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The Concepts of Four-handed Dentistry Including Ergonomic Instrument Transfer and Exercises for Stress Reduction

Course Number: 643

Strategies for Conserving Motion

Motion economy should be the primary consideration when purchasing and positioning dental equipment since this concept reduces or eliminates the number and length of motions used during basic treatment procedures. To improve motion economy at chairside, consider the following suggestions:

  1. Decrease the number of instruments used for a procedure by maximizing the use of each one for multiple functions.

  2. Position the instruments on a preset tray/cassette in the sequence that they will be used.

  3. Position instruments, materials, and equipment in advance, whenever possible.

  4. Have back up supplies and larger armamentarium located in easy reach to avoid Class V motion or the need to leave the operative site. Also, having a roving dental assistant to assist the team when unexpected items are now necessary.

  5. Place the armamentarium as close to the patient as possible.

  6. Place the patient in a supine position.

  7. Seat the operating team as close to the patient as possible.

  8. Place the assistant’s legs parallel to the patient chair to ensure the assistant is close to the patient and will not need to reach. The assistant must utilize the foot rest to ensure full comfort and safety while seated for treatment.

  9. Use appropriate stools that promote good posture and provide back and/or abdominal support. The operator stool allows thighs to be parallel to the floor while the assistant stool adjusts vertically to allow the assistant to be seated 4-6 inches higher than the operator. The operator stool also provides abdominal support for the assistant to lean against for stability on the seat.

  10. Provide work areas that are 1 to 2 inches below the elbow. Notice, too, the business assistant’s thighs are parallel to the floor regardless of the height of the stool.3

  11. Minimize the number of eye movements between the close and brightly lit operating field. Objects that are more distant in the treatment room receive less illumination.

  12. Reduce the length and number of motions made by the operator and the dental assistant to accomplish routine and repetitive tasks.

  13. Use smooth continuous motions and avoid distracting zigzag movement.

  14. The ultimate goal is to avoid Class IV and V motions.1