The Concepts of Four-handed Dentistry Including Ergonomic Instrument Transfer and Exercises for Stress Reduction
Course Number: 643
Course Contents
Basic Tenets of Four-handed Dentistry
Many dental teams claim they practice four‑handed dentistry, yet they still suffer the results of physical stress due to the use of inappropriate equipment and techniques that fall short of meeting the basic tenets of the true four‑handed dentistry concept. Dentists can still be observed changing their own burs, reaching for an instrument, refocusing their eyes after looking away, or twisting and turning to reach equipment on their side of the operatory. If the clinical assistant is not in charge of all instrument transfers, and the equipment is not within reach of the assistant, true four‑handed dentistry cannot be practiced.
Additionally, the application of these concepts must not be overlooked in the dental business office. Though this course is designed primarily for the clinical area of the dental practice, business assistants should take time to evaluate their movement and efficiency practices possibly finding many of these principles easily applied to the business office.
The concept of true four‑handed dentistry is based on a set of criteria that define the conditions under which efficiency can be attained. To practice true four‑handed dentistry, the following criteria must be met:2
Use ergonomically designed equipment to minimize unnecessary motion. This is a showroom photograph for patients and barriers would need to be placed for patient treatment.
Place the patient in supine position. Has the patient donned the offered safety glasses? Technically the dental team should wear a disposable gown. Best practices now include safety glasses for the patient to eliminate accidental injury during treatment.
The operator and dental assistant are seated comfortably using their ergonomically-designed equipment.
Practice motion economy.
Seat the operating team as close to the patient as possible with the legs of the assistant parallel to the patient chair. Seated dentistry is important for the chairside team to relieve stress, strain, and fatigue. The ideal is to begin in a neutral position with weight evenly distributed, legs comfortably apart, and feet flat of the floor or footrest.1
Position equipment, instruments, and materials in advance.
Minimize the number of instruments to be used.
Place instruments in sequence of use in order from left to right or top to bottom as preferred.
Place additional equipment such as material tubs and UV light within a forward reach that does not require over stretching or body twisting.
Dentist utilizes qualified dental assistants to assign all legally delegable duties based on the state’s guidelines.
Patient treatment is discussed with the patient and planned in a logical sequence to minimize time and motion waste.