How To Choose The Right Dental Chair For Your Practice

About The Author

Murray is an experienced dental surgery consultant. Having started off as an engineer in the field for 6 years, he gained a deep technical understanding of dental equipment. He then progressed to designing surgeries and specifying dental equipment, having many years of experience and has since completed hundreds of fit-out, squats and refurbishment projects.

What’s The Best Dental Chair To Buy?

We are often asked this question and the quick answer (as often) is a boring one: it depends! This article will attempt to explore the factors that should influence your choice and provide an unbiased opinion.

The main factors to consider are:

1. Value for money
2. Surgery design
3. Ongoing maintenance
4. Recommendations
5. Auxiliary equipment

Value For Money

Dental suites cost anywhere from £9k to £35k, so the first decision to make is what your budget is and what’s important to you in features. You should consider the following:

1. Patient comfort – Many manufacturers offer luxury or stitched upholstery at a small additional cost but this has a significant positive impact on patient experience. Often remembered!
2. Time-saving options – For example, an electric motor, when used correctly will significantly increase the speed of certain procedures, allowing dentistry to be more efficient.
3. The comfort of working – What is your musculoskeletal health in retirement worth to you now?
4. Lifetime cost – The cost of the chair across its lifetime (10-15 years), including annual servicing.
5. Automatic cleaning systems (e.g. mains plumbed water) – A big time saver for dental nurses, removes the likelihood of breakdowns and increases efficiency.
6. Integration – Why have a separate camera, separate implant motor, and separate scaler, when it can all be integrated into one unit?
7. Lead times – Some brands will be available sooner than others and if you are forced to wait for delivery, this will have a negative cost implication. If your requirement is urgent, it may be beneficial to consider alternative brands that are available sooner.

Entry-level chairs will be functional and have low-cost maintenance but will not offer much by way of time-saving features or comfort. Generally, the more expensive packages will include several additional items, more time-saving features and be more customizable. Often, buyers forget to calculate the value of time. If a dental chair will be used 5 days per week for 15 years, then a time saving of 10 minutes per day from having spent a little more during purchase, will have a significantly ‘cheaper’ lifetime cost than an entry-level, basic package.

Anglian’s TOP TIP!

The initial cost of a chair package is only part of the ‘cost calculation’. Before deciding or when comparing costs it’s so important to consider the other aspects mentioned above rather than just the purchase price.

The cheapest chairs on the market would be more expensive than an intelligently specified mid-range chair when considering lifetime costs, servicing and potential time-saving features.

Surgery Design

This is often overlooked. Not all chairs will suit all room shapes and sizes! Choosing a package correctly for the specific surgery will enable improved working ergonomics, patient entry and nurse flow. Every room is different and it’s vital you have someone with experience in dental surgery design to advise. The most important features to consider are:

1. Surgery door entry position. Where does the door position ‘bring’ the patient onto the chair? For ‘over the patient’ delivery chairs, patient entry is best from behind the chair or from the dentist’s side. For ‘behind the patient’ the best entry point is at the toe of the chair
2. Nurse access to outside the surgery whilst chair is in use. Can they get ‘around’ the chair without moving any of the arms?
3. Ceiling mounted lights. These are less obtrusive than unit mounted.
4. ‘Over the patient’ units need space to manoeuvre the arm, and this should be considered when choosing the chair
5. Size of the room. Different chairs have differing footprints. Please see the below table for a guide on the minimum size surgery for models of chairs
6. Existing services (pipes). In an existing surgery, the location of the pipes may influence the choice of the new chair. Be aware that not all chairs have the position of the same services, and an engineer should advise what the impact of choosing a certain chair may have on the work needed. Changing services and reflooring is usually a good idea when replacing a chair anyhow.
7. Knee break. Often considered where surgeries are small. However, they are the same size as other chairs when reclined! The main benefit these chairs provide is to put patients at ease. Subconsciously patients will prefer to have their feet on the ground for as long as possible because they feel less vulnerable. This usually results in them being more receptive to consultative dentistry, treatment plan discussions and oral health education.

Anglian’s TOP TIP!

In the UK, a large proportion of surgeries are rectangular in shape with the entrance door to the toe of the chair. In these instances, a behind-patient delivery system (e.g. Belmont Voyager, tbCompass) generally are most ergonomic for patient and clinical staff.

Where you are choosing an ‘over the patient’ delivery system (for example a KaVo E50 or a Heka Unicline S), make sure the patient entry is either from behind or from the dentist’s side, as this will make the patient entry significantly smoother. Square-shaped surgeries and wider rooms are needed for ‘over the patient’ delivery chairs.

Ongoing Maintenance

The availability of trained engineers for your chosen brand is important. Make sure you are not reliant on one or two companies for the ongoing maintenance of your equipment brand. Engineers will usually have to undergo manufacturer training to be qualified to work on brands of equipment so ensure your supplier has the engineer certificates to prove this.

Complete, or ask for help to complete, a life cycle analysis of your chair. Be aware of regular expected ongoing maintenance costs.

Make sure spare parts, service kits and consumables are held in stock with multiple suppliers in the country, and available for next-day delivery. The cost of surgery downtime will be significant in most instances and it’s worth paying slightly extra for peace of mind and good backup.

Annual servicing is a must. This will reduce the likelihood of future failures and will prolong the life of your equipment. CQC guidelines recommend servicing to manufacturers’ guidelines so it’s important to know what this is and how regularly it should be undertaken. Service kits are usually supplied by the manufacturer, and these have been built specifically to reduce breakdowns.

Anglian’s TOP TIP

In the UK, the most easily repaired brands are Belmont and A-dec because they’re relatively simple and most engineers can get parts to repair this. However, not all engineers are manufacturer trained and some do not use genuine manufacturer parts.

Brands such as Sirona, KaVo, Planmeca, Heka, and Ancar also have a well-developed network of support and spare parts. Some of these brands have had previous support challenges but are now resolved. Repairs for these brands are generally only through approved dealers, and it is recommended to only use manufacturer-approved engineers. There will be fewer engineers available for these brands, but this does not mean repairs will take longer or cost more. The most important thing is to partner with at least one reliable, established, and trained engineering company that has a team of engineers competent to cover your equipment.

Recommendations

Speak to a wide range of industry stakeholders when making your equipment choice. There are numerous ways you can do this:

1. Facebook groups, networking opportunities. Ask for opinions from existing users.
2. Ask opinions of engineers but be aware of bias they have due to personal preferences or ability to supply!
3. Ask suppliers for references from a dentist already using the chair you are considering.
4. See the equipment in real life before buying. Consider arranging a demo, viewing at an exhibition, or visiting a showroom. Nothing can replace a real test!

The most important aspect is to not only listen to suppliers and engineers but gain insight from current and previous users. However, be aware that some brands that have had poor back-historically, now have very good support due to significant manufacturer investment in training.

Auxiliary Equipment and Optional Extras

There is a wide array of options available on most brands. Make sure your chosen chair will have the options needed and has the future ability to have additional modifications, should your requirements change. Most manufacturers will include, or have the options of:

1. Electric motors
2. Scalers (piezo, cavitron, EMS etc.)
3. Fibre-optics
4. Soft, luxury, comfort upholstery
5. Water systems, removing the need for water bottles
6. Cleaning system, automated suction, and water line cleaning
7. Camera systems, including chair-side monitors
8. Wireless foot pedal
9. Curing light
10. Implant or endo electric motor functions
11. Amalgam separators, spittoon valves, depending on the suction system installed
12. Additional movements e.g. spittoon bowl rotation, electric headrest, Trendelenburg adjustment

Anglian’s TOP TIP!

Whilst every project differs, in most cases of general dentistry, I recommend considering mid-range dental units such as the Belmont tbCompass or KaVo E50 that include luxury upholstery for patient comfort, and an electric motor, a scaler and an element of automation (for example mains water plumbed) if available. This range of chairs will provide significant time-saving and patient comfort benefits that easily pay back the initial (comparatively small) additional purchase cost when compared to an entry-level package. Too much integration ‘just because it’s possible’ may lead to overly complex units, difficult to repair and reliability issues.

Two tips here:

1. Avoid having amalgam separators installed within chairs! Problematic
2. Rather than install a camera on the chair, have a USB camera projected onto a screen on the wall. This will save costs, be more reliable and give a better patient experience.

In summary, the choice of a dental chair is not straightforward and there is no ‘one size fits all. We are fortunate to have a wide range of types, makes and options available. The choice should not be made without consulting an expert, having the surgery designed professionally and a wide range of factors and opinions being considered.

Below is a matrix comparing the most sold equipment in the UK across some key aspects

Please note, that this only includes a full dental suite (chair, unit, spittoon, lights). This is a guide only.

 

Make / Model	Design comments	Ambidextrous?	Customizable	Cost (approx.)	Ease of repair	Maintenance costs (approx. per annum)	Room Access
Belmont Cleo II / Eurus S6	Knee-break ‘behind patient’ delivery	No	4/5	£20 – £26k	4/5	£600	Front from dentist side entrance. Minimum room dimension 3m (w) x 3.2m (L)
Belmont Voyager III	‘Behind patient’ delivery.	Yes	4/5	£10-£12k	5/5	£450	Front or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L)
Belmont tbCompass / Eurus S8	‘Behind patient’ delivery	Yes	5/5	£19-£25k	4/5	£600	Front or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L)
Belmont Eurus S1	‘Over the patient’ delivery. Whip arm or drop hose available	No	4/5	£20-£26k	4/5	£600	Rear or dentist side. Minimum room dimension 3m (W) x 3.4m (L).
A-dec 300	‘Under patient’ delivery	Yes	4/5	£12 – 16k	4/5	£750	Rear or dentist side. Minimum room dimension 2.8m (W) x 3.2m (L).
A-dec 400	‘Under patient’ delivery	Yes	5/5	£16 – 22k	4/5	£750	Rear or dentist side. Minimum room dimension 2.8m (W) x 3.2m (L).
A-dec 500	‘Under patient’ delivery	Yes	5/5	£25 – 30k	4/5	£850	Rear or dentist side. Minimum room dimension 2.8m (W) x 3.2m (L).
KaVo E30	‘Over patient’ delivery. Drop hose or whip arm available	Yes	4/5	£10 – £15k	4/5	£550	Rear or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L).
KaVo 1058	Knee-break option ‘Over patient’ delivery. Drop hose or whip arm available	Semi	4/5	£14 – £20k	4/5	£650	Rear or dentist side. Minimum room dimension 3m (W) x 3.4m (L).
KaVo E50	‘Over patient’ delivery. Drop hose or whip arm available	No	5/5	£16 – £22k	4/5	£650	Rear or dentist side. Minimum room dimension 3m (W) x 3.4m (L).
KaVo E70/80	Floating chair. ‘Over patient’ delivery. Drop hose or whip arm available	No	5/5	£28 – £35k	3/5	£750	Rear or dentist side. Minimum room dimension 3.5m (W) x 4m (L).
Planmeca compact i3	Semi-knee-break, ‘Over patient’ delivery. Drop hose or whip arm available	Semi	4/5	TBA	3/5	£400	Rear or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L).
Planmeca compact i5	Semi-knee-break, floating chair. ‘Over patient’ delivery. Drop hose or whip arm available	Semi	4/5	TBA	4/5	£400	Rear or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L).
Ancar S1	Semi-knee-break ‘Over patient’ delivery. Drop hose or whip arm available	No	5/5	£15 – 20k	4/5	£500	Rear or dentist side. Minimum room dimension 3m (W) x 3.4m (L).
Ancar 350	Floating chair. ‘Over patient’ delivery. Drop hose or whip arm available	No	5/5	TBA	5/5	£600	Rear or dentist side. Minimum room dimension 3m (W) x 3.4m (L).
Heka Unicline S	Semi-knee-break ‘Over patient’ delivery. Drop hose or whip arm available	Semi	5/5	£20-30k	3/5	£600	Rear or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L).
Ajax	‘Over patient’ delivery. Drop hose or whip arm available	No	2/5	£8k – £14k	3/5	£300	Rear or dentist side. Minimum room dimension 2.6m (W) x 3.2m (L).