The document discusses optimal positioning for dentists and patients during dental procedures. It describes three positions for the dental chair - upright, supine, and reclined at 45 degrees. The supine and reclined positions are preferred. The optimal position depends on factors like the patient's and dentist's comfort, as well as visibility and access to different areas of the mouth. The document also outlines clock positions from the dentist's perspective, with 7, 9, 11 and 12 o'clock being most commonly used depending on handedness and the area of the mouth being worked on. Key ergonomic factors are also discussed to promote patient and dentist comfort during procedures.

1. Are you and your patient
sitting in the right position?

2. Position of the chair
The position of the chair can be placed in three
different forms:
 Upright position
 Supine position
 Reclined 45° position

3. Supine and Reclined 45° are the most preferred position for
the doctors to carry out the dental operations.
When in the supine position the head, knee, and feet if the
patient is approximately at the same level. In Reclined 45°,
mostly the mandibular and occlusal surfaces are visible and
operated on.
The position or the angle of the chair is all about the
comfort of the patient. Once the position of the patient is
set the dentist can find their comfortable place according to
the treatment preference.

4. Operating position of the dentist
The position of the dentist depends on various aspects which makes it
comfortable for the dentist such as the patient should be at the elbow
level of the doctor, legs and back of the dentist should be relaxed in
order to carry out the procedure flawlessly.
Similarly, the angle and the sitting position of the operator also has a
great impact on the operation. The sitting position of the dentist is
designed according to the angle of the clock, where the head of the
patient is treated as the center.
The treatment angle for the right-handed operators is from 7 o’clock to
11 o’clock and for left-handed operators, it is from 5 o’clock to 1
o’clock and 12 o’clock.

5. 7 o’clock
7 o’clock in the front position which helps in
examining the patient and gives clear visibility and
makes it easy when the face is turned towards the
dentist. This is the preferred position when the
working areas are Mandibular anterior, Mandibular
right posterior teeth, and Maxillary anterior
teeth.

6. 9 o’clock
In 9 o’clock position the dentist is exactly at the
right angle to the patient. The working areas for
this position are the facial surfaces of the
maxillary and mandibular right posterior teeth,
and the occlusal surface of mandibular right
posterior teeth.

7. 11 o’clock
11 o’clock is treated as one of the most preferred
and comfortable positions for dentists as it gives
visibility and accessibility for both direct and
indirect vision. The working areas for this position
are mandibular teeth with direct vision and palatal
and incisal, occlusal surface for the maxillary
teeth.

8. 12 o’clock
At 12 o’clock position the dentist sits exactly behind
the patient and this position is useful only for
limited operations. Lingual surfaces of mandibular
teeth are the working areas for this position.

9. Working position according to Archs &
Surfaces
 Mandibular Arch and Anterior Surfaces
Anterior surfaces of the mandibular arch can be treated from two clock
positions, i.e. 8-9 o’clock and 12 o’clock. When the dentist is operating
from 8-9 o’clock position the anterior surface is towards the non-
dominant hand. While operating from 12 o’clock position the anterior
surface is away from non-dominant hand. The chin is slightly towards &
downward in both the positions.

10.  Maxillary Arch and Anterior Surfaces
Anterior surfaces of the maxillary arch can be treated from two clock
positions, i.e. 8-9 o’clock and 12 o’clock. When the dentist is
operating from 8-9 o’clock position the anterior surface is towards
the non-dominant hand. While operating from 12 o’clock position
the anterior surface is away from non-dominant hand. The chin is
slightly towards & upward in both the positions.
 Mandibular Arch and Posterior Surfaces
While working on a mandibular arch, the right facial and left lingual
aspects of posterior teeth at 9 o’clock where the head of the
patient is slightly away and chin is downward.
When the operator is working on the right lingual and left facial
aspects of posterior teeth at 10-11 o’clock, the head of the patient
is towards the operator and chin remains downward.

11.  Maxillary Arch and Posterior Surfaces
The maxillary arch and posterior aspects can be treated in two clock
positions, 10-11 o’clock & 9 o’clock position. For 10-11 o’clock the
working areas are right lingual and left facial while the head of the
patient is towards the dentist and the chin is upwards.
For 9 o’clock position the working areas are left lingual and right facial
and the head is away from the dentist and chin remains upward.

12. Key aspects to be considered while
operating
 The maxillary occlusal surfaces should be perpendicular while working on the
maxillary arch.
 The mandibular occlusal surface should be 45° to the floor while working on
the mandibular arch.
 Maintain the proper working distance as if gives confidence to the patient and
increases cooperation.
 Do not rest your arms on your patient’s shoulder.
 Do not put things or instruments on your patient’s chest.
 Let your patient change position in order to avoid muscle strain and fatigue.
Following these principles and keep in mind the following aspects could help both
the dentist and the patient to carry on the dental procedures.