Chair position in conservative & endodontics

Why patient positionong is important?

• For the welfare of patient & operator

For patient

A comfortable position

Relaxation of the patient

Reduced muscular tension

Co-operative potential is increased

FOR THE OPERATOR

OPTIMAL OPERATING POSITIONS & GOOD POSTURE

Less physical strain & fatigue

Decreased possibility of developing masculoskeletal disorders

Improper operator position

Unnecessary curvature of spinal column

slumping of the shoulders

Improper breathing & circulation

Basic body position of the operator

• Back & chest held in an upright position

• Shoulders squared

Restorative dentistry’s – what type of dentistry?

Sit-down dentistry(almost all)

• THE STUDY OF MAN IN RELATION TO HIS WORK ENVIRONMENT

Dentist stool/chair

• Be fully adjustable & mobile• Provide a broad,prefarably anatomically

contoured seat which gives support in the lumbar region

• It should be height adjustable for individual workers to distribute the weight b/w the theighs & feet

Design of dental nurse chair

• Differs in that it should be adjustable 10cm in height 7 with bar stool type rim rest for the feet

Operator position

• Normally work within a range of 12 ‘o’clock position to 9’o’clock position relative to the patient’s head(most of them completed at or near 12’o’clock position

Nurse or assistant’s position

• Fixed position-usually 4 ‘o’clock• At a relatively higher position than the patient

& the operator - facilitates different tasks,enables the assistant to visualize the back of the mouth & facilitates removal of the accumulated debris & water

Operator vision

• Any tooth is best visualized by direct vision• The nature of operative dentistry demands the line

of vision must be perpendicular to the tooth surface • The surfaces inaccesible by direct vision must be

visualized indirectly through a mouth mirror – indirect vision

• Magnification of the working area like the use of surgical microscope,surgical loupes,endoscope promotes higher standards of working & reduces the eye strain

Patient’s position

• Home position (how it originated) adoption of the supine patient position by

most dental practitioners has focused attention on optimal position of the patients head in relation to the seated operator

• Home position(by paul who compared dentistry to any other precision activity by a seated operator

• This is the mid-sternal position,with the head tilted forward to see the fingers

• Dentists usually adopts to this position by trail & error / programme it that way to return to that position after every patient

• Observations reveal that for some procedures with the patient in the supine position the operator will adopt to uncomfortable,distorted & fatiguing positions

Why uncomfortable positions?

• because of adoption to direct visual approach-corrected by training & practice.

• visualize the tooth surface via perpendicular approach without proper positioning & rotating of the patient head- corrected by modified home position approach i.e.the chair base considerably lower ,but tilted forward to approximately 40o from the waist to return the patient’s head to home position)

An adjunt to chair positions

• Illumination – angle poise lamp in the past,halogen unit lamps at the present,newly emerged fibre-optic handpieces wnich eliminates the use of mouth mirror to focus the unit sourced-light

What is Ergonomics

• The science of designing the job, equipment, and workplace to fit the worker.

• Proper ergonomic design is necessary to prevent repetitive strain injuries, which can develop over time and can lead to long-term disability.

• Ergonomics derives from two Greek words: ergon, meaning work, and nomoi, meaning natural laws, to create a word that means the science of work and a person’s relationship to that work.

• The International Ergonomics Association has adopted this technical definition: ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance

• ergonomics literally means the science of work. So ergonomists, i.e. the practitioners of ergonomics, study work, how work is done and how to work better.

• Ergonomics helps define how it is used, how it meets you needs, and most importantly if you like it. It makes things comfy and efficient