4 handed dentistry Flashcards
balance position
- Approx 90 degree at hip and knee
- Thigs roughly parallel to floor
- Feet on the floor, back and neck upright
- Shoulders should be rested
- Move with the chair, do not bend, twist or stop
distance between operator and pt
12-18 inches
should the pt chair be touching operator
no
elbow angle for operator
90
shoulders of operator should be
relaxed
where should operator reach from
elbows
nurse position relative to operator
2-4 inches higher
how should operator move whilst in chair
Move on your axis with arms extended
Do not twist or stoop
Move with chair
where should instruments be held
why
Hold instruments higher up handle to aid vision
how to hold aspirator
- Aspiration held in dominant hand in a pencil like grip
- The aspirator should be held firmly where the tip joins the suction tubing
- The cut off end (bevel) of the aspirator tip should be held adjacent and distal to the tooth/teeth being treated
Ensure switched on
Be firm but gentle – can bruise mucosa
direct aspiration
- Adj to the tooth being treated
- Distal to tooth to remove water/debrus
- Try not obscure the view
- Belvel adj to tooth
- Remember any excess debris/fluid gathers at pt mouth
- Do no go over the centre of the tongue to access to back of through – go down buccal sulcus or ask to swallow
indirect aspiration
- Anterior (3-3) – prevent obscuring view
- Position the aspirator to side closest to you
- Left handed op – lower right quadrant
- Right handed op – lower left quadrant
- Remove the water/debris effectively without impairing the operators view
how to use a 3 in 1
Insert unscrew the silver nut slightly
Insert the tip firmly and tighten the nut securely
Always try the 3 in 1 outside the mouth to ensure secure
Do not put nut in clinical waste or sharps box
NAFAL
Nurse Always First And Last
upper right quadrant soft tissue retraction and aspiration
3:1 to retract and support the cheek – use water and air as needed
Aspirator on palatal surface
Always the check the back of mouth for build up
Allows maximum access and EO illumination
upper left quadrant soft tissue retraction and aspiration
3:1 retracts and supports the lower lip and cheek
Aspirator retracts and supports the cheek – placed in buccal sulcus
lower left quadrant soft tissue retraction and aspiration
Care not to press the lip onto the teeth
Aspirator retracts and supports the cheek
Gently stretch soft tissues
3:1 slight further forward
lower right quadrant soft tissue retraction and aspiration
3:1 to retract and support the cheek
Place the aspirator between the tongue and the lingual surface of the teeth
Retract the tongue - hard, control tongue
upper anterior soft tissue retraction and aspiration
Awkward to get all fluid
Aspirator can often obscure vision
Mouth mirror gets obscured by water
Indirect aspiration required
Steady flow air should be blown onto the mirror
Cotton wool roll can be placed under lip if labial use 3:1 to hold
5 tools that can be used to retract soft tissues
- Aspirator wide bore or narrow bore
- Dental mouth mirror
- Tongue depressor
- 3:1 syringe
- Cheek retractor
NOT FINGER
aspiration can be done by the operator alone?
NO
Never aspirate by yourself – dangerous
Risk high speed lacerations
right handed operator
static zone
12-2
(where bracket table should be)
right handed operator
dental nurse zone
2-4
right handed operator
transfer zone
4-7
right handed operator
operator zone
7-12
left handed operator
operator zone
12-5
left handed operator
transfer zone
5-8
left handed operator
dental nurse zone
8-10
left handed operator
static zone
10-12
4 handed dentistry transfer technique
- Instruments kept by the dental nurse prevents injury, mess and things falling
- Instruments are maintained and kept clean
- Hold the instruments at the end during transfer
- Additional instruments held in the pinkie then transfer, operator does need to lift their head
- Instrument retrieval with nurse pinky and give finger and thumb (firm)
- Medicaments can also be transferred
- Amalgam can be placed in cavities by nurse
what to do when hand scaling to clean tools of debris
use aspirator – yanker suction tube close to where working and suck off - do not use gauze
aspirator use
always with 3:1
never aspirator alone
