The Dental Equipment & Dental Office Blog

With the rise in popularity, and now nearly universal acceptance of fiber optic high speed dental handpieces, more and more dentists are starting to complain about a lack of visibility when using a slow speed dental handpiece during trimming and polishing procedures.

Luckily, the solution to this already exists; fiber optic slow speed attachments and motors are available from a wide variety of manufacturers.

If you are currently using an electric handpiece motor for your high speed, fiber optic slow speed attachments will click right onto your existing motor, allowing you to use the light contained in it.

If you prefer an air driven motor, slow speed air motors are also readily available with fiber optic lighting. Some of these motors even feature quick disconnect bases to make lubrication and cleaning easier. Read my earlier article about maintenance of slow speed dental handpieces here.

There is a cost associated with the use of fiber optic slow speeds, as you might imagine. Generic ‘throw-away’ slow speed motors and attachments are very inexpensive, but fiber optic attachments can run upwards of $600, depending on make, chuck style, and other features. The fiber optic motors are also quite expensive when compared to the standard variety. It helps to remember that, when properly maintained, these motors often last more than a decade, so the actual price difference per year of use is quite small.

Finally, to use a fiber optic slow speed you also need to ensure that you have a fiber optic tubing and power supply available in your dental unit. If the dental delivery system has an existing fiber optic power supply, it is usually possible to hook up multiple handpieces to it, but you will almost certainly have to add a fiber optic handpiece tubing. The cost of these tubings has been coming down for the past couple of years, and this is no longer a large investment.

With a little bit of shopping, and some work on the part of your technician, you can improve visibility, and probably improve the quality of your work, with the addition of fiber optic light.

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Fiber optic lighting was a major breakthrough in high speed dental handpieces when it was first introduced. By placing a glass fiber optic rod inside the handpiece, and an incandescent bulb in either the handpiece coupler or the handpiece tubing, manufacturers were able to shine light directly on the cutting area, dramatically improving visibility in the oral cavity. As time passed however, it became more and more obvious that the system wasn’t perfect - mainly because the expensive fiber optic bulbs burned out frequently.

Engineers from W & H, a world leader in handpiece manufacturing, set about trying to find a solution to this problem: Enter the latest innovation from W&H dental handpieces, the TA-97LED and the TA-98LED. These two remarkable handpieces replace the traditional and expensive glass incandescent light bulb with a high powered and long lasting LED light. The LED is built right into the handpiece, and is used with a special handpiece coupler that has electrical contacts on it, rather than a bulb or fiber optic rod. These contacts transfer the power from the tubing to the handpiece.

One benefit to no longer placing a long glass rod inside the handpiece is the remarkable weight savings. The weight of the TA-97LED is only 40g, compared to 58g for the TA-97LW handpiece. That is a one third weight savings, which is really quite remarkable.

The new technological innovations don’t simply stop with the LED lighting. W&H has also introduced a new 5 port water spray for better cooling of the tooth during cutting. Users of the W&H TA-97LW and TA-98LW will appreciate that Adec has kept the same great cutting power (17w and 20w respectively) that they currently enjoy.

The head sizes are difference between the two handpieces. The TA-97LED is the small head handpiece, producing 17w of power at 59dB, while the TA-98LED is the regular size head producing 20W of power at 57dB. More information can be found by visiting the manufacturer’s website located at www.wh.com

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No, no, no - I am not asking you to hire a Dental Assistant called Tina!

On a serious note, it is a curious fact that so many dental offices leave the most basic of handpiece maintenance to chance. With current turbine replacement costs for some brands topping $550, not properly maintaining handpieces is like throwing money away.

The best way to ensure your dental handpieces are being properly maintained is to use a machine, like the Assistina 301 Plus.

Many manufacturers offer handpiece lubricators, but given the machine’s simplicity and long service history, it is really hard to beat the Assistina in terms of value and reliability. Installation of an Assistina requires only an air line in the room. If not present, an air line can usually be run into the room from a nearby operatory with minimal difficulty.

The Assistina does the two things necessary to keep your dental handpieces running smoothly.

The first is that is dispenses the proper amount of oil. The second is that after dispensing the lubricant, it runs the handpiece. Running the handpiece is a crucial step, ensuring that the vital lubricant is thoroughly and evenly dispersed throughout all of the bearings and gears in your handpieces. The Assistina also flushes the water lines with an alcohol cleaner to help keep them clean, although this is really just a bonus step and isn’t really necessary for handpiece maintenance.

Maintaining the Assistina is easy. When it comes time to reorder the cleaning solution and lubricant, order the entire service kit and replace the filters on the machine as well.

Finally, check the motor coupling shaft daily to ensure that the two o-rings are present. If one is missing, pop a new one on.

Given the high prices of handpiece repair, and their necessity in the field of dentistry, an Assistina will probably save an average dental office enough money to pay for itself in the first year. Increasing your turbine life from 10 months to 16 months could save thousands of dollars over the life span of your handpieces.

You can learn more about the Assistina, and download a pdf version of its brochure  here

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Slow-speed motors (or low-speed motors) are one of the least maintained pieces of equipment in a dental office today. They are easy to forget about. They rarely break down, even when ignored for years.

Usually they are simply left connected to the handpiece tubing, wiped down between each patient, and reused. Because the motors rarely seem to give the users any trouble, and they are relatively inexpensive to replace, most offices are content to ignore them.

This is fine for some offices, but as dentists add more expensive and more capable motors to their inventory, this disregard for motor maintenance can result in surprising repair bills.

Motors of Slow speed dental handpieces begin talking to us as they age, slowly letting us know that they are getting closer to retirement. Often, the motor becomes a little noisier, a little less responsive, and a little more difficult to finesse over time. One of the most common reasons for this is simply a lack of lubrication.

Contrary to popular belief, slow-speed manufacturers DO recommend lubricating these motors. In fact, most recommend lubrication twice a day, or after 30 minutes of continuous use. Since many people NEVER lubricate slow-speed motors, it is easy to see how this can dramatically affect the lifespan and efficiency of the motor.

Lubricating these motors is not much different than lubricating a high speed handpiece. Remove the motor from the tubing, add oil to the drive air port on the back of the handpiece, and run for 15 to 30 seconds. Clean, and return the motor to the handpiece tubing.

Usually slow-speed motors are not sterilized, they are simply wiped down. This is because the heat and moisture of the sterilizer can actually damage some of the moving parts inside the motor. However, many of these motors can be sterilized. You can identify a slow-speed motor that is safe for sterilization by looking for a mark on the side of the motor that shows that it is safe for sterilization.

If the motor is rated for sterilization, it is a good idea to reevaluate your asepsis procedures and consider adding slow-speed sterilization to your routine. This can give great peace of mind to dentists or hygienists who are concerned about cross contamination, or those who work on high-risk patients.

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Dentsply Professional has an interesting new high speed handpiece on the market under the Midwest brand. Called the Stylus ATC (Adaptive Torque Control), it is being marketed as a hybrid air/electric handpiece.

What does that mean - hybrid air/electric?

Midwest’s marketing material says that the handpiece combines the small size, speed, and light weight of a traditional air turbine handpiece, coupled with the torque and power of an electric.

How is this accomplished?

Make no mistake, the Stylus ATC is an air driven handpiece. It differs from a traditional air turbine powered handpiece in two ways. First, Midwest recommends that the handpiece air pressure be set at 75psi, instead of the traditional 39 to 45psi of traditional handpieces like a Kavo 635B or W&H TA98 (Midwest says the handpiece will work fine at 60psi). Obviously, you could dramatically increase the cutting power of any handpiece by doubling the drive pressure, but you would also seriously reduce the life of the turbine.

Midwest adds sensors to the handpiece that transmit speed sensors to an electronic control box. The control box continuously samples the speed of the bur (hundreds of times a second) and adjusts the power of the handpiece. In addition, the handpiece has the ability to idle the handpiece when not cutting to increase turbine life.

Will this idea take off?

It’s certainly a new technology in the dental marketplace. The key to success lies in two areas.

First, can you actually get 60psi – 75psi of pressure from your dental delivery system? Theoretically it’s possible, but many dental units run into a wall at around 50psi – 55psi. Increasing the pressure in the floor box could cause other problems, especially on older units. Newer delivery systems are more likely to be able to achieve higher pressures.

The second factor is the reliability and longevity of the dental handpiece and turbine. If the electronics prove reliable, and don’t seem to be negatively affected from being banged around and run through the sterilizer (no electrical items on electric dental handpieces actually go into a sterilizer, while the sensors in the ATC appear to be inside the handpiece itself) the product has great potential.

There are a lot of Dentists that could benefit from a technology like this. You can learn more at http://www.stylusatc.com

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Dentistry is a professional career, but it does have one major thing in common with the trades – a reliance on the tools that are used.

In every stage of a dentist’s career, from student to associate to owner, a dentist will have to evaluate whether a certain piece of equipment meets their needs; that is, saves them time, improves their work, or is capable of saving or producing money.

Each category of equipment potentially has dozens of characteristics that could be evaluated to make that determination. However, there are some considerations that all equipment purchases have in common.

Why Do I Want New Dental Equipment?

Whether to buy a new or used dental equipment supplies is always a key consideration. Clarity will often help save money. Dentists work hard, and don’t need to justify the desire to purchase a new toy for their operatory. Still, you should be aware of the reasons you want to purchase the equipment, as it can help focus your needs.

A real world example of this is intra oral cameras. The prices range on these units considerably, from as low as $400 to $5000 and more. If you want the camera to take detailed before and after shots of your cosmetic work, you should be looking at a good digital SLR rather than an intra oral camera.

On the other hand, if you want to send images to the insurance company, a good quality intraoral camera will be faster and easier. If the camera is simply to show patients pictures of their teeth, one of the inexpensive handheld plastic intraoral cameras will suit your needs.

Do I Have Any History With This Type Of Equipment?

If you have been a long time user of Kavo handpieces, and are happy with their price and performance, is there any reason to change? Consistency in equipment from room to room is a benefit in a dental practice. Your staff is more familiar with the operation of the equipment which can save money.

All service technicians have stories about rushing to offices for emergency calls only to flip a switch to fix the problem. In addition, you will probably have learned some tricks with the equipment over the years, and you will be able to simplify your inventory on things such as disposable suction traps and infection control barriers.

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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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Dental hand pieces are one of the most important tools of dental practices after the dental chair. They can be bought new or used. If they are bought used then they should be inspected to make sure that they are still in proper working condition.

Dental hand pieces tend to wear out fast due to regular use and heating and steaming during disinfection. It is advisable to go for new dental hand pieces.

Otherwise known as the dental drill, the dental hand piece is the most feared dental instrument and comes with the possibility to attach different kinds of hand pieces for different functions.

What makes dental hand pieces tick?

Weight:

When choosing a dental hand piece it is important to consider it’s weigh. In order to avoid strain choose pieces that are made of light weight material.

Fibre optic light:

Some dental hand pieces come with fibre optic light transmission capability which makes a dentist’s work easier. While shopping, consider that 10,000 lux transmissions considered a minimum and also consider that sterilization may reduce light output in the long run.

Noise:

Dental hand pieces produce noise when in use. Older versions produce more noise than newer models because of the improved toque and turbine speed. Whatever you decide to buy as a dental hand piece, noise levels should not exceed 80 db.

Power and speed

For a dental hand piece its power is measure of its ability to remove tooth structure; the higher the power the more work the dental hand piece can do. The power depends on the torque and turbine speed of the piece. At high speeds a dental hand piece is expected to perform at 300,000 revolutions per minute. Speed air turbine hand pieces are designed to operate at free-running speeds in excess of 300,000 rpm (revolutions per minute). Their power can be between 9 to 15 watts. The lower the power the less effective the effective the dental hand piece is removing tooth elements.

Air and water spray

When using high speed dental hand pieces it is important to have the air and water spray to avoid damage to the tooth pulp form the heat generated. The American Dental Association (ADA) recommends that a dental hand piece allow for a combination of air and water in good measure to cool and irrigate the surface under treatment.

Durability

Because all dental equipment including dental hand pieces must undergo sterilization between patients and that this reduces their efficiency, it is important to shop around for those products which have met the standards to withstand the effects of sterilization for a reasonable time. The Centers for Disease Control and Prevention (CDC) and other agencies recommend dentals hand pieces that can withstand at least 250 cycles of sterilization. To help keep your dental hand pieces longer they should be treated with the right lubricating spray as per manufacturer’s directions.

Care of dental hand pieces

All dental hand pieces come in contact with saliva and blood. It is important that they are thoroughly sterilized between patients. Because sterilization can be tough on dental hand pieces it is very important that the maker’s instructions are followed to the letter as concerns lubrication and care. Lubricant spray is sold by the same dealers who sell the dental hand pieces.

When considering a dealer to buy from, it is important to check the kind of after sales service they provide. If they can repair your tools at a reasonable rate and in reasonable time then it makes sense to go with such a provider. The more established a dealer is the higher the possibility that you will get good service from them.

By choosing the best dental hand pieces around you will save money, keep your clients happy and keep more money in the bank. In addition you will make your work easier and much more enjoyable, everyday working day will be a day you look forward to.

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