Most aspects of providing clinical care to patients using portable equipment vs mobile vehicles are very similar. Review the Program operations sections of Chapter 2. In many ways, however, portable systems require much more careful planning and organization since everything has to be transported from another location. Leaving one container of instruments or dental materials at home can be disastrous for an appointment that is 30 miles away. There are not as many back-up options for supplies and equipment as there are in a mobile van or mobile-portable hybrid system unless there are multiple teams working at the same site.
Inclement weather can also be a problem for transporting equipment from the vehicle into a facility or home. Working environments in private homes or in other facilities may be extremely variable, requiring adaptations in equipment/supply layout, efficiency, and maintenance of a sterile environment. Narrow or steep stairs can also present challenges, as can extremely low lighting, warm or cold conditions, crowding or clutter, pets, or unsafe living conditions.
If not utilizing digital technologies, the portable practice may have less capacity to develop radiographs onsite compared to larger scale mobile/hybrid practices. Self-developing x-rays, such as shown in the photo, or use of portable darkrooms with rapid developing solution are available options.
Dental lab work such as pouring dental impressions is typically minimized in portable dental practices; developing close working relationships with a dental laboratory becomes imperative.
Dental charting/documentation issues are likely to be similar to mobile programs. A system should be created that appropriately documents the oral health status of patients but is not too cumbersome for the dental provider or the facility/program. When working in a setting such as a long-term care facility where there is an existing medical chart, it is important to collaboratively decide: 1) the placement of dental records in the medical records, 2) how to write prescriptions or execute telephone orders, and 3) how to update patient care plans with revised dental treatment plans. Forms should be utilized to note permission for routine and/or emergency dental care, labeling of dentures, and permission to access dental records from previous dentists. It is also important to document communications between the dental provider, patient, family members, and guardian.