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What is Four-Handed Dentistry?

Four-Handed Dentistry is an operatory technique that was

conceptualized by many researchers during the early 1960's and
formalized through clinical studies at the University of Alabama
School of Dentistry, funded by government grants in the late 1960s.
Applying time and motion study techniques used by industrial
engineers to increase efficiency and productivity in repetitive task
environments, the university studied dental procedures of hundreds
of practicing dentists and dental students to define the criteria for
Four-Handed Dentistry.

The Concept Developed specified:

1. Positioning - Correct interaction of personnel
2. Organization - Procedural and work flow
3. Equipment - Criteria and selection process
Applying the criteria and concept allowed the attainment of more
effective and efficient dentistry. This research proved Increased
productivity, Reduced stress and fatigue, and Improved quality of
dental care was achievable by all dentists.

MYTH ... The Doctor or hygienist and the assistant, utilizing two
hands each (which equals four hands), are performing Four-Handed
FACT ... Unless the assistant has been properly trained to create team
synergy, unless organization and standardization is employed and
maintained in operatories, and unless ergonomically designed
equipment is used, the dental team is in fact only performing
traditional sit-down dentistry.
Four-Handed Dentistry introduced Synergy - the cooperative action
of two bodies to significantly enhance each others overall
productivity and effectiveness - into the dental vocabulary. The most
significant time losses to a dentist are the unnecessary, wasted and
stress producing Class IV and V movements. These movements
reduce productivity and increase time at chairside. Since Time is
Money, your income potential is significantly reduced.

Research has shown that a properly trained, full-time chairside

assistant, applying synergistic concepts and working in an
ergonomically designed environment with the right equipment, can
assume up to 92% of all non-invasive movements. Through the
elimination of unnecessary and wasted motions in the operatory,
productivity increases of up to 100% are obtained, patient care is
improved, and reduced stress and fatigue are the benefits of
practicing true Four-Handed Dentistry.
Every minute spent at chairside performing unnecessary movements
reduces productivity and the potential earnings of the practice.

Transthoracic delivery eliminates Class IV and V movements that

reduce productivity and create stress and fatigue. When unnecessary
movements are eliminated, productivity is increased and the practice
earns higher profits.

Four-Handed Dentistry Equipment

Clinical research has identified and defined the criteria required of
equipment to achieve increased productivity and to practice true
Four-Handed Dentistry.
Ergonomics (i.e., the combination of human and machine into an
integrated and more productive unit) demanded that proper design
was the overriding consideration among equipment criteria. The six
components defined in the research and specific criteria are:

Patient Chair:
Properly designed to allow optimum see-ability into the oral cavity. The back must be thin
and narrow to facilitate the operators' proper position.
The chair must be solid.
Ideal positioning of the patient by either the operator or assistant.
Aseptic covering.
Maintains patient comfort in all positions and utilizes a solid design to create a secure,
supportive platform.

Properly designed for correct posture, positioning, and
comfort. Proper operator positioning to facilitate circulation
of blood to the lower extremities. Stable bases. Abdomen
support for assistant.

Properly designed so the assistant can transfer all handpieces
and power instrumentation to the operator from the Transfer
Zone. The unit must be positioned in the Transfer Zone with
both doctor and assistant instrumentation on one unit.

A HSP transthoracic delivery unit allows the operator to maintain

concentration and the field of vision on the dental procedure.
Unit design must eliminate unnecessary turning, twisting and other
movements which creates operator stress and fatigue, reduces productivity,
and decreases the quality of patient care.

Mobile Cabinet:
Properly designed and organized to allow the assistant access to
commonly used materials and supplies and with a platform for
the pre-set tray and a work area. When properly used, a mobile
cabinet can contribute 50% to an assistant's efficiency and
creates flexibility in the positioning of fixed cabinetry.

Pre-set Instrument Trays:

Provides an organized procedural flow of hand instruments
and supplies in a sequenced manner and a sterile environment.

Dental Light:

Provides ideal lighting for see-ability. Designed to be color

corrected with a diffused pattern to reduce eye strain.

"I have used rear, side, a competitor's transthorax

delivery, and the Morita delivery system. None compare
to the efficiency and ease of operation of the HSP unit
Michael L. Milligan, D.M.D.
Bloomington, Illinois

"Performance and Product Credibility.... Ask A Doctor Who

Uses the HSP Equipment System"

Four-Handed Dentistry Seminars

HSP offers the dental profession the only live, hands-on seminar program on
Four-Handed Dentistry. Our seminar, which is AGD approved for seven hours of
Continuing Education credits, is based on the research and clinical operating
technique developed and taught, by the University of Alabama School of
Call for more information about HSP seminars or see the education section of
our website.

Come To Learn and Earn More

HSP welcomes every practicing dentist to attend a seminar in our world class
facilities in Birmingham, Alabama. This facility contains our latest equipment
and employs the latest advanced lecture and training room for interaction and
technique analysis between members of the Dental Team. You will learn a more
proficient chairside technique and the concepts to improve quality of dental
patient care, increase productivity and earn more!

Four-Handed Dentistry Seminar Curriculum

Team Synergy:
(1)Definition (2) Productivity Benefits
Principles of Motion Efficiency:
(1) Classes of Movements (2) Elimination (3) Combination
(4) Rearrangement (5) Simplification (6) Assistant Utilization
Specific Concepts:
(1) Proper Positioning (2) Procedural Flow (3) Equipment Criteria
(4) Equipment Arrangement (5) Standardization (6) Instrumentation
(7) Handpiece Transfer (8) Instrument Transfer (9) Pre-tray Set-ups
(10) Evacuation Techniques (11) Appointment Control

"I congratulate you for your efforts and know that your
program can help many dentists and auxiliaries. I have
supported and taught the concept for over 30 years. I find that
your equipment is the most revolutionary on the market today
tailored for the teaching of Four-Handed Dentistry. This
concept allows for a more proficient method for the delivery of
general dentistry while removing the operator stress with
improved patient care."
Gordon J. Christensen, D.D.S., PhD
Clinical Research Associates
Provo, Utah

Profitability Through Productivity

Partners In Progress
1000 11th Court West, Birmingham, AL. 35204

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