University of Palestine College of Dentistry DR. MUSTAFA I. ELGHOUL B.SC,B.D.S,MS(ORTHO) Master of Orthodontic FOUR HANDED DENTISTRY& INFECTION CONTROL

What is Four-Handed Dentistry? Is an operatory technique that was conceptualized by many researchers during the early 1960's and formalized through clinical studies at the University of Alabama, School of Dentistry,

Applying time and motion study techniques used by industrial engineers to increase efficiency and productivity in repetitive task environments, the university studied dental procedures of hundreds of practicing dentists and dental students to define the criteria for Four-Handed Dentistry

FOUR-HANDED DENTISTRY The goal of four-handed dentistry is to allow the dentist and assistant to function as a team in a seated position with maximal efficiency and minimal strain

Four-handed dentistry, as it has been developed, not only increases productivity, but also reduces stress and fatigue on the provider and assistant. Four-handed dentistry can be used in all of the specialty areas, and in operative dentistry.

The Concept The two most frequent issues facing practicing dentists are (1) the need to minimize stress and fatigue and (2) the need to maintain or even increase productivity without sacrificing the quality of care. As the practice of dentistry has become more complex with intervention at almost every level by third parties and government agencies, the intrusion on the dentist's chairside time has become critical. The use of this concept of four-handed dentistry will enable the practitioner to spend their time at chairside more efficiently.

Concepts important to teamwork dentistry Done in seated position Done in seated position Patient position Patient position Work area used Work area used Operatory equipment Operatory equipment Availability of second assistant Availability of second assistant Instrument exchange Instrument exchange

The dentist has many choices as to what they will do with time saved: 1- One can see more patients, 2- spend more time with each patient, 3- spend the time in other activities.

Four-handed dentistry, therefore, we should see it as the effective use of the principles of time and motion allowing the practitioner more schedule flexibility

The Benefits Include: -- There is an increase in the efficiency of the dentist through the use of a full time trained chair side assistant. --- There is a decrease in the muscular stresses involved with the practice of dentistry through conservation of muscular activity,

-- adherence to the principles of balanced posture. -- The dentist is able to concentrate their skill and judgment on the tasks directly associated with patient care.

The concept of four-handed dentistry described by Dr. G.E.Robinson and others will be reviewed. Research shows that production can be increased by 100% and simultaneously stress and fatigue will be reduced by 50% -70%.

The following will describe 1- the principles of four-handed dentistry, 2- areas of activity, 3- work simplification and motion economy. 4- the proper selection and arrangement of operatory equipment according to the criteria as established by the research completed at the University of Alabama principles of four-handed dentistry

This system of four-handed dentistry is based on the following principles: 1. POSITIONS: The dentist (or hygienist), assistant and patient are seated and positioned properly. 2. ASSISTANT UTILIZATION: The operator uses the skills of competent, full-time chair side assistant.

3. TREATMENT ORGANIZATIONS: Every aspect of the patient's treatment is organized and repetitive tasks simplified to take maximum advantage of the chair side time available. 4. EQUIPMENT ARRANGEMENT: The equipment used is selected carefully and positioned properly to enable the operating team to use the principles of work simplification and motion economy principles