Research has shown that ergonomic four‑handed dentistry is the most efficient way to create a stress free productive dental practice. It requires that the selection of equipment be based on the assistant’s domain and good ergonomic practice. Ideal four‑handed dentistry requires that appropriate techniques be followed for seating the patient and operating team, instrument transfer, oral evacuation, and infection control. Furthermore, during all of these procedures attention must be given to conserving motion. It is unwise to continue to work with equipment that does not include ergonomic concepts in its design to promote productivity and reduce stress for the operating team. The assistant and dentist must work as a team, in practice as well as in design of a safe ergonomically sound working environment.