© 2009 Delmar, Cengage Learning
Chapter 18
Dental Assistant Skills
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Career Highlights
• Dental assistants are valuable members of the dental health care field
• Education requirements
• Certification obtained through the Dental Assisting National Board
• Duties performed follow state regulations
• Required skills
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18:1 Identifying the Structures and Tissues of a Tooth
• Odontology: study of the anatomy, growth, and diseases of the teeth
• Teeth are accessory organs of thedigestive tract
• Aid in mastication (chewing) of food
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Two Sets of Teeth
• Dentitions: sets of teeth
• Primary or deciduous dentition
• Permanent or succedaneous dentition
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The Tooth
• Crown—visible in the mouth
• Root—below the gum line
• Cervix—where the crown meets the root
• Apex—tip of the root
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Tissues of the Tooth
• Enamel—covers the crown
• Cementum—covers the outside of the root
• Dentin—located under the enamel and cementum of the root
• Pulp—in the inner area of the tooth
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Periodontium
• Structures that surround and support teeth
• Alveolar process or ridge—surrounds the roots and has sockets
• Periodontal ligament—supports the tooth in the socket
• Gingiva or gums—surrounds the cervix
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Dental Care
• Disease can affect the teeth and supporting structures
• Dental care – Preventing and treating dental disease
– Preserving and prolonging the life of the teeth
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18:2 Identifying the Teeth
• Incisors—front and center of the mouth
• Cuspids—at angles of lips
• Bicuspids—before the molars
• Molars—back of the mouth
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Primary or Deciduous Teeth
• First set of teeth—called “baby” teeth
• 20 teeth
• Naming of teeth
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Permanent or Succedaneous Teeth
• Second or permanent set of teeth
• 32 teeth
• Naming of teeth
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18:3 Identifying TeethUsing Numbering Systems
• Universal National Numbering System– Identified by using letters A to T
• Federation Dentaire International System– Two-digit code and 4 quadrants
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18:4 Identifying the Surfaces of the Teeth
• Anterior (toward the front) teeth
• Posterior (toward the back) teeth
• Crown surfaces
• Suggested abbreviations
(continues)
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Identifying the Surfaces of the Teeth(continued)
• Line angles—form where two crown surfaces meet
• Point angles—form where three crown surfaces meet
• Abbreviations for line angles and point angles of anterior teeth
• Abbreviations for line angles and point angles of posterior teeth
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18:5 Charting Conditions of the Teeth
• Conditions of the teeth are often charted on dental charts or insurance forms
• Forms, symbols used, abbreviations, and other factors vary
• Dental charts are legal records
• Dental charts
• Anatomic diagrams
(continues)
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Charting Conditions of the Teeth(continued)
• Geometric diagrams
• Surfaces of teeth
• Charting guidelines
• Common symbols for anatomic or geometric diagrams
• Recording treatments or services
• Use of computerized dental charting
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18:6 Operating and MaintainingDental Equipment
• Follow manufacturer’s recommendations for operation of equipment
• Infection control
• Personal protective equipment (PPE)
• Occupational Safety and Health Administration (OSHA)
• Covers for dental equipment(continues)
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Operating and MaintainingDental Equipment
(continued)
• Dental light
• Dental chair
• Air compressor
• Oral-evacuation system
• Assistant’s cart
• Tri-flow or air-water syringe
• Saliva ejector (continues)
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Operating and MaintainingDental Equipment
(continued)
• High-velocity oral evacuator
• Cuspidor
• Doctor’s cart
• Low-speed hand piece– Contra angle for cutting and polishing
– Prophylaxis angle for holding cups, etc.
• High-speed handpiece (ultraspeed)
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Summary
• Responsibilities for care and maintenance of dental equipment will vary
• Dental assistant should learn exactly what maintenance is expected as a part of the job
• Read specific manufacturer’s instructions for equipment you will handle
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18:7 Identifying Dental Instruments and Preparing Dental Trays
• Methods for setting up dental trays
• Organization of trays
• Main parts of a dental hand instrument
• Standard instruments
• Guidelines for preparing dental trays
• Examples of tray set-ups
• Basic principles for preparing dental trays
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18:8 Positioning a Patientin the Dental Chair
• Designed to position patient comfortably while providing doctor and assistant easy access to oral cavity
• Headrests• Supine position• Explanation of all chair movements• Protective drape and safety glasses• Positioning of light• Principles of seating patient in dental chair
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18:9 Demonstrating Brushing and Flossing Techniques
• Using correct brushing and flossing techniques is essential in prevention of dental disease
• May be responsible for teaching patients
• Correct brushing and flossing is one method of prophylactic care
(continues)
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Demonstrating Brushing andFlossing Techniques
(continued)
• Purposes
• Demonstrations
• Bass method
• Five surfaces on each tooth
• Toothbrushes
• Toothpastes or dentifrices
• Dental floss
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Summary
• Correct brushing and flossing provides prophylactic care
• Give thorough explanation to all patients
• Be sure patient understands procedures
• Asking patient to demonstrate procedures is a good way to determine if all points have been learned
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18:10 Taking Impressionsand Pouring Molds
• Impression– Negative film reproduction of a tooth, several teeth,
or a dental arch
– Taken to form a model of the area for restoration treatment that will take place outside of the mouth
– Common materials used to take impressions
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Alginate
• Hydrocolloid impression material that cannot be returned to its original state
• Advantages• Disadvantages• Alginate powder—follow manufacturer’s
recommended directions• Principles for taking alginate impression• Storage of alginate material
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Rubber Base or Polysulfide
• Elastomeric impression material that is elastic and rubbery in nature
• Three types are available
• Can be used in any type of dental impression
• Not as subject to dimension changes as alginate
(continues)
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Rubber Base or Polysulfide(continued)
• Models should be poured promptly if possible
• Disadvantages
• Basic principles of preparing rubber base
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Silicones
• Polysiloxane or polyvinylsiloxane
• Available in different material qualities
• Supplied in two tubes—base and catalyst
• Advantages
• Disadvantages
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Gypsum Products
• Two main products to form models– Plaster
– Stone
• Principles for the use of gypsum
• Follow standard precautions for infection control when taking impressions and pouring models
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18:11 Making Custom Trays
• Impression trays that are made to fit patient’s mouth
• Materials used to produce trays
• Acrylic resins are self-curing or light-curing
• Types of custom trays
• Clean and replace all equipment
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18:12 Maintaining and Loading an Anesthetic Aspirating Syringe
• Anesthesia is used for pain control
• Types of anesthesia– General anesthesia
– Analgesia
– Local anesthesia
– Topical anesthesia
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Injections
• Two main kinds of injections for used for local anesthesia– Block
– Infiltration
• Types of medications
• Anesthetic carpules (cartridges)
• Aspirating syringes
• Follow standard precautions
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18:13 Mixing Dental Cements and Bases
• Cements and bases used in variety of dental procedures
• Terminology
• Types of products
• Basic principles of mixing cements and bases
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18:14 Preparing Restorative Materials
• Restoration: process of replacing a diseased portion of a tooth or a lost tooth by artificial means
• May include filling material, crowns, bridge, denture, partial denture, or implant
• Dental caries or decay
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Amalgam
• Restorative material used mostly on posterior teeth
• Contains four main metals– Silver
– Tin
– Copper
– Zinc
(continues)
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Amalgam(continued)
• Mercury when added to other metals forms amalgam
• Must be handled with care due to toxicity
• Use protective clothing
• Follow manufacturer’s recommendations
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Composite
• Restorative material used primarily for the repair of anterior teeth– Self-curing (chemical-curing)
– Light-curing
• Various shades to blend with teeth
• Follow manufacturer’s instructions
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18:15 Developing and MountingDental X-Rays
• Dental X-rays or radiographs– Radiolucents
– Radiopaque
• Types of dental radiographs
• Developing films
• Mounting X-rays
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Summary
• The dental assistant acquires many skills
• Use of these skills enables the dental assistant to perform or assist with many procedures in the dental care setting
• Following procedures the assistant is often responsible for cleaning and care of equipment used