Dental Assistant Skills Chapter 18 Dental Assistant Skills

Career Highlights Dental assistants are valuable members of the dental health care field Education requirements Certification obtained through the Dental Assisting National Board Duties performed follow state regulations Required skills

18:1 Identifying the Structures and Tissues of a Tooth Odontology: study of the anatomy, growth, and diseases of the teeth Teeth are accessory organs of the digestive tract Aid in mastication (chewing) of food

Two Sets of Teeth Dentitions: sets of teeth Primary or deciduous dentition Permanent or succedaneous dentition

The Tooth Crown—visible in the mouth Root—below the gum line Cervix—where the crown meets the root Apex—tip of the root

Tissues of the Tooth Enamel—covers the crown Cementum—covers the outside of the root Dentin—located under the enamel and cementum of the root Pulp—in the inner area of the tooth

Periodontium Structures that surround and support teeth Alveolar process or ridge—surrounds the roots and has sockets Periodontal ligament—supports the tooth in the socket Gingiva or gums—surrounds the cervix

Dental Care Disease can affect the teeth and supporting structures Preventing and treating dental disease Preserving and prolonging the life of the teeth

18:2 Identifying the Teeth Incisors—front and center of the mouth Cuspids—at angles of lips Bicuspids—before the molars Molars—back of the mouth

Primary or Deciduous Teeth First set of teeth—called “baby” teeth 20 teeth Naming of teeth

Permanent or Succedaneous Teeth Second or permanent set of teeth 32 teeth Naming of teeth

18:3 Identifying Teeth Using Numbering Systems Universal National Numbering System Identified by using letters A to T Federation Dentaire International System Two-digit code and 4 quadrants

18:4 Identifying the Surfaces of the Teeth Anterior (toward the front) teeth Posterior (toward the back) teeth Crown surfaces Suggested abbreviations (continues)

Identifying the Surfaces of the Teeth (continued) Line angles—form where two crown surfaces meet Point angles—form where three crown surfaces meet Abbreviations for line angles and point angles of anterior teeth Abbreviations for line angles and point angles of posterior teeth

18:5 Charting Conditions of the Teeth Conditions of the teeth are often charted on dental charts or insurance forms Forms, symbols used, abbreviations, and other factors vary Dental charts are legal records Dental charts Anatomic diagrams (continues)

Charting Conditions of the Teeth (continued) Geometric diagrams Surfaces of teeth Charting guidelines Common symbols for anatomic or geometric diagrams Recording treatments or services Use of computerized dental charting

18:6 Operating and Maintaining Dental Equipment Follow manufacturer’s recommendations for operation of equipment Infection control Personal protective equipment (PPE) Occupational Safety and Health Administration (OSHA) Covers for dental equipment (continues)

Operating and Maintaining Dental Equipment (continued) Dental light Dental chair Air compressor Oral-evacuation system Assistant’s cart Tri-flow or air-water syringe Saliva ejector (continues)

Operating and Maintaining Dental Equipment (continued) High-velocity oral evacuator Cuspidor Doctor’s cart Low-speed hand piece Contra angle for cutting and polishing Prophylaxis angle for holding cups, etc. High-speed handpiece (ultraspeed)

Summary Responsibilities for care and maintenance of dental equipment will vary Dental assistant should learn exactly what maintenance is expected as a part of the job Read specific manufacturer’s instructions for equipment you will handle

18:7 Identifying Dental Instruments and Preparing Dental Trays Methods for setting up dental trays Organization of trays Main parts of a dental hand instrument Standard instruments Guidelines for preparing dental trays Examples of tray set-ups Basic principles for preparing dental trays

18:8 Positioning a Patient in the Dental Chair Designed to position patient comfortably while providing doctor and assistant easy access to oral cavity Headrests Supine position Explanation of all chair movements Protective drape and safety glasses Positioning of light Principles of seating patient in dental chair

18:9 Demonstrating Brushing and Flossing Techniques Using correct brushing and flossing techniques is essential in prevention of dental disease May be responsible for teaching patients Correct brushing and flossing is one method of prophylactic care (continues)

Demonstrating Brushing and Flossing Techniques (continued) Purposes Demonstrations Bass method Five surfaces on each tooth Toothbrushes Toothpastes or dentifrices Dental floss

Summary Correct brushing and flossing provides prophylactic care Give thorough explanation to all patients Be sure patient understands procedures Asking patient to demonstrate procedures is a good way to determine if all points have been learned

18:10 Taking Impressions and Pouring Molds Negative film reproduction of a tooth, several teeth, or a dental arch Taken to form a model of the area for restoration treatment that will take place outside of the mouth Common materials used to take impressions

Alginate Hydrocolloid impression material that cannot be returned to its original state Advantages Disadvantages Alginate powder—follow manufacturer’s recommended directions Principles for taking alginate impression Storage of alginate material

Rubber Base or Polysulfide Elastomeric impression material that is elastic and rubbery in nature Three types are available Can be used in any type of dental impression Not as subject to dimension changes as alginate (continues)

Rubber Base or Polysulfide (continued) Models should be poured promptly if possible Disadvantages Basic principles of preparing rubber base

Silicones Polysiloxane or polyvinylsiloxane Available in different material qualities Supplied in two tubes—base and catalyst Advantages Disadvantages

Gypsum Products Two main products to form models Plaster Stone Principles for the use of gypsum Follow standard precautions for infection control when taking impressions and pouring models

18:11 Making Custom Trays Impression trays that are made to fit patient’s mouth Materials used to produce trays Acrylic resins are self-curing or light-curing Types of custom trays Clean and replace all equipment

18:12 Maintaining and Loading an Anesthetic Aspirating Syringe Anesthesia is used for pain control Types of anesthesia General anesthesia Analgesia Local anesthesia Topical anesthesia

Injections Two main kinds of injections for used for local anesthesia Block Infiltration Types of medications Anesthetic carpules (cartridges) Aspirating syringes Follow standard precautions

18:13 Mixing Dental Cements and Bases Cements and bases used in variety of dental procedures Terminology Types of products Basic principles of mixing cements and bases

18:14 Preparing Restorative Materials Restoration: process of replacing a diseased portion of a tooth or a lost tooth by artificial means May include filling material, crowns, bridge, denture, partial denture, or implant Dental caries or decay

Amalgam Restorative material used mostly on posterior teeth Contains four main metals Silver Tin Copper Zinc (continues)

Amalgam (continued) Mercury when added to other metals forms amalgam Must be handled with care due to toxicity Use protective clothing Follow manufacturer’s recommendations

Composite Restorative material used primarily for the repair of anterior teeth Self-curing (chemical-curing) Light-curing Various shades to blend with teeth Follow manufacturer’s instructions

18:15 Developing and Mounting Dental X-Rays Dental X-rays or radiographs Radiolucents Radiopaque Types of dental radiographs Developing films Mounting X-rays

Summary The dental assistant acquires many skills Use of these skills enables the dental assistant to perform or assist with many procedures in the dental care setting Following procedures the assistant is often responsible for cleaning and care of equipment used