W3 - 2: Chair position

Question 1

1. What is Four-handed dentistry?

Answer 1

1. Dentist and assistant are sitting cosily around the lain patient’s head
2. Dentist and assistant are both using their arms actively
3. Aim: to treat more patients at the highest standard & shortest time without health damage of the dentist

Question 2

2. What are Benefits of four-handed dentistry?

Answer 2

1. Preservation of the health of dental team
2. Active contribution of the assistant (retraction of soft tissues, using exhaustor)
3. The efficiency of the dental treatment is rising
4. Treatment time is shorter (better for the patient & for the team)
5. Better access and visual control in the mouthsometimes direct vision
   * Better visual control
   => better and easier isolation, placement of rubberdam is faster
6. Choke hazard and danger of aspiration are reduced (tounge closes the throat while lying)
7. Patient is more relaxed while lying down; dentist’s muscular system is more relaxed => easier to do better physical work
8. Patient’s brain circulation is better => smaller danger of collapse

Question 3

3. What is the Position of the patient?

Answer 3

1. Optimal position: 140 angle between body and back rest
2. Full body of the patient is supported in a horizontal position
   => spine relaxed, comfortable feeling
3. Back of patient is paralel to the floor
4. Patient’s oral cavity is positioned at an equal height to the seated clinician’s heart and elbow
5. It can be complicated at elderly patients

Question 4

4. What is the chair position when treating the maxillary arch?

Answer 4

1. Back-rest is horizontal, upper arch vertical
2. Patient position also horizontal (head, feets same hight)
3. Patient’s head is a little tilted back, neck is supported!!!
4. Dentist sitting behind patient’s head
   * Choke hazard is smaller in this position

Question 5

5. What is the chair position when treating the mandibular arch?

Answer 5

1. Back-rest: half tilted position
2. Patient’s head is higher than his feet
3. Lower arch ~ 45 degree (closed mouth), horizontal if opened
4. Dentist sitting behind patient’s head
5. Direct visual control + mirror

Question 6

6. How should the dentist’s position be?

Answer 6

Remember that the patient is only in the chair for a limited period of time while the clinician spends hours at chairside day after day
Rules:
* Feet resting flat on the floor
* Legs in fully supported position
* Angle between the spine and the thighs should be 90-110 degrees
* Back is vertical
* Upper arms are close to your body
* Elbow/forearm angle is close to 90 degrees
* Head is a little bit tilted forward

Question 7

7. How should Dentist- and assistant’s position be?

Answer 7

1. Based on the numbers of the clock
2. Patient’s head at 12 o’clock, legs at 6 o’clock
3. Right handed dentist: at the right side of the patient at 7-9-11-12 o’clock, assistant at the left 1-2, 3-4 o’clock
4. Assistant most frequent position: 2-3 o’clock; sits 10 cm higher, feet on foot rest

Question 8

8. How should Dentist- and assistant’s position be when treating left upper premolars and molars?

Answer 8

1. Dentist at 9-10 o’clock, patient’s head is tilted to the dentist side
2. Assistant at 2 o’clock

Question 9

9. How should Dentist- and assistant’s position be when treating left lower premolars and molars?

Answer 9

1. Dentist at 9-10 o’clock, patient’s head is tilted to the dentist side
2. Assistant at 2 o’clock, in right hand exhauster, in left hand mirror (to retract soft tissues)

Question 10

10. How should Dentist- and assistant’s position be when treating Lower fronts?

Answer 10

1. Dentist at 11-12 o’clock, at the lingual side => mirror
2. Assistant at 3 o’clock

Question 11

11. How should Dentist- and assistant’s position be when treating Right lower premolars and molars?

Answer 11

1. Dentist at 7-9 o’clock, patient’s head tilted to the dentist
2. Assistant at 1-2 o’clock, in the left hand exhauster, in right hand mirror (to retract soft tissues)