1. Overall Classification: UNCLASSIFIED//REL TO NATO/ISAF

2.  The primary objective of the operator in positioning himself is to:  have access to the operating field.  have an unobstructed view of the operating field.  be physically comfortable. AFAMS Dental Advisor Team

3.  The operator should also keep in mind when positioning the patient that a patient seated in a comfortable position:  is under less nervous tension.  has reduced muscular tension.  is more capable of cooperating with the dentist. AFAMS Dental Advisor Team

4. The most common patient positions for operative dentistry are:  fully reclined with feet, knees and head at the same level (“nose to toes”) (only raise the feet and knees above head level with emergency syncope treatment).  reclined 45 degrees (= semi prone). AFAMS Dental Advisor Team

5. By assuming the natural operating positions and good posture, the operator:  reduces physical strain and fatigue.  prolongs physical endurance.  prolongs productive capabilities. AFAMS Dental Advisor Team

6. Several physical problems are fostered through the constant neglect of healthy operating positions. Therefore it is important to: ◦ avoid positions that create unnecessary curvature of the spinal column and slumping of shoulders ◦ have the trunk of your body in an upright position with shoulders back. This basic body position will ensure that circulation and breathing are not compromised. AFAMS Dental Advisor Team

7. Several physical problems are fostered through the constant neglect of healthy operating positions. Therefore it is important to: ◦ make sure that there is a proper distribution of balance on both feet (especially when operating in a standing position). When in a sitting position ensure that your feet are flat on the floor and your thighs are parallel or at a slight obtuse angle to the floor. AFAMS Dental Advisor Team

8.  Patient is reclined at a 45o angle.  Operator is at a 7 to 9 o'clock position facing the patient.  Operator’s back and neck should be reasonably straight.  Working position for hands should be elbow height.  Patient’s head is turned towards operator slightly. AFAMS Dental Advisor Team

10.  Patient is reclined at a 25o angle (from horizontal).  Patient’s head is turned towards operator slightly.  Operator is at a 10 to 11 o'clock position.  Working position for hands should be at elbow height. AFAMS Dental Advisor Team

12.  Seating Position For Mandibular Anteriors (either seating position above) AFAMS Dental Advisor Team

13. ◦ Patient fully reclined (horizontal) (or “nose to toes”). ◦ Operator in 11 to 12 o'clock position. ◦ Do not attempt to use direct vision, instead use the mirror when working in the upper quadrants. ◦ For added access and visibility, have patient lift his chin up slightly. ◦ Working position for hands should be at elbow height. AFAMS Dental Advisor Team

15.  These positions are for a right-handed individual and would be reversed for left- handed individuals.  The 11 to 12 o’clock position is the most stable position for the operator. AFAMS Dental Advisor Team

16. Overall Classification: UNCLASSIFIED//REL TO NATO/ISAF