Electric dental handpieces used by dentist and oral surgeons have been leaving many people with severe burns. The culprit in many of these dental handpiece injuries, says the Food & Drug Administration (FDA), are poorly maintained devices.
According to an FDA warning issued yesterday, patients have been severely burned when poorly maintained electric dental handpieces were used during dental procedures. Some patients even suffered third degree burns which required plastic surgery. The FDA said that the burns are often not apparent to the operator or the patient until after the tissue damage is done, because the anesthetized patient cannot feel the tissue burning and the dental handpiece housing insulates the operator from the heated attachment. The FDA warning said that while all of the reported burns have so far occurred during cutting of tooth and bone, tooth extraction and other dental surgical procedures, overheating could occur during any dental procedure.
The burns have only been reported in relation to the use of electric dental handpieces, and not with the air-driven variety. 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. But a poorly maintained electric handpiece does not provide a similar warning that maintenance is needed. Instead, 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.
The FDA recommended that dentists and other practitioners who use the electric dental handpieces be aware of the burn risk associated with them, and take steps to insure that they are properly maintained according to manufacturer’s instructions. Users of these devices should also verify with the manufacturer the appropriate routine service interval for their dental practice based on the actual use of the electric dental handpieces. Personnel should be trained to properly clean and maintain the electric dental handpieces and to follow specific device maintenance requirements. The FDA also recommended that practitioners develop a method for tracking maintenance and routine service for each handpiece used. Dentists were also cautioned to examine all dental handpiece attachments prior to use. Finally, the FDA warned that worn drills or burs and poorly maintained electric dental handpieces should never be used.
This is not the first time the FDA has reported on burn problems related to hand held medical devices. In 2003 the FDA warned that rotary surgical handpieces can cause patient burns during orthopedic procedures, as reported in the July 2003 edition of FDA Patient Safety News
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