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University of Palestine

University of Palestine. College of Dentistry. F OUR HANDED DENTISTRY&INFECTION CONTROL. DR. MUSTAFA I. ELGHOUL B.SC,B.D.S,MS(ORTHO) Master of Orthodontic. This system of four-handed dentistry is based on the following principles :

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University of Palestine

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  1. University of Palestine College of Dentistry FOUR HANDED DENTISTRY&INFECTION CONTROL DR. MUSTAFA I. ELGHOUL B.SC,B.D.S,MS(ORTHO) Master of Orthodontic

  2. This system of four-handed dentistry is based on the following principles: 1-RATIONLISATION AND STANDARDISATION Standardization technique and rationalize supply of instruments so that this practice grater efficiency will be achieved. 2. POSITIONS: The dentist (or hygienist), assistant and patient are seated and positioned properly

  3. principles 3. ASSISTANT UTILIZATION: The operator uses the skills of competent, full-time chair side assistant . 4- TREATMENT ORGANIZATIONS: Every aspect of the patient's treatment is organized and repetitive tasks simplified to take maximum advantage of the chair side time available.

  4. principles 5- EQUIPMENT ARRANGEMENT: The equipment used is selected carefully and positioned properly to enable the operating team to use the principles of work simplification and motion economy

  5. PRICIPLES OF FOUR HANDED 1-RATIOLISATION AND STANDARDISATION Standardization technique and rationalize supply of instruments so that by this practice grater efficiency will be achieved

  6. 2- Position It is not enough that the operator and the assistant merely sit during patient treatment. They should adhere as strictly as possible to the principles of balanced posture. The operator should sit with their thighs parallel to the floor, feet flat on the floor, neck and back relatively straight with forearms parallel to the floor.

  7. This results in an operating distance of roughly fourteen inches. Additionally, the lower visual eye fields should be used in an effort to offset the strain usually felt in the neck when the head is continually tilted forward

  8. Position The assistant will likewise sit with balanced posture. The only difference is that their feet are rested on the ring of the assistant stool, since their position is usually four to six inches higher than the operator.

  9. Patients are positioned with their head at the uppermost area of the chair and in the supine position for most procedures.

  10. This position is defined as one in which the patient's head and knees are at the same level on a plane parallel to the floor..

  11. One should not tilt the chair excessively toward the Trendelenberg position for routine procedures. Rather, the operator should take maximum advantage of the mobility of the patient's head to tilt and turn the patient's head to afford better visibility and access

  12. ZONES AND POSITIONS The position of the patient is determined by the procedure to be performed. Most dental treatment is provided with the patient in the supine position. Once the patient has been seated, the dentist and the assistant should place themselves in the proper positions for treatment.

  13. These positions are best understood by relating them to a clock. In the clock concept, an imaginary circle is placed over the dental chair, with the patient’s head at the center of the circle. The circle is numbered like a clock with the top of the circle at 12 o'clock..

  14. The clock, is divided into four zones of operation: Static zone Assistant's zone Transfer zone Operator's zone The use of these zones is the key to the efficient implementation of the principles of four-handed dentistry

  15. For right-handed dentists, seated to the right of the patient, the operator's zone is between 8 and 11 o'clock, and the assistant's zone is between 2

  16. Positioning the Operator • Work environment is adapted to the operator • Operator positioned first then • Patient • Assistant • equipment

  17. Characteristics of Balance Posture for Operator Operators thighs parallel to floor Entire surface of seat used to support weight Backrest supports back without interference Forearms parallel to floor when hands are in operative position Elbows close to the body Back and neck reasonably upright with top of shoulders parallel to floor

  18. Distance of approximately 14 – 18 inches between the operator’s nose and the patients oral cavity maintained • Operative field is operators midline

  19. Positioning the Assistant • Must be able to see and have favorable access to be able to • Retract tissues • Evacuate fluids • View to anticipate needs of operator • Maintain clear field

  20. THANK YOU

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