MC 101
Saliva Ejector
- Small strawlike oral evacuator used for less invasive dental procedures
- Indications for use:
- Preventive procedures such as prophylaxis, fluoride treatments, and sealant placement
- Helps control saliva and moisture accumulation under the dental dam
- For the cementation of a crown or bridge
- During an orthodontic bonding procedure
One of the most important responsibilities of the dental assistant is to maintain moisture control during a procedure.
Why is moisture control so important?
The term “oral evacuation” describes the process of removing excess fluids from the mouth.
When is an oral evacuator used? (Before, during, and after a dental procedure.)
The saliva ejector and high-volume evacuator are the two types of evacuators used in dentistry.
What is the main function of the saliva ejector? (Removes liquids from the mouth; not powerful enough to remove debris.)
The saliva ejector is made of a soft plastic tubing that can be shaped and easily placed in the oral cavity.
Saliva Ejector
Place the saliva ejector cautiously to avoid traumatizing soft tissue (e.g., floor of the mouth, frenums, mucosa).
What common dental item can be used as a buffer to help avoid trauma? (Cotton roll.)
Instruct the patient to avoid closing down on the saliva ejector and clamping off the vacuum suction.
Tell the patient not to close the lips around the saliva ejector during suctioning.
Placement of Saliva Ejector
- Bend and shape the saliva ejector for stationary placement.
- Position the ejector under the tongue.
- Position the ejector opposite the side on which the dentist is working.
Hold the saliva ejector throughout the procedure, repeatedly sweeping the mouth to remove fluids, or position the suction in the mouth during a procedure.
When the saliva ejector is stationary, bend it into the shape of a candy cane. This shape permits easy placement under the tongue.
High-Volume Evacuator
- Used for most dental procedures, especially when the dental handpiece is in use
- Indications for use
- Keeps the mouth free of saliva, blood, water, and debris
- Retracts the tongue and cheek from the field of operation
- Reduces bacterial aerosol caused by the high-speed handpiece
The HVE, also known as the oral evacuator, works on a vacuum system.
It is stronger than the saliva ejector and can remove debris because a high volume of air is moved into the vacuum hose.
Two types of HVE tips are available. Each is designed for specific dental procedures.
Types of HVE Tips
- Operative-suction tips
- Designed with a straight or slight angle in the middle
- Beveled working end
- Made of durable plastic or stainless steel
- Surgical-suction tips
- Much smaller in circumference
- Made of stainless steel
Name an advantage and a disadvantage of a plastic operative tip. (Advantage: disposable; disadvantage: cost.)
Why does the surgical tip have a smaller circumference? (So it can operate within the limited space and visibility of a surgical site.)
What is the main function of the surgical tip? (Removes blood, tissue, and debris instead of large amounts of water and fluids.)
The stainless-steel tip is part of the surgical setup tray.
Grasps used for operating the HVE.
Top, thumb-to-nose grasp; bottom, pen grasp.
Describe the two HVE grasps pictured in the slide. (Top: thumb-to-nose grasp; bottom: pen grasp.)
Both methods enable the dental assistant to control the tip.
Why is it important to control the tip? (For placement and to assure patient comfort and safety.)
Guidelines for Positioning the HVE
- Place the evacuator before the dentist positions the handpiece and mouth mirror.
- Position the HVE on the surface of the tooth closest to you.
- Position the tip as close as possible to the tooth being worked on.
- Position the bevel of the tip so that it is parallel to the tooth surface.
- Keep the edge of the tip even or slightly beyond the occlusal or incisal edge.
Depending on how much the tissue resists retraction and on the area being treated, you may want to reduce dental-assistant fatigue by changing the position of the evacuator.
In which hand does the dental assistant hold the evacuator tip when assisting a right-handed dentist? (Right hand.)
Hold the evacuator tip in the left hand when assisting a left-handed dentist.
Operator and assistant positions in high-volume evacuation.
The efficiency and effectiveness of the procedure depends on timing when suction is needed, when the HVE is positioned, and when to remove the suction tip.
Notice how the suction tip is close to the working end of the handpiece.
Why should the dental assistant position the HVE close to the handpiece? (To catch water spray and debris before it collects in the patient’s mouth.)
The Air-Water Syringe
- Used for convenience and accuracy to complete the rinsing process
- Guidelines for use
- Direct the tip toward the tooth being worked on.
- Keep a close distance between the operative site and the syringe tip.
- Use air on the mouth mirror continuously when indirect vision is involved.
- When you hear the handpiece stop, it’s time to rinse and dry the site (a 1 second burst of air/water followed by air).
- When completing a limited area or full-mouth rinse, move the tip while spraying the area.
Use the air-water syringe to increase visibility of the treatment area.
The air-water syringe is attached to the dental unit; it directs air, water, or both through a small, sterile metal tip or plastic disposable tip.
Rinsing also removes debris from the patient’s mouth before dismissal.
Rinsing the Oral Cavity
- Maintains a clear operating field for the dentist and keeps the patient comfortable
- Two types of rinsing procedures
- Limited-area rinsing
- Performed frequently throughout a procedure
- Accomplished quickly and efficiently
- Full-mouth rinse
- Freshens the patient’s entire mouth
- Completed at the end of a procedure
- Limited-area rinsing
Perform limited rinsing quickly and efficiently, without delaying the procedure, when the dentist exits the mouth and pauses for inspection.