Preventing Patient Burns from Electric Dental Handpieces: A Persistent Risk

In 2010, the U.S. Food and Drug Administration (FDA) issued a critical warning to the dental community: patients were suffering severe burns during procedures involving poorly maintained electric dental handpieces. Despite the passage of time, this warning remains highly relevant today.

Hidden Dangers of Overheating

According to the FDA, “Burns may not be apparent to the operator or the patient until after the tissue damage has occurred, because the anesthetized patient cannot feel the tissue burning and the handpiece housing insulates the operator from the heated attachment. These burns range from first-degree burns to third-degree burns requiring reconstructive surgery.”

The burns have occurred in various clinical scenarios - from tooth cutting and bone surgery to extractions and other routine dental procedures. In essence, any procedure involving an electric handpiece carries a risk, especially when the device is not properly maintained.

Why Electric Handpieces Pose Unique Risks

With air-driven handpieces, performance issues such as sluggish operation or excessive vibration typically alert the dentist to underlying problems, such as a dull bur or worn bearings. In contrast, electric handpieces may continue to function at full strength even when internal components are compromised. When a handpiece becomes clogged or worn, its electric motor may compensate by delivering more power, often without noticeable symptoms to the operator.

This additional power rapidly generates heat at the handpiece head or attachment. Due to efficient heat conduction through the metal casing and the patient’s anesthesia, tissue burns can occur before anyone realizes something is wrong. Too often, a patient’s injury is the first indication of an equipment malfunction. 

Best Practices for Burn Prevention

To protect patients from this silent threat, dental professionals should implement the following safeguards:

• Strictly follow the manufacturer’s maintenance guidelines for each electric handpiece in use.
• Consult the manufacturer to determine the ideal service intervals based on the frequency of use in your practice.
• Train all clinical and sterilization staff to properly clean, inspect, and maintain handpieces by the manufacturer’s specifications.
• Establish a tracking system to monitor maintenance, service dates, and component replacements for each handpiece.
• Scrutinize handpiece attachments before every procedure.
• Avoid using worn burs or drills as these can increase friction and contribute to dangerous heat buildup.
• Retire or repair faulty handpieces immediately; continued use of unreliable equipment poses a risk to patient safety and exposes the practitioner to potential legal liability.

If a Burn Occurs: Respond Promptly

Despite best efforts, if a patient sustains a burn during treatment:

1. Advise immediate medical evaluation from a qualified provider.
2. Follow up personally to ensure proper care and resolution.
3. Document the event clearly in the patient’s medical record, including details of the equipment used, the staff involved, and the response. 

Remain Proactive in Preventing Burns

Electric handpieces offer precision and power, but they also demand rigorous maintenance and oversight. As the FDA’s warning remains in effect more than a decade later, dental teams must remain proactive in preventing injuries. Through consistent training, diligent equipment care, and patient-focused protocols, you can minimize the risks and ensure safe, effective care.

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The information contained on the DentistCare Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.