The Nurse's
Handbook

Welcome to ACE DNTL STUDIO. You're about to become part of something patients fly across continents for — and your hands at the chair are a real part of why the result is what it is.

This handbook is yours. Read it once from front to back in your first week, then keep it as the thing you reach for when you're not sure. It won't replace standing next to an experienced colleague — nothing does — but it will mean you're rarely starting from zero.

0.1 Who we are

ACE DNTL STUDIO is an internationally recognised aesthetic dental studio, founded by Dr. Ace Korkchi. We have three studios on the Costa del Sol — Marbella, Estepona (your studio), and Riviera del Sol — and our own boutique ceramics laboratory dedicated entirely to our cases.

We are best known for smile makeovers and porcelain veneers. That's our specialty. But it's important you understand from day one:

So if a patient ever asks "do you do extractions?" or "can you see me, I'm in pain?" — the answer is yes, warmly. Never tell a patient we're "cosmetic only." We're not.

0.2 What kind of clinic this is

Most of what you'll assist is aesthetic and elective — patients choosing to change their smile, often after years of thinking about it. That changes the room. There's no emergency rush to most of our work; there's care, precision, and time. A few things define how we work, and they'll come up again and again in this book:

• Never rushed. A smile makeover is two or three visits with a mock-up in between — about two weeks for most patients, longer when travel asks for it. We measure treatment in visits, not days. You'll never hear us promise "five to ten days" or "one trip."
• Anxiety is clinical. We treat nervousness as a real clinical variable, not an inconvenience. For many patients, a calm nurse is the reason they stay in the chair.
• The room is the first treatment. Music, warm light, a signature scent — we stage the studio like a boutique hotel, not a clinic. For an anxious patient, that calm is where the dentistry begins. You set the scene every morning (Part 1.4).
• Everything is documented. Photos, plans, shade notes — all saved in our system (BACKSTAGE) under an anonymised patient ID before the patient stands up.
• The lab is ours. Our ceramists only work on ACE cases. That control is our advantage — and it means the briefs you help prepare have to be precise.

0.3 How to read this handbook

Each part builds on the last. Throughout, watch for these boxes:

The full, formal versions of our protocols live in BACKSTAGE (our internal system). This handbook teaches you your part in them. Where a formal protocol exists, it's named so you can find it.

1.1 Three studios, one signature

We work across three locations on the coast — Marbella (Puerto Banús / Nueva Andalucía), Estepona, and Riviera del Sol (Mijas Costa). You're based in Estepona, but you're part of one studio with one standard. A patient should feel the same ACE wherever they sit.

The lab — our real advantage

Here's something to understand and be able to explain, because patients ask. We own our own laboratory: ACE DNTL LAB. It's a central, boutique laboratory dedicated to ACE cases, sitting between our three clinics. A digital designer works in the room in every studio, alongside the dentist and the patient. Master ceramists then build the work at the lab.

1.2 The team around the chair

You'll work alongside several roles. Knowing who does what helps you anticipate and helps the patient feel held.

Role	What they do	Your relationship to them
Dentist	Diagnoses, plans, preps, cements. Founded by Dr. Ace Korkchi; you'll assist whichever dentist is on chair.	You are their second pair of hands. Anticipate, don't wait to be asked.
Nurse / Assistant (you)	Sets up, sterilises, suctions, passes instruments, mixes materials, supports the patient, documents.	The constant in the room. You make everything flow.
Digital designer	Designs the smile on screen (Digital Smile Design) in the room with the patient.	You'll help capture the photos and scans they design from.
Hygienist	Professional cleaning, scaling, airflow, gum health.	You may set up and turn around their room too.
Reception / coordinator	First contact, bookings, the patient's calm welcome, the mirror at the reveal.	They hand the patient over to you ready, and you hand them back cared-for.
Ceramists (the lab)	Build the veneers and crowns by hand. Only work on ACE cases.	They depend on the briefs, shades and photos you help capture being perfect.

1.3 The shape of your day

Our days have a rhythm. It's set out formally in the Sterilisation & Treatment-Room Setup protocol; here's the human version. (Full detail in Part 2.)

• Morning openThe first clinical act of the day. Start the autoclave cycle, check the room, wipe surfaces, lay nothing out for the patient yet. The duty nurse owns this — then sets the scene (1.4).
• Per-patient setupBefore each patient walks in, the tray for their procedure is laid out. Nothing is ever taken from a drawer in front of the patient.
• Between-patient resetA calm, seven-minute reset. Same order every time. Instruments go to processing — never left in the room. Bib changed, water fresh.
• End-of-day resetThe studio is left ready for tomorrow morning, not for the next minute. Everything processed, restocked, wiped, powered down in order.

1.4 Setting the scene — the studio, not the clinic

ACE is a non-traditional dentist, and a patient feels it the moment they walk in. What they hear, smell, see and feel is not decoration — it is the first treatment. For someone who has dreaded this visit for weeks, the atmosphere is where the calm begins, before a single word is spoken. And every morning, before any patient arrives, you set that stage.

The first thirty seconds

A nervous patient's body decides how the appointment will go before they ever reach the chair. Warmth, scent and sound settle the nervous system; a cold, bright, silent, chemical-smelling room does the opposite. Staging the studio well is one of the kindest clinical things we do — and it costs nothing but care.

Music — always on

The playlist goes on before the doors open and stays on until the end-of-day reset. Set the volume so it is present but easy to talk over — low, calm, never silent and never loud. Silence is the enemy: in a quiet room, every sound of dentistry grows louder in the patient's mind. The music gives them something else to hold on to.

Scent — it must smell beautiful

The signature scent is refreshed first thing — diffuser on, rooms aired. No clinical smell ever reaches the patient. That note of disinfectant or eugenol that instantly says "dentist" is exactly what we design out. The studio should smell like a hotel lobby, not a surgery. (At the end of each day we set the scent for the next morning, so it is already there when the doors open.)

Light — warm, never clinical

Soft and layered. Blinds to gentle daylight, lamps on; the harsh overhead clinical light belongs only in the treatment field, switched on when the dentist needs it and off in between. Where patients wait and walk, the light should flatter, never glare.

Warmth and comfort

The studio is kept comfortable — warm, around 21–22°C — with a blanket or cushion offered before it is asked for, and water, tea or coffee ready. Cold and bare reads as "clinic." Warm and considered reads as "studio."

The eye, and the welcome

Nothing clinical is on show in the patient's world: no loose instruments, no trays, no clutter. Glass and mirrors are clean, flowers are fresh, surfaces are clear. And we greet a patient the way a good hotel greets a guest — by name, their file ready, their preferences remembered: their drink, their music, the thing that makes them nervous. They are received, not processed. (The human side of this is Part 8.)

Your morning staging checklist — the boutique-hotel pass

Run this every morning alongside the clinical morning-open in Part 2. The clinical open makes the studio safe; this makes it feel like ACE.

• Playlist on, volume set — present, but easy to talk over.
• Signature scent refreshed and diffuser on; rooms aired; no chemical note anywhere a patient goes.
• Warm lighting on; blinds to soft daylight; clinical lights off in waiting and reception.
• Temperature comfortable; blankets and cushions ready.
• Water, tea and coffee — stocked, fresh, and beautifully set.
• Flowers fresh; every surface clear of anything clinical; glass and mirrors spotless.
• Reception tidy; today's patients' files and preferences ready.
• Walk the patient's path — sit where they will sit, look at what they will see, and fix whatever breaks the spell.

A beautiful veneer means nothing if the instrument that placed it wasn't clean. Infection control is the part of the job no patient sees — and the part you can never, ever cut a corner on. This is where you start.

2.1 The two ideas behind everything

Two simple ideas sit under every rule in this part:

• Cross-infection. Germs travel — from patient to you, you to patient, patient to patient — on hands, instruments, surfaces, and the air (aerosols from the drill). Our whole job is to break that chain.
• Clean vs. dirty (zoning). At every moment, something is "clean" (ready to use, or sterilised) and something is "dirty" (used, contaminated). Never let the two touch. Used instruments go one way only — to processing — and never come back to a clean tray until they've been through the full cycle.

2.2 Hand hygiene

Your hands are the number-one route of cross-infection, and the number-one defence. Wash or sanitise at five moments: before touching a patient, before a clean/aseptic task, after any risk of body-fluid exposure, after touching a patient, and after touching the patient's surroundings.

• Wet hands, soap, and rub for a full 40–60 seconds — palms, backs, between fingers, thumbs, fingertips, wrists.
• Alcohol gel for 20–30 seconds when hands are visibly clean; soap and water when they're soiled or after glove removal.
• Nothing below the elbow: no rings (a plain band aside, per clinic policy), no wristwatch, no bracelets. Nails short, clean, unvarnished, no gels or extensions.
• Cover any cut on your own hands with a waterproof dressing before gloving.

2.3 PPE — what you wear, and the order

Item	When	The rule
Gloves	Every patient contact	New pair per patient. Never wash and re-use. Change if torn. Remove before touching pens, phones, drawers, door handles.
Mask	Any aerosol-generating work (drilling, scaling, air/water)	Fresh per session / when damp. Covers nose and mouth, moulded to the nose.
Eye protection	You and the patient	Safety glasses for you; glasses or a shield for the patient — splatter and debris fly further than you'd think.
Tunic / scrubs	Clinical sessions	Clean daily, changed if contaminated. Short sleeves so you can wash to the elbow.

Order on: hand hygiene → mask → eyewear → gloves. Order off (most-to-least dirty): gloves → hand hygiene → eyewear → mask → hand hygiene again. Gloves come off first because they're the dirtiest thing on you.

2.4 The sterilisation cycle — the chain a dirty instrument travels

This is the single most important sequence in this part. Used instruments travel in one direction through these stages. Learn the order.

• CleanRemove all visible debris first — sterilisation does not work through blood or cement. Wipe, then ultrasonic bath or washer-disinfector. Always handle sharp ends away from you.
• Rinse & inspectRinse, dry, and check each instrument is spotless and undamaged. Anything still soiled goes back a step.
• PouchBag instruments in sealed pouches. Date and sign every pouch. The seal is the patient's proof it hasn't been opened since.
• Autoclave (steam sterilise)Run the correct cycle. The autoclave kills everything with pressurised steam. Don't overload it; let steam reach every surface.
• StoreStore pouched, sterile sets clean and dry, ready for the next setup. Sterility has a shelf life — use oldest first, and re-process anything past date or with a broken seal.

Checks that prove the autoclave is working

• Every cycle: confirm it reached the right temperature, pressure and time, and that the chemical indicator on the pouch changed colour.
• Daily: the machine's start-up tests (per its manufacturer and your clinic's log).
• Weekly: a biological indicator test — the gold-standard proof that living spores were killed.
• Log everything. If a record was never written, in audit terms it never happened.

2.5 The ACE daily rhythm

This is the Sterilisation & Treatment-Room Setup protocol, in your hands.

2.6 Surfaces, waste & sharps

• Surfaces & barriers. Wipe clinical contact surfaces between every patient with the approved disinfectant. Use barrier film on things that are hard to clean (light handles, chair buttons, the 3-in-1 syringe) and change it per patient.
• Waste segregation. Know your bins: clinical/infectious waste, sharps, amalgam (kept separate, never down a drain or in normal waste), and general waste. When unsure, treat it as clinical.
• Sharps. Never re-sheath a needle two-handed. Use a one-handed scoop or a re-sheathing device. Drop sharps into the sharps box yourself — never leave a needle for someone else, and never overfill the box past the line.

3.1 The room, piece by piece

Equipment	What it is & your part
Dental chair	Positions the patient. You'll learn the supine (lying-back) position for most work, and to raise the patient slowly afterward so they don't feel dizzy.
Operating light	Lights the mouth. You adjust it so the dentist sees the field — and so it's never shining in the patient's eyes.
Delivery unit	Holds the handpieces and the 3-in-1 syringe. You keep it stocked, clean, and the lines flushed.
Suction lines	The high-volume (HVE) and low-volume (saliva ejector) suction. Your main tools — all of Part 4.
3-in-1 / triple syringe	Delivers air, water, or a spray. You'll use it to rinse and dry the field.
Curing light	Sets (hardens) light-cured materials — bonding, composite, some cements. Hold it close and steady for the full time; never shine it in anyone's eyes.
Handpieces	The "drills." High-speed (fast, water-cooled, for cutting); slow-speed (for polishing, adjusting); plus the ultrasonic scaler and surgical handpieces.
X-ray	Imaging. Know the radiation rules — who steps out, where you stand, and the patient's apron.
Intraoral scanner	Takes a digital impression of the teeth — central to our Digital Smile Design. Keep the tip sterile and the software ready.

3.2 Where you sit — the clock and the zones

Picture a clock face around the patient's head (12 is straight above their head). Four-handed dentistry divides it into zones so two people can work over one small space without colliding. For a right-handed dentist:

• Operator's zone (7–12): where the dentist works.
• Your zone — the assistant's zone (2–4): across from the dentist. From here you reach the mouth, the suction, and the delivery unit.
• The transfer zone (4–7): the space over the patient's chest and chin where instruments are passed between you and the dentist. Nothing sharp is ever passed over the patient's face — always through this zone, below the chin.
• The static zone (12–2): behind the patient's head — where the prepared tray sits, out of the patient's sightline.

If you're left-handed or the dentist is, the whole picture mirrors. The principle doesn't change: you sit opposite, you pass below the chin, and the patient never sees the sharp things coming.

3.3 The instruments to recognise

You don't need to memorise everything in week one — but you'll quickly learn to set the right tray and hand the right thing. Here are the families.

Examination — on almost every tray

Mouth mirror	Reflects light, lets the dentist see indirectly, and retracts the cheek or tongue.
Probe / explorer	A fine point to feel for decay, edges and roughness.
Periodontal (WHO) probe	Banded ruler-tip to measure gum pockets.
College tweezers	Angled tweezers to carry small items — cotton pellets, wedges — to and from the mouth.

Restorative & aesthetic — veneers, composite, fillings

Flat plastic / composite instruments	Place and shape soft composite or cement before it's set.
Excavator	Spoon-shaped, scoops out soft decay.
Burnisher	Smooths and adapts margins.
Matrix band & wedge	Wraps a tooth to rebuild its wall; the wedge seals the gap at the gum.
Articulating paper & holder	Coloured paper that marks where the bite touches, so the dentist adjusts high spots.

Surgical — extractions & implants

Elevators / luxators	Loosen a tooth in its socket before removal.
Extraction forceps	Grip and deliver the tooth; shaped differently for each tooth type.
Periosteal elevator	Lifts the gum to expose bone in surgery.
Needle holder, sutures, scissors	To stitch the gum closed.

Hygiene & perio

Scalers & curettes	Hand instruments that remove hard deposits (tartar) above and below the gum.
Ultrasonic scaler	Vibrates deposits off with water cooling — aerosol-heavy, so mask and suction matter.

This is the heart of chairside assisting — and for aesthetic work especially, it's everything. Bonding a veneer needs a field that is bone dry and crystal clear. The dentist's hands are full; keeping that field is your job, and you'll do it thousands of times. Here's how to do it well.

4.1 The two suctions

Suction	What it's for
High-Volume Evacuator (HVE — the big one)	Your main tool. Clears water, saliva, blood and debris fast, pulls away the aerosol spray from the drill, and retracts the cheek or tongue. Used actively, in your hand, throughout cutting and rinsing.
Saliva ejector (low-volume — the thin one)	Gentle, continuous, low suction. Sits in the floor of the mouth to draw off pooling saliva while the patient rests — during cementation under isolation, or while a material sets. Hooks over the lip; you don't hold it.

4.2 How to hold the HVE

Two grips, depending on where you're reaching:

• Pen grasp — held like a pen, for front teeth and easy-access areas. Comfortable and precise.
• Thumb-to-nose (reverse palm) grasp — the tube runs back along your thumb toward your own face, the tip turned into the mouth. This gives you reach and stability for the back teeth, where a pen grasp would twist your wrist.

Which hand? You hold the suction in the hand nearer the patient's head, leaving your other hand free for the 3-in-1 syringe and to pass instruments in the transfer zone over the chin. Rest the tube against your forearm so its weight isn't all in your fingers — you'll be holding it a long time.

4.3 Where to place the tip — the rules that matter

Good suction is mostly good placement. Six rules carry almost all of it:

1. Tip in firstPlace your suction before the dentist brings the handpiece or mirror to the tooth — never chase the drill in afterwards.
2. Opposite the drillIf the dentist works the cheek-side (buccal) surface, your tip sits on the tongue-side (lingual), and vice-versa. You mirror them, close to the tooth but not crowding it.
3. Bevel parallelTurn the slanted opening (the bevel) so it faces and runs parallel to the surface being worked — it catches the spray straight off the bur.
4. Level with the edgeThe edge of the tip sits even with, or a touch past, the biting/incisal edge of the tooth. Roughly the middle of the opening at the middle of the tooth.
5. Retract, don't pokeUse the side of the tip to hold the cheek or tongue back — gently. Never let the opening grab soft tissue (it pinches and pulls), and keep clear of the soft palate at the back, which triggers gagging.
6. Never block the view or lightKeep the tube out of the dentist's line of sight, off the mirror, and out of the operating light's beam.

4.4 The 3-in-1 syringe — your other hand

While the HVE clears, your free hand often holds the 3-in-1 (triple) syringe to rinse and dry: water to wash debris, air to dry the tooth for the dentist to inspect, and a spray of both to flush. A common move is the wash-and-dry: spray, then catch all of it instantly with the HVE so nothing pools or sprays the patient. For aesthetic bonding, drying the tooth properly between steps is critical — wet bonding fails.

4.5 Isolation — keeping the field dry for longer

For the most moisture-sensitive work — above all, cementing veneers — suction alone isn't enough. We isolate the teeth completely. (This connects to the Final Cementation Protocol in Part 7.)

Rubber dam	A thin sheet stretched over a frame, isolating the teeth through small holes so they stay perfectly dry and clean — saliva, lip and tongue all held back. Used for every veneer cementation, no exceptions. You help place, secure and clear around it.
Cotton rolls & dry tips	Absorbent rolls in the cheek and floor of the mouth; dry tips over the salivary gland openings. Simple, fast isolation for shorter procedures.
Saliva ejector	Sits under the dam or beside the cotton rolls to draw off whatever still pools.

"Four-handed" means the dentist never takes their eyes off the tooth or their hands out of the mouth to reach for something. You bring it. Done well, it looks like one person with four hands — calm, quiet, fast.

5.1 The instrument transfer

Instruments are passed in the transfer zone — over the patient's chest, below the chin — never across the face. The classic exchange:

• AnticipateHave the next instrument ready in your hand before the dentist asks. You're reading the procedure, not waiting for a request.
• SignalThe dentist lifts the used instrument slightly, or simply opens their fingers — your cue to collect and deliver.
• Collect with your little fingerUsing the same hand, your little finger curls around the used instrument and takes it.
• Deliver the new oneYou rotate and place the new instrument into the same grip position, business-end pointing the right way, so the dentist closes their hand and is ready to work — no repositioning.
• Parallel, not over the faceBoth instruments stay parallel, low, in the transfer zone. Sharp tips never point at the patient.

5.2 Anticipation — the real skill

Passing is mechanical; anticipating is the craft. Once you know a procedure's sequence, you prepare the next step while the current one is happening:

• The dentist is etching → you're already loading the bonding agent and uncapping the microbrush.
• The dentist is placing the last veneer → you're readying the curing light and the floss to clear the contacts.
• The bite is being checked → articulating paper is already in your tweezers.

You'll learn each sequence by watching, then doing. This handbook's Part 7 walks the main ones. Within a few weeks, the rhythm becomes yours.

5.3 Mixing & preparing materials

Many materials are mixed or loaded at the exact moment they're needed — and many have a working time of seconds. You'll learn to prepare them on cue, fast and clean: impression material loaded as the tray is called, cement mixed the instant the dentist is ready, the curing light charged and waiting. Part 6 tells you what each material is and how it behaves.

A nurse who knows the materials is worth their weight in gold — you'll prepare the right thing at the right moment without being told, and you'll spot when something's wrong. Use this as a reference. You won't memorise it in a week, and you don't need to.

6.1 Impressions & records

How we capture the shape of the teeth — increasingly digital here, but you'll see both.

6.2 Isolation & moisture control

6.3 Adhesion & cementation — the core of aesthetic work

This group bonds porcelain to tooth. The sequence matters and the timing is tight — learn this family well.

6.4 Restorative & provisional

6.5 Ceramics — the ACE signature

This is what makes us, us. Understand it well enough to explain it simply.

6.6 Whitening

6.7 Anaesthesia

You prepare and pass these; the dentist administers. Knowing them keeps you fast and safe.

6.8 The wider toolkit — full-service adult work

Because we're a full-service adult practice, you'll also meet these. A working familiarity is plenty for now.

Area	Materials you'll see
Root canals (endodontics)	Sodium hypochlorite (disinfecting irrigant — bleach-like, protect clothing & eyes), EDTA, files, gutta-percha (the rubbery root filling), sealer, paper points.
Extractions & surgery	Sterile saline, sutures, haemostatic sponge (collagen/gelatin to help clotting), gauze for the patient to bite on.
Implants	The implant kit (sterile, sequence-critical), sterile drapes and irrigation, sometimes bone graft and membrane. Strict surgical asepsis — your setup must be flawless.
Night guards / splints	Made from a model after an impression or scan; protect the new veneers at night. We treat the guard as part of the treatment, not an optional extra.

6.9 Burs & sundries

Most of your work will be the smile-makeover journey: a patient changing their smile with porcelain veneers. It unfolds across a few unhurried visits. Here's the whole arc, then your role at each step.

7.1 The journey, end to end

• Consultation & recordsListen, photograph, score the smile, plan. No tooth is touched. (Protocol: Veneer Consultation)
• Digital Smile DesignThe designer builds the proposed smile on screen, in the room with the patient.
• Mock-up / trial smileThe design is tried in the mouth in temporary material — the patient wears their future smile in the real world before committing.
• PreparationThe teeth are gently prepared; impression or scan taken; shade mapped; temporaries placed.
• Try-inThe finished veneers are tried with try-in paste; the patient reacts; the lab gets one final instruction. (Protocol: Veneer Try-In)
• CementationUnder rubber dam, the veneers are bonded permanently. The reveal. (Protocol: Final Cementation)
• Post-op & night guardAftercare, check-ins, the night guard fitted. (Protocol: Veneer Post-Op)

7.2 The consultation — your role

The first visit is a clinical conversation, not a sales call. The patient should leave with a plan they can sleep on. Your job is to make the room feel calm and the records perfect.

• Patient file open; room set for a conversation — no instruments in view.
• Daylight-balanced photo lighting set, white balance manual.
• Greet by name, take coats and phones to the shelf, offer water (never sell it). New international patients get a short studio tour.
• Support the photography — the eight mandatory frames (next) — and re-shoot anything missing before moving on.
• Everything saved in BACKSTAGE under the anonymised ID before the patient stands up.

7.3 The eight photographs — every makeover patient, no exceptions

Photography here is clinical documentation, lab communication and consent — not marketing. If the photo set is incomplete, the treatment record is incomplete. The eight frames:

1 · Portrait	5 · Upper arch (occlusal)
2 · Profile (left & right)	6 · Lower arch (occlusal)
3 · Full smile, retracted	7 · Lateral smile left · 45°
4 · Full smile, relaxed	8 · Lateral smile right · 45°

Daylight-balanced strobe, no mixed colour temperatures, manual white balance, focus on the central incisors. A shade tab in focus, touching the central teeth, in at least one frame. For the relaxed smile, ask the patient to swallow, sit, and smile naturally — never "smile big." We re-shoot; we never retouch.

7.4 Prep, try-in & the three questions

At preparation, you'll run suction and isolation (Part 4), pass instruments (Part 5), assist the impression or scan, help pack retraction cord, and place temporaries. Then the veneers come back from the lab for try-in.

At try-in we preview the result with try-in paste — set out in order centrals → laterals → canines — photograph before the patient sees it, then walk them to natural light. The coordinator hands the mirror, not the dentist. We never ask "do you like it?" We ask three structured questions, in order:

The patient's exact words are captured separately from the clinical translation — the lab adjusts on structured notes, never on adjectives.

7.5 Shade — the five-region map

Shade is the hardest thing to communicate in dentistry, and a single tab won't do it. We map five regions, each photographed separately with its own tab touching that region:

Region	What it captures
Body	The dominant shade across the middle of the tooth.
Neck	The warmth near the gum.
Incisal	The translucency and effect at the biting edge.
Translucency	The depth and width of the see-through zone.
Character	Mamelons, white marks, halo, craze lines, surface stains.

Seated upright (not reclined), daylight-balanced light only. Your care here is the difference between a veneer that looks placed and one that looks grown.

7.6 Cementation — the reveal

This is the moment the design becomes permanent. Everything before it was rehearsal. Your setup and your dry field carry this visit.

Your pre-cementation checklist

• Try-in photos final and uploaded; lab brief reviewed against the case file.
• Consent reconfirmed verbally with the patient.
• Every veneer checked against the delivery sheet — every unit present and correct.
• Cement system fresh, expiry checked.
• Isolation kit ready — rubber dam and clamps. Rubber dam every time, no exceptions.

The dentist bonds in a fixed order — centrals first, laterals second, canines last — and bonds pairs symmetrically, never one side fully before the other. You keep the field bone-dry, manage the curing light, and clear excess cement. Then the bite is checked (static first, then the dynamic movements). The dam comes off, the patient sits up, and is walked to the natural-light window — where the coordinator hands the mirror and the dentist watches their first reaction. Final photographs, same eight angles, before they leave the room.

7.7 Post-op & the night guard

Aftercare runs on three touchpoints — a day-of message (within four hours, aftercare PDF attached), a 48-hour check-in (an open question — "how are you finding the new smile?" — never "any problems?"), and a two-week night-guard fitting. The night guard is part of the treatment, not optional — it protects the work. You'll all use the same sensitivity script so the patient hears one consistent explanation:

Normal	Cold sensitivity, an occasional dull ache — typically from 48 hours up to ten days.
Not normal	Sharp pain on biting, throbbing at rest, anything escalating → the patient messages the studio's direct line.

7.8 The other treatments, in brief

Beyond veneers, you'll set up and assist across our full adult scope. The fundamentals carry over — sterile setup, suction, transfer, the right tray:

Treatment	Your focus
Whitening	Gum barrier, eye protection, timing, desensitiser, reassurance.
Hygiene cleaning	Aerosol control — mask and suction during ultrasonic scaling; airflow set-up.
Implants	Strict surgical asepsis, sterile sequence-critical kit, irrigation, calm for an anxious patient.
Invisalign / orthodontics	Scans, attachment placement (etch, composite, template), aligner handover and instructions.
Root canal	Rubber dam, irrigant handling (protect eyes/clothing), file organisation, magnification light.
Extraction / emergency	Reassurance first, surgical setup, gauze, post-op bleeding and aftercare instructions.

Our patients often fly in for us. Many have been let down before, or have quietly disliked their smile for years. How they feel in your care matters as much as the dentistry — and you are the person in the room with them the longest.

8.1 How we are with patients

• Calm, quiet confidence. We never sound surprised someone is interested, never oversell, never rush. We let the patient talk first and we don't finish their sentences.
• Greeted by name, met at eye level. The patient sits before they speak. Water is offered, never sold. New international patients get a short studio tour.
• Never rushed. "Visits, not days." If a patient asks how fast, the honest frame is two or three visits across about two weeks, longer if travel needs it. We never promise "five to ten days" or "one trip."

8.2 Anxiety is a clinical variable

We treat nervousness as a real part of the case, not an annoyance. For a frightened patient, you are often the reason they stay in the chair. Small things matter enormously:

• Tell them what's about to happen before it happens — no surprises.
• Agree a stop signal (a raised hand) and honour it instantly.
• Keep sharp things out of sight; open pouches calmly; keep your own movements small and unhurried.
• Watch their hands and breathing, not just the tooth. If they tense, the dentist should know.

8.3 Confidentiality & consent

• Everything is documented under an anonymised patient ID in BACKSTAGE. Patient privacy is absolute — no names on loose notes, no patient images shared anywhere without signed consent.
• Marketing photos are only ever used with the patient's signed consent on file. When in doubt, it's a no.
• Follow data-protection rules (GDPR) as your clinic trains you — what you see and hear in the room stays in the room.

Medical emergencies in a dental chair are uncommon — but when one happens, calm, fast, correct action matters. You won't manage these alone; your job is to recognise early, call for help, and support the team. Learn this part, and refresh it often.

9.1 Before anything — the medical history

Most emergencies are foreseeable. Always make sure the patient's medical history is up to date and flagged for the dentist before treatment: allergies (especially latex, anaesthetic, penicillin), heart conditions, diabetes, asthma, epilepsy, blood thinners, pregnancy. A flagged history prevents most of what follows.

9.2 The ones to recognise

Emergency	Signs	First moves (support the team)
Faint (syncope)	Pale, sweaty, dizzy, briefly loses consciousness. The most common.	Lay flat, raise the legs, loosen tight clothing, air. Usually recovers quickly.
Low blood sugar (hypoglycaemia)	Diabetic patient — shaky, confused, sweaty, irritable.	If conscious and able to swallow, fast sugar (glucose drink/gel). Escalate if not improving.
Allergic reaction / anaphylaxis	Rash, swelling of lips/face, wheeze, struggling to breathe, collapse.	Call for help & 112 immediately; the kit's adrenaline auto-injector; oxygen; nothing by mouth.
Asthma attack	Wheeze, breathless, can't speak in full sentences.	Sit up, their own blue inhaler, calm, oxygen; escalate if no improvement.
Chest pain / angina	Crushing chest pain, may spread to the arm/jaw.	Sit up, their GTN spray, oxygen; if not settling, treat as a heart attack — 112.
Seizure	Collapse, shaking, unresponsive.	Protect from injury, cushion the head, don't restrain or put anything in the mouth, time it.
Choking / swallowed item	Coughing, grasping the throat, can't breathe.	Encourage coughing; back blows and abdominal thrusts if it becomes severe; 112.
Anaesthetic reaction / collapse	Faint, palpitations or rapid deterioration after an injection.	Stop, lay flat, monitor breathing & pulse, oxygen, escalate.

9.3 Your own safety

• Needlestick / sharps injury: encourage the wound to bleed under running water, wash, cover, report it immediately, and follow the clinic's exposure procedure. Never hide it.
• Splashes to eyes/mouth: rinse thoroughly with water or eyewash; report.
• Chemicals: know that etch and root-canal irrigant are caustic; protect the patient's and your eyes and skin; rinse spills.
• Radiation: follow the X-ray rules — distance, position, no holding films for patients.

Nobody expects you to know everything on day one. Here's a realistic way to grow into the role, and the reference cards worth keeping close.

10.1 Day one

• Tour the studio — treatment rooms, sterilisation area, stock, staff room, fire exits, the emergency kit & oxygen.
• Meet the team; learn names and who to ask (fill in the box in 1.2).
• Get your scrubs, locker, and BACKSTAGE login sorted.
• Read Parts 0–2 of this handbook properly.
• Shadow a colleague through a morning open and a between-patient reset.

10.2 Week one

• Own the sterilisation cycle and the daily room rhythm (Part 2).
• Learn the standard trays — consultation, prep, try-in, cementation, hygiene.
• Practise suction placement on every case you assist (Part 4).
• Fill in every "Confirm with your team" box in this book.
• Confirm your CPR/BLS and emergency knowledge (Part 9).

10.3 First month

• Smooth instrument transfer without being asked (Part 5).
• Prepare materials on cue — impressions, cements, try-in pastes (Part 6).
• Confidently support an anxious patient (Part 8).
• Read the full BACKSTAGE protocols this handbook draws from.
• Know the veneer journey well enough to anticipate each step (Part 7).

10.4 Quick reference — tooth notation (FDI)

We use the two-digit FDI system, standard across Europe. The mouth is split into four quadrants; the first digit is the quadrant (from the patient's upper-right, clockwise: 1, 2, 3, 4), the second is the tooth counting from the midline (1 = central incisor … 8 = wisdom tooth). So tooth 11 is the upper-right central incisor; 26 is an upper-left molar.

18

17

16

15

14

13

12

11

21

22

23

24

25

26

27

28

48

47

46

45

44

43

42

41

31

32

33

34

35

36

37

38

10.5 Quick reference — common abbreviations

HVE	High-volume evacuator (the big suction)
DSD	Digital Smile Design
PVS	Polyvinyl siloxane (addition silicone impression)
LA	Local anaesthetic
RCT	Root canal treatment (endodontics)
OHI	Oral hygiene instruction
PPE	Personal protective equipment
BLS	Basic life support
e-max	Lithium-disilicate ceramic (our strength layer)
BL2	A bleach shade — our default veneer shade

10.6 The three cards to keep close