Some of the Equipment Selection topics outlined in this course are discussed in this video clip.
Before four-handed dentistry can be practiced effectively, it is necessary to select equipment that will be ergonomically sound and promote a stress-free environment. Though the ergonomics concept can be applied to other areas of the dental practice, such as the business office, emphasis will be placed in this videotape on the selection of equipment for the dental treatment room or operatory.
The patient chair must be positioned for easy access, have a thin narrow back with a concave seat cushion and lower lumbar support, provide supportive neck and head positioner. Provide adjustment devices accessible to both sides of the chair that are aseptic, automatic, and foot controlled. Be able to be placed in supine position. Be free of protrusive devices on back. Be easily cleanable. No fabric upholstery. Have a frame and base that are stable, rigid and durable. Be capable of universal right and left design mount for the dental unit.
The dental unit must be a trans-thorac style, adjust vertically and have a horizontal tilt, have smooth tubing that is tangle-free, off the floor, and gravity retractable. Be able to withstand rigorous daily use. Be accessible to right- or left-handed operator. Not include a bracket tray. Not include a cuspidor.
The following features are components of the dental unit: The HVE system must contain lightweight, smooth, flexible tubing, have an on/off control that is easily managed with one hand, empty waste directly into the sewer system, provide a trap for separation of solids, be adaptable for saliva-ejector use, contain two tubings when desired. The air/water syringe must be lightweight, easily operable, provide air, water, and aerated spray with graduated flow, retain a tip that is angled and rotates, accept autoclavable or disposable tips. Two syringes are optional.
High-speed hand pieces must easy to use, contain tubing that is smooth and flexible, provide a range of speeds, possess a locking mechanism for hoses, provide a fiber optic option, be positioned so that the assistant can easily pass them to the operator.
Slow-speed hand pieces must follow the same criteria as the high-speed hand pieces and be able to accept a variety of attachments.
Curing light, ultrasonic scaler and electrosurgery units must be easy to use, adjustment buttons readily accessible, contain tubing that is smooth and flexible, ideally be located on the dental unit.
Foot control must be easily activated with foot pressure, accessible to right- or left-handed operator, contain a chip blower option.
Dental stools must provide a stable base with four or five casters, a flat or contoured, well-padded seat, easy adjustment, back and abdominal support that adjusts vertically and horizontally.
Operating lights should be mounted on the ceiling, wall or chair base, easily adjustable by operator or assistant, easy to maintain, easy to adjust light intensity.
Mobile cabinetry must be easily moved and be stable, provide an optional arm rest for the dentist, provide easy access to instruments and materials, provide an adequate work surface, provide a moveable work surface that can be positioned over the assistant’s lap, provide adequate storage with a deep well at the top.
Fixed cabinetry should be kept to a minimum, be positioned to provide for maximum floor space, positioned so the assistant can gain access to back-up materials as needed.
Sinks should be provided for the operator and assistant, contain a knee, foot, or automatic-activated soap dispenser, contain faucets that knee on/off, or operable without the use of hands, contain an eye wash or have them available nearby.
Let’s take a look at some equipment designs that will interfere with the efficient practice of four-handed dentistry.
Avoid fabric-covered chairs. Eliminate chairs that have wide back supports; they prevent the operating team from being positioned close to the patient. Avoid units that allow hoses and tubing to drape across the patient or that block the light or field of view. Avoid mobile cabinets with restrictive work areas and no storage. Cuspidors are unsanitary and decrease productivity. Coiled hoses inhibit infection control and are difficult for the operator to maneuver.
The video segments are excerpts from the videotape entitled, “Clinical Dynamics of Four‑Handed Dentistry,” and used with the permission of Health Sciences Products, Birmingham, Alabama. The entire video tape can be purchased at: