Clinical Foundations - Outcome 3 &Week 3 PP Flashcards
The Dental Handpiece
- The dental handpiece is the most frequently used instrument in restorative dentistry
- Rheostat used to activate
General use Handpieces
- Low - Speed /Slow- Speed
▪ straight attachment
▪ contra angle attachment (most versatile)
▪ prophy attachment (least versatile) - High - Speed
- Laboratory
Specialized Handpieces
- Ultrasonic
- Laser
- Air Abrasion
- Implant
- Endodontic
- Surgical
handpiece components
Working end (head) – where the rotary instruments and attachments are secured
Shank – the grip of the handle portion
Connection end – the component which attaches to the power source
Slow Speed Contra Angle
Speed - 30,000 Rotations Per Minute (RPM)
Settings Available - Forward, Neutral & Reverse
Bur Type - Latch or Screw
Purpose - Restorative & Preventive, Used to adjust, remove decay, refine cavity, prep
- Water coolant not present
-Fixed shank and head design
-Interchangeable heads design
-Electric
Slow Speed Straight
Speed - 30,000 RPM
Settings Available - Forward, Neutral & Reverse
Bur type - Straight
Purpose - Used to adjust/trim removable appliances: ortho, dentures, sport & night guard. Used in dental operatory during fitting appointment.
- Water coolant not present
- NOT USED IN PATIENTS MOUTH
Laboratory Slow Speed Straight Handpiece
Speed - 20,000 RPM
Settings - Forward only
Bur type - Straight
Purpose - Laboratory adjust/trim of removable appliances: ortho, dentures, sport & night guards. Used in the labs during fabrications.
- water coolant not present
-note used intra oral
Cordless slow speed prophy
Speed: 20,000 RPM
Settings: Forward only
Bur type: Prophy head
Purpose: Preventive - polishing
- water coolant not present
High Speed Air Driven
Speed - 450,000 RPM
Settings - Forward only
Bur Type - Friction grip
Purpose - Restorative: Used to cut tooth, bone, remove decay, remove old restorations
- water cooling present
-fiberoptic light present
Low/Slow Speed Handpiece Summary
- Used intra oral and extra oral
- Speed max 30,000 rotations per minute (RPM)
- Used in forward(reverse option available- not used often)
- Many designs: latch, screw/prophy, straight/ electric
- Water line is not present.
- Lubrication after each patient
- Sterilize after each patient
- Dental Assistant role:
a) set up, check prior use
b) use with certain procedures, example; plaque removal
High-speed Electric
Speed - 200,000 RPM
Settings - forward only
Bur type: Friction grip
Purpose: Restorative - used to cut tooth, bone, remove decay, remove old restorations
- water cooling present
-fiberoptic light present
Ultrasonic handpiece
- Electric and mechanical radiant energy with sound vibration
- Pulsating spray of water
-can switch between low-medium-high
-Bur type - ultrasonic tip
-Used for calculus removal (hard deposits) stains, bonding materials
-used by a hygienist, or an assistant with Preventive Module
Laser Handpiece
- high beam of light energy
-operates in wavelengths (0.5-7 watts)
-varies by procedures: diode, CO2, lasers - Pulse, custom, debride, perio cut
- Bur type: laser tip
- used in restorative and preventive
-used to cut hard and soft tissue (biopsy)
-water coolant present
-eye protection required (special eyewear)
-fiber optic cable – fragile (handle with caution!!!)
Air Abrasion Handpiece
-high pressure
-aluminum oxide particles
-bur type: removable air abrasion attachment
- Used for shallow decay, sealants, class 1 and 6 cavity prep & minor non-invasive procedures
-many units available
Implant Hand Piece
Speed: 40,000 RPM
Bur type: Fiction grip, straight and specialized attachments
- Used with implants which are surgical procedures
-Available in electric or air
Endodontic Handpiece
Speed: 40,000 RPM
Settings varies as per unit used
Bur type - Special & latched
- Used to clean and shape canals during root canal procedures
- many units available
Surgical handpiece
Speed - 80,000 to 400,000 RPM
- Settings varies as per unit used
- Bur type - straight and specialized
- used with all invasive surgical procedures
- does not allow air into cavity during spraying - crucial during sterile environment
High Speed Handpiece Summary
- Used intra oral
- Electric -Speed max 200,000 rotations per minute (RPM)
- Turbine/Air driven- Speed max 450,000 rotations per minute (RPM)
- One setting: forward
- Water line present
- Friction-grip - burs
- Lubrication after each patient
- Sterilize after each patient
- Dental Assistant role:
a) set up, check prior use
b) do not use !
Restorative Appointment - what handpieces do you set up?
- Slow speed contra angle
- high speed handpiece
Preventive Appointment - what hand piece do you set up?
Slow speed contra angle
What grasp is used on dental handpieces?
Modified pen grasp
Burs
- high speed handpiece: fissure/friction grip bur
- slow speed contra angle: latch, screw
- slow speed straight: straight large bur
- specialized handpiece: specialized burs
General Care of handpieces
- Wipe after use (2X2 gauze and/or disinfectant wipe)
- Purge water line (done in op)
* 2 min (beginning of the day)
* 20 sec ( after each patient) - Lubricate/Flush after each patient (done is Steri)
* Done with most automated lubrication units
* Flush removes debris from the head - Sterilize (critical item)
Manual or Auto Lubricator
- Used to flush and lubricate
- After each use
Dental Assistant Scope of Practice
Dental assistants can only operate slow
handpieces
* It is not within the Scope of Practice to
operate other handpieces
Slow-Speed Handpiece Components - Motor Section
The handpiece has a “forward”, “neutral” and “reverse” indicator on the switch sleeve.
The mark on the switch sleeve shows the operating condition adjusted.
To place in a forward rotating position, move the switch sleeve until the mark corresponds to the position needed “F”
Slow speed handpieces components - Shanks and Heads (attachments)
Connecting and Disconnecting Handpiece Shanks
To connect either the “straight” or “contra-angle” shank, fit the shank onto the motor until it audibly slots in.
To disconnect either shank, turn the coupling to the right or left and then release the shank from the motor
Attach and remove rotary cutting instruments (dental burs) from the head. Bur type required: latch, screw type or straight.
Screw type attachment is the least versatile, as is only comes with 2 bur types: brush and a rubber cup.
Latch type attachment is the most versatile and multiple attachments are available.
High speed handpieces components - Motor Section (Coupler)
The handpiece has only “forward” rotations.
The red mark/dot on the switch sleeve must be aligned at all times in order to operate.
High speed handpieces components - Shank and Head
Connecting and Disconnecting Handpiece:
Shank and head come as one unit
To connect handpiece onto the motor, align attachment and press inwards
To disconnect handpiece from the coupler, pull the coupling apart from the handpiece
Attach and remove rotary cutting instruments (dental burs) from the head. Bur type required: friction grip
Care of Handpieces - General Safety Precautions for Handling and Maintenance
Assemble handpieces over the tray or cart to avoid dropping and damaging the components.
When placing and removing burs, ALWAYS ensure that the rheostat is not engaged.
Ensure handpieces with burs inserted are stored facing toward the operator cart to avoid contaminated bur injuries.
Manufacturer’s instructions for the daily care of the components must be followed for each brand or type of handpiece. This generally includes cleaning and lubrication of the components to maintain proper function.
Care of Handpieces - Pre Cleaning
Handpieces are cleaned at the point of contact (the operatory) to avoid the transfer of potentially infectious material
After treatment, remove rotary instruments
Remove any barriers from the handpieces
A brush can be used to remove debris in hard to access grooves or ridges
The components are wiped with a disinfectant wipe or 2x2 gauze
High-speed handpieces require extra care:
Avoid bending handpiece tubing to avoid breaking the fibers. In addition, handle the coupler and light bulb with care. Dropping the handpiece can cause the light bulb to break.
After treatment, wipe visible debris from the handpiece and then run the rheostat for 20-30 seconds to flush the air and water lines through the handpiece to remove debris from the water lines and turbines within the handpiece.
The fiber optics at both ends of the handpiece are routinely cleaned with a damp cotton tip applicator to ensure no buildup occurs on these components
Lubrication of Handpieces
Lubrication serves to clean the internal surfaces of the handpiece as well as lubricate the working parts.
Always lubricate handpieces according to the manufacturer’s directions.
Failure to perform this step prior to sterilization may lead to excess lubricant accumulating in the working assembly and ‘gumming up’ during the heat cycle of sterilization.
Wipe the excess oil from the handpiece with a gauze
There are currently various automated lubricators to clean, lubricate and purge handpieces. The unit has a coupler to which the handpiece components are attached and processed through fixed programmed cycles. Some units have more than one coupler to process more than one handpiece at a time.
Reprocessing of handpieces
In order to avoid the spread of disease, dental offices are not to use handpieces unless the handpiece has been sterilized after each patient. The handpiece is considered a critical item.
Clean/debride all components of the handpiece at the point of use
Lubricate the handpiece
Inspect and package
Sterilize
Store and deliver
What type of handpiece are you able to use as a dental assistant?
All low speed handpieces (Contra angle, straight, laboratory, prophy)
What type of handpiece requires line flushing?
High speed handpiece and ultrasonic scaler
This type of handpieces are not used inside the patient’s mouth
slow speed straight handpiece
labratory slow speed hand piece
What is required to operate any type of handpiece?
rheostat
what type of specialized handpiece is used with root canals?
endodontic
what type of handpiece is used to remove shallow decay or stain from teeth?
air abrasion
What is the maximum speed for a high-speed electric handpiece?
20,000 RPM
How many handpieces are typically set up for restorative appointment?
high speed and slow speed latch
What type handpiece is set up for preventive appointment?
slow contra angle latch or screw type, assistant preference
Handpeices not used inside a patient’s mouth
slow speed straight handpiece & laboratory slow speed handpiece
