Title Page
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Practice/ Clinic Name
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Conducted on
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Prepared by Melbourne Dental
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Location
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CLINIC NAME AND SURGERY
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CHAIR TYPE SERIAL NUMBER AND YEAR
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DELIVERY SERIAL NUMBER AND YEAR
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CHAIR
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Check operation of chair lift, tilt and programming functions with touchpad (if fitted) and foot switch (if fitted) operation and advise on repair/ replacement where required.
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Check upholstery condition of chair base, backrest and headrest.
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Check and adjust headrest tensions.
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Check for irregular noises.
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Replace air and water filters with new. (1443436)
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Check and adjust incoming air and water pressure if required.
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Check for air and water leaks.
Check for air and water leaks.
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Check for damaged, brittle or stiff tubing.
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Check all arm pivot points for correct tension, adjusting where necessary.
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Check Bowl rinse and cup fill functionality and run on time to be sufficient.
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Clean spittoon drain where required.
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Check functionality of Durr spittoon valve where fitted. Remove and clean yellow filter.
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Remove and clean suction separator where fitted. Replace 1 way drain seal. (1434245)
FOOT CONTROL
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Check correct functionality of foot control.
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Check condition of foot control tubing.
ASSISTANT ELEMENT
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Replace HVE and Salving Ejector hose connection o-rings then check for correct operation. (7038391)
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Replace suction strainer and oring where required. (4197443, 1891816)
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Replace Triplex style centre isolation oring and check functionality. (DCI-2255)
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Check correct functionality of suction activation micro switches.
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Check appearance and functionality of HVE and Saliva Ejector handpieces
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Check condition of suction tubings and replace if required.
DELIVERY SYSTEM
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Check oil/water accumulation in exhaust catcher, replace exhaust filter and clean.
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Check for damage, brittle or stiff tubings.
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Check for anti-retraction operation.
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Replace Triplex style centre isolation oring and check functionality. (DCI-2255)
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Check whip arm movement and re-align where necessary.
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Check fibre optic voltages and adjust if necessary.
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Check and recalibrate Handpiece pressures to manufactures standards.
OPERATING LIGHT
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Check for correct operation of light.
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Check with clinician if a spare lamp is present in their stock.
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Check intensity switch operation.
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Check and ,if necessary, adjust tension for vertical movement of light arm. Advised if strut requires replacement.
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Check and, if necessary, adjust tension for each axis of rotational movement of light head assembly.
VACUUM SYSTEM
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Check that a recommended vacuum system cleaner is being used and advise as necessary.
OTHER
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Check dental unit saftey switch functionality.
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Check and adjust levels of trays, delivery unit and arms.
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Instruct staff on correct maintenance and operation if required.
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Check for waste leaks from vacuum and/or cuspidor drain lines and advise on repair where necessary.
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Check condition of Handpiece coupling o-rings and advise on repair necessary.
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Check and instruct on self contained water system cleaning protocol and ensure correct use.
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Report on repairs as deemed necessary and quote where required.
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Ensure Treatment Centre for Correct Functionality at End of Service (Air/ Water/ Electrics turned on, Handpieces, Suction & OP Light working correctly)
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FOLLOW UP WORK REQUIRED:
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EXTRA WORK PERFORMED:
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EXTRA PARTS USED:
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TECHNICIAN SIGNATURE:
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NEXT SERVICE DUE:
