The following guidelines
represent a general approach to handpiece maintenance. Always follow the
suggested maintenance procedures supplied with the handpiece. Especially
during the warranty period, it is important to follow these instructions
to the letter to avoid disputed warranty claims.
- Surface
Clean The Handpiece. CDC guidelines call for flushing water
through the handpiece in the operatory for 30 seconds to remove potential
contaminants from the internal water line. In the sterilization area,
clean off any bio burden using a brush under running water. Use of a
mild detergent is acceptable. Bio burden left on dental instruments
may act as a protective shield for microorganisms in the sterilizer.
Alcohol should never be used as a cleaning agent as it can dehydrate
spores increasing resistance to sterilization. Do not use any chemical
solutions for cleaning, foreign substances may have a detrimental effect
on the sterilizer or the handpiece, through a harmful reaction during
the sterilization cycle.
- Dry Off
the Handpiece. This step is very important if the office is
using a chemiclave sterilizer. Excess water will allow oxidation to
occur in the chamber leading to corrosion.
- Lubricate
the Handpiece. Use the proper lubricating tip to spray oil
into the drive air line. Spray until oil comes out the handpiece head.
This ensures that lubricant has penetrated to the bearings. Even if
lubricant is delivered incorrectly, oil coming from the head indicates
it has reached the bearings.
Note: Using a spray oil has become less popular because of perceived
mess and wastage. Many offices are moving to dropper style applicators
to oil the handpiece. Use of a dropper makes the next step, running
out the excess oil critical, because the droplets will not be delivered
to the bearings without being propelled by pressurized air. If you prefer
a dropper, apply 2-3 good size drops to the drive air hole and immediately
run the handpiece.
- Run the
Handpiece to Expel Excess Oil. After lubrication, it is important
to run the handpiece to evenly distribute the oil through the bearings,
and to expel excess oil to prevent coagulation during autoclaving. Install
a bur in the chuck and run the handpiece for twenty seconds. Do not
use a bur blank, they are not made to iso specifications and do not
run concentrically, possibly damaging the turbine. *Note: some manufacturers
specifically state NOT to install a bur prior to operation.
Air flush stations located in the sterilization area are an excellent
investment. A flush station eliminates a trip back to the operatory
to run the handpiece. These stations are readily available from many
sources and only require a connection to an air line. Most stations
have a handpiece adapter that operates the handpiece when pressed. Using
an air station also prevents oil from being exhausted back into the
handpiece tubing where leading to discoloration, and stiffening. After
operating, remove the bur. Lever style handpieces must remain in the
closed position during sterilization.
- Clean Fiber
Optic Surfaces. Alcohol and a cue tip may be used to remove
excess oil and debris from all fiber optic surfaces.
- Bag the
Handpiece. CDC guidelines recommend bagging instruments and
handpieces to maintain sterility. A paper/plastic combination bag is
preferred, allowing steam to dissipate through the paper side while
contents remain readily identifiable.
- Sterilize.
Autoclave the handpiece following manufacturer guidelines. Allow the
sterilizer to completely process through the dry cycle.
- Dry the
Handpiece. After the cycle, place the bag containing the handpiece
paper side up on top of the sterilizer to thoroughly dry. This is a
warm area; as the heat from the sterilizer rises, the handpiece will
more thoroughly dry. New sterilizer models feature dry/storage compartments
outside the chamber. Paper side up allows the moisture from the condensing
steam to evaporate easily. Leaving the plastic side up traps condensation
in the bag creating a corrosive atmosphere for the handpiece.
Things to
Watch Out For
- Using a
chemical wipe down on a handpiece before sterilizing –
Not only is this redundant, but it may multiply harmful reactions when
subjected to heat
- Using
an ultrasonic cleaner or solution – Never immerse a handpiece
in any fluids other than a cleaning solution offered by the handpiece
manufacturer
- Lubricating
in the wrong hole – The drive air line leads directly
to the turbine, other orifices such as exhaust, water, etc. do not.
If you are using a liquid oil applicator on a swivel type handpiece,
it is critical that you deliver oil to the correct internal opening
- Incorrect
lube applicator – Make sure the spray tip fits the handpiece
quick disconnect correctly. Some models depend on a pressurized fit
to flush debris out of the handpiece.
- Not applying
enough lubricant – Staff is sometimes admonished not
to overspray oil into the handpiece to reduce excess residue, however
you must ensure that oil is getting to the bearings by seeing oil in
the head
- Not running
the handpiece prior to autoclaving – Failure to operate
the handpiece following lubrication will result in “gumming up”
the turbine as excess oil gets baked into the bearings. An undesirable
clinical effect is expelling oil into the operating field after the
not properly running out any excess
- Not cleaning the
fiber optic bundles – Failure to keep the fiber optic bundle surfaces
clean will lead to a build up of oil and debris affecting the ability
to transmit light
- Leaving
the bur in the chuck during autoclaving – While a bur
is held in an autochuck the spring is compressed. Subjecting any spring
to heat and corrosion under tension will weaken it and shorten the life.
Leaving a bur in a manual chuck leads to debris building up in and on
the chuck leading to increased difficulty of operation.
- Leaving
levers open during autoclaving – When a lever autochuck
is actuated, about 8lbs. of force is exerted through the front o ring
of the turbine. During normal operation this force is momentary as a
bur is changed. Leaving the chuck open during the autoclave cycle means
compressing the o ring while subjecting it to heat for thirty minutes,
dramatically accelerating failure.
- Failure
to maintain autoclaves – If your autoclave is not properly
cleaned, build up can occur that contaminates the entire system including
your handpieces.
Many manufacturers
offer a fully automatic clean and lube station to take staff time and
guesswork out of the maintenance process. Most units allow for one touch
operation, applying a cleaner and lubricant, before running the handpiece.
Although costly, these maintenance centers reduce staff time associated
with handpiece maintenance. Some manufacturers extend handpiece warranties
if their automatic station is used.
Low Speed
Motors & Attachments
CDC
guidelines indicate “only the portion of the attachment that comes
in contact with patient tissue” is required to be sterilized, or
disposed of. It is not necessary to sterilize the motor if a barrier is
used. If you are not autoclaving motors, make sure they are removed from
the tubing and lubricated at least once a week. Not removing motors at
some interval leads to the accumulated disinfectant corroding the threads
onto the tubing permanently.
- Motors.
Motors, especially vane rotors, do not require that much oil. Dental
motors and attachments require higher viscosity oil than a high speed
spray. One or two drops of oil in the drive air line are all that is
necessary. Run the motor to distribute the oil. Also apply some oil
as a preventative measure to forward/reverse valves, shift rings, and
sheath attachment points. Wipe away excess oil with a paper towel.
- Sheaths
and Attachments. Most straight sheaths do not require lubrication.
It is recommended to do an external cleaning with a brush under running
water prior to bagging the nose cone for sterilization.
- Latch
Angles. It is very important to take latch angles apart for
proper lubrication. At least once a day unscrew the head from the sheath
and remove the transmission gear for cleaning and oiling. Suggest first
thing in the morning as part of the opening routine. A Star latch angle
requires the knuckle in the middle to be unscrewed in order to remove
the transmission gear. Apply a drop of oil under each gear on the transmission
gear as well as into the center hole. Apply several drops of oil to
the exposed cartridge while the transmission gear is removed.
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