Chapters
32, 33, 34, & 35
Clinical Dentistry

• This study power point is to be used as an aid, to help you understand what to study
• To be successful, you must take accountability for your own destiny.
– Which means that I give you this as a guide, not a complete “answer key” for the test!
• Success should always be a goal.

• Office Environment
– Temperature
– Lighting
– Wall and Floor Coverings
– Traffic Control
– Sound Control
– Privacy

Specific Areas of the Dental Office
• Reception area
• Administrative/business area
• Clinical treatment areas
• Sterilization center
• Dental Lab
• Dentist’s private office
• Dental staff lounge

• Patients are received
• Greeted pleasantly and welcomed
• Cleaned everyday
• Adequate seating
• Current journals
• Play area

• Hub of the office
• Management and business

• Also known as the Dental Operatory
• Usually two or more units
• Comfort and mobility for team

• Patient Dental Chair
– Designed for comfort
– Patient seated with chair in lowest and upright and arm rest raised

• Operator– large seat and back
– Adjustable
• Assistant’s stool—provide stability, mobility and comfort
– 4-6 inches higher than operator

• Basic function– provide necessary electrical and air-operated mechanics
• Delivery systems
– Can be mounted on the floor, wall or side
• Rheostat
– Operates hand pieces
• Waterlines
– Supplies water

• Air-Water syringe-needed for every procedure
– Delivers a stream of water
– Delivers a stream of air
– Delivers a combined spray of air and water

• Illuminates the oral cavity during procedures
• After patient is seated in supine position, light is positioned over patients chest approximately 25 to 30 inches below patients chin

• Saliva ejector
• High-volume evacuator (HVE)
– Both used to remove water/debris from patients mouth

• Understand the following
– Central Vacuum Compressor
– Central Air Compressor

• Used for maintaining dental instruments
– Two areas
• Contaminated area
• Clean area

• Dental Lab
• Private Office
• Staff lounge
• Morning and evening routines for assistants

Chapter 33
Delivering Dental Care
• Understand how to prepare the treatment area
• Knowing your patient
• Reviewing their chart
• Treatment room checklist

• Understand the proper steps for the procedure (found in your book)

• Theory—four-handed dentistry
– Operator and assistant work together to perform clinical procedures in an ergonomically structured environment.
– Main goal—to deliver the best and most effective care to your patient by increasing productivity

• Utilize ergonomically correct dental equipment
• Utilize preset trays
• Minimize stress and fatigue
• Follow the principles of motion economy during transfer of instruments and materials
• Use appropriate moisture-control techniques
• Delegate expanded functions

• Patient
– Lowered to supine position
– Operator will make final adjustments
• Operator
– Access and vision are most essential
– Needs comfort and support
– Seated as far back as possible, front edge of stool just touching the backs of knees
– Thighs parallel to floor
– Feet kept flat on floor
– Backrest of chair positioned to support
– Height to maintained to allow forearms parallel to the floor

• Dental Assistant
– Anticipate what is needed next
– Seated well back on stool
– Feet resting on foot ring
– Positioned as close as possible to dental chair
– Legs parallel to patients chair
– Eye level four to six inches above the operator

• Class I—
– Movement of fingers only
• Class II
– Movement of fingers and wrist
• Class III
– Movement of finger, wrist and elbow
• Class IV-
– Use of entire arm and shoulder
• Class V-
– Use of entire upper torso

• Understand examples of each Class
• Used to reduce fatigue

• Using the Clock concept understand the
(time) zones.
– Example transfer zone is 4 – 7 for righthanded operator
• Always assume that you are working with a right-handed operator unless otherwise stated.

• Four-handed dentistry is the concept that a qualified chair side assistant is seated across from the dentist and they work as a team

Objectives for Efficient Instrument
Transfer
• In your book there is a list of the objectives, please be very familiar with these objectives

• Pen grasp
• Palm grasp
• Palm-thumb grasp
– You should be able to identify the grasp that should be used with any given instrument
– Understand the concept of the different grasp

• You will need to know the method of fourhanded instrument transfer
– Including each type of instrument as well as grasp

Expanded Functions Dental
Assistants
• Understand the laws applying to EFDA’s
• Credentialing
• Dental Supervision

• Dental Hand Instruments

• Instrument
– Number
– Design
• Handle, shank, working end
– Black’s Formula
– Id the 1 st , 2 nd and 3 rd number

Classification of Hand Instruments
• Examination instruments
– examples
• Hand cutting instruments
– examples
• Restorative Instruments
– examples
• Accessory instruments
– examples

• How is the tray set up??

• Mouth Mirror
• Explorer
• Cotton Pliers

• You are responsible for knowing the names and uses of each instrument that we have covered in class

• Dental Hand pieces and Accessories

• What types of hand pieces are there?
• What is the difference in the hand pieces?
• What type of burs are used in each?
• What type of attachments are there, and which hand pieces do the fit in?

• Name the different types of burs.
• What burs are used in what areas/procedures
• How do you know??

• Maintenance
– Know and understand the general considerations for Hand piece sterilization

• Parts of a Bur
– Shank
– Neck
– Head
• Straight shank--???
• Latch type shank--???
• Finishing burs, diamond rotary , abrasive rotary, laboratory rotary

• Carbide steel burs
– Used in the operatory, in patients mouth
• Lab burs
– Used in Lab to smooth or shape, models, dentures, appliances, crowns, etc.

• Straight attachment???
• Contra angle--???
• Prophy angle--???