Technical Training Module-Dental

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TECHNICAL TRAINING MODULE

DENTAL CHAIRS SYSTEM


2012

Prepared by
Mohd Nizam Abdullah

Introduction
Dentistry is the branch of medicine that is involved in the study, diagnosis,
prevention, and treatment of diseases, disorders and conditions of the oral cavity,
the maxillofacial area and the adjacent and associated structures, and their
impact on the human body. To the layman, dentistry tends to be perceived as
being focused primarily on human teeth, though it is not limited strictly to this.
Dentistry is widely considered necessary for complete overall health. Doctors
who practice dentistry are known as dentists. The dentist's supporting team
which includes dental assistants, dental hygienists, dental technicians, and dental
therapists aids in providing oral health services.
Dentistry usually encompasses very important practices related to the oral cavity.
Oral diseases are major public health problems due to their high incidence and
prevalence across the globe with the disadvantaged affected more than other
socio-economic groups.
The majority of dental treatments are carried out to prevent or treat the two most
common oral diseases which are dental caries (tooth decay) and periodontal
disease (gum disease or pyorrhea). Common treatments involve the restoration of
teeth as a treatment for dental caries (fillings), extraction or surgical removal of teeth
which cannot be restored, scaling of teeth to treat periodontal problems and
endodontic root canal treatment to treat abscessed teeth.

Dental chair system is basically used for oral and orthodontic treatment on the
patients including dental surgery.
History
The Indus Valley Civilization (IVC) has yielded evidence of dentistry being practiced
as far back as 7000 BC. IVC sites in Pakistan indicate that this earliest form of
dentistry involved curing tooth related disorders with bow drills operated, perhaps, by
skilled bead craftsmen. The reconstruction of this ancient form of dentistry showed
that the methods used were reliable and effective.

The first dental foot engine was built by John Greenwood and one of George
Washingtons dentists. It was made from an adapted foot-powered spinning wheel.

The first dental drill was a foot driven instrument invented by John Greenwood in
1790. Far from the high tech dental drills of today, the first dental drill John
Greenwood made was really just a modified version of his mother's foot treadle
spinning wheel. While, a bit unwieldy, it did the trick. In 1957, a dentist named John
Borden invented the high speed contra angle hand piece with 30,000 rotations per
minute, a monumental step forward in dental drilling and polishing.

1790- Was a big year for dentistry, as this was also the year the first specialized
dental chair was invented. It was made from a wooden Windsor chair with a headrest
attached.

In 1790, a prominent American dentist named Josiah Flagg invented the first dentist
chair, complete with headrest and tray for keeping track of implements. In 1832,
inventor James Snell improved on Greenwood's invention by making the chair
recline, making it easier for a dentist to see in his victim's (or patient's) mouth. In
1877, the chair once again made dental headlines when the Wilkerson chair
replaced the Snell chair as the predominant chair type used by dentists.

1840 The First Dental School is founded


Chapin Harris and Horace Hayden founded the Baltimore College of Dental Surgery,
the first school dedicated solely to dentistry. The college merged with the University
of Maryland School of Dentistry in 1923, which still exists today.

1871-George F. Green invented the first electrical dental engine.

In 1957, John Borden invented the first high speed electric hand drill.

1960s, the first dental lasers are developed and used for soft tissue procedures.
1. Device Application
A dental chair for supporting a patient during examination and the performance of
procedures on the patient includes a patient support having a seat and a back, a
base adapted to engage a floor surface, and a lift arm.
Conventional dental operatories generally include an articulating dental chair for
supporting a patient in a variety of positions to facilitate the performance of dental
procedures and operations. For example, dental chairs are generally adapted to be
raised and lowered relative to a floor surface, and to be moved between a first
orientation where a seat back is inclined relative to a seat base to support the patient
in a seated position, and a second orientation where the seat back is reclined to
support the patient in a generally supine position.

The dental operatory may also include a dental delivery unit adapted to support
various instruments and tools used during the performance of dental procedures.
The delivery unit is typically provided with water and pressurized air for operating the
instruments, and may include a tray for supporting instruments or other articles used
by the practitioner. The delivery unit may be supported on a movable arm that
facilitates positioning the unit and instruments adjacent the dental chair for
convenient access by the practitioner during the performance of a procedure, then
moved away to permit the patient to exit the dental chair when the procedure is
complete.

Conventional dental operatories may further include a cuspidor provided adjacent


the dental chair to permit patients to expel the contents of their mouths during or at
the conclusion of the dental procedure, an adjustably positionable lamphead to
illuminate the treatment area, and various other devices useful for the performance
of dental procedures. Such devices may be supported on cabinetry or other structure
positioned adjacent the dental chair for convenient access by the patient or the
dental practitioner.
A dental chair should generally be movable from a lowered position with the seat
back inclined, which facilitates entry and exit from the chair, and a raised position
with the seat back reclined, which facilitates examination and the performance of
procedures by a dental practitioner. Conventional dental chairs use a lift arm
pivotally coupled to a base at a position intermediate the front and rear ends of the
base to raise and lower the chair. This configuration generally results in a bulky base
structure that has a rather large footprint, making it difficult for a dental practitioner to
navigate around the chair during the performance of procedures. This configuration
also limits the maximum length of the lift arm. In general, a longer lift arm is more
desirable because it provides a greater vertical rise of the chair while minimizing for
and aft movement of the chair during raising and lowering.
Dental chair system is basically, used for oral and orthodontic treatment on the
patients including dental surgery.
The system will consist:

Motor controlled mains padded cushion chair;

Handpiece Delivery System

Dental Lights

Monitor mount choices for all mount to rotating arms for greater flexibility
and improved positioning.

Floor Box

Cuspidor

Water System

Motor controlled mains padded cushion chair.


The integral chair-unit is well designed for hi-levels in comfort, safety, quietness and
vibration-free movements, to support the patient and the surgeon at highest
efficiency levels. The latest unit is designed with new technology concepts with nocompromise to quality of construction, hygiene or performance and ergonomically
designed for use in both two and four hand dentistry.
Easily accessible controls with on-line instrument arm and electronically operated
panel, the unit is complete is every respect and exceptionally flexible in movements.
The all purpose, flexible and moving mechanism just fits-in to your preference of
work position.
Handpiece Delivery System
Handpiece Delivery System is built around a control block for three handpieces and,
in most instances, autoclavable syringe.
Handpiece actuation is automatic. When you lift a handpiece from its holder, the
handpiece becomes active and will run when you press on the foot control disc.
Return the handpiece to its resting position to deactivate it.

Handpiece Controls
Drive Air Pressure Controls

The Drive Air Pressure Controls are used to adjust the drive air pressure to each
handpiece
Coolant Air Flow Control
The coolant air flow control is used to adjust the coolant air flow to all handpieces.
Coolant Water Flow Controls
The coolant water flow controls are used to adjust the flow of coolant water to each
handpiece.
Handpiece Tubing Flush Control
The handpiece tubing flush system flushes more water through the tubings in less
time than is normally possible when operating the foot control only.
Handpiece Dry Block Conversion
The handpiece delivery system has three to four handpiece control blocks with
coolant water to the handpiece. In some cases a control block without coolant water,
a dry block, is required. If you require a dry block (offering no water to the
handpiece) on the handpiece control system, a dry block conversion kit has been
included with your system.
Autoclavable Syringe.
The Autoclavable Syringe is a three-way air and water syringe with a patented quickdisconnect autoclavable tip system.
The features are:

Syringe buttons

Syringe tip retainer assembly

Syringe tip

Warm water syringe

Quick disconnect syringe terminal

Syringe Buttons

Autoclavable syringes feature buttons that provide modulated


control of syringe water, air and spray functions.

Quick-Disconnect Syringe Terminal


A quick-disconnect terminal allows a syringe to be removed from the delivery system
without turning the system off.
Operation - Syringe Tip
A-dec designed the syringe tip with three grooves and the syringe tip retainer
assembly with three O-rings to ensure that the syringe performs properly. The first
and second grooves seat two O-rings to prevent tip ejection from the syringe. The
third groove is an indicator of proper installation and is not visible when the tip is
properly installed. The third O-ring prevents water from entering the air tubing in the
syringe tip (see Figure).

Maintenance
All syringe tips are considered critical items and must be heat sterilized between
patients. Remove the syringe and syringe tips from the delivery system for
sterilization. Pre-clean the syringe and tips before sterilization. This prevents the
sterilization process from adhering the accumulated debris onto the syringe and tip.
Pre-clean the syringe and tip
1. Gently brush the syringe threads with a nylon or brass bristle brush.
2. Remove the tip from the syringe.
3. Immerse the tip in a holding solution until ready for ultrasonic cleaning.

4. Clean the tip ultrasonically, following the ultrasonic manufacturer's instructions.


5. Purge all cleaning agents from the syringe and tip before sterilization.
Sterilization
Sterilize the syringe and tip at a maximum temperature of 275P (135C).
Sterilize syringes using chemical vapor or steam autoclave at a maximum 275P
(135C) for four minutes.
Sterilize syringe tips using dry heat, chemical vapor or steam autoclave at a
maximum 275P (135C) for four minutes.
Silicone Lubricant
Use Silicone Lubricant to lubricate the syringe button assemblies and the O-rings
used in the syringe tip retainer assembly. Syringe is designed to be easily serviced.
The syringe parts subject to wear under normal use are provided in a syringe repair
kit which can be ordered from your authorized dealer.
Replacement Parts
As a means of preventive maintenance, it is recommends to replace the two internal
O-rings and the small O-ring in the syringe tip retainer assembly at least once a year.
Lubricate the O-rings with silicone lubricant at the time of replacement.

Troubleshooting

Problem
Syringe leaks air or
water from a button
Syringe tip drips
when the syringe is
not in uses
A short burst of
water sprays from
the tip when the air
button is pressed
Water or air leaks
from the syringe
handle

Possible Cause
Faulty a-rings on the
button
Faulty a-rings on the water
buttons

Action
Replace the button
assembly
Replace the water button

Improperly installed or
damaged syringe tip.

Pull out and reinstall the


syringe tip correctly.
Replace the syringe tip if it
still leaks
Tighten the syringe handle
onto the syringe

Syringe handle is not


tightly connected to the
syringe
a-rings on the terminal are
damaged

Air leaks from the


top of the tip
retainer assembly

Syringe tip is damaged


Retainer internal
a-rings are damaged

Syringe tip is
difficult to install

Retainer internal
a-rings have been
lubricated with a
petroleum-based lubricant

Water leaks from


base of tip retainer
assembly

The tip retainer assembly


has been damaged
Tip is not fully installed

Small a-ring in the retainer


assembly has failed
Syringe tip is loose
in the retainer
assembly

A non-A-dec syringe tip is


in use
Retainer a-rings are worn
or damaged

Replace the a-rings on the


terminal and lubricate with
A-dec silicone lubricant
Replace with a new tip.
Replace the two inner
a-rings of the retainer
assembly
Replace the a-rings and
remove remaining
lubricant from the
retainer. Use A-dec silicone
lubricant on the new
a-rings
Replace the tip retainer
assembly
Push tip completely into
place with the third groove
hidden
Replace the a-ring or
replace the retainer
assembly
Replace with an
A-dec syringe tip
Replace the a-rings

How the Water System Works


Air pressure forces the water from the bottle into the water pick-up tube and out to
various water outputs such as the handpiece control block, syringe, and the cuspidor
cup fill. A self-contained water system is a closed system isolating your chosen
treatment water from the municipal supply
How to Choose Treatment Water
The correct water to use in the self-contained water system (for patient treatment)
depends on the quality of water available from your municipal source and the goals
you have for using the self-contained water system. It is important that whenever
treatment water is specified for a procedure, that you are consistent in your water
source quality.
CUSPIDOR
The cuspidor is equipped with a timer for the bowl rinse. This timer can be adjusted
to increase or decrease the length of time water flows into the bowl. The cuspidor
comes standard with an automatically timed cup fill.
On most units, the cuspidor on/off function is controlled by the master on/off toggle
on the control head. For cuspidor only units, the cuspidor on/off function is controlled
by the on/off toggle on the post box.
Contoured Water Spout

Bowl Rinse Button

Master On/Off Toggle


The master on/off toggle can be found on the post box, control head or Master
Series touch pad. Moving the toggle to the ON position provides air and water to the
system. Move the toggle to the OFF position while the unit is unattended to prevent
water damage in case of a leak.
Cuspidor Limit Switch
To test the cuspidor limit switch, slightly lift the cuspidor and listen for a "click". The
"click" indicates that a switch has been activated. To check the operation of the limit
switch, start lowering the chair. While the chair is in motion, lift the cuspidor slightly.
The chair will stop and all chair functions except Base Up will be disabled. The Base
Up function remains active so you can raise the chair to remove any object caught
under the cuspidor. When the object has been removed, all chair functions will
operate normally.

Gravity Drain Cleaning


At the end of each day, flush the drain to remove debris which can collect in the
flexible drain tubing. If the drain is not flushed regularly, debris may build up and
impair cuspidor draining. To flush the drain, raise the chair to its highest position and
run the bowl rinse several times, long enough so that water flows down the drain for
about 60 seconds.

Cleaning the Cuspidor


The cuspidor is designed for quick and easy cleaning. The contoured spouts and the
smooth cuspidor housing help facilitate more complete cleaning. When cleaning, do
not remove the contoured water spout. Also remember to empty and clean the bowl
screen.
Bowl Rinse Adjustment
The flow of water to rinse the bowl and the length of time that water flows to rinse the
bowl are set at the factory.
The bowl rinse flow adjustment location is inside the post box or under the cuspidor
bowl. To remove the side cover from the post box; insert your fingers under the lower
edge of the cover and pullout and down on the side cover. Loosen the thumbscrew
and lower the cover. Locate the bowl rinse flow adjustment. Notice the position of the
indicator dot which shows the present setting of the flow control. Using an
adjustment key or a 1%a-inch hex key, turn the adjustment key clockwise to increase
the flow rate and counterclockwise to decrease the flow rate. Check the flow rate by
pressing the bowl rinse button. When the adjustment has been completed, reinstall
the cover.

Bowl Rinse Time Adjustment


To change the length of time that water flows for the bowl rinse, locate the time
adjustment screw (see Figure). Use an adjustment key or a 1%a-inch hex key and

turn the adjustment key clockwise (as viewed from the bottom) to increase the length
of time water flows to rinse the bowl or counterclockwise to decrease the length of
time. Check the length of time for water flow and adjust until it is satisfactory.

Adjustment screw

Timed or Manual Cup Fill


The timer for the automatic cup fill is set at the factory. If you ordered an optional
manual cup fill, the water flow is set during installation to prevent splashing. In either
case, the amount of water flowing into the cup may be changed.
If an adjustment is necessary to either the manual or timed cup fill, remove the side
cover on the post box by inserting your fingers under the lower edge of the cover and
pulling out and down on the cover, loosen the thumbscrew and lower the cover.
Locate the cup fiII flow adjustment. Notice the location of the indicator dot showing
the position of the current setting. Use an adjustment key or a hex key and turn the
key clockwise to increase the flow rate or counterclockwise to decrease the flow rate.
Check the cup fill flow. When the adjustment has been completed, reinstall the
cover.

Dental Lights
The dental light has balanced lighting to give you a clear view of tooth surfaces, the
precision-balanced arm allows for smooth positioning, and the light's diagonal axis
lets you angle the light head.
The light is equipped with a large On/Off toggle and On/Off control is also located on
the touchpad. There are three intensity settings which you can choose from high,
medium or composite settings by moving the intensity switch located on the back of
the switch housing. A quick press on the Light button on the touchpad allows you to
toggle between intensity settings, depending on the location of the dental light's
intensity switch.
Operation
The dental light includes a number of features designed to make your job easier. The
balanced light gives a clear view of tooth surfaces, the precision-balanced arm
allows for smooth positioning, and the light's diagonal axis lets you angle the light
head just where you need it.
The dental light also has an Auto On/Off feature. When the chair reaches an
operating position, the dental light will turn on. When the chair moves out of the
operating position, the dental light turns off. The auto on/ off setting can be turned off
by pressing and holding the Program button and then the Light button together for
three seconds. One beep will confirm that the factory preset has been turned off. To
return to the factory preset, repeat steps. Three beeps will confirm that the auto
on/off function is on.

A - Intensity switch; B - On/Off switch

How to Adjust the Dental Light


The light is adjusted at for proper illumination at 27 inches (700 mm) from the oral
cavity. However, you can quickly and easily adjust the light focus (between 18 and
31 inches [460 mm and 790 mm]) to best suit your needs.
How to Focus the Light
1. Place a white towel over the chair headrest to represent the oral cavity.
2. Position the light head at the distance you would normally use it when
working in the oral cavity (select a distance representative of most of your
work).
3. Turn the light ON.
4. Use a large screwdriver or coin to turn the focus adjusting screw until the light
within the borders of the light pattern is most uniform.
FLOOR BOXES
The recessed or stainless steel floor box is mounted over the utilities on the floor or
wall of the clinic. Located in the floor box are the air and water manual shutoff
valves, filters, and pressure pre-regulators. You will find vacuum or gravity drains as
well as electrical outlets. The stainless steel floor box covers lift off for access to the
utilities and optional power supplies and/or water heater.
Floor Box Controls and Functions
The stainless steel floor box covers lift off for access to the utilities and optional
power supplies and/or water heater.
To remove the cover from your Cascade Floor Box, slide the cover forward a little
and lift.
The recessed floor box cover is held in place by four screws. Removing the screws
will allow you to lift the cover.

Note
Do not use saline solution, mouth rinses, or any chemical solutions not specified in
the manual in your municipal water supply. These may damage the water system
components and cause the failure of your dental unit. As a general rule, water that is
suitable for drinking is suitable to use in your delivery system.
Filter

Water temperature control


(tank Type Water heater)

Pre regulator

Air actuated water shutoff valve


Water manual shutoff valve

FiIter Maintenance
Air and Water Filter Elements
Air and water pass through separate filters before entering the regulators. A filter
must be replaced when it becomes sufficiently clogged causing restricted flow to the
regulator.

Checking for a Clogged Air Filter


To check for a clogged air filter, flip the master onoff toggle to the ON position and
remove the floor box cover. While watching the air pressure gauge in the floor box,
press the syringe air button. If the air pressure indicated by the gauge drops by more
than 15 psi, the fiIter element is clogged and must be replaced.
Checking for a Clogged Water Filter
To check for a clogged water filter, flip the master on-off toggle on the control head
to the ON position, then remove the floor box cover. Watch the water gauge, press
the syringe water button. If the water pressure drops by more than 10 psi, the water
filter is clogged and must be replaced.
To inspect or replace a filter element, flip the master on-off toggle to the OFF
position, then close the manual shutoff valves. Bleed the system of air and water
pressure by operating the syringe buttons until air and water no longer flow. Using a
standard (flat-blade) screwdriver, remove the filter housing from the air and/or water
pre-regulators assemblies (see Figure) and remove the filter. If the filter is visibly
clogged or discolored, you will need to replace it.
When installing a new filter, notice that one end of the filter has a beveled edge.
Install the filter with the beveled edge facing the manifold (see Figure). The system
will not work properly if the filter is installed incorrectly.
Filter Housing
O Ring
Filter Element
Beveled Edge

Planned Preventive Maintenance

PPM consists of the following:1. Qualitative Tasks


2. Preventive Maintenance Tasks
3. Quantitative Tasks
4. Electrical Safety Test
Qualitative Tasks
Indicators/Displays verify proper illumination and operation.
Valves/Solenoids verify integrity and operation.
Tubes/Hoses verify conditions.
Incoming Air Pressure verify availability.
Incoming Water Supply verify availability.
Filters verify condition.
Labeling - verify presence and placement of all labels, placards, instructions
cards etc.
Accessories verify availability.
Preventive Maintenance Tasks
1. Clean Exterior.
2. Inspect/Clean Interior of unit.
3. Lubricate recommended parts and areas.
4. Filters change if necessary.
5. Water Supply Line Clean/de-scale if necessary.
6. Air and Water Traps Flash clean, replace O ring seal if necessary.
7. Oil Level Inspect and check level, top up if necessary.

8. Align/Adjust Electrical Components.


9. Align/Adjust Mechanical Components.
Quantitative Tasks
1. Incoming Water Pressure
2. Incoming Air Pressure
3. Vacuum Pressure
Test Equipment
1.

Electrical Safety Test

2.

Pressure Test Gauges/ Vacuum Gauge.

Above information is a general guide to better understanding of the Dental


Chair System. For further detail information, please refer to Manufacturers
Operation/Service manuals.

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