Setting up Surgery

 Enter surgery and turn on the lights, chair and its suction pump.
 Place on gloves and with disinfectant wipes wipe down all surfaces and the chair.
 Lower the chair and attach full bottle of purified water and the suction adaptors and filters
 Run water lines into spittoon following the daily checklist guidance.
 Remove “dirty” gloves and set up the surgery for the first patient (depending on what’s
booked in diary) using day list printed.
 Place suction tubes into suction adaptors and make up mouthwash into cup and place on
spittoon.
 Place tray out with required equipment with bib and safety goggles. (If treatment)
 Ensure surgery is stocked up with all materials and equipment that will be needed.

End of Day Shutdown

 Remove all “dirty” trays and equipment from chair and throw away disposable items. Place
dirty instruments and tray into red box and close lid.
 Applying clean gloves and using disinfectant wipes, wipe down all surfaces and chair.
Remove suction adaptors and filers from chair and place in pot over night with chlorine
water to disinfect. Run the suction tubes with disinfectant solution and place ¼ of the
solution into the spittoon.
 Run water lines so that no water is sat in pipes overnight (once a week cleancert solution
must be run through water lines to prevent legionnaire’s disease from building in pipes.)
 Heighten chair to highest position and place foot peddle under the chair off of the floor.
 Brush and mop floor so that the surgery is completely clean and tidy ready for the next
working day.

DISCLAIMER: Tools in each practice will be different in how they are packed and what they look
like.

Examination (Check Up’s)

Check-up Pack (Pack Includes: Mirror, Probe and BPE probe), Tray liner and 3 in 1 tip. If routine x-
rays are required in the check-up, Bitewing x-ray holder and films will be needed.

Mirror

Probe

Bitewing
BPE Probe Holder
 Filling

Check-up pack, Filling Pack (Filling pack contains: Tweezers, Ball End Burnisher, Flat Plastic and
Amalgam Plugger), Tray Liner, 3 in 1 tip, Cotton rolls, Cotton pellets, Bib, Fast and Slow Handpiece
with burs that the dentist requires, and the Filling material requested by the dentist.

Tweezers Amalgam Plugger Ball-ended Burnisher Flat Plastic

Additional Tools that may be used for fillings are

- Wards Carver

- Excavator
 Extraction (XLA)

Probe and Mirror (in a pack), Tray liner, 3 in 1 tip, Anaesthetic Syringe, Needle, Needle Adaptor,
Anaesthetic (that dentist requires) Gauze pack, Bib, Extraction box (includes all tools dentist will
require for extraction), Aftercare Instructions and Spare Gauze Pack.

Anaesthetic
Dark
Orange Gold
Green

Light
Blue
Green
This is all the types of anaesthetic that we use in
practice, each dentist will have a preference of which
anaesthetic they will use and also depending on the
patient’s medical history will effect which one can be
used for their treatment.
Before every treatment the dentist should instruct
which one they will use so that you can get the
correct one prepared for them.
 Root Canal Treatment (RCT)

Probe and Mirror (in pack), Filling Pack, Tray Liner, 3 in 1 tip, Cotton Rolls + Pellets, Anaesthetic
Syringe, Needle, Needle Adaptor, Anaesthetic (that dentist requires), Bib, Dental Ruler (to measure K
files and Sendoline files), K files (size 10 and 15), Sendoline File (size 1, 2, 3), Apex Locator +
attachments, Irrigation Syringe (contains Sodium Hypochlorite), Gutta Purchas (size 2, 3) Paper
Points (size 2, 3), Tweezers and Excavator, AH plus/ Tubiseal (canal cement), Mixing pad, Lighter,
Fast and Slow Handpiece with burs that the dentist requires, and the Filling material requested by
the dentist.
 Denture Appointments

Impressions: Tray, Tray Liner, Bib and Check-up Pack

Alginate Powder, Mixing Bowl, Spatula and
Impression Tray
Bite Registration: Tray, Tray Liner, Bib and Check-up Pack
Alginate Powder, Mixing Bowl, Spatula and Special Tray and
Bite Wax (provided by the lab), Burner and Wax knife.

Denture Try-In: Tray, Tray Liner, Bib and Check-up Pack

Wax Try-In (provided by lab) and Wax Knife.

Denture Fit: Tray, Tray Liner, Bib and Check-up Pack

Denture (provided by lab), Articulating paper for Bite
and Straight Hand Piece with Acrylic Bur (for
adjusting denture of High Spots/Bite).
 Crown/Bridge Preparation

Probe and Mirror (in pack), Filling Pack, Tray Liner, 3 in 1 tip, Cotton Rolls + Pellets, Anaesthetic
Syringe, Needle, Needle Adaptor, Anaesthetic (that dentist requires), Bib, Fast and Slow Handpieces
with burs that the dentist requires, Putty Impression material with scoop, Fast set Wash, Bite
Registration, Application gun, Posterior or Anterior Tray and Lab Work Bag and Form.
 Filling Materials

Amalgam:

 Yellow= 1 Spill (small)

 Red= 2 Spill (medium)
 Blue= 3 Spill (large)
 Mixed in Amalgamator for 10 seconds, once mixed placed in dappens dish and pressed into
amalgam carrier to present to dentist to fill cavity.
 Once placed in cavity dentist will then carver material so that it is comfortable to the
patient’s bite, at this time suction is required to take all the waste amalgam out of the
mouth so that the patient doesn’t swallow it.

Glass Ionomer (GI):

 Capsules of GI are mixed in amalgamator for 10-15 seconds and placed in GI gun for the
dentist to be able to apply filling to cavity.
 Hand mix GI consists of the base powder and accelerator liquid which should be mixed to
the ratio of 1 drop of liquid to 1 scoop of powder. When mixed together should form a thick
dough consistency unless the dentist has requested a certain consistency. Addition powder
may be required if mix is to runny or equally more liquid if it is too hard.
 2 types of GI- Self Cure (dark blue packet) - Cures by its self within an hour. Light Cure (light
purple packet) - Light cure GI requires the UV light cure to be used for 20 seconds over the
material to set the material completely.
 GI Cement is used for crown and bridge cements. This is a dark green packet and is mixed
the same way as GI filling material and is placed in the GI gun for application but does not
need the light cure as it sets by its self.

Composite

 Composite requires etch, bond, either flowable composite or packable composite and the
light cure.
 Etch is applied to the tooth and left for 20-30 seconds to clean the surface of the tooth and
is then rinsed off (suction is required)
 Bond is then applied and cured for 20 seconds with the light cure
 Either flowable composite or packable composite (using the composite gun) is applied to the
cavity and cured for 20 seconds.

All fillings are checked for height using articulating paper to see that it will be comfortable for the
patient to bite and if it is high it can be adjusted using either the fast or slow handpieces with
polishing bur.

Impression Materials

Alginate:

 2 Scoops of alginate powder to 2 water (second line on the measuring cup)

 Using bowl and mixing spatula, mix powder and water together until smooth consistency
with no left over powder
 The dentist will then load the impression tray with material once mixed.
  A disinfectant bath consisting of water and disinfectant powder must be made up to be able
to disinfect the impressions before being sent to the lab. They must be left in the
disinfectant bath for 10 minutes.
 Alginate impressions once disinfected must be washed over and wrapped in tissue and
placed in an air tight bag so that they do not dry out otherwise impressions can warp and
become miss shaped.

Putty Impression

 Putty is used for crown/bridge preparation impressions

 For the impression, 1 scoop of catalyst and 1 scoop of base putty is needed and to be
kneaded together until 1 solid colour. In the meantime the dentist will cover the area in
the wash material and then get the patient to bite down on to the tray or push the tray
over the teeth until material is set and safe to remove.
 Once the impression is done a bite registration will be taken, either with the bite reg
liquid putty or a wax bite reg.
 These will then need to be disinfected in the bath for 10 minutes and rinsed before
wrapping and placing in the air tight bag.

Lab sheets are usually written by the dentist but on each lab sheet must be:

 Patients name
 Patient ID number
 Practice number or address
 Dentists name
 Date sent
 Date next stage of work required
 What work is requested

Decontamination Process

 In decon there are 2 sinks, 1 Scrubbing sink, 1 Rinsing sink. The instruments apart from
handpieces are submerged into the water of the scrubbing sink while washing over
handpieces and oiling them for maintenance. Once handpieces have been washed they can
be placed back onto the tray and the other instruments can be scrubbed and rinsed and
placed onto the tray.
 They then go into the autoclave on the 134° cycle, which usually take 15 minutes. Once they
have been through the cycle they are then taken out of the autoclave and placed on to a
cooling rack before needing to be pouched.
 If the practice has a ultrasonic then tools can be placed in the ultrasonic and once placed
through the cycle, tools must be checked and scrubbed if required and then placed through
the auto clave
 Pouches must be stamped with the date of sterilisation expiry which is 12 months from the
date of sterilisation. Once the instruments are cool enough they can then be pouched into
their correct pairings and taken back into the surgery.