Module 2 - Clinician's position in relation to treatment area

Goal of clinician positioning

Seated clinician can move around the patient to maintain neutral body posture

1. Neutral possture for clinician’s head, arms, wrists, and hands

2. Visibility of tooth surfaces

Clock positions

Help identify clinician’s position in relation to the patient

Patient’s head

• 12 o’clock

Feet

• 6 o’clock

Left handed — 11 to 4 o’clock

Right handed — 8 to 1 o’clock

6 increments

3 to 4 o’clock position (Front of the patient)

Torso position

• Sit infront of patient with hips at patient’s upper arm

Leg position

• Thighs rest against side of patient chair

Arm positions

• Hold arms slightly away from sides. Lower arm over patient’s chest. Right hand rest on patient’s right cheekbone and upper lip (DO NOT rest right hand on patient’s head or chest)

Line of vision

• Straight ahead into patient’s mouth

Limit 4 o clock position (difficult to maintain neutral position)

3 o’ clock position (Side of patient)

Torso position

• Sit facing the side of patient’s head

• Midline of torso — patient’s mouth

Leg position

1. Straddling patient chair (best)

2. Underneath headrest of patient’s chair

Arm positions

• Lower left arm align with patient’s shoulder

• Right hand and wrist over patient’s left eye

Line of vision

• Straight ahead into patient’s mouth

1 to 2 o’clock position (Near corner of headrest)

Torso position

• Top left corner of headrest

• Midline of torso — left temple region of patient’s head

Leg position

• Straddle corner of headrest

Arm positions

• Left hand directly across corner of patient’s mouth

• Right hand and wrist above patient’s nose and forehead

Line of vision

• Straight ahead into patient’s mouth

12 o’ clock position (directly behind patient)

Torso position

• Behind patient’s head

Leg position

• Straddle headrest

Arm positions

• Wrist and hands above patient’s ears and cheeks

Line of vision

• Straight ahead into patient’s mouth

10 to 11 o’clock position (near corner of headrest)

Torso position

• Top right of headrest

• Midline of torso — right temple region of patient’s head

Leg position

• Straddle corner of headrest

Arm positions

• Right hand across corner of patient’s mouth

• Left hand and wrist above patient’s nose and forehead

Line of vision

• Straight ahead into patient’s mouth

Sequence for patient / clinician position

1. ME

• Assume clock position for the treatment areas

2. MY PATIENT

• Establish patient chair and head position

3. MY EQUIPMENT

• Adjust light. Pause and self check clinician, patient, and equipment position.

4. MY NON—DOMINANT HAND

• Place fingertips of nondominant hand according to clock positions

5. MY DOMINANT HAND

• Place fingertips of dominant hand according to clock positions

Anterior surfaces towards clinician

• Tooth in yellow are anterior surfaces (Towards the clinician)

• Clinician sit: Clock position for anterior surfaces is 3 to 4 o’clock

Anterior surfaces away from clinician

• Tooth in purple are anterior surfaces (Away from clinician)

• Clinician sit: Clock position for anterior surfaces is 11 to 1 o’clock

Mandibular anterior surface (TOWARDS)

• Clinician sits 3 to 4 o’clock position

• Patient chin DOWN

• Mandibular occlusal parallel to floor

• Patient head: Neutral, left, or right

Maxillary anterior surface (TOWARDS)

• Clinician sits 3 to 4 o’clock position

• Patient chin UP

• Maxillary occlusal plane perpendicular to floor

• Patient head: Neutral, left, or right

Mandibular anterior surfaces (AWAY)

• Clinician sits 11 to 1 o’clock position

• Patient chin DOWN

• Mandibular occlusal parallel to floor

• Patient head: Neutral, left, or right

Maxillary anterior surfaces (AWAY)

• Clinician sits 11 to 1 o’clock position

• Patient chin UP

• Maxillary occlusal perpendicular to floor

• Patient head: Neutral, left, or right

Posterior teeth facing towards clinician

• Posterior aspects facing towards clinician in yellow

• Clock position: 3 o’clock

Posterior teeth facing away from clinician

• Posterior aspects facing away from clinician in blue

• Clock position: 2 o’clock

Mandibular posterior aspects facing TOWARDS

• Clinician in 3 o’clock position

• Chin down

• Mandibular occlusal parallel to floor

• Patient’s head: neutral or slightly away from clinician

Maxillary posterior aspect facing TOWARD

• Clinician in 3 o’clock position

• Chin UP

• Maxillary occlusal perpendicular to floor

• Patient head: Neutral or slightly away from clinician

Mandibular posterior aspect facing AWAY

• Clinician in 1 to 2 o’clock position

• Chin DOWN

• Mandibular occlusal parallel to floor

• Patient head: Towards clinician

Maxillary posterior aspect facing AWAY

• Clinician seated 1 to 2 o’ clock position

• Chin UP

• Maxillary occlusal perpendicular to floor

• Patient head: Towards clinician

Clock position summary for treatment area

Treatment area, clock positions, and patient head positions

Modified position: standing position

• Used when patient can’t be in supine position due to medical or physical contraindications

• Used for mandibular areas

• First pic (correct) Second pic (incorrect)