UNIT 2- postural hygiene, ergonomics working positions

what is postural hygiene

set of rules, advice, and postural actives that are static and dynamic aimed at maintaining proper alignment of the entire body to prevent possible injuries

postural hygiene

what can carrying it out correctly achieve/ what does it prevent

prevent bodies going through pathological and disabling situations

what is the aim of workplace exercises and active breaks

breaks the m…

break the monotony and strength the immune system and muscles and nervous system

workplace exercises and active breaks

muscle stretches and eye exercises are common what do they counteract

the effects of static postures and repetitive movements

workplace exercises and active breaks BENEFITS

done

what does workplace exercises and active breaks prevent

prevents and treats muscle injuries

what does workplace exercises and active breaks reduce

• stress and fatigue

• workplace accidents

what does workplace exercises and active breaks improve/ enhance (3)

improves productivity and efficiency

improves posture and neuromuscular awareness

enhances the work environment

what does workplace exercises and active breaks decrease

(the practice of regularly staying away from work or school without good reason)

decreases absenteeism

types of movement during work

class I movements

only fingers move

types of movement during work

class II movements

fingers and wrists move

types of movement during work

class III movements

fingers, wrists and forearms move from the elbow

types of movement during work

class IV (4) movements

whole arm moves from the shoulder

types of movement during work

class V (5) movements

the arm moves with body rotation

types of movement during work

class VI (6) movements

occur when the dentist momentarily leaves their workstation

types of movement during work

what movements are not suitable for simplifying work

class IV ( whole arm moves from the shoulder)

class V (arm moves with body rotation)

types of movement during work

what movement requires interrupting the task and so leading to consequent disadvantages

class VI (6)

types of movement during work

what are the highest ergonomic movements as they do not distract the dentist

• class I

• class II

• class III

finger resting points

done

finger resting points

need to be firm but where should you be cautious

support on periodontal teeth

finger resting points

where should you be positioned when using the contra-angle

as close as possible to the tooth when using the contra angle

finger resting points

where should you be when using high-speed equipment

little further away

finger resting points

where should your fingers rest - which arch

on the working arch to the antagonist arch

finger resting points

tooth support is preferable to what

bone support

finger resting points

bone support is preferable to what

mucosal support

two-handed dentistry

how many people present

1

two-handed dentistry

why would we use two-handed dentistry (5)

• minimise ….

• not being …..

• leaving …. free

• difficulty finding ….

• professional … quiero

• minimise costs

• not being dependent on another

• leaving assistant free for other tasks

• difficulty finding qualified personnel

• professional wants to work alone

two-handed dentistry

• disadvantages (4)

• increased …..

• managing …..

• adjusting …..

• preparing …

1. increased workload

2. managing suction system

3. adjusting lighting focus

4. preparing instruments (contamination)

four-handed dentistry

how many people

2

what is the aim of four-handed dentistry

enable the dental team to perform high quality treatments on a greater number of patients in less time

four-handed dentistry

production can increase by

fatigue can decrease by

tension can decrease by

100%

50%

70%

four-handed dentistry

objectives (7)

1. increased EE

2. reduce P MW

3. maximise …

4. Maximise time

5. Enhance …. training for

6. improve patient

7. enhance relationships

1. increases effectiveness and efficiency

2. reduce physical and mental workload

3. maximise the dentists skills

4. maximise dentist time with the dental chair

5. enhance professional training for auxiliaries

6. improve patient comfort

7. enhances team member relationships

four-handed dentistry

what are the principles? (4)

1. …… control

2. comprehensive utilization of ……

3. S

4. O

• posture control

• comprehensive utilization of auxiliary personnel

• simplification

• organisation

four-handed dentistry - posture control

dentist

why is there a need for this?

dentists used to stand and that caused unnatural spinal posture that caused many problems ( osteoarthrosis, cervical pain, spasms)

four-handed dentistry - posture control

what position should the dentist be in

BHOP - balanced human operating position

four-handed dentistry - posture control - dentist

consists of

1. spinal column what ?

upright spinal column

four-handed dentistry - posture control - dentist

consists of

2. thighs parallel to …?

thighs parallel to the horizontal plane with an angle of 45

four-handed dentistry - posture control - dentist

consists of

3. legs …… to the floor

legs perpendicular to the floor

four-handed dentistry - posture control - dentist

consists of

4. a …… relationship between the different elements

a 90 angle relationship between the different elements

four-handed dentistry - posture control - dentist

consists of

5. feet what

feet fully supported on the ground

four-handed dentistry - posture control - dentist

consists of

6. slightly …. flexion, between …

slightly cervical flexion between 15 and 25

four-handed dentistry - posture control - dentist

consists of

7. where are the elbows

elbows close to the sides

four-handed dentistry - posture control - dentist

consists of

8. where are the hands

at the level of the patient

four-handed dentistry - posture control - dentist

consists of

where is the patient positioned and the distance

centre of the support triangle formed by the dentists two knees and coccyx and 30cm from dentists eyes

four-handed dentistry - posture control - assistant

in regards to the dentist how is the assistant positioned

facing the dentist in a similar position however slightly elevated working plane

four-handed dentistry - posture control - assistant

what is the purpose of the assistance chair having a raised ring

to provide a support triangle

four-handed dentistry - posture control - patient

the patient should be lying on their back whenever possible - what is the technical term for lying on your back called

supine position

four-handed dentistry - posture control - patient

when a patient has cardiopulmonary or degenerative spinal pathologies or in advanced pregnancy what position is recommended

semi-supine

four-handed dentistry - posture control - optimising auxiliary personnel

what is a four-handed assistant

the assistant who works alongside the dentist at the chair

four-handed dentistry - posture control -

what are the functions of the four-handed assistant (2)

• facilitating the dentists vision

• proper handling of instruments

four-handed dentistry - posture control

what are the 3 main ways to facilitate the dentists vision

• aspiration

• eliminating interferences

• illumination

aspiration of debris and fluids using what

surgical aspiration and saliva ejector

eliminating interferences - what are the assistants responsibility

the soft tissue on the assistants side (tongue, cheek, ect)

illumination- who manages the lamp

the assistant

illumination - how is the lamp directed in

1. direct vision

2. indirect vision

1. onto the area being treated

2. towards the mirror

four-handed dentistry - posture control - proper handling of instruments

regarding the handling of instruments we refer to 3 types =

1. grasping

2. delivery

3. transfer

four-handed dentistry - posture control - grasping types

5 types name them

1. pincer/pen grasp

2. modified or inverted pen grasp

3. palmer grasp

4. palm-thumb grasp

5. inverted palm-thumb grasp

four-handed dentistry - posture control - patterns of instrument delivery

what do dentist use to streamline their work

signal codes

four-handed dentistry - posture control - patterns of instrument delivery

code = joining fingers 1 and 2 means what

want a probe

four-handed dentistry - posture control - patterns of instrument delivery

what movement does the dentist make to signal that they want to make an exchange of instruments

slight separation movement

four-handed dentistry - posture control - patterns of instrument delivery

assistant will generally deliver the instruments by what

grasping them

four-handed dentistry - posture control - transfer patterns

what are the 3 transfer patterns

• rotation

• pick and place

• parallel

four-handed dentistry - posture control - transfer patterns r

rotation

the ….. instrument is rotated to use ……….. that is on the other end

the same instrument is rotated to use the active part that is on the other end

four-handed dentistry - posture control - transfer patterns

pick and place

one hand ……….. and the other hand …….

one hand removes one instrument and the other hand delivers the new one

four-handed dentistry - posture control - transfer patterns

parallel

where you remove and deliver …..

where you remove and deliver with the same hand (can be done for both hands simultaneously)

control of the working area

what are the 5 types of working area

• hourly division of the working area

• operators area

• assistant area

• static area

• working area

control of the working area

what does hourly division of the working area mean

where would the patients head be

patients head would coincide with 12 o’clock

control of the working area

what does operators area mean

surface where operator moves

control of the working area

using time markers -

where is the operators area 1. typically

and 2 occasionally

1. between 8 and 1 oclock

2. between 1 and 2 oclock

control of the working area

time marker for operators area for left handed dentists

between 11 and 5

control of the working area

assistant area s where the assistant is positioned

what is the usual ranges

between 2 and 4 oclock

control of the working area

assistant position when the dentist is left handed

between 8 and 10 oclock

control of the working area

where is the static area

between 1 and 2 oclock

control of the working area

what is the working area also known as

transfer area

control of the working area

where is the working or transfer area

between 7 and 4 o’clock, between the patients chin and xiphoid process of the sternum

control of the working area

what’s the use/purpose of the working/transfer area

transferring instruments and materials

DIN 13923 and ISO 4073-2009 standards

these standards define 4 positions for the dentists working elements and 4 for assistants working elements

which colour is for the dentist and which for the assistant

D = pink
A = yellow

DIN 13923 and ISO 4073-2009 standards

tell me the 4 BK positions

1/1 BK 1

2/2 BK 2

3/3 BK 3

4/4 BK 4

DIN 13923 and ISO 4073-2009 standards

these are pure combinations but you can also have other combinations such as ½

true or false

true

BASIC CONCEPT 1 BY SCHON

where is the dentist positioned =

where are the dentists working elements=

between 9 and 10

to the right

BASIC CONCEPT 1 BY SCHON

where is the assistant

where are the assistants working elements

between 1 and 3

to the left

BASIC CONCEPT 1 BY SCHON

ALL OF THIS

1. dentist

2. working elements

3. assistant

4. working elements

5. auxiliary furniture

1. 9 and 10

2. to the right

3. 1 and 3

4. to the left

5. 12 o’clock

BASIC CONCEPT 2

dentist =

9 o’clock

BASIC CONCEPT 2

assistant =

between 1 and 3 o’clock

BASIC CONCEPT 2

ALL

1. dentist

2. assistant

3. all working elements

1. 9

2. 1 and 3

3. 12 o’clock

BASIC CONCEPT 3

dentist

9 o’clock

BASIC CONCEPT 3

assistant

between 1 and 3

BASIC CONCEPT 3

dentist

assistant

working elements of the dentist and assistant are unified in a single element where

1. 9

2. 1 and 3

3. over the patients chest at 5 o’clock

BASIC CONCEPT 4 - both dent and assis work only while seated

Dentist

between 10 and 12

BASIC CONCEPT 4 - both dent and assis work only while seated

assistant

12 and 1

BASIC CONCEPT 4 - both dent and assis work only while seated

instument tray where and what does this mean

9 o’clock

not accessible by the assistant

BASIC CONCEPT 4 - both dent and assis work only while seated

ALL

1. dentist

2. assistant

3. instruments

1. 10 and12

2. 12 and 1

3. 9

six- handed technique

how many people does this involve

3 people

( dent and 2 x assistance)

six- handed technique

the assistant is the helper of the helper and has three main functions

1. prepare the operatory before patent arrival (instrument collection, cleaning, disinfection and sterilization)

2. prepare the instrument tray and arrange instruments in sequential order

3. accompany patient from the waiting room to dental chair and place cannula and bib

six- handed technique

one assistant handles … and one handles what

one handles clean tasks and one handles dirty tasks

dentistry in an standing position

the dentist is forced to work while standing when (4)

• patient cannot lie down

• necessary for patient to remain seated

• treatments are very short

• impossible to maintain correct posture while sitting

dentistry in an standing position

in this case the professional should adopt the following position

done