Delivering Dental Care Chapter 33 Copyright 2009 2006

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Delivering Dental Care Chapter 33 Copyright © 2009, 2006 by Saunders, an imprint of

Delivering Dental Care Chapter 33 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Chapter 33 Lesson 33. 1 Copyright © 2009, 2006 by Saunders, an imprint of

Chapter 33 Lesson 33. 1 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Learning Objectives Define and spell the Key Terms. Discuss the importance of preparing a

Learning Objectives Define and spell the Key Terms. Discuss the importance of preparing a dental treatment room for a procedure. Describe how to prepare the dental treatment area for a patient’s arrival. Demonstrate admitting and seating the patient. (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Learning Objectives (Cont’d) Describe how the operator is positioned during treatment. Describe how the

Learning Objectives (Cont’d) Describe how the operator is positioned during treatment. Describe how the assistant is positioned during treatment. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Introduction The clinical assistant assumes the important responsibility of preparing treatment areas, assisting the

Introduction The clinical assistant assumes the important responsibility of preparing treatment areas, assisting the dentist in procedures, and carrying out expanded functions. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Preparing for Your Patient Review patient record Administrative staff • Check for changes in

Preparing for Your Patient Review patient record Administrative staff • Check for changes in personal information. Ø Clinical staff • Check for health problems that may alter dental Ø treatment. • Look for medical alerts. • Review progress notes for planned for treatments of the day. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Preparing the Treatment Area Treatment room clean, disinfected, and ready for the next patient

Preparing the Treatment Area Treatment room clean, disinfected, and ready for the next patient Patient records, radiographs, and laboratory results in place Sterile preset tray and other supplies in place Dental chair positioned to seat the patient Equipment moved out of the way for the patient and dental team Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Admitting the Patient Pleasantly greet the patient by name in the reception area. Escort

Admitting the Patient Pleasantly greet the patient by name in the reception area. Escort the patient to the treatment area. Place the patient’s personal items in a safe place, out of the way of the procedure. Initiate conversation with the patient. Ask whether the patient has any questions about the treatment for the day that you might be able to answer. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Seating the Patient Seat the patient from the side of the dental chair. Lower

Seating the Patient Seat the patient from the side of the dental chair. Lower or slide the arm into position. Place the patient’s napkin. Inform the patient before adjusting the chair. Position the operating light. Complete treatment-room preparations. Wash hands and don personal protective equipment. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Team Dentistry Components of work simplification Decreased number of instruments. Ø Sequencing of instruments

Team Dentistry Components of work simplification Decreased number of instruments. Ø Sequencing of instruments on the tray by their use Ø Correct positioning of the patient, dentist, and assistant Ø Use of appropriate moisture-control techniques. Ø Transfer of instruments and dental materials as necessary Ø Use of the least possible amount of motion Ø Performance of expanded functions by the assistant Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 33 -1 The concept of four-handed dentistry is shown in the positioning of

Fig. 33 -1 The concept of four-handed dentistry is shown in the positioning of the patient and dental team. (Courtesy of A-dec. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Principles of Team Positioning Patient Lowered to the supine position Ø Head even with

Principles of Team Positioning Patient Lowered to the supine position Ø Head even with the top of the headrest Ø Final adjustments made by the operator Ø (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Principles of Team Positioning (Cont’d) Operator positioning Seated as far back as possible. Thighs

Principles of Team Positioning (Cont’d) Operator positioning Seated as far back as possible. Thighs parallel to the floor or knees slightly lower than the hips Feet flat on the floor Backrest of the chair positioned to support the lower portion or small of the back Operator’s forearms bent at the elbow and parallel to the floor (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 33 -3 Position of the operator when seated correctly. Copyright © 2009, 2006

Fig. 33 -3 Position of the operator when seated correctly. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Principles of Team Positioning (Cont’d) Dental assistant Seated back on the stool Feet on

Principles of Team Positioning (Cont’d) Dental assistant Seated back on the stool Feet on the base or foot ring of the stool Positioned as close as possible to the dental chair Legs parallel to the patient’s chair Eye level 4 to 6 inches above the eye level of the operator Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 33 -4 Position of the dental assistant when seated correctly. Copyright © 2009,

Fig. 33 -4 Position of the dental assistant when seated correctly. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Operating Zones Basic concept required for the efficient, comfortable practice of team dentistry Copyright

Operating Zones Basic concept required for the efficient, comfortable practice of team dentistry Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 33 -5 Operating zones for a right-handed operator. Copyright © 2009, 2006 by

Fig. 33 -5 Operating zones for a right-handed operator. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 33 -6 Operating zones for a left-handed operator. Copyright © 2009, 2006 by

Fig. 33 -6 Operating zones for a left-handed operator. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Four-Handed Dentistry An ergonomically sound way to practice dentistry using the skills of the

Four-Handed Dentistry An ergonomically sound way to practice dentistry using the skills of the dental assistant while including work simplification techniques Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Chapter 33 Lesson 33. 2 Copyright © 2009, 2006 by Saunders, an imprint of

Chapter 33 Lesson 33. 2 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Learning Objectives Explain instrument transfer. Demonstrate instrument transfer using a selection of instruments. Specify

Learning Objectives Explain instrument transfer. Demonstrate instrument transfer using a selection of instruments. Specify three grasps used by the operator. Demonstrate the correct grasp and use of hand instruments. Transfer instruments using the single-handed technique. (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Learning Objectives (Cont’d) Transfer instruments using the two-handed technique. Identify five areas in which

Learning Objectives (Cont’d) Transfer instruments using the two-handed technique. Identify five areas in which the assistant must have competency when practicing expanded functions. Demonstrate the proper use of a dental mirror. Demonstrate the intraoral use of a dental instrument. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Instrument Transfer and Exchange Benefits Standardized operating sequence Ø Reduced amount of time in

Instrument Transfer and Exchange Benefits Standardized operating sequence Ø Reduced amount of time in the dental chair for the patient Ø Increases productivity Ø Less fatigue and stress Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Operator’s Grasp Three basic grasps Pen grasp: The instrument is held in the same

Operator’s Grasp Three basic grasps Pen grasp: The instrument is held in the same manner as a pen. Ø Palm grasp: The instrument is held securely in the palm of the hand. Ø Palm-thumb grasp: The instrument is held in the palm of the hand the thumb is used to stabilize and guide the instrument. Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 33 -7 Basic instrument grasps. A, Pen grasp. B, Palm grasp. C, Palm-thumb

Fig. 33 -7 Basic instrument grasps. A, Pen grasp. B, Palm grasp. C, Palm-thumb grasp. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Principles of Instrument Transfer Understand the sequence of procedures and anticipate when an instrument

Principles of Instrument Transfer Understand the sequence of procedures and anticipate when an instrument transfer is required. Transfer dental instruments and dental materials with the left hand. Transfer of instruments should be accomplished with a minimum of motion, involving only the fingers, wrist, and elbow. Instruments are transferred in their position of use. An instrument is transferred so that the dentist can grasp the instrument for its appropriate use. An instrument being transferred must be positioned in firmly in the dentist's hand. (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Principles of Instrument Transfer (Cont’d) Variations in instrument transfer Mirror and explorer Ø Cotton

Principles of Instrument Transfer (Cont’d) Variations in instrument transfer Mirror and explorer Ø Cotton pliers Ø Handpiece Ø Instruments with hinges Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

The Expanded-Function Dental Assistant “Expanded function” refers to specific intraoral procedures or part of

The Expanded-Function Dental Assistant “Expanded function” refers to specific intraoral procedures or part of a procedure by the clinical dental assistant that have been delegated by the dentist. Advantages Increased productivity Ø Less stress on the dentist Ø More patients seen Ø Increased job satisfaction Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Working as the Operator Understand dental anatomy. Follow guidelines for operator positioning. Develop intraoral

Working as the Operator Understand dental anatomy. Follow guidelines for operator positioning. Develop intraoral mirror skills. Use an intraoral fulcrum. Understand cavity preparations. Adapt instrumentation. Apply dental materials. Evaluate the expanded function. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.