 
which time the final diagnosis is given, she should be taken 
to the x-ray room rather than to the operating room because 
the dentist can there best explain his diagnosis, especially if 
he has a display of radiographs. These displays are very 
impressive to patients and can be made interesting to them 
if radiographs of cases similar to that of the patient are shown, 
giving conditions before and after treatment. There is con- 
siderable psychology in this method of managing patients 
which would not be so effective if attempted in the operating 
room because of insufficient film display space, etc. 
Another point in favor of an x-ray room is that all radio- 
graphic check-up work can be accomplished by the nurse 
without interrupting the dentist in the operating room. 
The nurse will be given an incentive for greater effort if 
allowed to do all the radiographic work because she will then 
look upon the x-ray room and its equipment as her own, for 
which she is to be personally responsible. 
The Transilluminating Room 
The real purpose of the transilluminating room, aside 
from being of aid towards complete diagnosis is to enthuse 
patients with what it is possible to obtain in dentistry. There 
are certain branches of dentistry in which it is hard to convince 
patients that specified conditions actually exist, and that they 
should be eliminated through a series of treatments. In the 
absence of a transilluminating room, a small percentage of 
patients will at first enthuse over what the dentist proposes 
to do for them but this enthusiasm is short-lived because it 
is not always possible for them to see or even to feel the gradual 
change for the better which is being effected through certain 
treatments. With the diminishing of their enthusiasm most 
238 Practice Building Suggestions 
of them fail to return for a continuance of the treatments, 
with the result that through lack of understanding the den- 
tist loses patients. All of this has resulted in some discour- 
agement to the dentist and it can truthfully be said that 
because of this many of them have not considered certain 
branches worth while, preferring to leave them to the spe- 
cialist. 
People are more apt to believe what they see than what they 
hear, and because “doubting Thomases” go to dentists every 
day for dentistry which they attempt to dictate to the den- 
tist, he should not be content to do only such work as patients 
desire. Through the medium of a transilluminating room he 
can convince people of what they should have, because it is 
possible for them to see with their own eyes the true conditions 
as they exist, which is not possible in those offices where 
transillumination is not resorted to. 
Most dentists have a certain percentage of patients who still 
believe that $8.00 for a gold crown or $5.00 a tooth for bridge 
work or $30.00 for a pair of dentures should be an established 
fee. Anything over this amount, regardless of the nature of 
the work, is looked upon by them as being preposterous. 
As a rule these same people will not hesitate to spend any- 
where from $500 to $1000 for a fur coat. Such patients as 
described will pay these goodly sums for furs and other things 
only because they can see before them what they are going 
to buy, and in addition can visualize the wearing of such 
apparel. By the same process a transilluminating room will 
convert such people to better dentistry because through it, 
together with the proper health talk from the dentist, these 
patients can be made to actually see the unhealthy conditions 
of their mouths, as well as being enabled to visualize the work 
from the start and its progress. 
A transilluminating room is adaptable to all branches 
of dentistry where it is necessary to give patients detailed 
instruction, which if carried out by them will insure a sue 
cessful conclusion of the work. Aside from a general practice 
the transilluminating room is invaluable to such branches of 
dentistry as listed below: 
Prophylaxis 
Pyorrhea 
Orthodontia 
Pediadontia 
239 Practice Building Suggestions 
Its Proper Location and Equipment 
The ideal location for a transilluminating room is anywhere 
in the dental office easily accessible to the patient, nurse and 
dentist from the operating room. It should never be placed 
in such departments as the business office, reception room or 
retiring room. 
It should be large enough to accommodate three people 
at one time—namely, the patient, nurse and the dentist. 
A space of 4 feet, 6 inches square, or not less than 4 feet square, 
inside measure, will be found adequate. 
The equipment to be placed in the room should be as follows: 
Mirrors on two sides, meeting in corner of room. 
They should be unframed and studded to the wall. 
Narrow console table or shelf directly underneath one 
of the mirrors. 
An aseptic flat jar with cover containing extra diag- 
nostic bulbs. 
Bottle with stopper containing disclosing solution. 
Switch handle and cord attached to the Unit from 
which connection is to be made by separate wire 
to Unit in the operating room. By this arrange- 
ment the electric current can be automatically 
turned into the switch handle by merely removing 
it from the clip. 
Electric wall fan mounted 72 inches from floor. 
Ceiling light operating either from push button or 
pull chain. 
A ventilator grill should be mounted in the wall 6 
inches below the ceiling line. 
Because all natural light is excluded from the room, making 
it similar to a dark room, the same color scheme predominating 
in the operating department should also be carried out in the 
transilluminating room. While it is true that the room must 
be dark during transillumination, it is not necessary to go to 
extremes by using a jet black color scheme for the walls and 
ceiling. The exclusion of natural light in itself is sufficient 
for transillumination regardless of the color scheme. 
240 Practice Building Suggestions 
The Business Office 
It is just as important to impress patients with business 
principles in this department of the dental office as it is to 
impress them with operative skill in the operating room. 
A properly furnished business office narrows down the 
final interview between the dentist and patient to one of a 
strictly business nature. 
Picture Subjects 
The proper picture subjects for the business department 
of the dental office should be those of modern or ancient 
architecture. Such subjects embrace strong and lasting 
principles and as business should be one of strict purposes 
these subjects would be most appropriate for the dentist’s 
office. Photographs of dentists of national reputation as well 
as pictures of dental dispensaries, such as that of the Eastman 
Dental Dispensary are appropriate. A picture suitable for 
a reception room would not be proper in the business office, 
neither would a retiring room picture subject be correct. 
Furniture and Fixtures 
Furniture for the business office should consist of the follow- 
ing articles: 
Small flat top or roll top desk, supplied with plate glass 
top. 
Revolving desk chair, providing there is sufficient space; 
if not, then a small straight back Windsor chair would 
be more practical. 
A semi-stuffed chair of a low design or a decorative Wind- 
sor armchair for the patient. 
A small flat top desk or table with glass top, for the nurse. 
A small straight back chair for the nurse, providing there 
is sufficient space, if not, then a small bench would 
be more practical as it can be moved under the desk 
or table when not in use. 
Small size typewriter. 
Costumer. 
Two waste baskets, one for the dentist and one for the 
nurse. 
Sectional cabinet letter file. 
X-Ray film filing cabinet. 
241 Practice Building Suggestions 
Small size safe. 
Desk lights. 
8 inch oscillating wall fan. 
Depending somewhat on the general furnishings of the suite, 
the furniture for the business department should be a fine 
grain dull waxed white oak, brown mahogany or dull waxed 
walnut. A combination of finishes, such as walnut and mahog- 
any, is satisfactory. High polish golden oak should never be 
selected. 
The chair for the patient should be at least 6 inches lower 
than the chair of the dentist. A chair of this height insures 
comfort for those patients who are short-limbed, especially 
ladies. The narrow, straight-backed chair with a small and 
high seating surface, which is used in so many business offices 
of dentists, is most uncomfortable, especially during lengthy 
interviews with those patients for whom study models have 
been made. It is as important to make a patient comfortable 
in the business office when discussing fees, methods of pay- 
ment, etc., as it is in the other departments. 
' If a business office is small we would suggest the type of 
chair for the nurse which could be pushed under the desk 
when not in use. For the small office a desk bench is very 
practical. Junior Windsor chairs with low backs are also very 
desirable as well as the low back regulation dressing table 
chair. 
Enclosed Radiators and Their Construction 
By “Enclosed radiator” is meant a cabinet built in the form 
of a window seat or utility cabinet and placed over the radiator. 
A radiator when not covered in this fashion is not pleasant 
to look upon, particularly when it is located directly in front 
of the dental chair. A great many dentists are content to 
bronze a radiator once a year but the newness of the bronze 
is short-lived and the finish soon deteriorates. A radiator cover 
of proper design will forever eliminate the unsightliness of the 
radiator and will give a finished touch to the room. 
A radiator which is not covered in this fashion will cause 
the wall about it to become streaked and furthermore the 
radiation of heat starts a circulation of dust in the air which 
242 Practice Building Suggestions 
is something to be avoided in any department of a dental 
office. 
The construction of a radiator cover depends entirely upon 
its location and the department in which it is to be placed. 
For such departments as the reception room, retiring room, 
or business office, where the radiators are usually of a low 
type, the cover should be constructed in such a manner that 
it can be used as a seat. The top should be covered with a 
pad in a color harmonizing with the balance of the room. 
Should the radiator be of a high type, then the top of the 
cover should be overspread with a piece of verdi marble upon 
which could be placed articles tending to give it a decorative 
effect. 
A radiator cover is not a stock article and usually must be 
made to order by a cabinet maker or by one who specializes 
in them. They should be made of a fine grade of wood and 
the inside lined with asbestos. The front and sides of the 
cover should consist of cane panels or metal grill work. The 
shape, style and design of these panels depend upon the size 
of the radiator and the general style of the cover. On the 
ends of the radiator cover small hinged doors should be placed 
so as to conveniently permit the heat to be turned on or off, or 
to drain the radiator, without having to remove the entire 
cover. 
In the operating room different conditions prevail than in 
the other departments. Every foot of space in the operating 
room should be made productive. Instead of constructing a 
radiator cover to be used as a window seat, it should be de- 
signed with an idea of utilizing it as an auxiliary sterilizing 
cabinet. The average height of a radiator in an operating 
room is 25 inches. As a rule the space between the floor and 
window sill is 36 inches. If a radiator cover is used on this 
type of radiator, having the cover stop at the 25 inch height 
and providing the radiator is located in front of the chair, there 
is a waste of space of at least 10 to 12 inches. This space can 
be made productive by building the radiator cover to the 
height of the window sill. The space between the sill and 
the top of the radiator can be converted into compartments 
with glass doors. The inside of these compartments should 
be white enameled. In such a case illumination is made pos- 
sible by using small electric light bulbs at the inside top of 
243 Practice Building Suggestions 
the cover or at any place within the compartment out of the 
direct view of the patient. Trays of instruments after steriliza- 
tion can be placed in this compartment providing a good 
sterilizing medium, such as formaldehyde, etc., is placed within 
the inclosure. 
The appearance of this type of radiator cover can be en- 
hanced by placing on the top of it a heavy vitralite glass. 
This can be used for the placing of a conductive anaesthesia 
outfit during an operation, also glass jars containing steril- 
ized gauze, cotton rolls, napkins, etc. If such a radiator 
cover is properly constructed the radiator itself will be com- 
pletely camouflaged and the general appearance will suggest 
a scientific cabinet for sterilization. 
Care must be taken when constructing radiator covers that 
plenty of radiation is allowed for the heat from the radiator. 
Construction with no thought to heat radiation results in the 
sacrificing of at least 50 per cent of it. Therefore thought 
must be given to sufficient panelling either of metal or cane 
grill. 
244 Practice Building Suggestions 
SECTION XIV 
Stationery Suggestions 
Letterheads 
IETTERHEADS are the sheets on which dentists 
transact, through correspondence, a part of their business. 
A slovenly letterhead oftentimes has much to do with the 
failure of written business transactions and it has been our 
experience that a little money well spent on a letterhead of 
dignified character is an exceptionally good investment. 
The letterhead may be a single or folded sheet, depending 
upon your taste. It should be of a size that requires but one 
fold to fit the envelope. Our suggestion for size would be 
5X by 7yi inches. This size is convenient to handle and large 
enough to meet all correspondence requirements. 
The quality of papers suggested are, Crane’s Linen, Par- 
son’s Linen or Vellum finished stocks and we might say here 
that the same paper stock should be specified for both the 
envelope and letterhead. 
Engraving or printing should be of a plain face and of the 
same style as used on the envelopes. The wording as shown in 
the reproduction is considered the most practical as it con- 
tains no superfluous phrases or titles and has an attractive 
appearance. 
JOHN SMITH 
DENTIST 
309-311 RELIANCE BUILDING 
JACKSONVILLE, N. Y. 
245 Practice Building Suggestions 
Envelopes 
Standard size envelopes of the baronial style and of good 
quality are the best for a dentist’s general correspondence. 
An envelope of by inches is very convenient and enables 
the mailing of all courtesy cards, letters, statements, etc. 
in it. 
A good quality of paper, preferably Crane’s Linen, Parson’s 
Linen or Vellum finished stock is suggested. 
The engraving or printing, whichever may be the case, 
should be of plain face and of the same style as used on the 
letterhead. Wording should be confined to the dentist’s 
name, street address, city and state, and should be placed 
on the flap of the envelope as shown in the reproduction. 
Supplementary phrases such as, “Return in five days,” 
“Dental Practitioner,” etc. are superfluous and should be 
omitted. 
JOHN JONES, D. D. S. 
eoo OSAGE BUILDING 
PERRYVILLE. WIS. 
Monthly Statements 
Statement forms should be of the same size as that for 
correspondence and the same quality of paper should be 
used so that the envelopes will answer for both forms. The 
statements may be engraved or printed on a single sheet 
which will fold once across the center to fit the envelope. 
The following illustration is our suggestion for a statement. 
It does not suggest anything to be itemized. It does, however, 
suggest in a professional way that the dentist expects pay- 
ments promptly each month regardless of whether or not the 
case is completed. If he talks along these lines to the patient 
246 Practice Building Suggestions 
at the time that he first contracts for the case, the wording 
on the statement when received by the patient each month 
will then be a gentle reminder of the conditions under which 
the dentist accepted the case from a financial viewpoint. 
STATEMENT 
TO JOHN JENKINS, D. D. S., DR. 
! PHONE: GEN. 206 W 
ROCHESTER, N. Y. 
167 HOBART ST. 
] BILLS PAYABLE MONTHLY AS WORK 
j PROGRESSES WHETHER ENTIRE CASE 
i IS COMPLETED OR NOT. ITEMS OF 
j THIS ACCOUNT MAY BE EXAMINED 
i AT THE OFFICE AT ANY TIME. 
Opinions vary as to the proper size for an appointment 
card. We have determined through observation that there is 
one size more practical than all others, this size being 3 x 
1 yi inches. Our reasons for this are that when given to ladies 
it is not too large for the small vanity case often carried and 
neither is it too large for the vest pocket or the average size 
card case carried by men. 
In addition, this size appointment card is small enough so 
that it will fit in the spectacle case of a forgetful patient. 
The nurse can suggest in a gracious way when handing this 
size appointment card to patients who carry a spectacle case 
that it be placed in it to act as a reminder of the engagement 
with the dentist each time the case is opened. If the card is of 
Appointment Cards 
247 Practice Building Suggestions 
a size which cannot be conveniently carried by the patient, 
its purpose is defeated. 
For the style and wording, we suggest the following as it 
does not contain any superfluous wording nor is it necessary 
to do a great deal of writing to fill it out. 
APPOINTMENT WITH 
PAUL JONES, D. D. S. 
127 EAST AVENUE 
A CHARGE WIU. BE MADE FOR FAILURE TO KEEP AN 
APPOINTMENT UNLESS CANCELLATION IS RECEIVED ONE 
DAY IN ADVANCE 
STONE 7637 
The appointment card as suggested above should be printed 
on single ply Vellum card stock and in black ink. 
Note 
For Announcements, Courtesy Cards, Courtesy Letters and 
Professional Cards see Section III. For Periodical Examina- 
tion Cards see Section V. 
248 Practice Building Suggestions 
SECTION XV 
Dentist’s Valuation of Time and Items to be 
Considered when Figuring Overhead 
IT has been but a few years since a young dentist starting out 
in practice determined his fees through those asked by 
other dentists in the community in which he located. His 
first step in the right direction was to call on all the neighboring 
dentists and ascertain their fees for various classes of work. In 
those days dentists did not take their overhead expenses into 
account. They were selling materials to their patients instead 
of time and skill. In other words, they were selling the fin- 
ished product, putting it on a commodity basis, even though 
this so-called finished product was only a means to an end. 
Today the young dentist', as well as those already established, 
have a definite basis upon which to fix their fees. They take 
into account what it costs them to conduct their office, and 
then add to this cost an amount which will insure them a 
reasonable remuneration for a man of scientific learning. What 
the remuneration over and above expenses should be must be 
determined by the value he attaches to his services and the 
demand by the laity for his services. This phase of the question 
has been more thoroughly covered in the chapter on “Law of 
Supply and Demand and Factors Affecting Demand.” It will 
be readily understood that the young dentist just starting out 
must be content with a much smaller remuneration than those 
dentists who have been established for some time, and for 
whose services there is considerable demand. Since the first 
step in the right direction is to determine overhead cost, we 
are listing as follows all items which must be taken into account: 
Auditor’s fees. 
Convention expense such as railroad fare, hotel, etc. 
Curtain material that is replaced at least yearly such as 
curtains, draw curtains, transom coverings, door curtains, etc. 
Dental magazines and other periodicals for reception room. 
Dental society dues: City, State and National. 
Dentist’s uniform such as coat, trousers, gown, white shoes, 
etc. 
Depreciation on entire office. 
Dry cleaning service such as carpet, rugs, portieres, over- 
249 Practice Building Suggestions 
drapes, side drapes, valances, table covers, furniture pads, 
reception room furniture upholstering, etc. 
Expense in connection with post-graduate courses. 
Fees and commissions to collection agency, legal advice and 
credit association. 
Gas. 
Insurance: Fire and Liability. 
Interest on notes for equipment. 
Laundry service, such as towels, napkins, sash curtains, 
dentist’s and secretary’s uniforms, doilies, patients’ aprons 
and bibs, headrest covers, draw curtains. 
Light and power. 
Office cleaning service, such as janitor, porterage, etc. 
Phone service. 
Rent. 
Secretary’s and Nurse’s salaries. 
Nurse’s uniform, such as gowns, caps, white shoes, hose, 
etc. 
Supplies for business office such as stationery, postage, 
statement forms, professional cards, appointment cards. 
Taxes—such as City, County, State, School and license 
to practice. 
Towel material, such as towels, napkins, headrest covers, 
patients’ aprons and bibs. 
Uncollectable accounts. 
Upkeep on equipment such as chair, engine, lathes, switch- 
board, compressor, x-ray, replacement on cuspidor, etc., 
replacement of broken and worn-out instruments, handpieces, 
glassware, etc. 
Water. 
Example: 
Assuming that the total of the expense in an office of the 
foregoing items would amount to $4,500 annually and the 
production hours equalled 1,500 hours, the overhead expense 
per hour of the items in question would equal $4,500 -5- 1,500 
hours, or $3 per hour. As overhead expense should equal about 
one-third of the hourly rate charged, the gross income per hour 
should, in this instance, be about $9 per hour or $13,500 gross 
annually. 
It must be noted that the foregoing example does not take 
250 Practice Building Suggestions 
into account expensive materials such as gold, alloy, cements, 
silicates, porcelains, artificial teeth and laboratory work. When 
the dentist makes a mental estimate of the number of hours 
required to do the work at so much per hour, he must add to 
the sum the cost of the materials as mentioned so as to arrive 
at a grand total which he will quote to the patient. 
In the example, the dentist with an office expense of $4,500 
annually would have to charge on the basis of $9 per hour if he 
would enjoy proper remuneration, taking into consideration 
that he is entitled to about two-thirds over and above his 
operating cost per hour. Since it is probable that he is catering 
to various classes of patients and that some cannot pay his 
hourly rate, it is necessary in order to equalize his earnings to 
classify his patients as in the chapter on “How to Establish 
Fees.” With the dentist who must charge $9 per hour the 
classification of patients would work out about as follows: 
Class I Patient—Minimum hourly fee $ 7.00 
Class II Patient—Minimum hourly fee 9.00 
Class III Patient—Minimum hourly fee 11.00 
Every dentist should install a good practical accounting 
system. However, he must be sure that the system that he 
might install has complete accounting detail, not only with 
regard to the items to be figured as overhead expense, but also 
materials and supplies which are used in daily practice. It is 
very important that his accounting system provide for proper 
records with regard to federal income tax and the various 
rulings which pertain specifically to dentists. There are 
various accounting systems published and sold. Information 
regarding them may be obtained from any representative 
dental dealer. 
251 Index 
Index 
A Page 
Advanced Arrangement with Patients for Payment 130 
Agents, How They Should be Handled 184 
Agency Reports on New Patients 132 
Agreements, Working 105 
Analysis of Cities 22 
Analysis of Communities 21 
Analysis of Large Cities 39 
Analysis of Rural Districts 21 
Analysis of Small Towns 21 
Analysis of Suburbs 30 
Analysis of Towns 22 
Analyzing Patient’s Needs 141 
Announcement Cards . 54 
Appointment Cards 247 
Appointment Cancellations, Three Steps to be Taken by Nurse 181 
Attention to be given to Patients after Extractions 177 
B 
Books for Reception Room 225 
Book-ends and Statuary 228 
Broken Appointments 88 
Business Office 241 
Business Office, Carpets and Rugs for 216 
Business Office, Duties of Nurse 172 
C 
Caps for Lady Patients as an Aid for Comfort and Convenience 185 
Carpets 216 
Case Records 129 
Child Patients, Relationship between Dentist, Nurse and 187 
Child Patients, How Dentist Should Receive a Child who is 
under Eight Years of Age 187 
Child Patients, How Nurse Should Receive a Child Under 
Eight Years of Age 188 
Child Patients, Conversation between Dentist or Nurse regarding 
Instruments 190 
Child Patients, How to Describe the Dental Chair to them.... 192 
Child Patients, When and Under What Conditions Parents 
Should be Admitted to Operating Room 193 
Children, Proper Literature for 190 
Children Patients, Letters to 68 
Choosing Right Location and Starting the Practice 21 
Cities 22 
Cities, Large 39 
Color Schemes for Northern Exposed Operating Rooms 207 
Color Schemes for Southern Exposed Operating Rooms 208 
252 Index 
Page 
Color Schemes for Eastern Exposed Operating Rooms 209 
Color Schemes for Western Exposed Operating Rooms 209 
Color Schemes for Retiring Room 210 
Color Schemes to Avoid when Furnishing Retiring Rooms 210 
Color Schemes for Sterlizing Rooms 211 
Color Treatments for Low Ceilings 213 
Collecting Accounts 89 
Collection Signs 126 
Communicating Windows 230 
Complete Restorations, Selling 138 
Condemning a Brother Practitioner’s Work 128 
Constructing the Dental Suite 199 
Conversation between Dentist or Nurse and the Child with 
Regard to Instruments 190 
Conversation between Nurse and Patient Prior to Extractions.. 176 
Contract Fees 95 
Courtesy Cards 57 
Credit, Rules for Extending 132 
Courtesy Letters 58 
Courtesy, Professional 142 
Cross Lights and How to Eliminate 213 
Cultivating Acquaintances 59 
D 
Decorating the Dental Suite 199 
Dental Chair, How to Describe to a Child 192 
Dental Nurse, Attentions to be given to Patients after Extractions 177 
Dental Nurse, Duties in Business Office :. 172 
Dental Nurse, Developing Radiographs 168 
Dental Nurse, Equipment which She Should Operate 162 
Dental Nurse, Filling Materials She Should Make Up 170 
Dental Nurse, How to Receive a Child who is Under Eight 
Years of Age 188 
Dental Nurse, Her Duties Prior to the Arrival of First Patient.. 166 
Dental Nurse, Her Conversation with Patient Prior to Extrac- 
tions 176 
Dental Nurse, Her Duties 158 
Dental Nurse, Laboratory Duties 171 
Dental Nurse, Miscellaneous Materials to be Prepared by Her 170 
Dental Nurse, Precautions to be Taken with Patients Prior to 
Extractions 176 
Dental Nurse, Relation to Patient 174 
Dental Nurse, Receiving Telephone Messages 174 
Dental Nurse, Relationship to Child Patients 187 
Dental Nurse, Time Saved Through Her Employment 159 
Dental Nurse, Twelve Requisites to be looked for 159 
Dental Nurse, Treatment Solutions She Should Make up 169 
Dental Hygienist as an Asset 194 
Dental Societies 139 
253 Index 
Page 
Dental Services, Laity’s Valuation 136 
Dental Suite, Planning the 196 
Dental Suite, Its Construction, Decoration and Furnishing 199 
Dentist’s Valuation of Time 249 
Developing Friendships 59 
Diagnoses, Charging for Same 83 
Dismissing Patients 123 
Dissecting Charts 126 
Dressing Tables and Chairs for Small Retiring Rooms 235 
Druggist’s Co-operation, Gaining 144 
E 
Eastern Exposures, Color Schemes for Operating Rooms 209 
Enclosed Radiators and Their Construction 242 
Entrance Door, Why It Should be Kept Closed 124 
Envelopes 246 
Equipment Finishes for Nervous Dentists 236 
Equipment Finishes for Dentists who are Deliberate and Good- 
Natured 236 
Equipment Finishes for Dentists who are of a Small Physical 
Build 237 
Ethical Publicity 50 
Extractions, Attention to be given Patients after 177 
Extractions, Attention to be given Patient Prior to 176 
Extractions, Precautions to be taken with Patients 176 
F 
Fees, Avoid Quoting to Minor Patients 85 
Fees, Determining for Large Complicated Cases 79 
Fees, Determining Through Mental Estimate 80 
Fees, Approximate Estimate before Case is Started 82 
Fees, Contract 95 
Fees for Children 84 
Fees, How to Establish 74 
Fees, How to Quote when Calculated on the Hourly Basis 81 
Fees, Increasing same in Mining, Railroad, Packing House and 
Congested Industrial Centers 86 
Fees, Radiographic, and Quoting Same 87 
Fees, Special 98 
Fees, Split 94 
Fees, Where to Discuss in Office 78 
Fees, Charging for Broken Appointments 88 
Extending Credit, Rules for 132 
Floor Coverings for Sterilizing Rooms 211 
Floor Lamps for Reception Room 227 
Following-up Patients 100 
Follow-up Letter Because of Added Facilities 102 
French Doors for Reception and Operating Rooms 228 
Furnishing the Dental Suite 199 
254 Index 
G Page 
Gaining Druggists’ Co-operation 144 
Getting the Patient’s Point of View 135 
Guaranteeing Dentistry to Patients 87 
H 
Health Talks as a Factor in Selling Services 115 
Health Talks, a Nucleus for Same 118 
High Ceilings, How to Alter lor Small Rooms 199 
Hold and Cultivating Acquaintances 59 
Hygienist as an Asset 194 
I 
Intimate Hints for the Dentist 115 
L 
Laboratory Duties for the Nurse 171 
Laity’s Valuation of Dental Service 136 
Large Cities 39 
Lavatories and Sinks, Their Fittings, Location and Installation 203 
Law of Supply and Demand and Factors Affecting Demand 10 
Letters for Following Up Patients, Because of Added Facilities. 102 
Letters for Advancement of Dentistry 64 
Letters to Child Patients 68 
Letterheads >. 245 
Linoleum 214 
Literature for Children 190 
Literature for Reception Room, Its Care 172 
M 
Magazines for Reception Room 225 
Main Entrance Door, Why It Should be Kept Closed 124 
Management of Child Patients 187 
Modern Office, Its Value 196 
N 
New Patients, Agency Reports 132 
Northern Exposure, Color Schemes for Operating Rooms 207 
O 
Office Wearing Apparel 122 
Operating Room Door, When to Keep Closed 125 
Operating Rooms, Color Schemes for Northern Exposures 207 
Operating Rooms, Color Schemes for Southern Exposures 208 
Operating Rooms, Color Schemes for Eastern Exposures 209 
Operating Rooms, Color Schemes for Western Exposures 209 
Operating Rooms, French Doors for 228 
Operating Rooms, Sanitary Treatment for Swinging Doors 214 
Operations, Preparatory Assistance by Nurse for 185 
Overhead, Items to be Considered When Figuring 249 
255 Index 
P Page 
Pain, Propriety of Nurse Sympathizing with Patients 179 
Pain, Special Attentions to be given Patients During Prolonged 
Operations 180 
Paneled Effects for Walls of Reception Rooms 206 
Parents, When and Under What Conditions to Admit to Operat- 
ing Room 193 
Partitions and How to Build 201 
Partnerships 105 
Partnerships, Legal Forms 105 
Patient, Reception to be given by Nurse... 184 
Patients, Attention to be given Sickly Patients by Nurse 182 
Patients, Caps for Lady Patients as an Aid for Comfort and 
Convenience 185 
Patients, How to Dismiss 123 
Patient’s Point of View, Getting the 135 
Patients, Satisfied 62 
Periodical Examination Cards 100 
Picture Subjects for Retiring Room 232 
Planning the Dental Suite 196 
Planning Service Offered by Ritter 196 
Population of Town or City 28 
Possibilities of Town or City 22 
Practicing What You Preach 121 
Precautions to be Taken with Patients Prior to Extractions.... 176 
Preliminary Analysis of Large Cities 39 
Preliminary Analysis of Suburbs 30 
(See first classification of suburbs) 
Preliminary Analysis of Suburbs 34 
(See second classification suburbs) 
Preliminary Analysis of Town or City 29 
Preparatory Operative Assistance by Nurse 185 
Professional Cards 56 
Professional Courtesy ... 142 
Psychology in Connection with Giving Health Talks and Quoting 
Fees to Patients 75 
Public Opinion and the Dental Profession 18 
Push-Button for Main Entrance Doors 217 
R 
Radiators, Enclosed Construction 242 
Radiographs to be Developed by Nurse 168 
Reception of Patient by Nurse 181 
Reception Room Furniture 224 
Reception Room, an Ideal Inside 222 
Reception Room, Book and Magazine Subjects for 225 
Reception Room, Book-ends and Statuary for 228 
Reception Room, Care of Literature 172 
Reception Room, Carpets and Rugs for 216 
Reception Room, Floor Lamps for 227 
256 Index 
Page 
Reception Room, French Doors for 228 
Reception Room, Vases and Pottery for 228 
Reception Rooms, Paneled Effects for Walls 206 
Reception Rooms, Why Rocking Chairs are Undesirable for 
Them 231 
Records of Cases 129 
Repairing Broken-down Walls 212 
Retiring Room Picture Subjects 232 
Retiring Room Toilet Articles 233 
Retiring Room, Carpets and Rugs for 216 
Retiring Rooms, Color Schemes 210 
Retiring Rooms, Color Schemes to Avoid 210 
Retiring Rooms, Dressing Table and Chairs for Small 235 
Retiring Room Door, When to Keep Closed 125 
Rocking Chairs, Why Undesirable for Reception Rooms 231 
Rules for Extending Credit 132 
Rugs 216 
Rural Districts 21 
S 
Salesmen, How They Should be Handled 184 
Satisfied Patients 62 
Self-Analysis and Self-Improvement 127 
Selling Complete Restorations 138 
Sickly Patients, Attention to be given by Nurse 182 
Small Rooms, How to Proportion 199 
Small Towns 21 
Societies, Dental 139 
Solicitors, How They Should be Handled 184 
Southern Exposures, Color Schemes for Operating Rooms 208 
Special Fees / 98 
Split Fees 94 
Stationery Suggestions 245 
Statements 246 
Sterilizing Room 218 
Sterilizing Room Equipment 221 
Sterilizing Room, Color Schemes, Floor Coverings, etc 211 
Sterilizing Room, Lighting Effect 220 
Suburbs 30 
Sympathizing with Patients Undergoing Pain 179 
T 
Talking Over a Patient’s Head, Its Meaning 118 
Telephone Messages, Procedure of Receiving 174 
Tile Floors 214 
Title for Nurse 158 
Towns 22 
Toilet Articles for Retiring Room 233 
Transilluminating Room 238 
257 Index 
Page 
Trim, Proper Size for Small Rooms 203 
U 
Unprofitable Side of the Dental Practice 148 
V 
Valuation of Time, Dentist’s 249 
Vases and Pottery 228 
Ventilation System, Its Installation 202 
W 
Wall Treatments Under Special Conditions on Account of Old 
or Broken-down Plaster 212 
Wearing Apparel for Office 122 
Western Exposed, Color Schemes for Operating Rooms 209 
Window Signs 52 
Wood Trim, Proper Size for Small Rooms 203 
Working Agreements 105 
Working Agreements, Legal Form 105 
X 
X-Ray Films, Why they Should Not be Given to Patients 126 
X-Ray Room, Its Advantages 237 
258 THE DUBOIS PRESS. ROCHESTER. H. Y. 
PRINTED IN U. S. A.