General Chairside Assisting
The General Chairside domain tests four-handed dentistry, instrument transfer, charting, isolation, restorative and impression materials, anesthesia support, and chairside emergencies. The exam favors tasks you perform in sequence, so know the steps and the reason behind each one.
Four-handed dentistry and transfer
Work within your zone and avoid crossing over the patient's face. Transfer instruments single-handed in the transfer zone, handle first, so the dentist can receive without looking away from the field. Use a palm grasp for exchange and maintain a fulcrum for scaling instruments; use a pen grasp for precision.
Charting
Universal numbering runs 1–32 for permanent teeth, starting with the maxillary right third molar; primary teeth use A–T. Surfaces are mesial, distal, facial (buccal or labial), lingual, and occlusal or incisal. Cavity classes: I pit/fissure; II posterior proximal; III anterior proximal without incisal edge; IV anterior proximal with incisal edge; V cervical; VI cusp tip. Record existing restorations, caries, missing teeth, and periodontal findings accurately.
Isolation and materials
Rubber dam: punch the hole, lubricate, seat the clamp, invert the dam, and ligate if needed. A matrix and wedge hold material and separate proximally. Amalgam is triturated, condensed, carved, and burnished; dispose of waste in a dedicated amalgam container and never touch it bare-handed. Composite requires etching, rinsing, drying, primer/adhesive, and curing; control moisture and shade under correct light. Alginate is measured, mixed, loaded, seated, removed after set, poured promptly, and disinfected if sent to the lab.
Suction and anesthesia
Place the high-volume evacuator tip near the tooth, not on soft tissue; use the saliva ejector for pooled fluids. Load the aspirating syringe, expel air, and aspirate before injecting. Never recap a needle with two hands.
Worked example
The dentist says: #19 MOD amalgam, #30 occlusal composite, and #8 mesial-incisal composite. How do you chart it? Universal numbering identifies #19 as the mandibular left first molar, #30 as the mandibular right second molar, and #8 as the maxillary right central incisor. MOD means mesial, occlusal, and distal, a Class II restoration. The occlusal surface of #30 is Class I. The mesial-incisal surface of #8 involves the incisal edge, so it is Class IV. Record surfaces and material, not just tooth numbers.
Traps
Do not mix Universal, Palmer, and FDI systems; do not call a posterior facial surface labial; do not transfer instruments across the patient's face; and do not send an impression to the lab without disinfection.