Safety spotlight

FDA warning on electric handpieces

Recently, the U.S. Food and Drug Administration alerted the dental community to reports of poorly maintained electric handpieces causing third-degree burns among patients (www.fda.gov/cdrh/safety/121207-dental.html). The injuries typically occurred “during tooth extractions, when cutting teeth and bone, and during other surgical procedures,” the agency said. To prevent further injury, the FDA recommended that dentists check their electric instruments for signs of drill or bur wear prior to each use, regularly maintain their handpieces according to manufacturer’s instructions, and ensure that staff is trained to clean and maintain the instruments (and keep up-to-date maintenance records).

To help flesh out the sources of potential problems with electric dental handpieces, and how to implement proper maintenance protocols, Dental Practice Report recently spoke with Technology Editor Dr. John Flucke.


Dental Practice: What are some warning signs that a problem with your handpiece is imminent?

Dr. Flucke: The reason people buy electric handpieces in the first place is that they provide a lot of torque, and that’s because they’re DC motor-driven rather than air driven. Turbines in air-driven rotor handpieces have a very, very low tolerance.
So when the turbine fails, the handpiece locks up, it won’t work. But the electric handpieces are much stronger; there’s so much torque that they can continue to turn longer even as they’re failing. And that’s what causes all the frictional buildup in the head that results in the overheating.        So to answer your question, I would be on the watch for whether the chuck is beginning to get difficult to release, or if it’s hard to put burs into the chuck. Also, when your frist step on the reostat, does the handpeice feel rough or choppy and then get better as you overpower it a bit with the motor/ those are the types of things I would look for.


Dental Practice: Is there a step during the maintenance process that dentists might easily overlook?

Dr. Flucke: Handpieces are built to very, very tight specs, and it’s really difficult to get them to work properly if you’re not following the manufacturer’s protocol. And I think what frequently happens is that when an office gets busy steps can get skipped, and someone might assume that someone else has done the maintenance on the handpiece.


Dental Practice: How can dentists ensure against that happening?

Dr. Flucke: Probably the easiest way to track maintenance is to number the handpieces and keep records. You can simply take a sharp bur to inscribe a number—1, 2, 3—on each handpiece. If you have multiple operatories and suspect that some of the handpieces are not being properly maintained by staff, what you can do is assign—and number accordingly—handpieces to certain treatment areas. For example, you could label them A1, A2, B1 and so forth. Then as you track the performance of the instruments, if you see that those out of room A are failing at a much higher rate, you can start looking for the breakdown in the system.

Dental Practice: Any other suggestions, doctor?

Dr. Flucke: The one thing we all need to be aware of is that these handpieces will overheat, and you cannot emphasize maintenance enough. You should also try not to retract with the handpiece—you know, push the cheek out of the way with the head of the handpiece. If you’ve always got air surrounding the head of the handpiece, it may get hot but at least you’re not going to burn anybody.