Operator Position, Patient Position and Chair Height in Dentistry

Operator Positions in Oral surgery is a very important aspect in the success of your Dental treatment. The correct positioning of the operator is very important to help the Operator or Doctor to have 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  per-requisites to proper  Dental Treatment.

Chair height and Position of Operator and Patient facilitates thoroughness of instrumentation. The position of the patient and operator should provide maximal accessibility to the area of the operation. Improper positioning and chair height will lead to premature tiring of the operator and diminishes the effectiveness of the Operator.

Dental Operator should have a straight Back while working to avoid undue Stress on the lower and upper spinal cord

The Universal Seated Position for the Clinician/Operator: 

• Forearm parallel to the floor
• Thighs parallel to the floor
• Hip angle of 90 degrees
• Seat height positioned low enough so that the heels of your feet touch the floor
• When working from clock positions 9-12:00, feet spread apart so that your legs and the chair base form a tripod which creates a stable position
• Avoid positioning your legs behind the patient’s chair
• Back of the operator should be always straight
• Head erect and should not be bent of drooping

Operator Position for Mandibular teeth

The 2 main things which we have to consider are the Operator Position and Chair Height:

• Chair height
• Operator Position
• Patient’s Position

Chair height:

For Maxillary Teeth:

• The Chair height should be 8cm or 3 inches below the shoulder level of the operator.

For Mandibular Teeth:

• The Chair height should be 16cm or 6 inches below the level of the operators elbow.

Operator Position:

Types of Chair Positions of Operator:

• 7 o’ clock position to the front of the patients head
• 9 o’ clock position to the side of the patients head
• 10 to 11 o’ clock, to the back of the patient’s head
• 12 o’ clock position, directly  behind the patient’s head

Based on the operators working hand:

Right Handed Operator or Clinician:

• Mandibular Arch – Anterior surfaces towards operator – 8-9:00 clock position – Patients head position should be Slightly toward operator and chin down.
• Maxillary Arch – Anterior surfaces towards operator – 8-9:00 clock position – Patients head should be slightly towards operator and chin-up
• Mandibular Arch – Anterior Surfaces away from operator – 12:00 clock position – Patients head should be slightly towards operator and chin-down
• Maxillary Arch – Anterior Surfaces away from operator – 12:00 clock position – Patients head should be slightly towards operator and chin-up
• Mandibular Arch – Posterior Surfaces facing towards the operator – 9:00 clock position – Slightly away from Operator, chin down
• Maxillary Arch – Posterior Surface facing towards the Operator – 9:00 clock position – Slightly away from the Operator, Chin – Up
• Mandibular Arch – Posterior Surface facing towards the Operator – 10 – 11:00 clock position – Towards the Operator and Chin-down
• Maxillary Arch – Posterior aspects facing Downwards – 10 – 11:00 clock position – Towards and Chin Up

Chair positions based on the operator position related to the position of the wall Clock

Left Handed Operator or Clinician:

• 5 o’ clock position, to the front of the patient’s head
• 3 o’ clock position, to the side of the patient’s head
• 2 to 10 o’ clock position, to the back of the patient’s head
• 12 o’ clock position, directly behind the patients head

Based On Maxillary and Mandibular Arches:

For Maxillary Teeth:

• Right Front of the patient

For Mandibular Teeth:

• All Left Mandibular Teeth – Right Front of the patient

Mandibular Teeth on the Right Side:

• Central incisor, Lateral incisor and Canine – Right front of the patient
• 1st and 2nd Premolar – Right of the patient
• 1st and 2nd Molar – Exact Right side of the patient
• 3rd Molar – Just behind the patient on Right Side

Patient’s Position:

The patient should mostly be in Supine Position

The Mouth of the patient should be close to the resting elbow of the Operator

Patients Body:

• For Maxillary Teeth – The back of the chair should be slightly at a 45 Degree position from the floor
• For Mandibular Teeth – The back of the chair should be almost parallel to the floor

Head and Chin Position:

• The patients head should be positioned at the edge of the head rest

Chin Position of the Patient:

• For Mandibular teeth – Chin Down position
• For Maxillary teeth – Chin Up position

Based on Sextants of the Arches:

Operator Position for Sextant 2: The Operator should be positioned 9 o’ clock to 11 o’ clock position which is depicted in green color. And the Positioning of the Operator in for the Areas of teeth depicted in Blue color is 11 o’clock to 12 o’ clock position.

Operator Position for Sextant 5: The Operator should be positioned 10 o’ clock to 12 o’ clock position which is depicted in green color. And the Positioning of the Operator in for the Areas of teeth depicted in Blue color is 11 o’clock to 12 o’ clock position.

Operator Positioning for sextant 5

Operator Position for Sextant 6 and 4: The Operator should be positioned 9 o’ clock to 10 o’ clock position which is depicted in green color. And the Positioning of the Operator in for the Areas of teeth depicted in Blue color is 9 o’clock to 11 o’ clock position.

Operator Positioning for sextants 4 and 6

Operator Position for Sextant 1 and 3: The Operator should be positioned 9 o’ clock to 12 o’ clock position which is depicted in green color. And the Positioning of the Operator in for the Areas of teeth depicted in Blue color is 10 o’clock to 12 o’ clock position.

Operator Positioning for sextants 1 and 3

Following ideal operator and patient chair position in Dentistry is very important in day to day practice as this helps in drastically reducing the amount of time spent on treatments as well to protect the Dentists, lower back and shoulders which are the most affected with regular work. Many dentists complain of lower back pain and elbow or shoulder pain due to prolonged work on patients through out the day.