Dental Delivery Systems: Choosing the Best Setup for Ergonomics & Efficiency
- Steph Botts
- Mar 21
- 2 min read
As a dental hygienist and ergonomics specialist, I’ve seen firsthand how different delivery systems impact clinicians’ posture, efficiency, and long-term health. The right setup can make a huge difference, but if used incorrectly, it can lead to unnecessary strain and fatigue. Let’s break down the pros and cons of three common delivery systems.
Rear Delivery: Great for Four-Handed Dentistry, Difficult for Solo Work
Rear delivery is ideal for true four-handed dentistry, where the dentist and assistant work together. It is great for instrument transfer, is excellent for small operatory layouts, and minimizes patient anxiety since instruments are out of sight.
However, for solo clinicians, like hygienists working alone, rear delivery can be an ergonomic nightmare. Everything is positioned behind and off to one side, leading to excessive reaching and twisting—major contributors to musculoskeletal strain. Without proper setup adjustments, this system can be inefficient and uncomfortable for single-user operation. Rear delivery units can also be challenging for a left-handed practicioner if it's configured for right-handed.
💡 Ergonomic Tip: I recommend using a moveable tray or cart to help balance out the operatory. This keeps instruments within easy reach, reducing twisting and reaching.
🎥 Watch my YouTube video on using rear delivery here
Split (Left/Right) Delivery: My Preferred System
Split or left/right delivery is the most versatile. It allows for ambidextrous use, balances instrument trays on both sides, and minimizes reaching and twisting. It’s also adaptable for four-handed dentistry, making it a well-rounded choice.
One downside is that it takes up more space than rear delivery. Depending on the setup, it may also place instruments within the patient’s view, which can be intimidating for some. Still, from an ergonomic standpoint, this is my top choice.
Continental (Whip Arm): Often Misused, Leading to Fatigue
Continental delivery has potential benefits—no cords on the floor, reduced clutter, and easy instrument access. However, many clinicians don’t use it as intended. The tray is designed to sit just above the patient’s chest, which can feel intrusive and uncomfortable for both patient and provider.
If the patient has a larger chest, the tray must be raised, leading to awkward arm positioning. It is also can be bumped easily by the patient if they move too much. Additionally, tight instrument cords force the clinician to constantly pull, increasing pinch force and hand fatigue over time. When used correctly, it can work well, but without proper adjustments, it quickly becomes an ergonomic issue.
Need Help Setting Up Your Delivery System?
If you’re struggling with your delivery system, I offer ergonomic assessments to help you optimize your setup for comfort and efficiency. Small changes can make a huge impact on reducing strain and preventing injury.
📩 Contact me to schedule an ergonomic assessment!
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