Lecture 1/2

Neutral clinician position

Forearms + thighs parallel to floor; hips 90°; weight balanced; heels on floor.

⭐ Maxillary arch chin position

Chin UP; metal rod parallel to floor.

⭐ Mandibular arch chin position

Chin DOWN; forehead higher than chin.

⭐ Maxillary light position

Above the CHEST.

⭐ Mandibular light position

Above the HEAD.

Quadrants

Q1 = Max R; Q2 = Max L; Q3 = Mand L; Q4 = Mand R.

Sextants

1 = Max R; 2 = Max middle; 3 = Max L; 4 = Mand L; 5 = Mand middle; 6 = Mand R.

⭐ Why are correct clock positions important?

Maintain neutral posture + optimal vision without compromising posture.

SA

Surface AWAY → tilt client's head TOWARD you.

ST

Surface TOWARD → tilt client's head AWAY from you.

⭐ Posterior ST clock position (RH)

8–9 o'clock.

⭐ Posterior SA clock position (RH)

10–11 o'clock.

Posterior ST clock position (LH)

3–4 o'clock.

Posterior SA clock position (LH)

1–2 o'clock.

⭐ LAB Dexter position

ST = TOWARD counter; SA = AWAY from counter.

8–9 o'clock RH

Dexter TOWARD counter.

10–11 o'clock RH

Dexter AWAY from counter.

12 o'clock

Sit at top of head; Dexter AWAY from counter.

⭐ PROBING anterior teeth

12 o'clock for ALL anterior teeth EXCEPT mandibular anterior facials.

⭐ Mandibular anterior FACIAL probing

RH = 8–9 o'clock; LH = 3–4 o'clock.

⭐ Probing Sextant 2

12 o'clock for facial + lingual.

⭐ Probing Sextant 5

Lingual = 12 o'clock; Facial = 8–9 RH / 3–4 LH.

Dominant hand

Holds the instrument.

Non-dominant hand

Holds the mouth mirror.

⭐ 3 parts of an instrument

Handle → Shank → Working end.

Shank parts

Functional shank (FS) + Terminal shank (TS).

⭐ Modified pen grasp fingers

Thumb + index = hold; middle = guide/feel; ring = fulcrum; pinky = no function.

Thumb + index

Hold instrument; opposite/even level; form a "C"; do NOT collapse/cross.

Middle finger

Guides working end + feels vibrations/calculus; rests on side of shank below side of nail.

⭐ Ring finger

FULCRUM finger; stabilizes/supports hand; must be straight.

Pinky

No function; tuck with ring finger.

⭐ Fulcrum surface

ONLY occlusal/incisal surfaces — NEVER facial/lingual or gingiva.

⭐ CP1 fulcrums

Intraoral ONLY; no extraoral or cross-arch fulcrums.

⭐ Fulcrum distance

About 1–4 teeth anterior/posterior to working tooth; as close as possible.

⭐ Can you fulcrum on the working tooth?

NO, except opposite cusp of maxillary molars #16/#26.

Fulcrum checklist

No finger splitting + digital activation + correct angulation + neutral wrist.

⭐ Maxillary palm position

Palm UP.

⭐ Mandibular palm position

Palm DOWN.

⭐ Mandibular posterior fulcrum

Ring/fulcrum finger is ALWAYS AHEAD of working tooth.

⭐ RH fulcrum general guide

Q1 F/L = ahead/behind; Q2 F = ahead; Q2 L = behind; Q3/Q4 F/L = ahead.

⭐ Mirror hand

ALWAYS non-dominant hand.

Mirror rule

Mirror faces tooth surface and should be held whenever using instruments.

⭐ Posterior retraction

NEVER retract cheeks with fingers while activating → use mirror.

⭐ When can mirror use palm grasp?

ONLY when activating maxillary/mandibular ANTERIOR FACIALS; retract lip with index finger.

⭐ 4 uses of mouth mirror

Retraction + Indirect vision + Transillumination + Indirect illumination.

Retraction

Moves tongue, cheeks, or lips.

Indirect vision

View surfaces that cannot be seen directly.

⭐ Transillumination

Direct light through teeth using mirror; ANTERIOR ONLY because anterior teeth are thin enough for light to pass through.

⭐ Indirect illumination

Reflect light with mirror into dark areas; POSTERIOR ONLY.