This document discusses proper dental instrument transfer techniques and maintaining the operating field. It describes how instruments should be held and passed between the dentist and assistant to reduce stress and fatigue while keeping the assistant's view on the oral cavity. It also explains how to properly use dental tools like the saliva ejector, air-water syringe, and evacuation system to isolate the treatment area and keep it dry.

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Instrument Transfer and
Maintaining the Operating
Field
Chapter 19

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Instrument Transfer
• Proper instrument transfer occurs when:
– Operator’s view remains on oral cavity
– Stress and fatigue are reduced
– Safety and comfort are maintained
– Production is increased with less motion

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Instrument Transfer
• Transfer zone
– Area just below patient’s nose near chin
• Fulcrum
– Point of rest on which fingers are stabilized
and can pivot
• Tactile sensation
– Feeling sensed by touch

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Instrument Transfer
• Transfer hand
– Assistant passes and receives instruments
with left hand while working with right-handed
dentist
– Assistant passes and receives instruments
with right hand while working with left-handed
dentist

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Instrument Grasps
• Pen • Modified pen
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Instrument Grasps
• Palm • Palm-thumb
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Instrument Grasps
• Reverse palm-thumb
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Eight Basic Instrument Transfer
Methods
1. Primary working end should be placed
away from assistant on tray
2. With straight-shank instruments, primary
working end should be placed toward
assistant

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Eight Basic Instrument Transfer
Methods
3. With hinged instruments, beaks are
placed toward assistant
4. Hold instrument between thumb and
index finger and middle finger

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Eight Basic Instrument Transfer
Methods
5. With pen grasp instrument, pick up
instrument from tray near end closest to
assistant
6. Assistant’s hand is placed on instrument
opposite from end operator uses

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Eight Basic Instrument Transfer
Methods
7. Rotate working end of instrument until it
is directed toward dental arch being
treated
8. Hold instrument to be passed parallel to
instrument held by operator

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Instrument Transfer Methods
• Instruments transferred by:
– One-handed transfer
– Two-handed transfer

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Dental Check
• What grasp would you use when using a
Wedelstaedt?
– Palm-thumb grasp

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Instrument Transfer Modifications
• Mirror and explorer
transfer
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Instrument Transfer Modifications
• Cotton pliers transfer
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Instrument Transfer Modifications
• Scissors transfer
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Instrument Transfer Modifications
• Dental handpieces
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Instrument Transfer Modifications
• Air-water syringe transfer
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Maintaining Operating Field
• Lighting
– Positioning
– Illumination of
oral cavity
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Maintaining Operating Field
• Evacuation system
– Remove water, saliva, blood, and debris
– Hose, evacuation tip, and handle
– Grasps
– Placement

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Placement for Evacuation
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Placement for Evacuation
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Placement for Evacuation
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Placement for Evacuation
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Maintaining Operating Field
• Saliva ejector
– Removal of saliva
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Maintaining Operating Field
• Air-water syringe
– Emits water, air, or
combination of both
– Rinse mouth
– Dry areas of mouth
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Maintaining Operating Field
• Retraction of tissues
to increase visual field
– Mouth mirror
– Mouth props
– Gauze
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Isolite System
• System to maintain clear, dry field for
operator
• Provides:
– Isolation
– Retraction
– Evacuation
– Light source

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Techniques for Moisture Control
and Isolation
• Cotton rolls
– Come in various sizes and shapes
– Isolate area
– Rest evacuator
– Place materials
– Serve as something on which patient can bite

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Techniques for Moisture Control
and Isolation
• Dry angles
– Triangular, absorbent
pads
– Absorb flow of saliva
and provide surface
for cheek retraction
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Expanded Functions
• Taking x-rays
• Placing and removing
rubber dam
• Coronal polishing
• Taking study model
impressions
• Placing sealants
• Making provisionals
• Placing bases and
liners
• Taking photographs
• Performing orthodontic
procedures
• Removing sutures
• Placing periodontal
dressing