Faster, Easier, Better: It May Be Time To Go Electric
Dentists describe their switch from air to electric handpieces, and how that has impacted their procedures and practices as a whole
Like most dentists, Dr. Charles Crowl came up through dental school and his initial years in practice using air-driven handpieces. Every now and then, a fellow dentist would tell him about the virtues of using an electric handpiece, but he didn’t give it serious consideration until he had the chance to demo one at a trade show. The handpiece performed exactly as his peers had described—with steadiness and power. So, when it came time to renovate his practice in the Chicago area, he put an electric handpiece in every room.
“Quite honestly, I’ve never looked back, because of what it brings to the table, which is so much. It’s not just the constant speed and higher torque, but I can do as good or better work in less time, and patients love that. If you’re like most patients, the less time you have to spend in the chair, the better,” said Dr. Crowl, who has since moved to Louisville, KY, and outfitted a new practice with Bien-Air electric handpieces in all 11 operatories.
Similarly, Dr. James Merrett had always used air-driven handpieces, simply because he’d never experienced electric. When looking to advance his work in cosmetic dentistry, he took a hands-on course using electric handpieces. “I said, ‘Holy smokes!’ Instead of feathering the handpiece back and forth, you could actually lean into the tooth and easily take off a lot more tooth structure. The bur wouldn’t stall, as it would if you put too much pressure on an air-driven.”
When he needed to upgrade the handpiece fleet at his practice in Maui, HI, Dr. Merrett made the transition to electric—a journey that has involved electric handpieces from 4 different manufacturers. Today, having relocated and purchased a practice in San Antonio, TX, he strictly uses Bien-Air electric handpieces, which he said not only perform the best, but have required fewer repairs. “They’ve been such workhorses for us. They’re like tanks in our practice.”
Feel the Power
Although far more prominent in Europe and Asia, the electric handpiece has been slowly but surely working its way into more American practices, thanks to attributes such as less noise and vibration, reduced heat generation, constant torque, and overall power. For most practitioners, those qualities add up to greater efficiency, time savings, and precision during procedures such as tooth preparation, crown removal, and adjusting occlusion.
“Electric handpieces are so much more efficient at cutting,” said Dr. Daniela Sever, who as a general dentist prefers using an electric handpiece for tasks like prep and crown removal. Now specializing in dental sleep medicine in Weymouth, MA, she uses it to adjust oral appliances. “They feel sturdy in the hand and exert a greater force on the cutting surface. They are a bit heavier than hydraulic handpieces, but you get used to that quickly. They also need significantly less frequent repair than traditional handpieces.”
For many dentists, the biggest draw is simply the “feel” of using an electric handpiece, whose head is designed to provide greater concentricity and less friction, giving the user more control. “I think there is a more proprioceptive feel with the electric handpieces, especially when prepping the corners or line angles of crown preps or onlays,” said Dr. Robert Beatty, who uses electric handpieces in two of his three operatories in Frisco, TX.
Removing Tough Crowns
One of the areas where electric handpieces are most efficient is during crown removal, thanks to the ability to use more aggressive cutting force. Cutting metal and zirconia crowns with an air-driven handpiece creates heat, will often cause the bur to stall as pressure is applied, and can ultimately result in premature wear on the air turbines.
"It's that much more efficient because you have that torque. You get a smoother surface and more precise margins."
-James Merrett, DDS
Dr. Merrett has found that removing crowns made of tough material such as porcelain-fused-to-metal (PFM), lithium disilicate, or zirconia is much easier and faster with an electric handpiece. “Zirconia, in particular, is really, really hard, so—even if you’re using a fine diamond bur with an air-driven handpiece—you’ll be there all day. The torque of the electric handpiece makes it much easier.”
For Dr. Crowl, the difference is “night and day,” and it’s only become more distinct with the proliferation of zirconia crowns. “With the electric and the appropriate bur, you can make pretty short order of it. Where I used to spend 5 to 10 minutes trying to cut a slot in a PFM or a similar material, nowadays it’s literally about a minute.”
Time Saved on Precision Preps
Time savings is, perhaps, where the electric handpiece has its greatest impact. Due to the lower torque in air-driven handpieces, dentists are trained to use a “feathering” technique that takes additional time and can result in a more rigid cut. “With the electric, you can use that painting stroke if you want, but you don’t need to,” said Dr. Merrett, “because you can just add a little more pressure and make your margins right there in one path. It’s that much more efficient because you have that torque. You get a smoother surface and more precise margins.”
Dr. Crowl, who calls electric handpieces a practice builder that—despite a higher cost to purchase than air-driven handpieces—may bring the greatest ROI of anything in his practice, simply based on time savings. Describing crown-and-bridge visits as the quintessential procedure in his practice, he estimated that he would spend an hour on the typical single-unit appointment when using an air-driven handpiece. With electric, the same procedure takes 40 minutes. “Because I can so efficiently prepare the tooth, and with everything else being the same, I’ve reduced the time it takes by at least a third—sometimes even half.”
"They feel sturdy in the hand and exert a greater force on the cutting surface."
-Daniela Sever, DMD, PC
No Going Back
Having reaped the rewards of electric handpieces for 15 years now, Dr. Merrett is happy to spread the word and watch other dentists discover the same advantages when he assists with a cosmetic dentistry course in Dallas. “The doctors come from all over Texas and they learn how to do cosmetics, such as veneers. They usually have air-driven handpieces in their practices, and when they come in and use the electrics, they’re like, ‘Wow, these are really good!’ It just feels stronger right away, and they love it. If they’re like me, they’d have a hard time going back to air.”
