copyright © 2005 by elsevier inc. all rights reserved. delivering dental care chapter 33

Copyright © 2005 by Elsevier Inc. All rights reserved.

Delivering Dental Care

Chapter 33


Introduction

The clinical assistant assumes the important responsibility of preparing

the treatment areas, assisting the dentist in procedures, and completing

expanded functions.


Preparing for Your Patient

• Review Patient Record

– Administrative Staff

• Review any changes in personal information.

– Clinical Staff

• Review for any health problems that may alter dental treatment.

• Medical Alerts.

• Review progress notes planned for treatment of the day.


• Treatment room clean, disinfected, and ready for the next patient.

• Patient records, radiographs, and laboratory results in place.

• Sterile preset tray and other supplies in place.

• Dental chair positioned to seat the patient.

• Equipment moved out of the way for the patient and dental team.

Preparing the Treatment Area


• Pleasantly greet patient in the reception area by name.

• Escort patient to the treatment area.

• Place the patient’s personal items in a safe place out of the way of the procedure.

• Initiate conversation with the patient.

• Ask if there are any questions that you can answer about treatment for the day.

Admitting the Patient


• Seat patient from side of the dental chair.

• Lower or slide the chair arm into position.

• Place patient napkin.

• Inform the patient before adjusting the chair.

• Position operating light.

• Complete treatment room preparations.

• Wash hands and place on personal protective equipment.

Seating the Patient


• Goals of Work Simplification

– Decrease number of instruments.

– Sequence instruments on a tray by their use.

– Follow correct positioning of the patient, dentist, and assistant.

– Use appropriate moisture control techniques.

– Transfer instruments and dental materials as necessary.

– Use the least amount of motion.

– Allow assistant to perform expanded functions.

Team Dentistry


Fig. 33-1 Concept of 4-handed dentistry (Courtesy A-dec.)


Positioning the Patient

• Criteria

– Patient is lowered to supine position.

– Patient slides up in chair so head is even with top of headrest.

– Final adjustments made by the operator.

Principles of Team Positioning


Positioning the Operator

• Criteria

– Seated as far back as possible.

– Thighs parallel to the floor, or knees slightly lower than the hips.

– Feet kept flat on the floor.

– Backrest of the chair positioned to support the lower portion or small of the back.

– Operator’s forearms bent at the elbow and parallel to the floor.

Principles of Team Positioning-cont’d


Fig. 33-3 Position of the operator


Positioning the Dental Assistant

• Criteria

– Seated back on the stool.

– Feet on the base or foot ring of the stool.

– Positioned as close as possible to the dental chair.

– Legs parallel to the patient’s chair.

– Eye level 4 to 6 inches above the eye level of the operator.

Principles of Team Positioning-cont’d


Fig. 33-4 Position of the Dental Assistant


Basic concept required for practicing efficient and comfortable

team dentistry

Operating Zones


Fig. 33-5 Operating zones for a right-handed operator


Fig. 33-6 Operating zones for a left-handed operator


An ergonomically sound way to practice dentistry using the skills of the dental assistant, while including

work simplification techniques.

Four-Handed Dentistry


• Benefits

– Standardized operating sequence

– Reduces the amount of time in the dental chair for the patient

– Increases productivity

– Less fatigue and stress

Instrument Transfer and Exchange


• Three Basic Grasps

– Pen Grasp: The instrument is held in the same manner as a pen.

– Palm Grasp: The instrument is held securely in the palm of the hand.

– Palm-thumb Grasp: The instrument is held in the palm of the hand, and the thumb is used to stabilize and guide the instrument.

Operator’s Grasp


Fig. 33-7 Basic Instrument Grasps


• Understand the sequence of procedure and anticipate when an instrument transfer is required.

• Transfer dental instruments and dental materials with left hand.

• Transfer of instruments should be accomplished with a minimum of motion involving only the fingers, wrist, and elbow.

• Instruments transferred in position of use.

• Instrument is transferred so dentist can grasp the instrument for its appropriate use.

• Instrument being transferred must be positioned in the dentist's hand firmly.

Principles of Instrument Transfer


• Variations in Instrument Transfer

– Mirror and explorer

– Cotton pliers

– Handpiece

– Instruments with hinges

Instrument Transfer and Exchange-cont’d


• Expanded Function refers to specific intraoral procedures or part of a procedure by the clinical dental assistant that have been delegated by the dentist.

• Advantages

– Increases productivity

– Lessens stress on dentist

– More patients are seen

– Increases job satisfaction

The Expanded-Function Dental Assistant


• Understand dental anatomy

• Follow guidelines for operator positioning

• Develop intraoral mirror skills

• Use an intraoral fulcrum

• Understand cavity preparations

• Adapt instrumentation

• Application of dental materials

• Evaluation of the expanded function

Working as the Operator

copyright © 2005 by elsevier inc. all rights reserved. delivering dental care chapter 33

Documents

dental chair

dental treatment

dental team

patient records

escort patient

patientseat patient

place patient napkin

dental assistantcriteriaseated