Week 3 Chairside 1- Clear field of operation

isolation techniques + oral evacuation systems

Oral evacuation

Moisture control is important to keep a clean oral environment

describes the process of removing excess fluids from mouth and is used before, during, and after a dental procedures

Two type of evacuators use in dent:

• HVE - High- volume evacuator

• Saliva ejector

Saliva ejector

Small straw-shaped oral evacuator used during less-invasive dent procedures; remove liquids from the mouth

Uses:

• preventive procedures such as fluoride treatment, prophylaxis, and sealant

• control of saliva + moisture accumulation

Component of saliva ejector

Tubing + on/off control

Saliva ejector may be clear or white + are typically plastic (disposable)

Placement of saliva ejector

Bed and shape for stationary placement

Position under the tongue were most fluids accumulate

Position ejector opposite side on which the dentist is working

HVE- High-volume evacuator

stronger than saliva ejector → remove debris due to high volume of air in moved into vacuum hose

Used for most dent procedures

Uses Include:

• mouth clean of saliva, blood, water, + debris

• retract tongue + cheek away from field of operation

  • Reduce bacterial aerosol due to high-speed handpiece

Grasping HVE

Thumb-to-nose grasp or the pen grasp

Positioning HVE

In a manner that doesn’t obscure the dent visual field

• place before the dent position the handpiece + mirror

• tip close as possible to the tooth being worked on

• Position the bevel of the tip so it’s parallel to tooth surface

Additional consideration

Tip can be used to retract tongue, cheek, or lip while simultaneously suction

don’t block operator’s vision or rest tip against patient’s gingiva

use other hand to hold air-water syringe ( 3 way syringe), mirror, etc

move suction to back of mouth to remove excess water

Care of suction system

While maintenance:

• wear PPE

• clean/flush system once per day

• both high + low volume

• Clean basket + traps (change basket as required)

Central vacuum compressor:

• Check manufactures’ instruction for routine maintenance procedures

Rinsing oral cavity

3 way syringe to increase visibility of the treatment area

Guidelines for 3 way syringe:

• direct tip towards tooth that’s being treated

• Close distance between operative site + syringe tip

• use air on mouth mirror continuously when indirect vision involved

  • When handpiece stop, rinse, + dry the site

Tissue retraction

Refers to restriction of tongue, cheek, and lip to provide better access to area being treated

may be accomplished w/:

• Mouth mirror

• finger

• HVE tip or 3 way syringe tip

• Various tissue retractors

Dent light adjustment

Mandibular arch: vertical

Maxillary arch: diagonal

isolation of teeth

Importance: Tooth being treated free from contaminants of other bioburden and debris

3 common isolation techniques :

Cotton roll isolation

dry-angle isolation

Dental dam placement

Cotton Roll isolation

Positioned close to salivary duct to absorb moisture + excess water

Best way to remove or place cotton roll is w/ cotton pliers

cotton=roll holder which are designed to hold multi cotton for more securely ( can be used in Mand. area)

Dry-angel isolation

Help isolate posterior area in max. and mand, arches

pad placed over stensen’s duct that extends from parotid gland opposite the max. second molar

Pad block flow of saliva + protect the tissue in area

Dental Dam

Thin, stretchable latex material that act as barrier when applied to selected teeth

when dam placed only the selected teeth are visible through the dam

Dam is placed after local anesthesia is administered and before the procedures begins