CHAIR AND OPERATOR POSITION

1 INTRODUCTION2 PATIENT AND OPERATOR POSITION3 CHAIR AND PATIENT POSITION > ALMOST SUPINE > RECLINED 45 DEGREE4 OPERATOR POSITION > RIGHT FRONT > RIGHT > RIGHT REAR > DIRECT REAR5 GENERAL CONSIDERATION 6 INSTRUMENT EXCHANGE7 MAGNIFICATION

CONTENTS

CHAIR AND PATIENT POSITIONS ARE IMPORTANT CONSIDERATIONS. MODERN DENTAL CHAIRS ARE DESIGNED TO PROVIDE TOTAL BODY SUPPORT IN ANY CHAIR POSITION

INTRODUCTION

- CHAIR POSITION IS A VERY IMPORTANT ASPECT IN THE SUCCESS OF A DENTAL TREATMENT.

- THE CORRECT POSITIONING HELPS THE OPERATOR TO HAVE A GOOD VISIBILITY AND ACCESSIBILITY OF THE ORAL CAVITY.

- PROPER POSITIONING OF THE PATIENT AND THE OPERATOR, ILLUMINATION AND RETRACTION FOR OPTIMAL VISIBILITY ARE THE FUNDAMENTAL PREREQUISITES TO PROPER DENTAL TREATMENT.

- IF OPERATOR MAINTAINS PROPER POSITION AND POSTURE DURING TREATMENT, THE OPERATOR IS LESS LIKELY TO GET STRAIN, BE MORE EFFICIENT AND LESS CHANCES OF GETTING MUSCULOSKELETAL DISORDERS.

INTRODUCTION

- IT SHOULD BE ABLE TO PROVIDE COMFERT TO THE PATIENT

- IT SHOULD BE ABLE TO PROVIDE TOTAL BODY SUPPORT

- HEADREST OF CHAIR SHOULD BE ATTACHED FOR SUPPORTING PATIENT’S CHIN AND REDUSING STRAIN ON CHIN MUSCLES

- IT SHOULD BE ABLE TO PROVIDE MAXIMUM WORKING AREA TO THE OPERATOR

FOLLOWING POINTS SHOUD BE KEPT IN MIND IN RELATION TO DENTAL CHAIR:

- IT SHOULD BE PLACED AT THE CONVENIENT LOCATION WITH ADJUSABLE CONTROL SWITCHES

- FOOT SWITCHES ARE PREFERED TO IMPROVE INFECTION CONTROL

- EFFICIENT PATIENT AND OPERATOR POSITIONS ARE BENEFICIAL FOR THE WELFARE OF BOTH INDIVIDUALS.

- A PATIENT WHO IS IN A COMFORTABLE POSITION IS MORE RELAXED, HAS LESS MUSCULAR TENSION AND IS MORE CAPABLE OF COOPERATING WITH THE DENTIST.

- BY USING PROPER OPERATING POSITIONS AND GOOD POSTURE THE OPERATOR EXPERIENCES LESS PHYSICAL STRAIN.

PATIENT AND OPERATOR POSITIONS

- THE DENTAL CHAIR SHOULD SUPPORT THE PATIENT’S HEAD, BACK AND ARMS.

- MODERN DENTAL CHAIRS ARE THE ARE CONTOURED TO PROVIDE TOTAL BODY SUPPORT AND COMFORT FOR THE PATIENT IN ANY CHAIR POSITION.

- THE PATIENT’S HEAD IS SUPPORTED BY THE HEADREST CUSHION WHICH IS ATTACHED TO THE CHAIR BACH AND IS ADJUSTABLE OR ARTICULATED.

CHAIR AND PATIENT POSITIONS

- THE HEADREST SUPPORTS THE PATIENT’S HEAD AND SLIGHTLY ELEVATES THE CHIN THUS REDUCING STRAIN ON THE NECK MUSCLES.

- SOME CHAIRS ARE ALSO EQUIPPED WITH PROGRAMMABLE OPERATING POSITIONS.

- THE PATIENT SHOULD HAVE DIRECT ACCESS TO THE CHAIR.

- WHILE MAKING THE PATIENT SIT ON THE DENTAL CHAIR, THE CHAIR HEIGHT IS KEPT LOW AND THE BACK REST IS UPRIGHT SO THAT THE PATIENT CAN SIT WITH EASE.

- DURING EXAMINATION OR TREATMENT PROCEDURES, THE CHAIR IS TILTED BACK.

- THE SWITCHES FOR CHAIR ADJUSTMENT SHOULD BE EASILY ACCESSIBLE TO THE DENTIST.

- FOOT SWITCHES ARE PREFERRED SO THST THE DENTIST CAN AVOID HAND CONTAMINATION DURING TREATMENT.

> SUPINE POSITION.

> RECLINED 45 DEGREES.

COMMON PATIENT POSITIONS

1 ALMOST SUPINE : IN THIS

POSITION, THE CHAIR IS TILTED SO THAT THE PATIENT IS ALMOST IN A

LYING DOWN POSTURE.

- THE PATIENT’S HEAD, KNEE AND FEET ARE APPROXIMATELTY AT THE SAME LEVEL; HOWEVER, THE HEAD SHOULD NOT BE POSITIONED LOWER THAN THE FEET EXCEPT WHEN THE PATIENT IS IN SYNCOPE.

2 RECLINED 45 DEGREES : IN THIS POSITION, THE CHAIR IS RECLINED AT 45 DRGREES SO THAT WHEN THE PATIENT IS SEATED,THE MANDIBULAR OCCLUSAL SURFACES ARE ALMOST 45 DEGREES OF THE FLOOR.

ONES THE TREATMENT IS OVER THE CHAIR IS BROUGHT BACK TO THE UPRIGHT POSITION SO THAT THE PATIENT CAN LEAVE THE CHAIR EASILY.

THE CHOICE OF CHAIR POSITION CAN BE DECIDED BY THE DENTIST BASED ON THE TYPE OF PROCEDURE AND THE ARCH BEING WORKED ON.

THIS IS THE CONVENIENT FOR EXAMINATION AND WORKING ON THE MANDIBULAR ANTERIOR TEETH, MANDIBULAR RIGHT POSTERIOR TEETH AND MAXILLARY ANTERIOR TEETH.

FOR ADDED EASE, THE PATIENT’S HEAD MAY BE SLIGHTLY TURNED TOWARDS THE DENTIST.

RIGHT FRONT POSITION

THE OPERATOR IS DIRECTLY TO THE RIGHT OF THE PATIENT.

THIS POSITION IS CONVENIENT FOR OPERATING ON THE FACIAL SURFACES OF THE MAXILLARY AND MANDIBULAR RIGHT POSTERIOR TEETH AND OCCLUSAL SUEFACES OF THE MANDIBULAR RIGHT POSTERIOR TEETH.

9-O’CLOCK POSITION.

RIGHT POSITION

THIS IS THE PREFERRED POSITION FOR MOST PROCEDURES.

FROM THIS POSITION THE DENTIST CAN HAVE GOOD ACCESS TO MOST AREAS OF THE MOUTH USING DIRECT OR INDIRECT VISION.

THE DENTIST SITS TO THE RIGHT AND SLIGHTLY BEHIND THE PATIENT AND THE LEFT ARM IS POSITIONED AROUND THE PATIENT’S HEAD.

THIS POSITION IS ALSO REFERED AS UNIVERSAL OPERATING SYSTEM…

RIGHT REAR POSITION

IN THIS POSITION WORKING ON THE LINGUAL SURFACES OF MAXILLARY ANTERIOR TEETH IS MOST CONVENIENT.

DIRECT VISION MAY BE ALSO USED ON THE MANDIBULAR TEETH, PARTICULARLY ON THE LEFT SIDE.

THIS POSITION HAS LIMITED APPLICATION.

THIS POSITION IS MAINLY USED ONLY FOR WORKING ON THE LINGUAL SURFACES OF MANDIBULAR ANTERIOR TEETH.

IT CAN ALSO BE USED WHILE WORKING ON THE LINGUAL SURFACES OF MAXILLARY ANTERIOR TEETH.

DIRECT REAR POSITION

1. THE PATIENT’S HEAD CAN BE ROTATED ACCORDING TO THE OPERATOR’S NEEDS TO ALLOW GOOD ACCESS AND VISIBILITY TO THE WORK AREA.

2. WHILE WORKING ON THE MAXILLARY ARCH, THE OCCUSAL SURFACES SHOULD BE ORIENTED APPROXIMATELY PERPENDICULAR TO THE FLOOR.

3. THE DENTIST SHOULD MAINTAIN ENOUGH DISTANCES FROM THE PATIENT SUCH AS WHILE READING A BOOK.BUT FOR SOME DETAILED PREPARATIONS OR INACCESSIBLE AREAS CLOSER PROXIMITY TO THE PATIENT MAY BE REQUIRED FOF ADEQUATE VISIBILITY.

GENERAL CONSIDERATIONS

4. WHILE WORKING FOR LONG PERIODS OF TIME, THE DENTIST CAN KEEP CHANGING POSITIONS TO RRDUCE MUSCLE STRAIN AND FATIGUE.

- THE STOOL SHOULD BE ON CASTERS FOR MOBILITY.

- IT SHOULD BE WELL PADDED WITH SMOOTH CUSHION EDGES AND SHOULD BE ADJUSTABLE UP AND DOWN.

- THE OPERATOR SHOULD NOT BE BALANCED ON THE STOOL USING IT AS A THIRD LEG ON A TRIPOD.

- THE OPERATOR SHOULD SIT BACK ON THE CUSHING, USING THE ENTIRE SEAT, NOT JUST THE FRONT.

- WITH THE PATIENT IN THE DENTAL CHAIR WHILE PRACTICING “ FOUR HANDED ” DENTISTRY, THE TRANSFER OF INSTRUMENTS BETWEEN TNE DENTIST AND THE ASSISTANT SHOULD OCCUR ONLY IN THE “ EXCHANGE ZONE ”.

- THIS EXCHANGE ZONE IS BELOW THE PATIENT’S CHIN AND SEVERAL INCHES ABOVE THE PATIENT’S CHEST.

- INSTRUMENT EXCHANGE SHOULD NEVER BE DONE OVER THE PATIENT’S FACE.

MAGNIFICATION OF THE AREA ENHANCES VISIBILITY AND ENABLES THE DENTIST TO PAY GOOD ATTENTION TO THE DETAILS OF EACH PROCEDURE.

MAGNIFICATION IS USEFUL AT ANY AGE TO ENABLE THE DENTIST TO PRECISELY PERFORM DELICATE RESTORATIVE PROCEDURES LIKE COMPOSITE RESOTARION, CAST RESTORATION, ETC.

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