Four-Handed Dentistry

Question 1

what is the goal of four-handed dentistry

Answer 1

allow provider and assistant to function a team with maximal efficiency and minimal strain

Question 2

4-H dentistry not only increases productivity but what

Answer 2

reduces stress and fatigue on the provider and assistant

Question 3

can 4H dentistry be used in all specialty areas and GD?

Answer 3

yes

Question 4

how many principles of 4H dentistry? what are they?

Answer 4

FIVE

1. dental assistants perform duties legally delegated to them. this allows provider to devote max attention and energy to pt care
2. make careful examination and diagnosis of pt dental condition
3. proper selection and arrangement of treatment equipment
4. positioning materials and equipment close to the point of use for motion economy and speed
5. use of infection control methods

Question 5

what principle allows dental team to work in a seated position

Answer 5

third - proper selection and arrangement of tx equipment

Question 6

the assistant is positioned ___ inches above provider’s eye level. why?

Answer 6

4-6 inches to allow better visibility

Question 7

should you place an object beyond an arm’s reach

Answer 7

no

Question 8

the position of the patient is determined by what

Answer 8

procedure to be performed

Question 9

what are the four zones of operation

Answer 9

1. static zone
2. assistant’s zone
3. transfer zone
4. provider/operator’s zone

Question 10

position of R and L providers

Answer 10

R: 8-11 o’clock
L: 1-4 o’clock

Question 11

when do providers use the 12 o’clock position

Answer 11

whenever treatment is on the lingual surfaces of anterior teeth

Question 12

position of R and L assistants

Answer 12

R: 2-4 o’clock
L: 8-10 o’clock

Question 13

all instruments and materials are located in what zone

Answer 13

assistant’s zone

Question 14

what is the transfer position

Answer 14

4-8 o’clock

Question 15

instruments and materials are passed and received in what zone?

Answer 15

transfer zone

Question 16

what is the static zone

Answer 16

11-2 o’clock

Question 17

what is the nontraffic area where equipment is located

Answer 17

static zone

Question 18

when the patient is properly positioned, the provider’s eyes should be ___ inches from the treatment site

Answer 18

14-16 inches

Question 19

as the assistant, how should you sit on the chair?

Answer 19

sit as close as possible to back of patient’s chair with feet directed toward head of chair

Question 20

when performing 4H dentistry, what must you also do?

Answer 20

irrigate with air and water as well as aspirate w/ high volume evacuator throughout procedure

Question 21

instrument exxchange between the provider and assistant takes place where

Answer 21

in transfer zone near patient’s chin

Question 22

instrument transfer is accomplished w/ minimum motion involving what

Answer 22

fingers, wrist, and elbow

Question 23

during transfer, should the provider move his/her finger rest of eyes from tx site?

Answer 23

no

Question 24

four stages of instrment transfer

Answer 24

1. working
2. signal
3. pretransfer
4. midtransfer

Question 25

what to do during working stage

Answer 25

pickup instrment to be used. grasp between thumb and first 2 fingers. receive instrument being used w/ pinky

Question 26

what to do during signal stage

Answer 26

provider signals for next instrument. provider positions instrument to be grasped with little finger

Question 27

what to do during pretransfer stage

Answer 27

grasp used instrument using little finger

Question 28

what to do during midtransfer stage

Answer 28

place next instrment into the provider’s hand w/ working end positioned towards treatement site

Question 29

where do you point the working end when tx site is on maxillary arch? mandibular arch?

Answer 29

max: point working end up

mand: working end pointed down

Question 30

when to release new instrument

Answer 30

until provider has firmly grasped the instrument

Question 31

what usually causes the instrments to become tangled during exchange

Answer 31

failure to parallel the handles before exchange

Question 32

what instruments are double-handed and must be transferred differently

Answer 32

scissors, hemostats, and forceps

Question 33

how to pass scissors, hemostats, and forceps

Answer 33

grasp working end and place handle into the palm of provider’s hand. point working end of passed instrument toward correct arch

Question 34

when provider is finished with scissors, hemostats, and forceps, how to receive?

Answer 34

receive by grasping working end

Question 35

how to exchange handpiece burs if provider is not using another instrument between bur exchanges

Answer 35

1. provider holds handpiece firmly over pt upper chest in transfer zone
2. assistant loosen and remove bur
3. immediately place next bur and secure it
4. gently tug on bur to ensure it is firmly on handpiece

Question 36

how to exchange bur if provider uses different instrument between bur exchanges

Answer 36

change bur outside transfer zone, usually over tray set up

Question 37

where are dental materials exchanged? why?

Answer 37

at patient’s chin in transfer zone. this prevents materials from being dropped on pt face

Question 38

small amounts of dental materials may be mixed and passed where

Answer 38

glass slab, paper pad, or dappen dish

Question 39

what to do when assisting amalgam restoration

Answer 39

1. load amalgam into carrier and pass loaded carrier to provider
2. if using two or more carriers, fill the barrel of one while provider is using the other
3. pass condensation instrments

Question 40

what to do when assisting procedure that uses cements

Answer 40

1. leave mixed cement on glass lab or mixing pad and hold it near treatment site
2. in other hand hold air syring to dry area for application and placement of material
3. other materials require holding gauze in other hand instead of air syringe to wipe excess material from application