Dental Assistant Instrument Transfer Basics

Dental Assistant Instrument Transfer Basics

One of the primary functions of a dental assistant is to work closely with a dentist while he or she is performing a procedure on a patient, transferring dental instruments back and forth with such ease and fluid movement that the technique has come to be know as “four-handed dentistry.” When a dentist and dental assistant work well together, it reduces fatigue and increases productivity for both members of the team. To be an effective dental assistant, you should be familiar with correct positioning, transfer zones, grasps and transfer techniques.

Transfer Zone

During procedures, the patient typically lies face-up on the dental chair with the dentist seated on one side of the patient’s head. The dental assistant sits with the instruments on the opposite side of the patient. The area between the dentist and assistant just over the patient’s chest is considered the “transfer zone,” meaning instruments are exchanged in this area (below the patient’s chin).

Common Instrument Grasps

Pen Grasp: A dental assistant using the pen grasp holds the instrument as if it were a pen or pencil: between the thumb and index finger. This is the most common type of dental instrument grasp.

Modified Pen Grasp: The modified pen grasp uses the middle finger instead of the index finger. Some dental assistants may find this provides more strength and stability.

Palm Grasp: The palm grasp is basically holding an instrument in a balled fist. It is used for bulky instruments like forceps, chisels and air/water syringes.

Palm-Thumb Grasp: The palm-thumb, or thumb-to-nose grasp, is like the palm grasp but with the thumb extended for extra stability. It is used by the dental assistant for holding the high-volume evacuator and other instruments that require vertical maneuvering.

Common Instrument Transfer Techniques

One-Handed Transfer: The one-handed transfer is the most common method of transferring dental instruments. It involves the dental assistant holding the evacuator or air-water syringe with one hand while handling an instrument with the other hand. To increase efficiency, the assistant actually receives the used instrument from the dentist and hands over the next instrument to be used in one motion.

Two-Handed Transfer: With the two-handed transfer, the dental assistant receives the instrument from the dentist with one hand and uses the other hand to pass the next instrument. This technique is used for larger objects, like forceps, or when the assistant doesn’t need to hole an evacuator or air-water syringe.

Mirror and Explorer Transfer: This transfer is used at the beginning of a procedure, when the dentist is examining the patient’s mouth using a mirror and explorer tool. The assistant delivers both instruments to the dentist simultaneously, one in each hand.

(Sources:, Integrated Publishing, Delmar’s Dental Assisting: A Comprehensive Approach)