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What is Four-Handed Dentistry?

Four-Handed Dentistry is an operatory technique that was


conceptualized by many researchers during the early 196!s and
"ormalized through clinical studies at the #ni$ersity o" %labama
&chool o" Dentistry' "unded by go$ernment grants in the late 196s(
%pplying time and motion study techniques used by industrial
engineers to increase e""iciency and producti$ity in repetiti$e tas)
en$ironments' the uni$ersity studied dental procedures o" hundreds
o" practicing dentists and dental students to de"ine the criteria "or
Four-Handed Dentistry(
The Concept Developed specified:
1( *ositioning - +orrect interaction o" personnel
,( -rganization - *rocedural and wor) "low
.( /quipment - +riteria and selection process
%pplying the criteria and concept allowed the attainment o" more
e""ecti$e and e""icient dentistry( 0his research pro$ed 1ncreased
producti$ity' 2educed stress and "atigue' and 1mpro$ed quality o"
dental care was achie$able by all dentists(
MYTH ... The Doctor or hygienist and the assistant, utilizing two
hands each (which euals four hands!, are perfor"ing #our$Handed
Dentistry.
#%CT ... &nless the assistant has 'een properly trained to create tea"
synergy, unless organization and standardization is e"ployed and
"aintained in operatories, and unless ergono"ically designed
euip"ent is used, the dental tea" is in fact only perfor"ing
traditional sit$down dentistry.
#our$Handed Dentistry introduced &ynergy - the cooperati$e action
o" two bodies to signi"icantly enhance each others o$erall
producti$ity and e""ecti$eness - into the dental $ocabulary( 0he most
signi"icant time losses to a dentist are the unnecessary' wasted and
stress producing +lass 13 and 3 mo$ements( 0hese mo$ements
reduce producti$ity and increase time at chairside( &ince Ti"e is
Money' your income potential is signi"icantly reduced(
2esearch has shown that a properly trained' "ull-time chairside
assistant' applying synergistic concepts and wor)ing in an
ergonomically designed en$ironment with the right equipment' can
assume up to 9,4 o" all non-in$asi$e mo$ements( 0hrough the
elimination o" unnecessary and wasted motions in the operatory'
producti$ity increases o" up to 14 are obtained' patient care is
impro$ed' and reduced stress and "atigue are the bene"its o"
practicing true Four-Handed Dentistry(
/$ery minute spent at chairside per"orming unnecessary mo$ements
reduces producti$ity and the potential earnings o" the practice(
0ransthoracic deli$ery eliminates +lass 13 and 3 mo$ements that
reduce producti$ity and create stress and "atigue( When unnecessary
mo$ements are eliminated' producti$ity is increased and the practice
earns higher pro"its(

#our$Handed Dentistry (uip"ent
+linical research has identi"ied and de"ined the criteria required o"
equipment to achie$e increased producti$ity and to practice true
Four-Handed Dentistry(
/rgonomics 5i(e(' the combination o" human and machine into an
integrated and more producti$e unit6 demanded that proper design
was the o$erriding consideration among equipment criteria( 0he si7
components de"ined in the research and speci"ic criteria are8

*atient +hair8
*roperly designed to allow optimum see-ability into the oral ca$ity( 0he bac) must be thin
and narrow to "acilitate the operators! proper position(
0he chair must be solid(
1deal positioning o" the patient by either the operator or assistant(
%septic co$ering(
9aintains patient com"ort in all positions and utilizes a solid design to create a secure'
supporti$e plat"orm(


&tools8
*roperly designed "or correct posture' positioning' and
com"ort( *roper operator positioning to "acilitate circulation
o" blood to the lower e7tremities( &table bases( %bdomen
support "or assistant(


#nit8
*roperly designed so the assistant can trans"er all handpieces
and power instrumentation to the operator "rom the 0rans"er
:one( 0he unit must be positioned in the 0rans"er :one with
both doctor and assistant instrumentation on one unit(
% H&* transthoracic deli$ery unit allows the operator to maintain
concentration and the "ield o" $ision on the dental procedure(
#nit design must eliminate unnecessary turning' twisting and other
mo$ements which creates operator stress and "atigue' reduces
producti$ity' and decreases the quality o" patient care(


9obile +abinet8
*roperly designed and organized to allow the assistant access to commonly used materials
and supplies and with a plat"orm "or the pre-set tray and a wor) area( When properly
used' a mobile cabinet can contribute ;4 to an assistant!s e""iciency and creates "le7ibility
in the positioning o" "i7ed cabinetry(


*re-set 1nstrument 0rays8
*ro$ides an organized procedural "low o" hand instruments
and supplies in a sequenced manner and a sterile en$ironment(


Dental <ight8
*ro$ides ideal lighting "or see-ability( Designed to be color
corrected with a di""used pattern to reduce eye strain(
=1 ha$e used rear' side' a competitor!s transthora7
deli$ery' and the 9orita deli$ery system( )one compare
to the e""iciency and ease o" operation o" the H&* unit
system(=
Michael *. Milligan, D.M.D.
+loo"ington, ,llinois
-.erfor"ance and .roduct Credi'ility.... %s/ % Doctor 0ho
&ses the H1. (uip"ent 1yste"-
#our$Handed Dentistry 1e"inars
H&* o""ers the dental pro"ession the only li$e' hands-on seminar program on
Four-Handed Dentistry( -ur seminar' which is %>D appro$ed "or se$en hours
o" +ontinuing /ducation credits' is based on the research and clinical operating
technique de$eloped and taught' by the #ni$ersity o" %labama &chool o"
Dentistry(
+all "or more in"ormation about H&* seminars or see the education section o"
our website(
Co"e To *earn and (arn More
H&* welcomes e$ery practicing dentist to attend a seminar in our world class
"acilities in ?irmingham' %labama( 0his "acility contains our latest equipment
and employs the latest ad$anced lecture and training room "or interaction and
technique analysis between members o" the Dental 0eam( @ou will learn a more
pro"icient chairside technique and the concepts to impro$e quality o" dental
patient care' increase producti$ity and earn moreA
#our$Handed Dentistry 1e"inar Curriculu"
Tea" 1ynergy:
(2!Definition (3! .roductivity +enefits
.rinciples of Motion (fficiency:
(2! Classes of Move"ents (3! (li"ination (4! Co"'ination
(5! 6earrange"ent (7! 1i"plification (8! %ssistant &tilization
1pecific Concepts:
(2! .roper .ositioning (3! .rocedural #low (4! (uip"ent Criteria
(5! (uip"ent %rrange"ent (7! 1tandardization (8! ,nstru"entation
(9! Handpiece Transfer (:! ,nstru"ent Transfer (;! .re$tray 1et$ups
(2<! (vacuation Techniues (22! %ppoint"ent Control
-, congratulate you for your efforts and /now that your
progra" can help "any dentists and au=iliaries. , have
supported and taught the concept for over 4< years. , find that
your euip"ent is the "ost revolutionary on the "ar/et today
tailored for the teaching of #our$Handed Dentistry. This
concept allows for a "ore proficient "ethod for the delivery of
general dentistry while re"oving the operator stress with
i"proved patient care.-
>ordon ?. Christensen, D.D.1., .hD
Clinical 6esearch %ssociates
.rovo, &tah
.rofita'ility Through .roductivity
H&*
*artners 1n *rogress
1-B-,.C-;C9D
1 11th +ourt West' ?irmingham' %<( .;,D
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% Di$ision -"
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