The Dental Equipment & Dental Office Blog

A style of dental delivery system that has been popular for some time in Europe is rapidly gaining acceptance in North America. The ‘Continental’ style delivery system is a delivery system in which the handpiece tubings come up over the top of the control unit, and are routed within a spring loaded arm. This contrasts the ‘Traditional’ delivery system in which the handpiece tubings drape under the dental control unit.

There are several factors which make this a desirable system. The weight of the tubing is held by an arm and spring, so handpieces feel lighter and more maneuverable. In addition, there is no risk of dropping the handpiece and having it fall to the ground; the spring arm will guide the handpiece back into its position on the control unit.

This is great in terms of infection control (not having a handpiece on the dirty floor), but also dramatically reduces the chance of damage to the tool from hitting the floor. This is certainly important for high speed handpieces, but also for items like intraoral cameras and curing lights, which are increasingly being integrated into the control head. Also, the units tend to look neater, as the tubings are not rubbing on the ground when the control unit is moved around in the operatory.

In the past, there have been negatives associated with this type of system-notably that water would drain out of the tubings and leak onto the floor. In recent years dental equipment manufacturers have improved the water control valves, and this problem has been eliminated.

Due to the vertical size of the spring arms, Continental delivery is only suitable for chair mounted, or ‘over the patient’ control units. Users of side delivery or rear delivery systems will have to stick with the Traditional system. As more and more dentists are exposed to this style of tubing routing, I predict that the popularity will continue to grow. This just might be a trend that sticks around for a little while.

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Dental Delivery Systems have come in many incarnations over the years, from small portable carts to elaborate built ins. Regardless of the style, they all serve one main function: regulating and controlling the delivery of three main things to the dental handpiece.

Those three things are: coolant water to prevent the tooth from overheating during cutting, coolant air, which transforms the water from a stream to a fine mist, and drive air, which regulates the cutting speed of the handpiece and bur.

A basic delivery system usually consists of two or three handpieces and an air/water syringe. The handpieces can be a mix of highspeed, electric, and slow speed, fiber optic or non fiber optic. Vacuum can be added in the form of an HVE or saliva ejector, although vacuum is most commonly installed in a separate Assistants Pack on the rear of the patient chair or on the rear support cabinet.

Today, almost any option can be included in a delivery system. Built in electric motors (including endo) are becoming more common, as are intraoral cameras and curing lights. All new delivery systems will include a bottled water system of some type. Bottled water systems allow you full control over the quality of the water you are using on your patients, and also dramatically simplify the plumbing requirements of an operatory.

This delivery system, often called a Dental Cart, is basically a small box on top of a cart or stand. Originally intended to be easily moved from operatory to operatory, or even from clinic to clinic, these units are popular even in fixed installation practices due to their small footprint. They require only an air and vacuum hookup at the facility. Always equipped with a bottled water system, some units even have an air vacuum system built in. Due to their small size, it can be difficult to find room inside the box for a lot of extras, but they are fully functional delivery systems.

Rear Delivery

This style of delivery, also called the 12 O’clock Delivery System, consists of a delivery system built into cabinetry behind the head of the patients chair. The hangers are laid out in a straight line, with the controls in easy reach. This style of delivery works very well with stand up dentistry, and is easy to adapt between left and right handed dentists. Due to the position of the handpieces, the operator must twist in order to pick up or hang a handpiece. Due to this twisting and turning motion, it is common for the hoses to become entangled if care is not used.

Side Delivery

A side delivery system is mounted on the side wall of the operatory on the operator’s side. Bolted to either the wall or a support cabinet, they hang on a swinging and articulating arm. Mounting the delivery system in this manner allows the operator to bring the control head right beside them for easy access. This style of delivery works equally well for both left and right handed dentists, but the same installation cannot be used for both, as they are permanently mounted. It is also very difficult to convert these units for opposite handedness, requiring major construction and plumbing changes.

Chair Mounted Delivery Systems

Originally mounted on one side of the chair or the other, chair mounted systems make use of a common support post mounted to one side of the chair, or sometimes to a post mounted directly to the floor. The delivery system itself is on a rotating and articulating arm that comes over the patient. Vacuum can also be added to the control head, creating a perfect single user chair for hygienists or those dentists who work alone. Because the unit comes over the patient the dental handpiece tubings would often drag over the patients legs. To combat the hanging tubings (known as standard delivery), a style called continental delivery was created. In this style of delivery system, the tubings come up from the back of the control head, and arch forward over a spring loaded arm. When the individual handpiece is pulled forward it is activated, and depressing the rheostat will cause the handpiece to run. These units can be converted from left hand dentistry to right hand dentistry by a service technician in just a couple of hours.

Some patients feel claustrophobic with this style of delivery system because the unit comes over them. In recent years ‘Radius’ delivery systems have alleviated this problem. By hanging the unit underneath the center of the chair, rather than off of a post above the patient, two problems have been solved. First, because the arms come from underneath the chair, patient comfort is much improved. Second, because the unit swings from the center of the chair, it can freely move from one side to another, making this the only permanent delivery system that can be freely used by both left and right handed dentists without any changes.

When deciding which system is right for you, consider the styles that you have worked with in the past and how they fit or contrast your working style. No matter what the pros and cons of one system may be, the best dental delivery system to use is the one which maximizes your personal productivity.

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