Dental Chair Maintenance, Instruments and Clinic Management

Dental Chair Maintenance and Instruments

1 - When we perform maintenance on the dental chair, we keep it in the rest position. Everything depends on the chair system.

2 - Cite some characteristics of the high-speed handpiece: small head, low volume body, light, abundant spray, and as quiet as possible.

3 - What is the purpose of the abundant spray in the high-speed handpiece? To cool the bur, since in contact with the tooth it generates heat, and heat causes damage to the pulp.

4 - Cite two disadvantages of the high-speed handpiece: in the patient, due to noise, and auditory discomfort for the dentist.

5 - What movements does the bur perform, and what movements does the turbine perform? The bur performs clockwise and counterclockwise movements. The turbine performs movement in only one direction.

6 - What is the area of action of the contra-angle, and of the straight handpiece? Contra-angle: inside the mouth. Straight handpiece: outside the mouth.

7 - How is hand instrument maintenance performed? Lubrication, cleaning, and spray.

8 - How do we maintain the integrity of the bur? Do not use a broken or clogged bur. It must be discarded and must not be reused.

9 - Sterilization is the elimination of all variable forms of microorganisms. It is not a degree of sterilization. Never disinfect what can be sterilized.

10 - What are fixed costs? Cite examples. Fixed costs are costs that do not vary: rent, taxes, staff remuneration, and equipment maintenance.

11 - Variable costs are costs that vary according to the number of patients served: electricity, telephone, and dental materials.

12 - How to reduce costs: increase productivity to dilute fixed costs in production, divide expenses with other professionals, increase production, and do not leave the office idle. Production is the absolute value; productivity is the relative value.

13 - We must pay attention to yield, productivity, costs, and time.

14 - Time is a precious and irreversible resource.

15 - Leisure time: family, social, recreational, and marital roles.

16 - Professional time is divided into operative and non-operative time.

17 - Operative time:

• Direct movements: 12%, working in the patient's mouth.
• Indirect movements: 40%, without working in the patient's mouth.
• Involuntary movements: 48%, the dentist is with the patient but cannot do anything to advance the treatment.

18 - Indirect movements can be reduced by hiring an assistant to help with procedures in the office.

19 - Non-operative time is divided into productive and unproductive time. Productive: the dentist is not with the patient in the chair but is engaged in activities for their practice. Unproductive: the dentist is not with the patient and is not doing anything, or the patient is absent.

20 - The day should be 8 hours of work: 8 for individual activities and 8 for sleep.

21 - Damage caused by fatigue: reduced productivity, and it may cause serious health disorders.

22 - Appointment organization: advance planning of the work to be performed, variation of the type of work, reservation of adequate time for each patient, and balance of schedules.

Dental Office Layout and Ergonomics

23 - Patient unit elements: dental chair (fixed), and dentist elements: stool, handpiece, and all equipment used for clinical treatment.

24 - Assistant elements: suction unit, stool, cabinets, and auxiliary table.

25 - Arrangement of units for the dentist (1/0 to 4/0):

• 1/0: element to the right of the dentist and to the right of the chair (kart-type equipment).
• 2/0: element to the left of the dentist and behind the chair (kart-type equipment or cabinet).
• 3/0: element to the right or in front of the dentist and above the chair (articulated arm).
• 4/0: element to the left of the dentist, at the back of the headrest.

26 - Arrangement of assistant elements (0/1 to 0/4):

• 0/1: element to the left of the assistant and to the left of the chair.
• 0/2: element to the right of the assistant and behind the chair.
• 0/3: element to the left of the assistant and above the chair, attached to an articulated arm.
• 0/4: element to the right of the assistant, at the back of the chair backrest.

27 - The most used and common combinations are 3/1, 3/2, and 3/3.

28 - Work areas: between 12 and 2 is the static zone; between 5 and 7 is the transfer zone; between 2 and 5 is the auxiliary zone; between 7 and 12 is the dentist zone.

29 - In practice, the assistant works in position 3.

30 - In practice, the most common position of the dentist is between 10 and 12.

31 - Position 3 allows the assistant to view all quadrants of the mouth. The stool is placed in front of the patient's head, as close as possible to the dental chair, with better visibility. The stool should be 10 to 15 cm higher than the dentist's stool, with the back straight, feet pointing toward the patient's head, and the foot resting on the stool support.

32 - The patient to be examined must be positioned in the supine position.