CHAIR POSITION

Presented by
Hemam Shankar Singh

CONTENTS
1. INTRODUCTION
2. CHAIR AND PATIENT POSITIONS
UPRIGHT POSITION
ALMOST SUPINE
RECLINED 45 DEGREE

3. OPERATING POSITION

RIGHT FRONT POSITION (7 O'CLOCK)

RIGHT POSITION (9 O'CLOCK)
RIGHT REAR POSITION (11 O'CLOCK)
DIRECT REAR POSITION (12 O'CLOCK)

4. CONSIDERATIONS FOR DENTISTS WHILE DOING

PATIENT
5. SEQUENCE FOR PRACTICING POSITIONING
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INTRODUCTION
CHAIR AND PATIENT POSITIONS ARE
IMPORTANT
CONSIDERATIONS.
MODERN
DENTAL
CHAIRS
ARE
DESIGNED TO PROVIDE TOTAL BODY
SUPPORT IN ANY CHAIR POSITION.

INTRODUCTION
CHAIR POSITION IS A VERY IMPORTANT ASPECT
IN THE SUCCESS OF A DENTAL TREATMENT.
THE
CORRECT
POSITIONING
HELPS
THE
OPERATOR TO HAVE A GOOD VISIBILITY AND
ACCESSIBILITY OF THE ORAL CAVITY
PROPER POSITIONING OF THE PATIENT AND THE
OPERATOR, ILLUMINATION AND RETRACTION
FOR
OPTIMAL
VISIBILITY
ARE
THE
FUNDAMENTAL PRE-REQUISITES TO PROPER
DENTAL TREATMENT
IF OPERATOR MAINTAINS PROPER POSITION AND
POSTURE DURING TREATMENT, THE OPERATOR IS
LESS LIKELY TO GET STRAIN, FATIGUE, BE MORE
EFFICIENT AND LESS CHANCES OF GETTING
MUSCULOSKELETAL DISORDERS.
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FOLLOWING POINTS SHOULD BE KEPT IN MIND IN

RELATION TO DENTAL CHAIR:
IT SHOULD BE ABLE TO PROVIDE COMFORT TO THE
PATIENT
IT SHOULD BE ABLE TO PROVIDE TOTAL BODY SUPPORT
HEADREST OF CHAIR SHOULD BE ATTACHED FOR
SUPPORTING PATIENT'S CHIN AND REDUCING STRAIN ON
CHIN MUSCLES
IT SHOULD BE ABLE TO PROVIDE MAXIMUM WORKING
AREA TO THE OPERATOR
IT SHOULD BE PLACED AT THE CONVENIENT LOCATION
WITH
ADJUSTABLE CONTROL SWITCHES

FOOT SWITCHES ARE PREFERRED TO IMPROVE

INFECTION
CONTROL
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PATIENT POSITIONS

VL

PATIENT SHOULD BE SEATED SO THAT ALL HIS

BODY PARTS ARE WELL SUPPORTED.
THE
PATIENT'S
HEAD
SHOULD
ALWAYS BE
SUPPORTED
BY
ADJUSTABLE/
ARTICULATED
HEADREST.
PREFERABLY THE PATIENT'S HEAD SHOULD BE IN
LINE WITH HIS BACK .
THE CHAIR HEIGHT SHOULD BE KEPT LOW,
BACKREST SHOULD BE UPRIGHT AND ARMREST
SHOULD BE ADJUSTABLE WHILE MAKING THE
PATIENT TO SEAT IN THE DENTAL CHAIR.
NOW, THE CHAIR CAN BE ADJUSTED TO PLACE THE
PATIENT IN RECLINING POSITION.
PATIENT POSITION CAN VARY WITH OPERATOR,
TYPE OF PROCEDURE AND AREA OF THE ORAL
CAVITY.
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CHAIR POSITIONS
FOR RESTORATIVE DENTAL PROCEDURES, THE
MOST PREFERRED OPERATING POSITIONS ARE:
1. UPRIGHT POSITION
2. ALMOST SUPINE
3. RECLINED 45 DEGREE
THE MOST COMMON PATIENT POSITIONS FOR
OPERATIVE DENTISTRY ARE ALMOST SUPINE OR
RECLINED 45 DEGREES. THE CHOICE OF PATIENT
POSITION VARIES WITH THE OPERATOR, THE
TYPE OF PROCEDURE, AND THE AREA OF THE
MOUTH INVOLVED IN THE OPERATION.
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Chair position
UPRIGHT POSITION
THIS IS THE INITIAL POSITION OF CHAIR FROM
WHICH FURTHER ADJUSTMENTS ARE MADE

ALMOST SUPINE
IN THIS , CHAIR POSITION IS SUCH THAT HEAD, KNEES
AND FEET ARE APPROX. AT SAME LEVEL
PATIENTS HEAD SHOULD NOT BE LOWER THAN FEET
EXCEPT IN CASE OF SYNCOPAL ATTACK

CLINED 45 DEGREES
HIS POSITION , CHAIR IS RECLINED AT 45 DEGREE
DIBULAR OCCLUSAL SURFACE ARE ALMOST 45 DEGREE TO THE F

10

OPERATING POSITIONS
ONCE THE PATIENT HAS BEEN
COMFORTABLY POSITIONED, THE
DENTIST AND THE ASSISTANT
SHOULD SIT THEMSELVES IN THE
PROPER
POSITIONS
FOR
TREATMENT.
USUALLY SITTING POSITION IS
PREFERRED
IN
MODERM
DENTISTRY TO RELIEVE STRESS
ON
OPERATOR'S
LEG
AND
SUPPORT
THE
OPERATOR'S
BACK.
THE LEVEL OF TEETH BEING
TREATED SHOULD BE PLACED AT
SAME LEVEL AS THE LEVEL OF
OPERATOR'S ELBOW.

11

FOR
BETTER
UNDERSTANDING,
SITTING
POSITIONS OF OPERATOR
ARE RELATED TO A CLOCK. IN
THIS CLOCK CONCEPT, AN
IMAGINARY
CIRCLE
IS
DRAWN OVER THE DENTAL
CHAIR,
KEEPING
THE
PATIENT'S HEAD AT THE
CENTER OF THE CIRCLE.

THEN THE NUMBERING TO

CIRCLE IS GIVEN SIMILAR TO
A CLOCK WITH THE TOP OF
THE CIRCLE AT 12 O'CLOCK.
ACCORDINGLY
THE
OPERATOR'S POSITIONS
(RIGHT HANDED OPERATOR)
7 O'CLOCK, 9 O'CLOCK, 11
O'CLOCK, AND 12 O'CLOCK

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RIGHT FRONT POSITION (7

O'CLOCK)
1. IT
HELPS
IN
EXAMINATION
OF
THE
PATIENT
2. WORKING
AREAS
INCLUDE:
a) MANDIBULAR
ANTERIOR
b) MANDIBULAR
POSTERIOR
TEETH
(RIGHT SIDE)
c) MAXILLARY ANTERIOR
TEETH
3. TO INCREASE THE EASE
AND
VISIBILITY,
THE
PATIENT'S HEAD MAY BE

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RIGHT POSITION (9 O'CLOCK)

1. IN
THIS
POSITION,
DENTIST SITS EXACTLY
RIGHT TO THE PATIENT
2. WORKING
AREAS
INCLUDE:
a) FACIAL SURFACES OF
MAXILLARY
RIGHT
POSTERIOR TEETH
b) FACIAL SURFACES OF
MANDIBULAR
RIGHT
POSTERIOR TEETH
c) OCCLUSAL
SURFACES
OF
MANDIBULAR
RIGHT
POSTERIOR
TEETH.
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RIGHT
REAR
POSITION
(11
O'CLOCK)
1. IN THIS POSITION, DENTIST SITS
BEHIND AND SLIGHTLY TO THE
RIGHT OF THE PATIENT AND THE
LEFT
ARM
IS
POSITIONED
AROUND PATIENT'S HEAD
2. THIS IS PREFERRED POSITION
FOR
MOST
OF
DENTAL
PROCEDURES
3. MOST AREAS OF MOUTH ARE
ACCESSIBLE
FROM
THIS
POSITION EITHER USING DIRECT
OR INDIRECT VISION
4. WORKING AREAS INCLUDE:
a) PALATAL
AND
INCISAL
(OCCLUSAL) SURFACES OF
MAXILLARY TEETH
b) MANDIBULAR
TEETH
(DIRECT VISION).

15

DIRECT REAR POSITION (12

O'CLOCK)
1. DENTIST
SITS
DIRECTLY
BEHIND THE PATIENT AND
LOOKS DOWN OVER THE
PATIENT'S
HEAD
DURING
PROCEDURE.
2. WORKING
AREAS
ARE
LINGUAL
SURFACES
OF
MANDIBULAR TEETH.
3. THIS POSITION HAS LIMITED
APPLICATION.

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RIGHT HANDED OPERATOR LEFT HANDED OPERATOR

3 PREFERRED POSITIONS
3 PREFERRED POSITIONS
7 OCLOCK

5 OCLOCK

9 OCLOCK

3 OCLOCK

11 OCLOCK

1 OCLOCK

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CONSIDERATIONS WHILE DOING PATIENT

1.WHILE DOING WORK IN MAXILLARY ARCH,
MAXILLARY OCCLUSAL SURFACES SHOULD BE
PERPENDICULAR TO THE FLOOR.
2.IN
MANDIBULAR
ARCH,
MANDIBULAR
OCCLUSAL SURFACE SHOULD BE ORIENTED
45 TO THE FLOOR.
3.
PATIENT'S
HEAD
CAN
BE
ROTATED
BACKWARD OR FORWARD OR FROM SIDE TO
SIDE FOR OPERATORS EASE AND VISIBILITY
WHILE DOING WORK.
4.MAINTAIN
PROPER
WORKING
DISTANCE
DURING DENTAL PROCEDURE. THIS WILL
LEAD TO INCREASE COOPERATION AND
CONFIDENCE AMONG THE PATIENT.
5.OPERATOR SHOULD NOT REST FOREARMS ON18

6. DENTIST SHOULD NOT USE

PATIENT'S CHEST AS A INSTRUMENT
TROLLEY.
7. THE OPERATOR SHOULD LEAVE
LEFT HAND FREE DURING MOST OF
DENTAL PROCEDURES FOR
RETRACTION USING MOUTH MIRRORS
OR FINGERS OF LEFT HAND.
8. OPERATOR SHOULD KEEP
CHANGING POSITION IF PROCEDURE
IS OF LONG DURATION TO DECREASE

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QUENCE FOR PRACTICING POSITIONING

FOR SUCCESSFUL INSTRUMENTATION, IT IS

IMPORTANT TO PROCEED IN A STEP-BY-STEP
MANNER. A USEFUL SAYING TO HELP YOU
REMEMBER THE STEP-BY-STEP APPROACH IS
ME, MY PATIENT, MY LIGHT, MY NON-DOMINANT
HAND, MY DOMINANT HAND.

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SEQUENCE FOR ESTABLISHING POSITION

ME.
ASSUME THE CLOCK POSITION FOR THE
TREATMENT AREA

MY PATIENT.
ESTABLISH PATIENT CHAIR AND HEAD POSITION.

MY EQUIPMENT.
ADJUST THE UNIT LIGHT. PAUSE AND SELF-CHECK
THE CLINICIAN, PATIENT, AND EQUIPMENT
POSITION.

MY NONDOMINANT HAND.
PLACE THE FINGERTIPS OF MY NONDOMINANT
HAND AS SHOWN IN THE ILLUSTRATION FOR THE
CLOCK POSITION.

MY DOMINANT HAND.
PLACE THE FINGERTIPS OF MY DOMINANT HAND
AS SHOWN IN THE ILLUSTRATION FOR THE CLOCK
POSITION.
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POSITIONING TERMINOLOGY

WHEN WORKING ON ANTERIOR

SEXTANTS, YOUR LEFT HAND
(NON-DOMINANT HAND) AND
YOUR RIGHT HAND (DOMINANT
HAND) ARE POSITIONED ON
OPPOSITE SIDES OF THE
PATIENTS MOUTH.

ANTERIOR SURFACES TOWARD MY

NON-DOMINANT HANDTHE
COLORED ANTERIOR SURFACES IN
THIS ILLUSTRATION.

ANTERIOR SURFACES AWAY FROM

MY NON-DOMINANT HANDTHE
WHITE ANTERIOR SURFACES IN
THIS ILLUSTRATION.
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POSITIONING TERMINOLOGY
POSTERIOR
ASPECTS
FACING
TOWARD
METHE
COLORED
POSTERIOR
SURFACES
IN
THIS
ILLUSTRATION.
MAXILLARY RIGHT POSTERIOR
SEXTANT, FACIAL SURFACES
MAXILLARY LEFT POSTERIOR
SEXTANT, LINGUAL SURFACES
MANDIBULAR RIGHT POSTERIOR
SEXTANT, FACIAL SURFACES
MANDIBULAR LEFT POSTERIOR
SEXTANT, LINGUAL SURFACES

23

POSITIONING TERMINOLOGY
POSTERIOR ASPECTS FACING AWAY
FROM METHE COLORED POSTERIOR
SURFACES IN THIS ILLUSTRATION.
MAXILLARY LEFT POSTERIOR
SEXTANT, FACIAL SURFACES
MAXILLARY RIGHT POSTERIOR
SEXTANT, LINGUAL SURFACES
MANDIBULAR LEFT POSTERIOR
SEXTANT, FACIAL SURFACES
MANDIBULAR RIGHT POSTERIOR
SEXTANT, LINGUAL SURFACES

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POSITION FOR THE RIGHT-HANDED

ARCH
MANDIBUL
AR ARCH

MAXILLAR
Y ARCH

MANDIBUL
AR ARCH

MAXILLAR
Y ARCH

TREATMENT AREA

CLOCK
POSITION

HEAD POSITION

ANTERIOR SURFACES TOWARD MY

NON-DOMINANT HAND

89

SLIGHTLY
TOWARD, CHIN
DOWN

ANTERIOR SURFACES AWAY FROM

MY NON-DOMINANT HAND

12

SLIGHTLY
TOWARD, CHIN
DOWN

ANTERIOR SURFACES TOWARD MY

NON-DOMINANT HAND

89

SLIGHTLY
TOWARD, CHIN
UP

ANTERIOR SURFACES AWAY FROM

MY NON DOMINANT HAND

12

SLIGHTLY
TOWARD, CHIN
UP

POSTERIOR ASPECTS FACING

TOWARD ME (RIGHT FACIAL AND
LEFT LINGUAL)

SLIGHTLY AWAY,
CHIN DOWN

POSTERIOR ASPECTS FACING

AWAY FROM ME (RIGHT LINGUAL
AND LEFT FACIAL)

1011

TOWARD, CHIN
DOWN

POSTERIOR ASPECTS FACING

AWAY FROM ME (RIGHT LINGUAL
AND LEFT FACIAL)

1011

TOWARD, CHIN
UP
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OSITIONING FOR THE ANTERIOR

Anterior Surfaces TOWARD My Nondominant Hand

7 TO 9 OCLOCK (8:00 OPTION SHOWN)

TURNED SLIGHTLY TOWARD THE
CLINICIAN
CHIN-DOWN POSITION

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OSITIONING FOR THE ANTERIOR

Anterior Surfaces TOWARD My Nondominant Hand

7 TO 9 OCLOCK (9:00 OPTION SHOWN)

TURNED SLIGHTLY TOWARD THE
CLINICIAN
CHIN-UP POSITION

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OSITIONING FOR THE ANTERIOR

Anterior Surfaces AWAY From My Nondominant Hand

12 OCLOCK POSITION
TURNED SLIGHTLY TOWARD THE
CLINICIAN

28

OSITIONING FOR THE ANTERIOR

Anterior Surfaces AWAY From My Nondominant Hand

12 OCLOCK POSITION
TURNED SLIGHTLY TOWARD THE
CLINICIAN
CHIN-UP POSITION

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OSITIONING FOR THE POSTERIOR

Posterior Aspects Facing TOWARD Me

9 OCLOCK (OPTION 1 FOR 9:00)

TURNED SLIGHTLY AWAY FROM THE
CLINICIAN
CHIN-DOWN POSITION
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OSITIONING FOR THE POSTERIOR

Posterior Aspects Facing TOWARD Me

9 OCLOCK (OPTION 2 FOR 9:00)

TURNED SLIGHTLY AWAY FROM THE
CLINICIAN
CHIN-UP POSITION
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OSITIONING FOR THE POSTERIOR

Posterior Aspects Facing AWAY From Me

10 TO 11 0CLOCK
TURNED TOWARD THE CLINICIAN
CHIN-DOWN POSITION

32

OSITIONING FOR THE POSTERIOR

Posterior Aspects Facing AWAY From Me

10 TO 11 0CLOCK
TURNED TOWARD THE CLINICIAN
CHIN-UP POSITION

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CONCLUSION

Proper use of the chair positions as

according to the relative operating areas
helps the operator to complete the
procedure without delayed. it also reduces
the chances of causing musculoskeletal
disorders.

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