DLA 1203- Exam 1

1. Routine Office Care
CHAPTER 17

2. Routine Office Care
 A daily routine to open and close the office must be
followed.
 This ensures that all steps and procedures are up and
running for the day as well as ready for the next day.

3. Opening the Office
 Often the responsibility of the Dental Assistant
 Daily, weekly, or monthly maintenance tasks might include:
 Changing xray processing solutions
 Cleaning the inside of the sterilizers
 Changing ultrasonic solutions
 Performing monitoring activities to check the effectiveness of the
sterilizers
 Making miscellaneous repairs

4. Opening and Closing the Office
 Whoever is responsible for opening, usually arrives 30-
45 minutes early and completes routine before other
staff members arrive
 Responsible for closing stays after last patient and
makes sure that everything is turned off and office is
ready for patients the next day

5. Daily Routine to Open Office
 Procedure Steps
1. Turn on master switches to lights, each dental unit, the vacuum system, and the air compressor.
2. Check the reception room, turn on lights, straighten the magazines and the children's area, and unlock the
patients' door to the office.
3. Turn on the communication system, check the answering machine or the answering system, start the
computers, unlock the files, and organize the business area.
4. Post copies of patient schedules in designated areas throughout the office according to HIPAA regulations.
5. Turn on all equipment in the x-ray processing area. Change the water in the processing tanks and replenish
solutions, if necessary.
6. Change into appropriate clinical clothing, following OSHA guidelines.
7. Review the daily patient schedule.
8. Prepare treatment rooms for the first patients. Check supplies, place barriers, fill water reservoirs, and review
patient records. Then, prepare the appropriate trays and lab work for the first patients.
9. Turn on any sterilizing equipment and check solutions levels. Prepare new ultrasonic and disinfection
solutions. Complete overnight sterilization procedures.
10. Replenish supplies needed for the day.

6. Daily Routine to Close the Office
 Procedure Steps
1. Clean the treatment rooms. This may include an in-depth cleaning of the dental
chair and dental unit. Flush the handpieces and air-water syringes, run solutions
through the evacuation hoses, clean traps/filters, and maintain water reservoirs.
2. Position the dental chair for evening housekeeping.
3. Turn off all master switches.
4. Process, mount, and file x-rays. Follow manufacturer instructions to shut down
automatic processors. Turn off water supply to manual processing tanks.
5. Wipe counters and turn off the safe light.
6. Sterilize all instruments and set up trays for the next day.
7. Empty ultrasonic solutions and turn off all equipment.
8. Restock supplies.

7. Daily Routine to Close the Office- CONT.
9. Make sure all laboratory cases have been sent to the lab and early-morning cases have been
received from the lab.
10. Confirm and complete appointment schedule for the next day, insurance forms, and daily
bookkeeping responsibilities. Pull charts for the next day or review patient information on
computer.
11. Turn off business office equipment and turn on the answering machine or service. Lock patient and
business office files.
12. Straighten the reception room. For the security of the office, all doors and windows should be
locked.
13. Change from uniform to street clothes, following OSHA guidelines.
14. Turn off machines in the staff lounge and clean tables and counters.

8. Concepts of Dental Assisting

9. Four- or Six-Handed Dentistry
 In four-handed dentistry, the assistant assists the dentist through the entire
procedure.
 If an additional assistant is necessary, this is called six-handed dentistry.

10. Activity Zones
Operating zone
Assisting zone
Static zone
Transfer zone
Shown for right-handed operator

11. Activity Zones
 The operating zone is where the operator is positioned to access the
oral cavity.
 The assisting zone is where the assistant is positioned to assist the
dentist and easily access equipment.
 The static zone is from 12 to 2 o’clock for a right-handed operator and
from 10 to 12 o’clock for a left-handed operator.
 The transfer zone is the area below the patient’s nose where
instruments and materials are passed between the dental assistant and
dentist.

12. Classifications of Motions
 Class I: Only finger movement
 Class II: Fingers and wrist
 Class III: Fingers, wrist, and elbow
 Class IV: Entire arm and shoulder
 Class V: Arm and twisting of body
 For proper ergonomics, the dental assistant should be
positioned in such a manner that only Class I, II, and III
motions are achieved.

13. WHICH CLASSIFICATION OF MOTION
INVOLVES MOVEMENT OF THE ENTIRE
ARM AND SHOULDER?
CLASS IV MOTION

14. Preparing the Treatment Room
 Prior to seating the patient
The treatment room must be properly disinfected
New barriers should be placed
The room should be tidied to be ready for the patient’s arrival.
 The dental assistant should also take some time to review
the patient’s records prior to seating the patient.

15. Seating the Dental Patient
Greet and escort
Seat and prepare
Napkin/bib
Safety glasses
Supine position
Position light

16. Seating the Dental Patient
 The dental assistant’s clinical observations of the patient
begin as the patient is greeted and escorted to the treatment
room.
 Assess for gait, proper verbal responses to questions, and
facial abnormalities.
 Once the patient is seated, place appropriate PPE and
position the light, instruments, and chair as required.

17. Ergonomics for the Operator and Assistant
 Ergonomics
Study and analysis of human work
Including anatomic and psychological aspects of people and their work
environments
Proper ergonomics will reduce the stress and strain on the dental
assistant and dentist.
This will keep dental team members healthier and allow them to
work with more efficiency.

18. Ergonomics for the Operator
 Positioned squarely
 Weight distributed evenly
 Feet flat on floor
 Back supported and in upright position
 Elbows close to body
 Position is the key to limit classifications of motion and allow access to
the oral cavity and improved visibility of the work field.

19. Ergonomics for the Operator
 Patient’s chair lowered over operator’s thighs
 Distance between operator’s face and patient’s oral cavity
approximately 14 to 18 inches

20. Ergonomics for Assistant
 Stool
4 to 6 inches above operator’s stool
 Weight distributed evenly over seat
 Front edge of stool even with patient’s mouth
 Feet on base of stool with thighs parallel to floor
 The assistant must have ready access to the instruments as
well as to be able to clearly see the work field.

21. Dismissing the Patient
Raise chair to upright position
Wipe debris from patient’s face
Ask if patient has questions
Give post-operative instructions
Escort patient to reception area

22. Patients with Special Needs
 Child
 Senior
 Pregnant
 Hearing impaired or blind
 Patients with wheelchairs or walkers
 Patients who do not speak English

23. Patients with Special Needs
 Care of the child will need to be tailored to the age of the child and the
child’s emotional and physical needs. Accommodations in seating the
child may need to be made.
 Address the child as well as the parent, and direct questions to children who are
of age to answer for themselves.
 Older patient’s may need assistance, and measures may need to be
made to accommodate them comfortably.
 The medical history of the senior patient should be carefully reviewed for
changes in health status.

24. Patients with Special Needs
 Pregnant patients may have difficulty breathing in certain conditions, and accommodations may
need to be made for this.
 Pregnant patients should not be subjected to x-rays.
 The hearing impaired patient may need to see the dental assistant’s or dentist’s lips in order to
understand questions and follow commands.
 The blind patient may need guidance and should be talked through the procedure.
 Patients with a wheel chair may need assistance in transfer from the wheel chair to the dental
chair.
 Patients who do not speak English may need the assistance of an interpreter or may need to see
visuals for instructions on care and procedures.

25. WHAT ARE SOME THINGS A DENTAL
ASSISTANT CAN DO TO AID THE PATIENT WHO
IS HEARING IMPAIRED?
Position oneself so the patient can see lip movement and
facial expression; speak slowly; make eye contact;
perhaps learn some sign language