Dental Ergonomics and Four Handed Dentistry Flashcards Preview

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Flashcards in Dental Ergonomics and Four Handed Dentistry Deck (41)
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1

Four-handed dentistry

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Ergonomics

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Ergonomics


ÒEfficiency and safety in our profession
ÒPlacement/positioning of equipment and each person on the team for:
ÉMaximum longevity of the each
ÉEfficiency or production
ÉPrevention of injury
 

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DAU


ÒDeveloped in the 1960’s.
ÒEmphasized proper positioning of dentist, dental assistant and patient.
ÒIncreases amount of patient care provided while decreasing amount of fatigue and stress on the dental team.
 

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Ergonomics

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Dental Equipment – EFFICIENCY designed 

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– EFFICIENCY designed

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Principles of DAU

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Principles of Work Simplification

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Elimination of Awkward Postures & Movements

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ÒThighs are :

  parallel

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ÒKeep vertebrae :
ÉNatural
ÒDo not bend neck
ÒDo not twist back
 


ÒKeep vertebrae :
ÉNatural
ÒDo not bend neck
ÒDo not twist back
 

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Balanced Position


ÒTo maintain a balanced position while working, the dentist should be guided by the criteria on the following slides.
 

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Postural Criteria – Dentist/operator 


ÒThe back should be supported and straight.
ÒAny leaning forward should be done from the hip.
ÒBoth shoulders should be at an equal height and parallel to the floor.
Ò

ÒThe elbows should be down at the sides.  Like golf, not wings)
ÒThe forearms  and thighs should be basically parallel to the floor.
ÒBoth feet should remain on the floor.
ÒThe lower legs should be perpendicular to the floor.


ÒEyes should be directed downward

    rather than looking straight ahead.

ÒThere should be a distance of

    14-18” from the dentist’s eyes to 

    the patient’s mouth. 

ÒDecreasing this distance blocks the

    light to the patient’s mouth. 

           Correctly adjusted loupes help to

           maintain this distance.             

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Postural Criteria – Dentist/operator 


ÒDistance of 14-18” to  the patient’s mouth. 
ÒBuy  and adjust loupes  to help to maintain this distance.             
 

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Postural Criteria – Dentist/operator 


ÒAny sustained occupational posture, when unbalanced or awkward, will produce harmful results over an extended period of time, leading to chronic ailments as a result of poor body mechanics.

  
ÒThe assistant should be seated 6-10” higher than the dentist.
ÒBoth feet should be on the foot ring or foot rest of the dental assistant chair.


ÒThe knees should be placed together parallel the dental chair.
ÒThe abdominal support of the chair should be used to lean forward into the field of operation.
ÒEyes should be directed downward.

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The Right-Handed Dentist Zones of Activity

OPERATOR’S ZONE

ÒFrom 8:00 to 12:00
Ò11:00 is most commonly used
Ò12:00 is used if working on the anterior segments
ÒMay use 8:00 or 9:00 if the right-handed dentist is working in the lower right quadrant

ASSISTANT’S ZONE

ÒFrom 2:00 to 4:00, with the center being 3:00.
ÒFrom the 3:00 position, the assistant has access to both the static zone and the transfer zone.

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The Left-Handed Dentist Zones of Activity

OPERATOR’S ZONE

ÒFrom 12:00 to 5:00. 
ÒThe 1:00 position is most commonly used.
ÒThe 3:00 and 4:00 positions sometimes provide greater visibility when working in the lower quadrants. 
ÒThe 12:00 position is useful when working in the anterior segments.


ÒASSISTANT’S ZONE – from 8:00 to 10:00, with the center being 9:00.
ÒTRANSFER ZONE – from 5:00 to 8:00.
ÒSTATIC ZONE – from 10:00 to 12:00.
ÒPATIENT’S ZONE – remains the same.
 

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STATIC ZONE

ÒFrom 10:00 to 12:00 and 12:00 to 2:00.
ÒUsually just in front of the assistant’s knees.
ÒThe zone of least activity.
ÒOccupied by the assistant’s cart, instruments and infrequently used equipment.
ÒRemains unchanged throughout the procedure.
ÒOnly the assistant enters the Static Zone.

STATIC ZONE

ÒFrom 10:00 to 12:00 and 12:00 to 2:00.
ÒUsually just in front of the assistant’s knees.
ÒThe zone of least activity.
ÒOccupied by the assistant’s cart, instruments and infrequently used equipment.
ÒRemains unchanged throughout the procedure.
ÒOnly the assistant enters the Static Zone.

20

Postural Criteria – Patient


ÒGenerally in a supine position.
ÒExact position is dictated by the quadrant in which the dentist is working.
ÒMAXILLARY ARCH – occlusal plane is perpendicular to the floor.
ÒMANDIBULAR ARCH – occlusal plane is parallel to the floor.

 


ÒGenerally in a supine position.
ÒExact position is dictated by the quadrant in which the dentist is working.
ÒMAXILLARY ARCH – occlusal plane is perpendicular to the floor.
ÒMANDIBULAR ARCH – occlusal plane is parallel to the floor.
 

21

Zones of Activity


ÒEach quadrant of the mouth necessitates a definite relative position of the dentist and dental assistant to the patient.
ÒRelative position – uses the numbers on the clock face.  The patient’s head is always at the 12:00 position, and the patient’s feet are always at the 6:00 position.
 

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Postural Criteria – Patient


ÒUR Quadrant

          Supine


ÒUL Quadrant

         Supine


ÒLR Quadrant

   Elevated 40o from the horizontal


ÒLL Quadrant

   Elevated 30o from the horizontal

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Postural Criteria – Patient


ÒNose and knees of the patient should be in the same horizontal line.
ÒPatient’s feet should be below that line.
ÒIf the patient’s feet are higher than his/her head, the patient may experience orthostatic hypotension when he/she stands up. 
 

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“I Can’t See Anything!”

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Motion Classification

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Motion Classification


ÒClass I – movement of the fingers only.
ÒClass II – movement of the fingers and wrist.
ÒClass III – movement of the fingers, wrist and elbow.
ÒClass IV – movement of the entire arm from the shoulder.
ÒClass V – movement of the entire arm and twisting of the body.
 

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Principles of Motion Economy


ÒMinimize the number of body motions.
ÒReduce the length of body motions.
ÒUse smooth, continuous motions rather than zigzag or jerky motions.
ÒPre-position instruments and materials whenever possible.
ÒLocate instruments and materials as close to the point of use as possible.

ÒPlan for the usual, not the unusual.
ÒPosition work surfaces, cabinet tops and trays approximately 2” below elbow level.
ÒUse stools and chairs that permit good posture.
ÒProvide good illumination for satisfactory visual perception.
ÒMinimize the need for refocusing and re-accommodation of the eyes.
 

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Preplanned Tray System


ÒFortunately, all of our instruments come on preplanned instrument trays.
ÒA preplanned tray system saves time and money, and requires the following:
ÒInstruments and materials to prepare the trays.
ÒStorage area for prepared trays.
ÒStorage area for used trays.
ÒCentral supply area for disposable items.
ÒPhotos or outlines of tray setups.                              
 

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Color Coding 


ÒInstruments should be color coded, using tape, plastic tubing or paint, for easy identification.
ÒDifferent procedures should receive different colors (for example:  red for endo, blue for operative, etc.)
ÒOne color should be placed in a straight line along one edge of the instruments.
ÒA different color should be placed in a diagonal line along the other edge of the instruments.  This saves time, in that it allows the assistants to set up the correct instruments on the correct trays by lining up the colors.  (See the next slide.)
Ò
Ò
 

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TRANSFER ZONE

ÒFrom 4:00 to 7:00.
ÒOut of the patient’s field of vision, in front of and below the patient’s chin.
ÒInstruments should not be transferred over the patient’s face.
ÒThe zone of greatest activity.
ÒThe only zone that is shared.

TRANSFER ZONE

ÒFrom 4:00 to 7:00.
ÒOut of the patient’s field of vision, in front of and below the patient’s chin.
ÒInstruments should not be transferred over the patient’s face.
ÒThe zone of greatest activity.
ÒThe only zone that is shared.

For Both Right and Left Handed Operators