Pediatric Dental Assistant Toc

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PEDIATRIC
DENTIST
Chairside Assistant
Manual
This manual has been produced by Cambridge Practice Consultants with the
express purpose of providing sample policies and procedures for your
practice which are intended to contribute to your efficiency and expansion.
No part of this manual may be reproduced, stored or transmitted in any way, including
but not limited to photocopy, photography, magnetism, or other recording technique,
without prior written permission of Custom Publications of Tampa Bay, Inc.

Note
The following policies comprise general information and guidelines only. The purpose
of these policies is to aid you in performing your job. They may or may not conform
with Federal, State and Local laws, rules and regulations and are not offered here as a
substitute for proper legal, accounting or other professional advice for specific
situations.
Prior to implementing any of these suggestions, or policies you should seek
professional counsel with your attorney or accountant and/or the appropriate governing
or licensing board or any other applicable government body for a full understanding of
all appropriate laws, rules, procedures or practices pertaining to your healthcare
discipline or business activities.

TRAINING MANUAL INFORMATION

READ FIRST
We hope your purpose for studying this training manual is to understand and use the tools
needed to effectively do your job.
Our reason for giving you this training manual is threefold. One, so you have the policies and
procedures in writing on how to do your job. Two, so you can refer back to the written material
as needed to correct or add to any of the exam questions since we only accept 100%. Three, so
you have the written policies and procedures as reference in the future as a review. We do not
expect you to memorize all the policies relating to your job. But we do expect you to refer back
to the appropriate written material and review them on your own as well as with your supervisor.
When you have finished reading the policies in this manual please see your supervisor for the
written exam. When you have finished the exam you will refer back to the appropriate policy in
an open book style to change or add to your answers until your supervisor is satisfied every
question and “active procedure” has been successfully done without error.
The end result of your having studied this manual should be the ability to effectively do your job
and know all the policies and procedures extremely well. This doesn’t mean you are fully
apprenticed, that will follow, once you have successfully completed this manual and all the
procedures and tests contained herein.

© 2007 Custom Publications

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TABLE OF CONTENTS
PURPOSE .......................................................................................................................................................6
PROPER HANDLING OF NEEDLES, SCALPELS AND SHARPS .......................................................7
CHAIRSIDE ASSISTANT JOB DESCRIPTION.......................................................................................8
USE OF PROTECTIVE COVERINGS .....................................................................................................14
HAND WASHING AND CARE OF HANDS ............................................................................................15
LIMITING CONTAMINATION OF CHARTS, TELEPHONES, PENS, ETC....................................16
INITIAL DENTRIX CHART SET-UP ......................................................................................................17
CHARTING TREATMENT NEEDED / COMPLETED TODAY .........................................................19
CHARTING X-RAYS ..................................................................................................................................20
BITEWING X-RAY PROTOCOL .............................................................................................................21
HOW TO TAKE BITEWING X-RAYS ....................................................................................................22
PERIAPICAL X-RAY PROTOCOL .........................................................................................................25
HOW TO TAKE PERIAPICAL X-RAYS.................................................................................................26
PANORAMIX X-RAY PROTOCOL .........................................................................................................30
HOW TO TAKE PANORAMIC X-RAYS ................................................................................................31
CEPHALOMETRIC X-RAY PROTOCOL ..............................................................................................32
HOW TO TAKE CEPHALOMETRIC X-RAYS .....................................................................................33
SCANNING X-RAYS INTO DENTRIX ....................................................................................................36
SCANNING X-RAYS INTO DOLPHIN....................................................................................................37
ANESTHESIA SET-UP ...............................................................................................................................39
RUBBER DAM SET-UP..............................................................................................................................40
COMPOSITE/LIDO SETUP AND PROCEDURE ..................................................................................42
COMPOSITE/NO LIDO SETUP AND PROCEDURE ...........................................................................44
PULPECTOMY (PEC) SETUP AND PROCEDURE ..............................................................................45
PULPOTOMY (PULP) SETUP AND PROCEDURE ..............................................................................46
STAINLESS STEEL CROWN SETUP AND PROCEDURE .................................................................47
RECALL EXAM SETUP AND PROCEDURE ........................................................................................48
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EMERGENCY SET-UP ..............................................................................................................................50
CEMENTS AND THEIR MIXING PROCEDURES ...............................................................................52
BASIC EXTRACTION (SIMPLE) SET-UP .............................................................................................56
CONSENT FOR REMOVAL OF TEETH ................................................................................................58
HOME CARE INSTRUCTIONS AFTER TOOTH EXTRACTION .....................................................60
SEALANT SET-UP ......................................................................................................................................63
PROGRESS NOTES ....................................................................................................................................65
PATIENT RAPPORT ..................................................................................................................................66
HANDLING THE NERVOUS PATIENT .................................................................................................67
STAYING ON TIME ...................................................................................................................................69
PATIENT DENTAL AND MEDICAL HISTORY ...................................................................................70
FILLING OUT PATIENT PAPERWORK ...............................................................................................71
FILLING OUT THE PATIENT’S TREATMENT PLAN .......................................................................72
REINFORCEMENT OF PATIENT’S TREATMENT PLAN ................................................................74
TREATMENT PLAN SHEETS..................................................................................................................77
LAB PRESCRIPTIONS ..............................................................................................................................78
PREPARATION OF LAB CASES .............................................................................................................80
PACKING LAB CASES ..............................................................................................................................81
DENTAL SUPPLY BUDGET .....................................................................................................................89
KEEPING TRACK OF WHAT YOU SPEND ..........................................................................................90
STOCKING OPERATORIES STANDARDLY........................................................................................92
ORDERING DENTAL SUPPLIES FROM VARIOUS VENDORS .......................................................93
BIOHAZARD WASTE & OPERATORY CLEAN-UP ...........................................................................98
OPERATORY CLEAN-UP AFTER PATIENT TREATMENT.............................................................99
OPERATORY SET-UP .............................................................................................................................100
HANDPIECE (DRILL) STERILIZATION.............................................................................................102
STERILIZATION OF INSTRUMENTS .................................................................................................103
CLEANING, DISINFECTION, AND STERILIZATION .....................................................................107
DON’T AUTOCLAVE THESE INSTRUMENTS - COLD STERILE ONLY ....................................108
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CLEANING THE COLD STERILES......................................................................................................109
LOADING THE BIOSONIC ....................................................................................................................110
CARE OF BIOSONIC ...............................................................................................................................112
HOW TO USE THE AUTOCLAVE ........................................................................................................117
AUTOCLAVE TESTING..........................................................................................................................122
AUTOCLAVE TESTING SCHEDULE...................................................................................................126
MUST BE POSTED IN DENTAL LABORATORY AT ALL TIMES.................................................126
MAINTAINING THE VACUUM PUMP ................................................................................................131
CHANGING THE FILTRATION WATER FILTERS..........................................................................132
MAINTAINING THE COMPRESSOR...................................................................................................133
MONTHLY MAINTENANCE .................................................................................................................134
MONTHLY MAINTENANCE SCHEDULE ..........................................................................................135
MUST BE POSTED IN DENTAL LABORATORY AT ALL TIMES.................................................136
INFECTION CONTROL FOR THE DENTAL HANDPIECE.............................................................137
HANDPIECE REPAIRS ...........................................................................................................................138
SUMMARY OF SAFETY PROCEDURES FOR ASSISTANT ............................................................140
KEEP INSTRUMENTS STERILIZED ...................................................................................................142
WEEK ENDING MAINTENANCE .........................................................................................................143
CLEANING AND MAINTAINING THE AUTOCLAVE .....................................................................144
DAILY ROUTINE .....................................................................................................................................148
OPENING PROCEDURES CHECKLIST ..............................................................................................150
DAILY ROUTINE CHECKLIST.............................................................................................................151
END OF DAY CHECKLIST.....................................................................................................................152
WEEK ENDING ROUTINE CHECKLIST ............................................................................................153
FINAL EXAM ............................................................................................................................................156
APPRENTICESHIP CHECKLIST ..........................................................................................................159

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ASSISTANT

3-6-06
POLICY
PURPOSE

To assist the dentist in every way possible, enabling her to provide the most efficient,
high quality dentistry to our patients.
To maintain excellent patient relations, ensuring the patient is well cared for, happy and
satisfied.

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ASSISTANT

3-6-06
POLICY

PROPER HANDLING OF NEEDLES, SCALPELS AND SHARPS

Needles and scalpels are disposable. Needles shall not be recapped, bent or broken by
hand, removed from disposable syringes, or otherwise manipulated by hand. Used
needles must be placed in the sharps disposal located in each operatory.
Sharps containers are found in each operatory.
The one (1) hand scoop technique is used for needle recapping. Dr. Johnson will
demonstrate this technique. You will be tested and signed off for proper handling of the
dental syringe.

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ASSISTANT

3-6-06
POLICY
CHAIRSIDE ASSISTANT JOB DESCRIPTION

1. The duties of a chairside assistant are not just assisting and cleaning instruments.
When there are no patients, this is the time to catch up on cleaning the treatment
rooms, tubes, tray, etc. (Refer to the Daily Checklist). The treatment rooms should
look immaculate at all times. This cannot be emphasized enough.
2. When patients arrive early, you are to seat them immediately if possible and, if
necessary, inform the doctor where they are seated. Use the onscreen Yahoo
Messenger.
3. When the doctor asks you to do anything or directs any statements to you, always
acknowledge her with an audible “okay” if you understand the doctor. If you don’t
understand, ask the doctor to clarify the statement.
4. When speaking with the patient, always promote the office and the doctor. Keep your
comments positive and lead conversation to allow the patient to talk about
themselves. Do not talk about your personal problems or situations.
5. When assisting the doctor, try to comfort the patient. Some patients want you to hold
their hand, or just need some comforting words. Talk with the patient to relax them
while assisting or doing the procedure. When alone, explain to the patient what you
are doing to minimize fear of the unknown.
6. When assisting, follow the doctor with the light. When the doctor asks the patient to
move, it is your clue to move the light.
7. When assisting, both hands should be used at all times, i.e., double retraction, or A/W
syringe plus single retraction, etc.
8. The assistant must anticipate the doctor’s needs. If the doctor has to be asking for
instruments repeatedly, then you are not anticipating.
9. While assisting, the assistant must keep the tray plus countertop free of debris and
keep it neat. All instruments must be in an orderly fashion.
12. When dismissing the patient, accompany them to their parents. Praise their good
behavior to the parent.
13. When appropriate, advise the parent that we use the best dental lab, the best materials,
high quality impression materials, cement and equipment.

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14. Again, the assistant must promote the doctor and dental office so as to give the parent
confidence in our office and encourage referrals. This is all part of the assistant’s job
performance.
15. When the patient is dismissed, the parent must feel we did everything possible to
make him comfortable. We cannot be just average in this category. The assistant is
an integral part of this function in that they spend a lot of time with the patient.
16. Before the patient enters the room, you must start in this order:
a.
b.
c.
d.
e.

Check schedule to see what procedures are scheduled.
Pull up patient’s chart on computer monitor.
Review health history noting any changes.
Pre-med verified if necessary.
Have all X-rays, FMX, PAN, and BW’s posted on monitor appropriate to what
procedure is being done.
f. Appropriate kit is ready for procedure (i.e. restorative trays).
17. After the patient enters the room, you must start in this order:
a.
b.
c.
d.
e.

Place dental napkin (bib) around neck.
Position chair.
Place Nitrous Mask and start nitrous at 30%.
Place topical anesthesia if appropriate.
Set up tray while topical is working.

18. After the doctor enters the room, you must start in this order:
a.
b.
c.
d.
e.
f.

Hand syringe with warm anesthetic.
Have additional carpules ready to hand to doctor if needed.
Comfort patient, hold their hand if possible, pat their hand and reassure them.
Divert attention of patient away from procedure with interesting conversation.
Ask if the patient is “okay”.
After injection offer patient to rinse.

19. The doctor should not have to request the assistant to do these functions. It is the
responsibility of the assistant to be ahead of the doctor.
20. When preparing the room, do it in the sequence by which the doctor would use the
items. Therefore, if the doctor or anything else interrupts you, this ensures you will
be several steps ahead of the doctor (anticipation).
21. When not assisting directly with the doctor, be prepared for the next appointed
patient. Set up the operatory for the next procedure.
22. The patient is the number one priority! We must complete his treatment ASAP to
minimize the patient’s time in the chair.
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23. It is the responsibility of the assistant to monitor the schedule and check up front
when the patient arrives, and seat him/her immediately. There are very few duties
that take priority over this. Being on time is the key to success and happy patients.
24. Befriend the patient. Ask him/her about their friends, pets, school, vacations, etc.
Befriend the parent also. Make conversation. Most people like to talk about
themselves.
25. The assistant must promote the dental practice and review patient charts routinely.
You will do this either prior to or after seating the patient, depending on whether the
doctor is running on time or behind schedule. The assistant should know the patient’s
total treatment and any questions should be reviewed with the doctor, if necessary.
26. When asking the patient to open, close, rinse, etc., preface it with please, and follow it
with thank you!
27. When explaining dental problems of the parent, be descriptive and educate through
visual props, such as, models, charts or pictures. Even draw the picture for the parent
if necessary. You need to get parent’s attention. Paint the picture. For example: “A
cracked tooth is like a crack in your windshield. It keeps traveling and getting
worse”. Or, “a cracked tooth is like a crack in the concrete”.
28. When parents ask about different treatments, you can say, “I’m not a dentist, and only
a dentist can diagnose, but if you were my mother or father, sister or brother, I would
tell you to get ortho.” (Or, have the fillings done, or have sealants, etc.) “But let’s
see what the doctor has to say.”
29. Take BWX (2 or 4) every 6 - 18 months depending on if pt has had interproximal
decay at the past visit or if areas are being watched. Take Pano at age 9 and when
indicated for ortho.
30. As needed - review home care, especially how to clean under braces.
31. As needed - review the use of floss threaders, etc.
32. Reinforce the necessity of regular cleanings. Many parents do not understand the
importance of regular check-ups.
33. If home care is good, praise the patient and parent. Contrast the good areas to the bad
areas. The regularly maintained patient without any breakdown deserves positive
reinforcement, a pat on the back!
34. Talk positively of the dental office and the doctor. Be upbeat and positive.
35. Use intraoral camera to demonstrate any abnormality in the mouth, such as, cavities
(decay), cracks/fractures in teeth, or gum disease (i.e. tartar & plaque).
36. Where indicated, encourage sealants. Use brochures and demo.
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37. Ask patient, “Are you okay?”, “How are you doing?” etc. Reinforce warm personal
care.
38. When the doctor calls you, you must stop what you are doing and check with her,
unless you are seating a patient or working with a patient on nitrous or local.
39. Re-read this job description many times per month.
40. When dismissing the patient, make sure he/she is doing just fine. Wipe the face of
any debris, such as cement, or blood.
41. Always direct parent to the office manager so they can take care of any payment for
services rendered.
42. Always discuss with parent what the next procedure is for them. Remember a
completed treatment plan and a well satisfied patient is what we want.

© 2007 Custom Publications

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