Are you and your patient sitting in the right position?

When it comes to dental procedures and comfort of the patient and the dentist is one of the most important and foremost things in the entire procedure. The dental chair has to be digitally equipped so that the flexibility can be managed according to the comfort zone of both the dentist and the patient. 

When the patient is comfortable on the chair and the doctor is in the correct position to operate the patient, it makes it easy for the doctor to have proper accessibility and visibility to the oral cavity. The proper positioning of the dentist makes it less strainful and fatigue for the patient. Proper positioning also helps in avoiding or has fewer chances of musculoskeletal disorder. 

Position of the Dental chair

The position of the chair can be placed in three different forms: 

  • Upright position 
  • Supine position
  • Reclined 45° position

 Supine and Reclined 45° are the most preferred position for the doctors to carry out the dental operations.  

When in the supine position the head, knee, and feet if the patient is approximately at the same level. In Reclined 45°, mostly the mandibular and occlusal surfaces are visible and operated on. 

 The position or the angle of the chair is all about the comfort of the patient. Once the position of the patient is set the dentist can find their comfortable place according to the treatment preference.

Operating position of the dentist:

The position of the dentist depends on various aspects which makes it comfortable for the dentist such as the patient should be at the elbow level of the doctor, legs and back of the dentist should be relaxed in order to carry out the procedure flawlessly. 

 Similarly, the angle and the sitting position of the operator also has a great impact on the operation. The sitting position of the dentist is designed according to the angle of the clock, where the head of the patient is treated as the center. 

 The treatment angle for the right-handed operators is from 7 o’clock to 11 o’clock and for left-handed operators, it is from 5 o’clock to 1 o’clock and 12 o’clock.

 

7 o’clock: 

7 o’clock in the front position which helps in examining the patient and gives clear visibility and makes it easy when the face is turned towards the dentist. This is the preferred position when the working areas are Mandibular anterior, Mandibular right posterior teeth, and Maxillary anterior teeth.   

 

9 o’clock:

In 9 o’clock position the dentist is exactly at the right angle to the patient. The working areas for this position are the facial surfaces of the maxillary and mandibular right posterior teeth, and the occlusal surface of mandibular right posterior teeth.

 

11 o’clock:

11 o’clock is treated as one of the most preferred and comfortable positions for dentists as it gives visibility and accessibility for both direct and indirect vision. The working areas for this position are mandibular teeth with direct vision and palatal and incisal, occlusal surface for the maxillary teeth

 

12 o’clock:

At 12 o’clock position the dentist sits exactly behind the patient and this position is useful only for limited operations. Lingual surfaces of mandibular teeth are the working areas for this position.  

 

Working position according to Archs & Surfaces: 

Mandibular Arch and Anterior Surfaces: 

Anterior surfaces of the mandibular arch can be treated from two clock positions, i.e. 8-9 o’clock and 12 o’clock. When the dentist is operating from 8-9 o’clock position the anterior surface is towards the non-dominant hand. While operating from 12 o’clock position the anterior surface is away from non-dominant hand. The chin is slightly towards & downward in both the positions.

 Maxillary Arch and  Anterior Surfaces:

Anterior surfaces of the maxillary arch can be treated from two clock positions, i.e. 8-9 o’clock and 12 o’clock. When the dentist is operating from 8-9 o’clock position the anterior surface is towards the non-dominant hand. While operating from 12 o’clock position the anterior surface is away from non-dominant hand. The chin is slightly towards & upward in both the positions.

Mandibular Arch and Posterior Surfaces: 

While working on a mandibular arch, the right facial and left lingual aspects of posterior teeth at 9 o’clock where the head of the patient is slightly away and chin is downward. 

When the operator is working on the right lingual and left facial aspects of posterior teeth at 10-11 o’clock, the head of the patient is towards the operator and chin remains downward. 

Maxillary Arch and Posterior Surfaces:

The maxillary arch and posterior aspects can be treated in two clock positions, 10-11 o’clock & 9 o’clock position. For 10-11 o’clock the working areas are right lingual and left facial while the head of the patient is towards the dentist and the chin is upwards. 

For 9 o’clock position the working areas are left lingual and right facial and the head is away from the dentist and chin remains upward.

 Key aspects to be considered while operating:

  • The maxillary occlusal surfaces should be perpendicular while working on the maxillary arch.
  • The mandibular occlusal surface should be 45° to the floor while working on the mandibular arch.
  • Maintain the proper working distance as if gives confidence to the patient and increases cooperation.
  • Do not rest your arms on your patient’s shoulder. 
  • Do not put things or instruments on your patient’s chest.
  • Let your patient change position in order to avoid muscle strain and fatigue.

Following these principles and keep in mind the following aspects could help both the dentist and the patient to carry on the dental procedures.