How to use and electric handpiece and control aerosols

By Joseph Blaes, DDS

My favorite thing to do is prep teeth. I really mean it, I love it. I look forward to going to the office. From the moment I sit down at my chair, I start visualizing how the tooth will look when I am finished prepping. With my Bien-Air EVO.15 handpiece and my Bien-Air MX2 electric motor, I have constant quiet power. This combination allows me to complete precise tooth preparations.

I have been using this particular electric handpiece brand for over 30 years. I have heard all the excuses for not buying an electric handpiece – the first is always, they are too heavy. If you hold an electric in a pinch grip at the head of the handpiece like you do an air driven handpiece, then it is too heavy. The right way to hold an electric handpiece is to balance the motor and handpiece in the fleshy part of the hand between the thumb and the index finger. Then you simply guide the handpiece with the thumb and index finger. It is really all about balance. With no “pinch grip” you will no longer experience hand fatigue.

Rubber dam in place

The handpiece I prefer is shorter, lighter and has a smaller head. In fact, it is the same length as an air driven handpiece. It is easier to balance in your hand which is especially important for women dentists. This is a high torque handpiece that does not stall. The motor has a speed range of 500 rpm to 200,000 rpm. This allows the dentist to prep the tooth at a higher rpm for quick reduction of enamel, and reduce the rpm for finishing the preps, and at even slower speeds for polishing restorative materials. You will need a slow speed attachment for endodontic treatment.

The handpiece I prefer cuts teeth with more precision in less time because the bur is milling the tooth rather than chopping it. It has constant high torque, much less noise, no vibration because the bur is running true in its bur-locking and rotation drive mechanism. It cuts teeth more efficiently and  converges four asymmetrical laser-precise air/water sprays on the tip of the bur for rapid and even cooling of the operative field. In combination with two multi-strand optical glass conductors, unobscured intraoral visibility is guaranteed. There is no worry about burning your patient’s intraoral tissue because of heat arresting technology. This revolutionizes patient safety by eliminating overheating and associated burn injuries.

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During this time of COVID-19 pandemic, we are all concerned with the aerosols produced by prepping teeth. I have a solution for controlling the aerosols. First, do quadrant dentistry and isolate the quadrant with a rubber dam. My dental assistant always uses the high-volume evacuator (HVE) and controls most of the aerosols by drawing horizontally across the occlusal plane.

I do most of my restorative dentistry air prepping teeth without the water spray but continuing to use the coolant air to cool the tooth. I use a disposable sharp diamond or bur for every patient. Using this procedure in the mouth produces dust, debris, and an odor that must be removed by the high-volume evacuator. Also, the HVE suction is actually cooling the tooth as well. I have been using an electric handpiece for more than 30 years. I have used many different brands, but my favorite remains the Evo.15 electric handpiece. Because it does not heat up, we can prep teeth with no water spray and no aerosols. While air prepping, it is important to limit bur contact time to 20-second intervals.

Dr Joseph Blaes, DDS

Joe Blaes, DDS

Joe Blaes, DDS, created a unique, insurance-free, fee-for-service general practice in St. Louis that emphasizes preventive, esthetic, reconstructive, and implant dentistry. He is best known as the former chief editor of Dental Economics. Dr. Blaes is a fellow of the American College of Dentists, a past president of the American Academy of Dental Practice Administration, and a founding member of the American Academy for Oral Systemic Health.

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