Dental assistants handle a wide range of responsibilities, but among the most important is four-handed dentistry. This innovative technique is the gold standard for efficient, high-quality dental treatment and the only way oral care professionals can keep up with a busy schedule. As a dental assistant, here’s what you need to know.
What is Four-handed Dentistry?
Four-handed dentistry is just that, a dentist’s two hands and a dental assistant’s two hands working together to streamline treatment for the patient. Sitting on either side of the chair, you work in unison to save time. The goal is for the dental assistant to anticipate what the dentist needs and be prepared to act in a timely fashion.
Developed in 1960, it’s not a new concept. But it’s changed significantly since its inception to include more facets of dental practice. Today, it’s embraced world-wide and part of a dental assisting program’s curriculum. The primary benefits of four-handed dentistry include:
- Efficiency
- Speed
- Reduced physical stress
- Patient comfort and safety
- Optimal visibility for both dentist and dental assistant
It’s an ergonomic, resource-friendly approach and in many ways begins before the patient arrives with set-up and planning.
How Does a Dental Assistant Help a Dentist?
Dental assistants play a versatile role in oral care practices. They work directly with patients and support the dentist by:
Preparing Treatment Rooms
Once the dentist and dental assistant are gloved up isn’t the time to notice supplies are missing. Local anesthetics only last so long, and it’s essential to complete treatments before it wears off. Trays aren’t sterile, but they are clean, so rooting through the supply cabinet means wasting time taking your gloves off, washing your hands and re-gloving. It doesn’t inspire patients’ confidence.
A well-prepared tray stocked with the necessary tools for the treatment saves time. Before patients arrive, you will determine which items are required and have them ready to go when the dentist walks in. Between patients, you will sanitize work areas, replenish supplies and prepare the next try based on the planned treatment.
Managing Patients
“Patient management” is a blanket term describing how patients and dental assistants interact from the time visits are scheduled until treatment is complete. It begins with making patients comfortable, answering their questions and explaining what to expect. Patients are less familiar with dental procedures than medical services, so concerns are to be expected. You can fill in most knowledge gaps before the dentist is ready. Dental assistants also screen patients for medical problems that could affect treatments, such as:
- New diagnoses
- Drug, tobacco and alcohol use
- Medication changes
- Drug allergies
- Nutritional concerns
Red flags, such as a new bleeding disorder, are brought to the attention of the dentist before work begins, safety first. As a dental assistant, you will also take patients’ blood pressure before each visit to ensure that drugs used during procedures won’t contribute to existing hypertension.
Then comes the practical considerations, such as x-rays, draping and positioning. Preparing the patient is as vital as setting up the treatment room. Ideally, patients should be ready before the dentist is. Challenging patients are common in oral care practices, more than half of adults report some degree of dental phobia. You will provide the knowledgeable and calming presence needed to manage their fears.
Taking X-rays
Radiography is part of most dental exams. Pictures that show the teeth, nerves and bone below the gum line help dentists diagnose disorders from caries to impacted wisdom teeth. It’s your role to take accurate, high-quality images.
Chairside Assisting
As a dental assistant, you have the extra pair of hands, in four-handed dentistry, to support oral care professionals chairside. You make procedures more efficient by passing instruments, managing suction, and preparing filling materials as the dentist works. Practicing four-handed dentistry allows practices to see more patients and lets dentists focus on critical tasks. It’s good for revenue and quality of care. Everything the dentist sees, you also see and can double-check.
Patients also benefit personally from chairside assistants. The emotional support and feedback they receive helps them. It’s reassuring to know things are going as planned.
Performing Minor Procedures
In most states, dental assistants may perform value-added services with close supervision, including sealants, fluoride treatments and coronal polishing. The dentist’s time is costly and limited, so you improve the practice’s bottom line by handling procedures that don’t require professional expertise.
Overseeing Aftercare
Procedures aren’t complete until patients are recovered and satisfied with the results. Whether it’s after a filling, a root canal or an extraction, clear follow-up instructions encourage proper home care.
You will review precautions after procedures as well as how to self-monitor their condition, take prescribed medications, report worrisome symptoms and handle minor emergencies. Serving as a representative between patients and the practice, you help ensure the best treatment outcomes.
Practicing Infection Control
Dental assistants safeguard patient health by keeping the office environment sanitized. The risk of contracting an infection in a dental office is relatively low, but public health authorities have identified and isolated dozens of cases in the last twenty years of disease transmission via blood-contaminated instruments.
Strict infection control protocols, from how equipment is handled to how it’s disinfected, are required to kill dangerous microorganisms. Instruments shared by patients must be sterilized between uses. Dental assistants use their clinical expertise and a range of sanitation methods to ensure every instrument they put on a tray is microbe-free and safe for the dentist to use.
Managing Documentation
Documentation is done in real-time during many dental procedures beginning with exams. As the dentist checks each tooth, he or she describes what they see. You will take note of periodontal pocket measurements, decay, fractures, bite characteristics, soft tissue quality, and lesions. This documentation creates a running treatment record so nothing is missed, and dentists can make the safest treatment decisions.
Skills to Master for Four-Handed Dentistry
Being a good partner for a dentist requires endurance, manual dexterity, communication, good time management, competency, a good memory, compassion, organization and professionalism. With these skills, you will be an important part of the four-handed dentistry strategy.
Skill #1: Endurance
Most dental procedures run 30-45 minutes, while oral surgery can last an hour or more. It’s a long time to remain still and focused, so physical and mental endurance are musts.
Skill #2: Manual Dexterity
As a dental assistant, you work with your hands in small spaces. You will handle delicate, precision instruments that can be dangerous if mishandled. Excellent hand-eye coordination and manual dexterity is imperative.
Skill #3: Proficient Communication
A dental assistant’s role is to stay focused on the dentist’s needs, anticipating every move. Each professional has their own style, and it takes practice to get on the same page. Good communication helps establish a working rhythm and soon, you’ll be working in unison.
Patients also need support in the form of feedback. Maintaining a dialogue during procedures by letting them know what to expect helps them respond appropriately. Simple instructions, from “open wide” to “we’re almost done,” promote patient comfort and earn valuable cooperation.
Skill #4: Time Management Skills
As a dental assistant, you will manage most procedures from set up to patient education. There are dozens of steps, all of which must be completed on time to be ready for the next procedure. The ability to use each moment wisely is a valuable skill that ensures preparedness and limits workplace stress.
Skill #5: Competency
Every dental procedure requires a different set of tools and equipment. You must be familiar with common treatments, dozens of instruments and hundreds of medications, filling materials and other supplies to set trays up correctly. Competency is required.
Skill #6: A Good Memory
A dental assistant employed in an extensive practice may work with many dentists, each with a different treatment approach. Cheat sheets can help you remember who prefers which instruments on a filling tray, for example. But at some point, it becomes too difficult to keep up with them without a good long-term memory.
Remembering patients’ idiosyncrasies is also helpful. Learning about your patients is part of giving good care. Recalling that someone passes out when they see needles, for example, is your cue to keep them out of sight. And recalling that a patient is allergic to the antibiotic the dentist just prescribed could save a life.
Skill #7: Compassion
Going to the dentist isn’t easy for many people. Research verifies what we already know, a large portion of the population feels stressed about seeing the dentist, and they need someone in their court.
Dental assistants are ideal patient advocates. You are knowledgeable and can walk patients through worrisome procedures, describing each step as you go. A caring smile and an understanding attitude are all it takes to calm a fearful patient.
Skill #8: Organizational Skills
Dentistry requires excellent organizational skills. When setting up equipment, dental assistants need to visualize procedures, reviewing the steps in their head so they understand how to best arrange instruments and supplies. Dental trays holding sterile supplies, for example, can be inadvertently contaminated when reaching over them for a tool on the far side. That risk is avoided by placing instruments in their order of use.
Organizational skills also include keeping workspaces tidy. Treatment rooms should be sanitized promptly to prevent the spread of germs and to keep the schedule running smoothly. Time is money and both the practice and patients appreciate efficient visits.
Skill #9: Professionalism
From the way you speak to how you are dressed; your behavior reflects on the entire team. Patients expect anyone working side-by-side with a dentist to be a competent, courteous professional. Being polite, sensitive, and carrying yourself confidently inspires patients’ trust in your care.
Final Thoughts
Four-handed dentistry is the backbone of oral care. It’s an art and a science, requiring both technical and soft skills to manage both instruments and people. It’s a crucial role for which dental assistants should be enthusiastic and well-prepared.
Did learning about four-handed dentistry interest you? Are you ready to learn more about becoming a dental assistant? The Dental Assistant training program at Meridian College provides extensive hands-on training including a school externship at a dental office where you will assist the dentist in treating actual patients.
Contact Meridian College today to learn more about becoming a dental assistant.