Poorly maintained electric dental handpieces can cause serious patient injuries, including third-degree burns, according to a recent public health notification from the US FDA.
Although the reported burns have occurred during cutting of tooth and bone, tooth extraction, and other dental surgical procedures, overheating could occur during any dental procedure. Burns may not be apparent to the operator or the patient until after the tissue damage has been done, because the anesthetized patient cannot feel the tissue burning, and the handpiece housing insulates the operator from the heated attachment.
With high- and low-speed air-driven handpieces, sluggish handpiece performance will alert the dental practitioner to maintenance issues such as a dull bur or worn or clogged gears or bearings. However, if an electric handpiece is worn or clogged, the electric motor sends increased power to the handpiece head or attachment in order to maintain handpiece performance. This increased power can rapidly generate heat at the head of the handpiece attachment. Because the heat buildup is so rapid, and is efficiently conducted through the metal handpiece, a burned patient may be the first indication of handpiece problems that the practitioner receives.
To avoid patient injury, FDA makes the following recommendations regarding handpiece maintenance:
- Be vigilant about maintaining electric dental handpieces according to the manufacturers’ instructions.
- Verify with the manufacturer the appropriate routine service interval for your dental practice based on the actual use of your handpieces.
- Train personnel to properly clean and maintain the electric dental handpieces and to follow specific device maintenance requirements.
- Develop a method for tracking maintenance and routine service for each handpiece used.
- Examine the handpiece attachments prior to use. Do not use worn drills or burs.
- Do not use poorly maintained electric dental handpieces.
[FDA, December 12, 2007]