Operating & Maintaining Dental Equipment Positioning a Patient in a Dental Chair Unit 18.6 -18.8

1. Operating & MaintainingDental EquipmentPositioning a Patient in a Dental ChairUnit 18.6 -18.8 Medical Technologies Jr. Program Dr. Hale

2. Introduction 1. Care of dental equipment may be a dental assistant’s responsibility 2. Check manufacturer’s recommendations prior to using or caring for equipment 3. Following information provides basic facts on equipment

3. Infection Control 1. Essential while operating and maintaining any dental equipment 2. Equipment can be contaminated with blood, saliva, and body fluids 3. Standard precautions must be observed at all times 4. Personal protective equipment (PPE) must be worn at all times while performing dental procedures and operating dental equipment

4. a. PPE includes gloves, gown, mask, and protective eyewear b. Gloves and mask discarded after each patient c. Masks must be changed anytime they become wet or are worn for longer than 30 minutes d. Protective eyewear must be disinfected, rinsed, and dried before being used for another patient

5. Dental PPE

6. 5. After any dental procedure, contaminated equipment must be disinfected or sterilized before it is used for another patient 6. Gloves must be worn while cleaning contaminated areas 7. Protective barriers must be placed on many parts of the equipment prior to use

8. a. Special covers can be purchased for dental chair, handles and switches on dental light, and to cover X-ray head b. Plastic wrap or aluminum foil can also be used to cover surfaces such as handles and switches on dental light c. Clear plastic wrap can be used on X-ray tube head

10. d. Plastic backed paper or plastic wrap can be used on the headrest, armrest, and other parts of dental chair, and to cover tops of dental carts

11. 8. When procedure is complete, contaminated barriers must be removed a. Assistant must wear gloves to remove barriers b. Areas must then be disinfected or sterilized if possible

12. 1) All surfaces are sprayed with a disinfectant 2) Wiped to remove any particles or debris 3) Areas are then sprayed a second time 4) Solution is left in place for the period of time recommended by the manufacturer, usually 10 minutes 5) All surfaces are then wiped again

13. c. Gloves must then be removed and hands washed thoroughly d. Clean protective barriers are put in place before next dental procedure

14. 9. Transmission of disease by dental equipment can be prevented by observing standard precautions and proper disinfection and/or sterilization procedures

15. Dental Light 1. Most lights are mounted on ceiling or to the dental unit 2. Used to illuminate the oral cavity or mouth 3. Light is positioned 30 to 50 inches from oral cavity a. Put in place after patient positioned in dental chair b. Should be positioned so light illuminates oral cavity but does not shine in patient’s eyes

16. Dental Lights Position light 30 – 50 inches from patient

17. 4. Lights contain dimmer switches to adjust the intensity of the light 5. Prior to a procedure, protective barriers are placed on handles and switches of the light a. Plastic wrap, aluminum foil, or commercial covers are used b. Barriers must be removed and replaced with clean covers after each patient

18. 6. Frequent cleaning of the light is important a. All parts that are touched must be disinfected after each patient b. Mild detergent and soft cloth should be used to clean light shield 7. All moving parts on light should be lubricated with general all-purpose oil at least once a week

19. Dental Chair 1. Designed to position patient comfortably while providing doctor and assistant easy access to oral cavity 2. Most chairs have thin, narrow headrests a. Allows doctor and assistant to position them- selves close to patient b. Patient’s head must be resting on upper narrow headrest c. Position short adults and children in chair starting with correct placement of the head

21. 3. Patient placed in supine or lying down position in four handed dentistry 4. Chair controls a. Most chairs contain controls on both sides and/or on the floor so they can be operated by doctor or assistant b. Control to raise or lower height of chair usually located on chair base and operated by foot

22. Four-handed area

23. c. Control to recline or raise chair usually located on side of chair by headrest and operated by hand d. Chair lock control on base usually operated by foot 1) Prevents movement of the chair 2) Must be locked when patient getting in or out of chair

24. 5. Cleaning chair a. Chair must be cleaned between patients b. Headrest, armrest, and any other contaminated area should be wiped clean with a disinfectant, then re-sprayed, left in place for the required time, and wiped again

25. c. Headrest usually covered with plastic disposable cover that is discarded after each use and replaced with clean cover d. Most manufacturers recommend frequent thorough cleaning with special upholstery cleaners or mild soap solutions

26. 6. Principles for seating patient in dental chair a. Chair must be locked in upright position before patient gets in or out of chair 1) Patient could be injured if chair moves 2) Always check chair lock before seating patient or assisting patient out of chair b. Elevate chair to height that will allow doctor to be seated comfortably by chair with patient’s head above doctor’s lap

27. c. Recline the chair slowly 1) Lowering to supine position quickly can cause dizziness, discomfort, and fear in some patients 2) Best to lower chair part way, pause, and then complete lowering the chair

28. d. Recline chair until patient lying basically flat 1) Imaginary line from patient’s chin to ankles should be parallel with the floor 2) Patient’s legs and head should be at same level e. Explain all movements of the chair to patients – unexpected movements could frighten patient

29. Dental Chairs

30. Dental Chairs…

31. f. Before dental procedures performed, place protective drape over patient’s chest 1) Protects clothing during procedure 2) Plastic side placed against clothing and paper side faces up aa. Paper absorbs any moisture bb. Plastic prevents moisture from soaking through to patient’s clothing

32. Dental Drapes

33. g. Maintain friendly, pleasant attitude toward patient 1) Make patient feel welcome 2) Allow patient to talk about their interests 3) Knowledge about patient allows you to ask questions aa. “How was your vacation?” bb. “How did your team do in the last game?” cc. “I hope you enjoy your first year at college.”

34. Air Compressor 1. Provides air pressure to operate handpieces and air syringes 2. Usually located in storage area or basement, and air lines carry air pressure to dental unit 3. Units usually set to provide 100 pounds of pressure 4. Maintenance of unit

36. a. Read and follow manufacturer’s instructions b. Some are sealed units and require no lubrication c. Other units require oil to operate 1) Check oil level frequently, usually weekly 2) If unit contains oil reservoir, remove cap or plug and check oil level 3) Report low oil levels immediately

37. d. Drain water that accumulates in main tank from compression of moist air 1) Water should be drained daily 2) Make sure pressure of tank is at zero 3) Open drain faucet or valve to release accumulated water

38. Oral Evacuation Systemor Central Vacuum System 1. Uses water for forming a suction or vacuum system to dental unit a. Aids in removing particles, debris, and liquids from oral cavity b. Similar to action of vacuum cleaner 2. System consists of main pump with vacuum lines to dental unit and is usually located in a storage area or utility closet

39. 3. Electrical control switches usually located on or near dental unit to turn pump on and off 4. Wastes and liquids drawn into system are discharged into a sanitary sewer line 5. Solids collector trap is located on oral evacuation unit or in the dental unit

40. a. Trap catches large particles and must be cleaned daily b. Particles should be emptied into paper towel and placed in correct waste container c. Trap should be washed with mild detergent, rinsed thoroughly, and dried d. Some manufacturers recommend using germicide spray or liquid daily to prevent growth of organisms and development of unpleasant odors

41. 6. Read and follow manufacturer’s instructions on specific care and maintenance or oral evacuation system

42. Assistant’s Cart 1. Vary from office to office 2. Most carts contain same basic equipment 3. Drawers or areas for instrument storage found on most carts 4. Many carts have sliding top with storage area under top 5. Hand-pieces such as tri-flow syringe, saliva ejector, and high velocity oral evacuator frequently located on cart

43. Tri-Flow or Air-Water Syringe 1. Provides air, water, or combination of air and water for various dental procedures 2. After each use, air-water syringe should be run for at least 30 seconds to flush out the unit 3. Plastic disposable tips are discarded 4. Metal tip is removed for sterilization in an autoclave

44. 5. Tip must be changed and replaced with sterile tip after each patient 6. Syringe and tubing must be wiped with disinfectant after each patient

45. Saliva Ejector 1. Provides a constant low volume suction to remove saliva from mouth 2. Most units contain screw-type know to turn suction on and off 3. Tips are disposable and must be changed between patients Saliva Ejectors

46. 4. Tip holder is covered with a protective barrier during use a. Barrier is removed after each patient b. Holder and tubing are disinfected c. New barrier is put in place 5. At least once daily, inside of tip holder should be cleaned thoroughly with a brush

47. 6. Germicide solution or spray can also be used for the inside of the tip holder 7. The tubing can be sanitized by turning the saliva ejector on and drawing a disinfecting and deodorizing solution into it

48. High Velocity Oral Evacuator 1. Also called high volume or high vacuum evacuator 2. Used to remove particles, debris, and large amounts of liquid from the oral cavity 3. Various tips are used in evacuator a. Plastic disposable tips are discarded after each patient b. Metal tips and non-disposable heavy plastic tips are cleaned and sterilized in an autoclave after each patient

49. Oral Evacuator Tips

50. 4. Evacuator holder is covered with a protective barrier during the procedure a. Barrier is removed after each patient b. Holder and tubing are disinfected c. New barrier is put in place 5. Disinfecting and deodorizing solution can be suctioned into the tubing to sanitize the interior of the unit