Copyright 2003, Elsevier Science (USA). All rights reserved. Chapter 33 Delivering Dental Care Copyright 2003, Elsevier Science (USA). All rights reserved.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Chapter 33Delivering Dental Care

Chapter 33Delivering Dental Care

Copyright 2003, Elsevier Science (USA).

All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher.

PowerPoint® presentation slides may be displayed and may be reproduced in print form for instructional purposes only, provided a proper copyright notice appears on the last page of each print-out.

Produced in the United States of America

ISBN 0-7216-9770-4


IntroductionIntroductionThe clinical assistant assumes the important responsibility of preparing the treatment areas, assisting in procedures, and providing expanded functions.

The clinical assistant assumes the important responsibility of preparing the treatment areas, assisting in procedures, and providing expanded functions.


Review the 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 for planned

treatment of the day.

Review the 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 for planned

treatment of the day.

Preparing for Your PatientPreparing for Your Patient


The treatment room is clean, disinfected, and ready for the next patient.

The patient’s record, radiographs, and laboratory results are all in place.

The appropriate sterile preset tray and other supplies are in place.

The dental chair is positioned to seat the patient.

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

The treatment room is clean, disinfected, and ready for the next patient.

The patient’s record, radiographs, and laboratory results are all in place.

The appropriate sterile preset tray and other supplies are in place.

The dental chair is positioned to seat the patient.

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

Preparing the Treatment AreaPreparing the Treatment Area


Pleasantly greet the patient in the reception area by name.

Escort the 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.

Pleasantly greet the patient in the reception area by name.

Escort the 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 PatientAdmitting the Patient


Ask the patient to sit on the side of the dental chair and then swing his or her legs onto the base of the chair.

Lower or slide the chair arm into position. Place the disposable patient napkin over the

patient’s chest and clasp the corners using a napkin chain.

Inform the patient before adjusting the chair. Position the operating light over the patient’s

chest, and turn on. Review once again that all treatment room

preparations are complete. Wash hands and put on personal protective

equipment.

Ask the patient to sit on the side of the dental chair and then swing his or her legs onto the base of the chair.

Lower or slide the chair arm into position. Place the disposable patient napkin over the

patient’s chest and clasp the corners using a napkin chain.

Inform the patient before adjusting the chair. Position the operating light over the patient’s

chest, and turn on. Review once again that all treatment room

preparations are complete. Wash hands and put on personal protective

equipment.

Seating the PatientSeating the Patient


Goals of work simplification• Decrease the number of instruments to be used

for a procedure.• Sequence the instruments on a tray by their use.• Minimize the stress and fatigue by using correct

positioning of the patient, dentist and assistant.• Use the appropriate moisture control techniques.• Transfer of instruments and dental materials as

necessary.• Use the least amount of motion during the

transfer of instruments and materials.• Allow the assistant to perform expanded

functions.

Goals of work simplification• Decrease the number of instruments to be used

for a procedure.• Sequence the instruments on a tray by their use.• Minimize the stress and fatigue by using correct

positioning of the patient, dentist and assistant.• Use the appropriate moisture control techniques.• Transfer of instruments and dental materials as

necessary.• Use the least amount of motion during the

transfer of instruments and materials.• Allow the assistant to perform expanded

functions.

Team DentistryTeam Dentistry


Basic concept required for practicing efficient and comfortable team dentistry (Figures 33-5 and 33-6).

Basic concept required for practicing efficient and comfortable team dentistry (Figures 33-5 and 33-6).

Operating ZonesOperating Zones


Fig. 33-5Fig. 33-5


Fig. 33-6Fig. 33-6


Positioning the patient Criteria

• Patient is lowered to supine position.• Patient slides up in chair so head is

even with top of headrest.• Final positioning adjustments will be

made by the operator.

Positioning the patient Criteria

• Patient is lowered to supine position.• Patient slides up in chair so head is

even with top of headrest.• Final positioning adjustments will be

made by the operator.

Principles of Team PositioningPrinciples of Team Positioning


Positioning the operator Criteria

• Seated as far back as possible, with the front edge of the stool just touching the back of the knees.

• 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.• Height of chair allows the operator’s forearms

when bent at the elbow to be parallel to the floor.

Positioning the operator Criteria

• Seated as far back as possible, with the front edge of the stool just touching the back of the knees.

• 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.• Height of chair allows the operator’s forearms

when bent at the elbow to be parallel to the floor.

Principles of Team Positioning cont’dPrinciples of Team Positioning cont’d


Positioning the dental assistant Criteria

• Seated well back on the stool.• Feet rest 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.

Positioning the dental assistant Criteria

• Seated well back on the stool.• Feet rest 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’dPrinciples of Team Positioning cont’d


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

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

Four-Handed DentistryFour-Handed Dentistry


Benefits• Standarized operating sequence.• Reduces the amount of time in the

dental chair for the patient.• Increased productivity.• Less fatigue and stress.

Benefits• Standarized operating sequence.• Reduces the amount of time in the

dental chair for the patient.• Increased productivity.• Less fatigue and stress.

Instrument Transfer and ExchangeInstrument Transfer and Exchange


Operator’s grasp 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 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.

Instrument Transfer and Exchange cont’dInstrument Transfer and Exchange cont’d


Fig. 33-10, A to C Basic grasps.Fig. 33-10, A to C Basic grasps.


Principles of instrument transfer• The assistant must understand the sequence of

the treatment procedure and anticipate when an instrument transfer will be required.

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

• Instruments are transferred in the position of use.

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

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

• The assistant will transfer dental instruments and dental materials with his or her left hand.

Principles of instrument transfer• The assistant must understand the sequence of

the treatment procedure and anticipate when an instrument transfer will be required.

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

• Instruments are transferred in the position of use.

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

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

• The assistant will transfer dental instruments and dental materials with his or her left hand.



Variations in instrument transfer• Mirror and explorer• Cotton pliers• Handpiece• Instruments with hinges

Variations in instrument transfer• Mirror and explorer• Cotton pliers• Handpiece• Instruments with hinges



Expanded function refers to specific intraoral tasks that are completed as a procedure or part of a procedure by the clinical dental assistant that have been delegated by the dentist. • Increased productivity• Less stress on dentist• More patients seen• Increased job satisfaction

Expanded function refers to specific intraoral tasks that are completed as a procedure or part of a procedure by the clinical dental assistant that have been delegated by the dentist. • Increased productivity• Less stress on dentist• More patients seen• Increased job satisfaction

The Expanded-Function Dental AssistantThe Expanded-Function Dental Assistant


Credentialing Dental supervision (direct vs. indirect)

Credentialing Dental supervision (direct vs. indirect)

The Expanded-Function Dental Assistant cont’dThe Expanded-Function Dental Assistant cont’d


Working as the operator Understanding dental anatomy Operator positioning Intraoral mirror skills Using an intraoral fulcrum Understanding cavity preparations Instrumentation Application of dental materials Evaluation of the expanded function

Working as the operator Understanding dental anatomy Operator positioning Intraoral mirror skills Using an intraoral fulcrum Understanding cavity preparations Instrumentation Application of dental materials Evaluation of the expanded function

The Expanded-Function Dental Assistant cont’dThe Expanded-Function Dental Assistant cont’d

Copyright 2003, Elsevier Science (USA). All rights reserved. Chapter 33 Delivering Dental Care Copyright 2003, Elsevier Science (USA). All rights reserved.

Documents

patient slide

dental treatment

treatment area slide

elsevier science usa

planned treatment

treatment room

disposable patient napkin

treatment areas