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Chapter 18
Dental Assistant Skills
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Two Sets of Teeth
• Dentitions: sets of teeth
• Primary or deciduous dentition
• Permanent or succedaneous dentition
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The Tooth
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Crown—visible in the mouth
Root—below the gum line
Cervix—where the crown meets the root
Apex—tip of the root
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Dental Care
• Disease can affect the teeth and supporting
structures
• Dental care
– Preventing and treating dental disease
– Preserving and prolonging the life of the teeth
© 2009 Delmar, Cengage Learning
18:2 Identifying the Teeth
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Incisors—front and center of the mouth
Cuspids—at angles of lips
Bicuspids—before the molars
Molars—back of the mouth
© 2009 Delmar, Cengage Learning
Primary or Deciduous Teeth
• First set of teeth—called “baby” teeth
• 20 teeth
• Naming of teeth
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Permanent or Succedaneous Teeth
• Second or permanent set of teeth
• 32 teeth
• Naming of teeth
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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
© 2009 Delmar, Cengage Learning
18:4 Identifying the Surfaces
of the Teeth
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Anterior (toward the front) teeth
Posterior (toward the back) teeth
Crown surfaces
Suggested abbreviations
(continues)
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning
Charting Conditions of the Teeth
(continued)
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Geometric diagrams
Surfaces of teeth
Charting guidelines
Common symbols for anatomic or
geometric diagrams
• Recording treatments or services
• Use of computerized dental charting
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning
Operating and Maintaining
Dental Equipment
(continued)
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Dental light
Dental chair
Air compressor
Oral-evacuation system
Assistant’s cart
Tri-flow or air-water syringe
Saliva ejector
(continues)
© 2009 Delmar, Cengage Learning
Operating and Maintaining
Dental Equipment
(continued)
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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)
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
18:7 Identifying Dental Instruments
and Preparing Dental Trays
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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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning
Demonstrating Brushing and
Flossing Techniques
(continued)
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Purposes
Demonstrations
Bass method
Five surfaces on each tooth
Toothbrushes
Toothpastes or dentifrices
Dental floss
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
18:10 Taking Impressions
and Pouring Molds
• Impression
– 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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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)
© 2009 Delmar, Cengage Learning
Rubber Base or Polysulfide
(continued)
• Models should be poured promptly
if possible
• Disadvantages
• Basic principles of preparing rubber base
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Silicones
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Polysiloxane or polyvinylsiloxane
Available in different material qualities
Supplied in two tubes—base and catalyst
Advantages
Disadvantages
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
18:12 Maintaining and Loading an
Anesthetic Aspirating Syringe
• Anesthesia is used for pain control
• Types of anesthesia
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General anesthesia
Analgesia
Local anesthesia
Topical anesthesia
© 2009 Delmar, Cengage Learning
Injections
• Two main kinds of injections for used for
local anesthesia
– Block
– Infiltration
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Types of medications
Anesthetic carpules (cartridges)
Aspirating syringes
Follow standard precautions
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
Amalgam
• Restorative material used mostly on
posterior teeth
• Contains four main metals
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Silver
Tin
Copper
Zinc
(continues)
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning
18:15 Developing and Mounting
Dental X-Rays
• Dental X-rays or radiographs
– Radiolucents
– Radiopaque
• Types of dental radiographs
• Developing films
• Mounting X-rays
© 2009 Delmar, Cengage Learning
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
© 2009 Delmar, Cengage Learning