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Increasing Productivity by Effective Use of Four-Handed Dentistry - Part 1: An Overview of the Concept


Betty Ladley Finkbeiner, CDA-Emeritus, BS, MS

Credit Hours:

2 Hour(s)


This course is the first of a three-part series and describes and discusses four‑handed dentistry and its integration in the modern dental office.

This course is designed to review the impact that four‑handed dentistry can make on producti...

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This course is the first of a three-part series and describes and discusses four‑handed dentistry and its integration in the modern dental office.

This course is designed to review the impact that four‑handed dentistry can make on productivity in the dental practice. New technology continues to be integrated into the modern dental office. However, no single product can increase productivity and reduce stress and strain on the dental team as much as using the concept of four‑handed dentistry.

The clinical dynamics of four‑handed dentistry is an ergonomic chairside concept performed by a well-trained dental team in an organized manner. Combined with the practice of ergonomics in the workplace, the concept of true four‑handed dentistry must be revisited by the dental profession and applied to both the clinical and business areas of the office. The young dentists of the 21st century have had minimal exposure to true four‑handed dentistry during their educational experiences due to budget cuts in many of the dental schools around the country.

The concept of four‑handed dentistry was born in the 1960s to overcome a manpower shortage. Demands were made on the dental profession to provide more services to more people due to the creation of third party payment. As the years have passed, this single concept, when done properly has become even more important. Even though the current economic period may have diminished the need based on third party payment, the profession must still seek to be more productive as the impact of regulatory agencies, managed care, and quality assurance places even greater demands on the practicing dentist to implement efficient clinical practice methods to ensure a safe, comfortable environment for the entire team. In this course the reader will explore the reasons why the concepts of true four‑handed dentistry, when applied to current technology, can increase productivity and reduce stress.

  • Intended Audience:

    Dentists, Dental Hygienists, Dental Assistants, Dental Students, Dental Hygiene Students, Dental Assistant Students

  • Date Course Online:

    Sep 2, 2013

  • Last Revision Date:

    Aug 27, 2017

  • Course Expiration Date:

    Feb 26, 2021

  • Cost:


  • Method:


  • AGD Subject Code(s):


Learning Objectives

Upon completion of this course, the dental professional should be able to:

  • Identify the basic tenets of true four‑handed dentistry.    
  • Describe motion economy.    
  • Identify the basic zones of activity.    
  • Explain why the concepts of true four‑handed dentistry can increase productivity.    
  • Identify dental team responsibilities to ensure effective four‑handed dentistry.    
  • Identify positive phrases to implement positive attitudes toward change.    
  • Understand how a microscope can improve chair position.    
  • Examine equipment to increase visibility.    
  • Understand the most ergonomic ways to deliver dentistry.    
  • Understand how the concepts of motion economy and ergonomics can apply to both the clinical and business areas of the dental practice.


P&G is providing these resource materials to dental professionals. We do not own this content nor are we responsible for any material herein. Participants must always be aware of the hazards of using limited knowledge in integrating new techniques or procedures into their practice.  Only sound evidence-based dentistry should be used in patient therapy. Note:  Registration is required to take test.


Conflict of Interest Disclosure Statement

  • The author reports no conflicts of interest associated with this course.

Betty Ladley Finkbeiner

CDA-Emeritus, BS, MS

Betty Ladley Finkbeiner, is a Faculty Emeritus at Washtenaw Community College in Ann Arbor, MI where she served as Chairperson of the Dental Assisting Program for over three decades. She has served as a consultant and staff representative fo...

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Submission Information

Academy of General Dentistry (AGD) Submission For credit transfers to appear in your AGD account in real time, make sure to add your AGD membership number in the field provided on the “Share Your Test Score” page.

CE Broker For all states that use CE Broker for licensure, “proof of completions” are electronically reported the first of every month. If a course was taken in November, the “proof of completion” will be submitted the beginning of December.



ADA CERP Recognized Provider

The Procter & Gamble Company is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

Concerns or complaints about a dental CE provider may be directed to the provider or to ADA CERP at:

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Approved PACE Program Provider


Nationally Approved PACE Program Provider for FAGD/MAGD credit.

Approval does not imply acceptance by any regulatory authority or AGD endorsement.

8/1/2021 to 7/31/2027

Provider ID# 211886


AADH Approved Program Provider

Procter & Gamble is designated as an approved Provider by the American Academy of Dental Hygiene, Inc. #AADHPGC (January 1, 2022-December 31, 2023). Approval does not imply acceptance by a state or provincial Board of Dentistry. Licensee should maintain this document in the event of an audit.