Outcome 2 - Dental Clinic Basics

What to do to prep operatory?

1. Treatment room clean, disinfected, and ready for the patient

◦ patient chair positioned to seat the patient

◦ ensure clear path, move obstacles ( overhead light, cords etc.)

2. Patient records, radiographs etc. are ready

3. Sterile instruments and other supplies in place

Types of chair in dental clinic?

1. patient chair

2. dentist chair

3. DA chair

Who can be the operator?

DA, DH, or dentist depending on the procedure

What are the different positions for patient in dental chair? (4)

Upright position – patient chair seated at 90 degrees

• used for consultations, examination, seating/dismissing

Supine position - head and knees are at the same level with the patient’s chin-to-ankle parallel to the floor

• used for procedures involving maxillary arch

Subsupine position (patients head below knees)

• to improve visibility and access during certain procedures

Suprasupine position (patient chin above knees)

• procedures with mandibular arch

Who takes care of patient chair? How?

DA (also maintains other stools)

• Disinfect * or re-barrier after each patient

• Replace in a storage position when not in use

• Notify service technician as wear and tear occurs

Patient arrival and dismissal?

Arrival

• patient records ready along with radiographs

• chair at comfortable length to sit down

  • adjust arm on the side to let them slide in

• chair positioned 15 degree from being perpendicular to floor

Dismissing

• dental light turned off and moved out of way

• upright position for chair

• removing bib using exam gloves

• removing debris from face if any (tissue or gauze)

• DA remove own PPE

• post-op instructions

• personal items returned

• escorted to reception area

Why is ergonomics important? Goal?

Safest, most efficient, and easiest way to work

The goal: stay healthy and at the same time perform work more effectively

• Prevent Musculoskeletal Disorders

What three interrelated factors contribute to increased risk of job-related injury?

1. posture

2. repetition

3. force

What are the different delivery type in treatment room? (3)

• Front delivery: positioned over the patient's lap

• Side delivery: positioned at either side of the patient's chair

• Rear delivery: positioned behind the dental chair

What are the different operating zones? (4)

1. operator’s zone

2. transfer zone

   1. materials/instruments transported to and from oral cavity

3. assistant’s zone

4. static zone

   1. non-traffic area

   2. additional materials, cabinets placed here

What are the zones for right-handed dentists vs left handed?

Right handed

1. operator’s zone: 7-12 o’clock

2. transfer zone: 4-7

3. assistant’s zone: 2-4

4. static zone: 12-2

Left handed

1. operator’s zone: 12-5

2. transfer zone: 5-8

3. assistant’s zone: 8-10

4. static zone: 10-12

What are the classification of motions?

5 categories according to extent of movement

◦ Class I: Movement of fingers only

◦ Class II: Movement of fingers and wrist

◦ Class III: Movement of fingers, wrist, and elbow

◦ Class IV: Use of the entire arm and shoulder

◦ Class V: Use of the entire upper tors

What is needed for dentist chair? (6)

• Mobility (have casters for easy movement).

• Swivel seat.

• A backrest.

• A footrest.

• Be weighted on the bottom so it won’t tip.

• Be adjustable in height.

How to position as an operator on operator chair? (6)

1. Operators thighs parallel to floor

2. Entire surface of seat used to support weight

3. Backrest supports back without interference

4. Forearms parallel to floor when hands are in operative position, elbows close to body

5. Elbows close to the body

6. Back and neck reasonably upright with top of shoulders parallel to floor

balanced posture

What distance is maintained between operator nose and patient oral cavity?

12-14 inches

What is positioning of people/things in order?

1. operator first

2. patient

3. assistant/operator

4. equipment

How to position as an DA on DA chair? (6)

1. Seated well back on the stool

2. Feet are restring on the foot ring

3. Positioned as close as possible to dental chair

4. Legs parallel to the patient chair

5. Back is straight

6. Back is supported by the lumber support (side)

7. Eye level above the dentist/operator (4-6 inches above)

8. Not leaning forward

Why do assistant sit higher than operator? (4)

Must be able to see and have access to be able to:

◦ Retract tissues

◦ Evacuate fluids

◦ Anticipate needs of operator

◦ Maintain clear field

What is the master switch in dental clinic?

Each clinic has one and it turns on the clinic's electricity, water, and suctions.

• turned on at beginning of day and off at the end

• sait in x-ray viewing area

What does the dentist unit have? (3)

• tray arm and bracket table where handpiece lines, a tray for supplies, air-water syringe  are

• counter(s) for additional equipment and or materials and lay-out instrumentation

• rheostat

What are components of dentist tray arm and bracket table? (7)

1. Unit Control Switch: Located at the back of the unit. 

2. Air/Water Syringe with Removable Tip: Syringe housing is located on both the unit is used primarily to dry or irritate the working area.

3. Air Pressure Gauge: This gauge indicates how much pressure per square inch (psi) is driving each of the handpieces.

4. Slow-Speed Handpiece Connectors: Connector lines are present that house handpieces commonly used to polish teeth and refine cavity preparations. (ideal air pressure is 5 – 30 psi).

5. High-Speed Handpiece Connector: Connector line is present that is to house a handpiece that revolves at extremely high speeds, commonly used to cut through tooth structure and bone. (Ideal air pressure is 15 - 45 psi)

6. Rheostat: A rheostat is a foot control that is used to drive air through the handpiece to make the turbines spin. It can be run at various speeds and is placed on the floor beside the operator during treatment.

7. Water Control Switch and Velocity Control Dials to the Handpieces: The water control switch is located on the operator unit. If water is required to be run through a handpiece, the water control switch can be turned on and the amount of water can be controlled by adjusting the velocity control dials which align with the handpiece on/off switches. 

Components of assistant unit at sait? (7)

1. desktop computer

2. high volume suction/evacuator  

3. low volume suction

4. air/water syringe

5. suction trap unit

6. counter(s) for additional equipment and or materials and lay-out instrumentation

7. additional water line for hygiene equipment

What is a central vacuum compressor?

It provides the suction needed for the oral evacuation systems. The central vacuum compressor has two parts:

• a compressor that creates airflow and

• a vacuum tank that screens the flow of air to create suction.

What is central air compressor?

It provides compressed air for the air-water syringe and air-driven handpieces.

• The central air compressor must be subjected to routine maintenance to avoid the buildup of condensation that can result in the formation of algae and sediment in the airlines and waterlines. 

What other equipment can be present in treatment room? (9)

1. Curing light

2. Amalgamator

3. Hygiene Cavitron and its additional water line

4. Laser unit

5. X-ray unit

6. Hand hygiene area

7. Towel dispenser

8. Mirror

9. Garbage