Essential Skills And Procedures For Chairside Dental Assisting

Delmar’sHANDBOOK OFEssential Skills andProcedures forChairside DentalAssistingDonna J. Phinney, CDA, BA, MEdSpokane Community CollegeJudy H. Halstead, CDA, BASpokane Community CollegeDELMARi%CENGAGE Learning'Australia Brazil Japan Korea Mexico Singapore Spain United Kingdom United States

; V DELMARCENGAGE Learning'Delmar’s Handbook of Essential Skills andProcedures for Chairside Dental AssistingDonna J. Phinney.Judy H. HalsteadBusiness Unit Director: William BrottmillerAcquisitions Editor: Marie LinvillEditorial Assistant: Jennifer FrisbeeExecutive Marketing Manager: DawnF. GerrainProject Editor: Maureen M. E. GrealishProduction Coordinator: Nina LontratoArt/Design Coordinator: Connie LundbergWatkinsCover Design: Connie Lundberg-Watkins 2002 Delmar, Cengage LearningALL RIGHTS RESERVED. No part of this work covered by the copyright hereinmay be reproduced, transmitted, stored or used in any form or by any meansgraphic, electronic, or mechanical, including but not limited to photocopying,recording, scanning, digitizing, taping, Web distribution, information networks,or information storage and retrieval systems, except as permitted under Section107 or 108 of the 1976 United States Copyright Act, without the prior writtenpermission of the publisher.For product information and technology assistance, contact us atCengage Learning Customer & Sales Support, 1-800-354-9706For permission to use material from this text or product,submit all requests online at www.cengage.com/permissionsFurther permissions questions can be emailed topermissionrequest@cengage.comLibrary of Congress Control Number: 3457-3DelmarExecutive Woods5 Maxwell DriveClifton Park, NY 12065USACengage Learning is a leading provider of customized learning solutions withoffice locations around the globe, including Singapore, the United Kingdom, Aus tralia, Mexico, Brazil, and Japan. Locate your local office at international.cengage.com/regionCengage Learning products are represented in Canada byNelson Education, Ltd.For your lifelong learning solutions, visit www.cengage.com/delmarVisit our corporate website at cengage.comNotice to the ReaderPublisher does not warrant or guarantee any of the products described herein or perform any independent analysis in connection with any of the product informationcontained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than that provided to it by the manufacturer.The reader is expressly warned to consider and adopt all safety precautions that might be indicated by the activities described herein and to avoid all potential hazards. Byfollowing the instructions contained herein, the reader willingly assumes all risks in connection with such instructions. The publisher makes no representations or warrantiesof any kind, including but not limited to, the warranties of fitness for particular purpose or merchantability, nor are any such representations implied with respect to thematerial set forth herein, and the publisher takes no responsibility with respect to such material. The publisher shall not be liable for any special, consequential, or exemplarydamages resulting, in whole or part, from the readers’ use of, or reliance upon, this material.Printed in the United States of America9 10 11 13 12 11

CONTENTSSection I: INTRODUCTION TODENTAL ASSISTING AND BASICDENTAL SCIENCES 1Cavity Classifications 53Abbreviations for Tooth SurfacesBasic Charting Terms 55Charting Color Indications andSymbols 5654Chapter 1 I Dental Assisting—The Profession 3The Career of Dental Assisting 4Employment for the Dental Assistant 4The Dental Team 6Dental Jurisprudence and Ethics 12Dental Practice Act 12State Board of Dentistry 12The Dentist, the Dental Assistant, and theLaw 13Standard of Care 13Dental Records 14Ethics 14Chapter 2 I Oral HealthIntroduction 16Preventive DentistryFluoride 221516Introduction 26Bones of the Head 27Muscles of Mastication 30Nerves of the Head and Neck 31Circulation to the Head and Neck 32Chapter 4 I Tooth Anatomy andSupporting Structures 35Tooth Structure 36Components of the Periodontium 36Dental Arches 38Dental Quadrants 38Types of Teeth and Their Functions 39Eruption Schedule 41Surfaces of the Teeth 42Anatomical Structures 45Introduction 50Dental Charts 50Numbering Systems50Chapter 6 I InfectionControl/Sterilization Procedures67Introduction 68Rationales and Regulations 68Cross-Contamination Pathways 72Routes of Microbial Transmission 73Infection Control in the Dental OfficeDisinfection 79Sterilization 84Sterilization Monitoring 86Clinical Asepsis Protocol 8673Chapter 7 I Management ofHazardous Materials 93Chapter 3 Head and NeckAnatomy 25Chapter 5 I Dental C hartingSection II: PRECLINICALDENTAL SKILLS 6549Introduction 94Engineering/Work Practice ControlsSharps 101Hazardous Chemicals 103100Chapter 8 I Preparation for PatientCare 105Introduction 106Patient History 106Vital Signs 107Section III: CLINICAL DENTALPROCEDURES 113Chapter 9 I Chairside AssistingSkills 115Dental Office Design 116Treatment Rooms 116Routine Office Care 122Concepts of Dental Assisting123

CONTENTSSeating the Dental Patient 125Positioning the Assistant 126Dismissing the Patient 128Instrument Transfer 128Maintaining the Operating Field133Chapter 10 I Dental Instrum ents andTray Systems 139Introduction 140Instruments for Basic ChairsideProcedures 140Dental Rotary Instruments 148Abrasives 151Dental Handpieces 153Tray Systems 155Chapter 1 1 1 DentalRadiography 157Introduction 158Biological Effects of Radiation 159Dental X-Ray Unit/Components 159Safety and Precautions 160Radiation Production 160Dental X-Ray Film 161Producing Quality Radiographs 162Processing Quality Radiographs 181Mounting Radiographs 188Legal Implications of Radiographs 190Chapter 12 1 Topical and LocalAnesthesia 191Introduction 192Anesthetics, Syringes, and Needles192Chapter 13 I Dental Cementsand Restorative Materials andTechniques 197Introduction 198Types of Restorative DentalMaterials 198Dental Cements 199Bonding Agents 209Restorative Dentistry 211Amalgam Restorative Materials 212Composite Restorative Materials 218Glass lonomer Restorations 218Chapter 14 I Laboratory Materialsand Techniques 221Introduction 222Hydrocolloid Impression Materials 222Elastomeric Impression Materials 230Gypsum Materials 236Articulating Casts or Study ModelsDental Waxes 246Custom Trays 248Constructing a Custom Tray 249Vacuum-Formed Tray 252246Chapter 15 1 Endodontics255Introduction 256Progress of Pulpal and PeriapicalDiseases 256Endodontic Diagnosis 257Endodontic Instruments 259Endodontic Materials 262Endodontic Procedures 263Surgical Endodontics 266Chapter 16 1 Oral and M axillofacialSurgery 269Introduction 270Oral Surgery Instruments 271Asepsis in Oral Surgery 273Patient Preparation 277Oral Surgery Procedures 278Dental Implants 287Sutures 289Procedures Prior to Removal ofSutures 289Suture Removal Criteria 290Suture Removal 290Post Suture Removal 292Chapter 17 1 O rthodontics295Introduction 296The Orthodontic Assistant 296Types of Orthodontic Treatment 297Preorthodontic Treatment 297The Consultation Appointment 298Orthodontic Appliances 298Orthodontic Instruments 300Orthodontic Treatments 301Completion Appointment 307Chapter 18 I Pediatric Dentistry309Introduction 310Procedures in Pediatric Dentistry 310Emergency Treatment for TraumaticInjuries 317Chapter 19 t Periodontics319Introduction 320The Periodontal Dental Assistant 320Periodontal Disease 320

CONTENTS Periodontal Diagnostic Procedures 321Periodontal Instruments 323Nonsurgical Procedures 325Surgical Periodontal Procedures 328Periodontal Dressing 332Chapter 20 I FixedProsthodontics 335Introduction 336Patient Considerations 336Types of Fixed Prostheses 336Types of Materials Used for FixedProstheses 339Role of the Dental Assistant 342Retention Techniques 344Implant Retainer Prosthesis 346Chapter 21 I RemovableProsthodontics 347Introduction 348The Dental Assistant's Role 348Diagnosis and Treatment Planning 348The Consultation Appointment 348The Removable Partial Denture 348The Complete Denture 352Denture Reline 359Polishing the Removable Prosthesis 361Chapter 23 Dental Dam and M atrixand W edge Techniques 387Introduction 388Materials and Equipment 388Preparation Before Placement of theDental Dam 391Placement and Removal of the DentalDam 392Preparation of a Tooth forRestoration 395Wedges 396Tofflemire Matrix 396Plastic Strip Matrix 397Chapter 24 I G ingival Retraction andSection IV: ADVANCEDFUNCTIONS 363Chapter 22 I Pit and Fissure Sealants,and Bleaching Techniques 365Introduction 366Abrasives and Polishing AgentsEquipment and Supplies 367Coronal Polish Procedures 371Cavity Liners, Varnishes, and CementBases 372Cavity Preparation/PulpalInvolvement 374Treatment of Cavity Preparations 374Cavity Liners 376Cavity Varnish 376Cement Bases 376Pit and Fissure Sealant Materials 376Placement of Pit and FissureSealants 380Bleaching Techniques 382366Tem porary Restorations 403Introduction 404Types of Gingival Retraction 404Temporary (Provisional)Restorations 407Index I417

PREFACEThis book is designed as a learning tool for dental assistants who have no pre vious professional education or are in a short-term training program. It is alsoideal as an office handbook for new dental assisting staff. The book is a resizedand reformatted approach of the main dental assisting textbook, Delmar’sDental Assisting, A Comprehensive Approach. Rather than the comprehensivecoverage of the main text, this handbook focuses on the essential clinical den tal assisting skills without going into depth in the background information. Thetext is divided into four primary sections. The first section, “Introduction toDented Assisting and Basic Dental Sciences” (Chapters 1-5), provides informa tion about the profession of dental assisting, along with oral health, head andneck anatomy, tooth anatomy and supporting structures, and dental charting.The second section, “Preclinical Dental Skills” (Chapters 6-8), covers infectioncontrol and management of hazardous materials. This section also coverspreparing the patient, reviewing health history, and reading vital signs. Thethird section, “Clinical Dental Procedures” (Chapters 9-21), covers chairsideassisting skills, dental instruments and tray systems, dented radiography, topi cal and local anesthesia, dental cements and laboratory materials, and thedental specialties. The final section, “Advanced Functions” (Chapters 22-24),covers coronal polish, cavity liners, varnish and cement bases, pit and fissuresealants, bleaching techniques, dental dam, matrix and wedge techniques,retraction cord, and temporary restorations.The chapters include the following pedagogical features: Chapter objectives Key termsI In-text icons indicating handwashing, gloves, mask and protective eyewear,basic setup, and expanded functionI Step-by-step procedures Detailed information on dental assisting competencies Icons at the beginning of procedures to indicate which function, instru ments, and protective equipment are needed Equipment and supplies lists prior to procedures Boxed information containing tips and summaries

DENTAL SCIENCES 1 Chapter 1 I Dental Assisting— The Profession 3 The Career of Dental Assisting 4 Employment for the Dental Assistant 4 The Dental Team 6 Dental Jurisprudence and Ethics 12 Dental Practice Act 12 State Board of Dentistry 12 The Dentist, the Dental Assistant, and the Law 13 Standard of Care 13 Dental Records 14 Ethics 14