MDA Chapter 25,28,33,34

Ergonomics

Adaptation of work environment and tasks to the human body

What is the goal or ergonomics

To help people stay healthy and at the same time perform their work more efficiently

Musculoskeletal Disorders

headaches, neck & shoulder pain, back pain, & carpal tunnel account for many disabling and potentially career-ending musculoskeletal disorders among dental professionals

neutral position

position of the body to maintain for a prolonged period, with a natural curvature of the spine

carpal tunnel syndrome (CTS)

condition that causes pain, numbness, and tingling in the hand and arm associated with continued flexion and extension of the wrist

Maximum horizontal reach

Reach created when the upper arm is fully extended

Maximum vertical reach

Reach created by a vertical sweep of the forearm while the elbow is kept at midtorso level.

Normal horizontal reach

Reach created by a sweep of the forearm with the upper arm held at the side

thenar eminence

the fleshy mass at the base of the thumb

Sprains

Injuries caused by sudden twisting or wrenching of a joint with stretching or tearing of ligaments

Strains

Injuries caused by extreme stretching of muscles or ligaments

ambidextrous gloves

gloves designed to be worn on either hand

Cumulative Trauma Disorder (CTD)

Painful conditions that result from ongoing stresses to muscles, tendons, nerves, and joints.

why patients seek dental care

-As a new patient to begin dental care

-As an emergency patient when in pain or experiencing discomfort

-For consultation with a specialist

-As a returning patient for continued assessment and care

Dental Assistant duties

- Assist the patient with forms

- Take and record vital signs

- Chart and record the dentist's findings during the EOE & IOE

- Expose radiographs

- Take preliminary impressions and fabricate diagnostic models

- Take extraoral and intraoral photographs

- Organize the patient record

- Prepare for the case presentation

visual evaluation

Specific examination areas include:

- Face

- Lymph nodes

- Lips

- Soft tissue within the mouth

- Tongue

- Tooth structure

- Restorations

Missing teeth

Palpation

to examine by touch, feeling for:

- Texture

- Size

- Consistency of hard and soft tissue

Mouth Mirror

used for indirect vision, reflection, tissue protection, & retraction

Explorer

Used for tactile feel

- Shepard's hook, pigtail, orban

Periodontal probe

An instrument to measure the pocket depths

Radiography

Identifies:

- Decay

- Defective restorations

- Periodontal conditions

- Pathology

- Developmental conditions

- Abnormalities

Intraoral

Inside the mouth

Extraoral

outside the mouth

Intraoral imaging

Allows the use of a video system:

- To magnify an image for better evaluation

For easier access to difficult areas

- For photocopying images for insurance purposes

- For case simulation or presentation

For medical and legal documentation

Photography

A diagnostic tool used for intraoral and extraoral structures

Anatomic Diagram Charting

Illustrations resemble the actual crown and root of the tooth

Geometric Diagram Charting

A circle represents each tooth and is divided to represent each tooth surface.

Universal Numbering System

Teeth are numbered from 1-16 on the upper arch, and 17-32 on the lower arch. The primary teeth are lettered A-T.

International Standards Organization (ISO)

Assigns a two-digit number to each tooth

Palmer Notation System

Uses a bracket to designate the four quadrants of the mouth

What does charting in a black/blue pen represent

Dental Work that has been completed

What does charting in a red pen represent

Dental work that needs to be completed

class 1 cavity classification

Decay in the pits and fissures of occlusal surfaces of posterior teeth.

Also in the Lingual pits of maxillary incisors

class 2 cavity classification

Decay in the proximal surfaces of posterior teeth (Mesial and Distal)

class 3 cavity classification

Decay in the proximal surfaces of incisors and canines (mesial and distal)

class 4 cavity classification

Decay in the proximal surfaces of incisors and canines that involve the INCISAL EDGE OR ANGLE of the tooth

class 5 cavity classification

Decay in the Gingival third of the facial or lingual surface of any tooth

Class 6 cavity classification

Decay on the incisal edges of the anterior teeth and the cusps tips of posterior teeth

How many tooth surfaces are there?

There are 7:

Mesial

Distal

Occlusal

Lingual

Buccal

Incisal

Facial

Soft tissue examination

examination of the cheeks, mucosa, lips, lingual and facial alveolar bone, palate, tonsil area, tongue, and floor of the mouth

How many probe readings per tooth?

6:

mesiofacial

facial

distofacial

mesiolingual

lingual

distolingual

How many classes of furcation are there?

There are 4 classes

Furcation

Area between two or more root branches

Dental Mobility

How much the tooth can be moved in the socket (Three Classes)

level 1 treatment plan

emergency care, relieves immediate discomfort

level 2 treatment plan

standard care, restores the patient to normal function

level 3 treatment plan

optimum care, restores the patient to maximum function

What is 4-handed dentistry?

The dental assistant works closely with the dentist on the procedure being performed. This helps to decrease fatigue and increase the success of dental procedures

What position should dental patients be lowered into?

Supine Position (Head below feet)

What is the proper working distance in the dental chair?

approximately 12 to 14 inches

How should dental providers sit?

- As far back on the chair

- Thighs parallel to the floor or knees slightly lower than the hips

- Feet flat on the floor

- operator forearms vent at the elbow and parallel to the floor

How should the dental assistant sit?

- 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

Class 1 movement

movement of fingers only

Class 2 movement

movement of fingers and wrist

Class 3 movement

fingers, wrist, and elbow

Class 4 movement

use of entire arm and shoulder

Class 5 movement

use of entire upper torso

Where is the operator's zone for a right-handed clinician on a clock?

7 to 12 o'clock

Where is the transfer zone for a right-handed clinician on a clock?

4 to 7 o'clock

Where is the assistant's zone for a right-handed clinician on a clock?

2 to 4 o'clock

Where is the static zone for a right-handed clinician on a clock?

12 to 2 o'clock

Where is the operator's zone for a left-handed clinician on a clock?

12 to 5 o'clock

Where is the transfer zone for a left-handed clinician on a clock?

5 to 8 o'clock

Where is the assistant's zone for a left-handed clinician on a clock?

8 to 10 o'clock

Where is the static zone for a left-handed clinician on a clock?

10 to 12 o'clock

What is the pen grasp?

The instrument is held in the same manner as a pen

What is the palm grasp?

The instrument is held securely in the palm of the hand

What is palm thumb grasp?

The instrument is held in the palm of the hand and the thumb is used to stabilize and guide the instrument

What is the assistant transfer technique

Single handed

Direct supervision

The dentist must be in the same treatment area as the EFDA for the assistant to perform the function

Indirect supervision

The dentist must be in the dental office area but not necessarily be present in the same treatment room as the EFDA

Dental instrument handle

Portion of the instrument that the operator grasps

Dental instrument shank

Part of the instrument that connects the working end to the handle

Dental instrument working end

Portion of the instrument designed for a specific function

Black's Instrument Formula

A formula describing the angulation and dimensions of the working end of an instrument

What instruments are used in an examination

Mouth Mirror, Explorer, Periodontal Probe, Cotton Forceps/Pliers

What are some hand cutting instruments?

Excavator, Hoe, Chisel, Hatchets, Gingival Margin Trimmers

What are some restorative instruments?

Amalgam Carrier, Condensers, Burnisher, Carvers, Composite Placement Instruments, Woodson

What are some Accessory instruments?

Spatulas, Scissors, Amalgam Well, Howe Pliers, Articulating Paper Holder

What instruments are in a Basic Setup?

Mouth mirror, explorer, cotton pliers, and sometimes perio probe

Cotton Pliers

used to carry, place, and retrieve small objects, such as cotton pellets, gingival retraction cord, matrix bands, and wedges, to and from the mouth.

- Locking and non locking

Small & large spoon excavator

Excavate decay

Dental Hoe

Blade is perpendicular to handle. Prepares tooth & plane the walls and floors of tooth prep with push and pull action

Bin-angle chisel

Forms the walls of the cavity prep PUSH MOTION

Wedelstaedt Chisel

Forms the wall of the cavity prep. PUSH MOTION

Straight angle hatchet

forms the wall of the cavity prep. PUSH AND PULL MOTION

Gingival Margin Trimmer

used to cut enamel and to place bevels along the gingival enamel margins of the preparation

Amalgam Carrier

To carry and dispense amalgam for cavity preparation

small and large condenser

Condenses. Amalgam or composite into the prepared tooth

Football Burnisher

polish/finish

polish hardened surfaces of restoration (occlusal)

Ball Burnisher

Smoothes occlusal surface of restoration

Acorn Burnisher

Carves and burnishes occlusal restorations.

T-ball burnisher

to smooth amalgam after condensing

Beaver tail burnisher

Used to smooth the restoration

Hollenback carver

Used to contour or remove excess material interproximally

disciod/cleoid carver

Contains sharp working end to remove excess material

Amalgam Knife

Used for the removal of excess restorative material along the margin where the material and tooth structure meet.

Plastic Instrument

Used to place and shape composite material. Can be either plastic or metal. (hockey stick looklike)

Articulating Paper Holder

Holds articulating paper

Amalgam Well

holds amalgam