Dent 112 Introduction to Chairside

Moisture Control Lecture

I. Saliva Ejector

A. A saliva ejector is used in the following circumstances:

1. During an oral prophylaxis

2. When the operator is working alone

3. When a patient resists the use of the suction

4. When a patient salivates heavily under the rubber dam

B. With the addition of an appropriate device, it retracts the tongue

II. High-Velocity Evacuation System

A. The HVE system is a natural adjunct to sit down, four-handed dentistry

when the patient is placed in a supine position for treatment.

B. Choosing an HVE tip involves the following considerations:

1. Two basic types of tips

a. Surgical

(1) This is more site specific than the standard operative tip.

(2) The narrow opening may clog frequently when evacuating

blood and tissue; thus it is necessary to clear the tip with

sterile water or saline solution.

b. Operative

(1) Used more frequently in general dentistry

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(2) Available in a variety of shapes

(3) Supplied with an angled or a straight shaft

(4) May be disposable or sterilizable

2. Angled versus straight shaft-tips with a bend in the shaft seem to be

more commonly used than straight tips.

III. Auxiliary Evacuator Devices

A. A svedopter can be used in the adapter or on the saliva ejector hose.

1. It serves as a saliva ejector.

2. It provides retraction of the tongue.

USING THE AIR/WATER SYRINGE

I. To supplement the effectiveness of oral evacuation it is necessary to use the

air/water (a/w) syringe with maximum efficiency.

A. The a/w syringe is used to rinse and dry the teeth and oral cavity.

B. The a/w syringe provides three forms of spray: air only, air and water

(aerated spray), or water only.

C. When using the a/w syringe, turn the tip in the direction of the arch-up

for the maxilla, down for the mandible.

USING THE ORAL EVACUATOR TIP

I. Successful oral evacuation is dependent on a few simple rules

II. Suggested tips for oral evacuation are listed

RULES FOR ORAL EVACUATOR PLACEMENT

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- Select the appropriate end.

- Use a thumb-to-nose or pen grasp

- When working with a right-handed operator, the assistant operates the oral

evacuator with the right hand and uses the left hand with a left handed

operator.

- Place the evacuator tip before the operator places the handpiece and/or

mirror.

- Place the tip as close to the tooth as possible.

- Keep the edge of the evacuator tip even with or slightly above the occlusal or

incisal edge of the tooth.

- Place the tip near the tooth surface closest to the assistant.

- When the handpiece is being used on the surface nearest the assistant, place

the HVE tip slightly distal to the tooth being treated.

SUGGESTIONS FOR ORAL EVACUATOR USE

1. Place the tip securely into the hose to avoid accidental

dislodgement.(especially with saliva ejector)

2. Minimize the noise of the HVE system by turning on the evacuator

completely.

3. Turn the angle of the tip opening parallel to the buccal or lingual plane of

the teeth to avoid contact with soft tissue.

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4. Avoid contact with soft tissue when the tip is initially placed in the mouth

by entering toward the midline where the opening is greater; then

concentrate on specific placement.

5. Avoid cold-temperature discomfort to sensitive or non-anesthetized teeth

by using a plastic HVE tip.

6. If a tip falls on the floor, ask for help and replace it with a clean one. Pick

up the dropped tip at the end of the procedure.

7. Clean a surgical tip frequently by dipping the tip into a cup of sterile water

or saline solution to avoid clogging.

8. Avoid quick and sudden movement of the tip. This can be distracting to

the operator and potentially dangerous to the patient.

9. Avoid contact with the soft palate and pillar areas to eliminate potential

gagging.

10. Remove the tip whenever possible to allow the patient to close and

swallow. This prevents over drying the mouth and gives the patient a break

from the constant noise.

11. Observe fluids and debris collecting in other areas of the mouth and

remove them intermittently.

12. When a complete mouth rinse is performed, turn the tip so that the back of

the tip (the side opposite the tip opening) lies on the lateral surface of the

tongue or cheek.
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13. Keep the evacuator tip turned on at the end of the procedure for a short

time to ensure that all fluids are drawn into the system and do not remain

at the hose opening.

14. Avoid saying "oops" or "I'm sorry" or gasping when you grasp tissue with

the HVE tip. Such reactions do not build patient confidence.

15. Avoid contact with sublingual tissues because they can be more susceptible

to injury than other oral tissues.

REASONS FOR USE OF HVE

1. Increase patient comfort

2. Increase success of restorations by providing a dry operative field

TYPES OF ISOLATION MATERIALS INCLUDE:

A. Cotton rolls

B. Cellulose wafers

C. Svedopters

D. Mouth props