OPERATIVE DENTISTRY 2 OPERATING POSITIONS
● May be described by the location of the operator or by the location of the
PREOPEARTIVE PATIENT AND DENTAL TEAM CONSIDERATIONS
operator’s arms in relation to patient position.
PATIENT AND OPERATOR POSITIONS ● A right-handed operator uses essentially three positions:
● By using proper operating positions and good posture, the operator
experiences less physical strain and fatigue and reduces the possibility of 1. Right front position (7-o’clock)
developing musculoskeletal disorders.
● Facilitates examination and treatment of
● Most restorative dental procedures can be accomplished while seated. (1) Mandibular anterior teeth
● Proper balance and weight distribution on both feet is essential when (2) Mandibular posterior teeth
(3) Maxillary anterior teeth
operating from a standing position.
● To increase visibility, the patient’s head may be turned
● Any uncomfortable or unnatural position that places undue strain on the
towards the operator
body should only rarely be used.
2. Right position (9-o’clock)
● The health and fitness of the dentist are significant factors contributing to
● The operator is directly to the right if the patient
physical endurance and productivity
● Convenient working areas:
CHAIR AND PATIENT POSITIONS (1) Facial surface of Maxillary right posterior
● Dental chairs are designed to provide total body support in any chair (2) Facial surface of Mandibular right posterior
position. (3) Occlusal surface of Mandibular right posterior
3. Right rear posistion (11-o’cloc)
● Most common patient positions for operative dentistry are almost supine
or reclined 45 degrees ● The position of choice for most operations
● The choice of patient position varies with (1) the operator, (2) the type of ● The operator is behind and slightly to the right of the
procedure and (3) the area of the mouth involved in the operation patient.
● In the almost supine position, the patient’s head, knees, and feet are ● Left arm is positioned around the patient’s head
approximately the same level.
● Convenient working areas:
● The patient’s head should not be lower than the feet
(1) Lingual/Palatal of Maxillary teeth
● The head should be positioned lower than feet only when the patient is in (2) Incisal surface of Maxillary teeth
(3) Mandibular teeth
syncope.
, ● Direct vision may be used on Mandibular teeth (on the ● The operator should not hesitate to rotate the patient’s head backward
left side) or forward or from side to side
NOTES: o To accommodate the demands of access and visibility of the
● For a left-handed operator, the three positions are the: operating field
o Allows the operator to maintain his or her basic body position
1. Left Front position (5-o’clock)
Working areas: ● When operating in the maxillary arch, the maxillary occlusal surface
(1) Mandibular anterior teeth should be oriented approximately perpendicular to the floor
(2) Mandibular posterior teeth
● In the mandibular arch, the mandibular occlusal surfaces should be
(3) Maxillary anterior teeth
2. Left position (3-o’clock) oriented approximately 45 degrees to the floor.
Working areas: ● The operator’s face should not come too close to the patient’s face
(1) Facial surface of Maxillary left posterior
(2) Facial surface of Mandibular Left posterior ● It is not appropriate for an operator to rest forearms on the patient’s
(3) Occlusal surface of Mandibular Left posterior shoulders or hands on the patient’s face or forehead
3. Left rear position (1-o’clock) ● The patient’s chest should not be used as an instrument tray
Working areas:
(1) Lingual/Palatal of Maxillary teeth
(2) Incisal surface of Maxillary teeth
(3) Mandibular teeth (right side)
● The left hand should be free to hold the mouth mirror
DIRECT REAR POSITION (12-o’clock) o To reflect light onto the operating field
● The teeth being treated should be the same level as the operator’s elbow o To view the tooth preparation indirectly
o To retract the check or tonque
● Operator directly behind the patient and looks down over the patient’s
● It is more appropriate to retract the cheek with one or two fingers than
head during procedure
the use of a mouth mirror
● Has limited application
OPERATING STOOLS
● Convenient working areas: SEAT
(1) Lingual surfaces of the Mandibular teeth ● Should be well padded with smooth cushion edges
GENERAL CONSIDERATIONS ● Should be adjustable for optimal leg position and back support
● May be described by the location of the operator or by the location of the
PREOPEARTIVE PATIENT AND DENTAL TEAM CONSIDERATIONS
operator’s arms in relation to patient position.
PATIENT AND OPERATOR POSITIONS ● A right-handed operator uses essentially three positions:
● By using proper operating positions and good posture, the operator
experiences less physical strain and fatigue and reduces the possibility of 1. Right front position (7-o’clock)
developing musculoskeletal disorders.
● Facilitates examination and treatment of
● Most restorative dental procedures can be accomplished while seated. (1) Mandibular anterior teeth
● Proper balance and weight distribution on both feet is essential when (2) Mandibular posterior teeth
(3) Maxillary anterior teeth
operating from a standing position.
● To increase visibility, the patient’s head may be turned
● Any uncomfortable or unnatural position that places undue strain on the
towards the operator
body should only rarely be used.
2. Right position (9-o’clock)
● The health and fitness of the dentist are significant factors contributing to
● The operator is directly to the right if the patient
physical endurance and productivity
● Convenient working areas:
CHAIR AND PATIENT POSITIONS (1) Facial surface of Maxillary right posterior
● Dental chairs are designed to provide total body support in any chair (2) Facial surface of Mandibular right posterior
position. (3) Occlusal surface of Mandibular right posterior
3. Right rear posistion (11-o’cloc)
● Most common patient positions for operative dentistry are almost supine
or reclined 45 degrees ● The position of choice for most operations
● The choice of patient position varies with (1) the operator, (2) the type of ● The operator is behind and slightly to the right of the
procedure and (3) the area of the mouth involved in the operation patient.
● In the almost supine position, the patient’s head, knees, and feet are ● Left arm is positioned around the patient’s head
approximately the same level.
● Convenient working areas:
● The patient’s head should not be lower than the feet
(1) Lingual/Palatal of Maxillary teeth
● The head should be positioned lower than feet only when the patient is in (2) Incisal surface of Maxillary teeth
(3) Mandibular teeth
syncope.
, ● Direct vision may be used on Mandibular teeth (on the ● The operator should not hesitate to rotate the patient’s head backward
left side) or forward or from side to side
NOTES: o To accommodate the demands of access and visibility of the
● For a left-handed operator, the three positions are the: operating field
o Allows the operator to maintain his or her basic body position
1. Left Front position (5-o’clock)
Working areas: ● When operating in the maxillary arch, the maxillary occlusal surface
(1) Mandibular anterior teeth should be oriented approximately perpendicular to the floor
(2) Mandibular posterior teeth
● In the mandibular arch, the mandibular occlusal surfaces should be
(3) Maxillary anterior teeth
2. Left position (3-o’clock) oriented approximately 45 degrees to the floor.
Working areas: ● The operator’s face should not come too close to the patient’s face
(1) Facial surface of Maxillary left posterior
(2) Facial surface of Mandibular Left posterior ● It is not appropriate for an operator to rest forearms on the patient’s
(3) Occlusal surface of Mandibular Left posterior shoulders or hands on the patient’s face or forehead
3. Left rear position (1-o’clock) ● The patient’s chest should not be used as an instrument tray
Working areas:
(1) Lingual/Palatal of Maxillary teeth
(2) Incisal surface of Maxillary teeth
(3) Mandibular teeth (right side)
● The left hand should be free to hold the mouth mirror
DIRECT REAR POSITION (12-o’clock) o To reflect light onto the operating field
● The teeth being treated should be the same level as the operator’s elbow o To view the tooth preparation indirectly
o To retract the check or tonque
● Operator directly behind the patient and looks down over the patient’s
● It is more appropriate to retract the cheek with one or two fingers than
head during procedure
the use of a mouth mirror
● Has limited application
OPERATING STOOLS
● Convenient working areas: SEAT
(1) Lingual surfaces of the Mandibular teeth ● Should be well padded with smooth cushion edges
GENERAL CONSIDERATIONS ● Should be adjustable for optimal leg position and back support
