Understanding dental handpiece maintenance, care and cleaning is crucial. Decon Pete gives a step-by-step guide for the correct cleaning and sterilisation process and explains why it’s so important.
Dental handpieces are a huge investment for any practice, so it is incredibly important that we understand how to maintain and care for them correctly. That means following the instructions from the handpiece manufacturer, the reprocessing equipment manufacturer and the relevant guidance for the part of the UK in which you work.
A handpiece may have limited contact with the oral cavity, but that does not remove the risk of contamination passing from one patient to another. At the very high rotational speeds produced by modern turbines, fluids and fine debris can be drawn into the head, chuck, bearings, gearing and internal air and water channels. Saliva, blood and dentinal debris left behind can present an infection prevention risk and can also contribute to blocked spray channels, poor bur retention, noise, overheating, corrosion and premature failure.
To put the speed into context, a turbine handpiece, driven by air pressure, can rotate at around 360,000 to 400,000+ rpm. At that speed, correct cleaning and lubrication are not optional extras. Small amounts of debris, old oil or friction can affect balance and performance and, over time, may lead to wobble, wear and expensive repairs. Preventive care after every patient is usually far more economical than dealing with failure once appointments are affected.
Four different stages – four different jobs
One of the most common sources of confusion is treating cleaning, disinfection, lubrication and sterilisation as though they mean the same thing. They do not.
- Cleaning removes visible and microscopic soil, including blood, saliva, debris and residues. Oil does not clean a contaminated handpiece unless the manufacturer has validated a particular cleaning-and-care process
- Disinfection reduces the number of viable microorganisms to a defined level. It may be thermal or chemical, depending on the validated process, but it is not the same as sterilisation
- Lubrication protects bearings, gears, chucks and other moving components. It supports performance and service life, but it does not disinfect or sterilise. Some cleaning or disinfection processes remove lubricant, so re-oiling may be required afterwards
- Sterilisation is a separate, validated process intended to render instruments free from viable microorganisms. It can only be relied upon after the preceding stages have been completed correctly and the correct cycle has been selected for the load.
Always check the instructions for use (IFU). Not every handpiece, motor, scaler or attachment can be processed in the same way, and not every device labelled as an automated ‘care’ unit performs all four stages.
A practical handpiece workflow
At the chairside
After treatment, remove the bur safely and deal with gross contamination promptly in line with the IFU and local protocol. Do not allow contamination to dry if the manufacturer specifies immediate pre-treatment. Transport the instrument safely to the decontamination area.
External cleaning
Clean the outside using a method and product approved by the handpiece manufacturer. Avoid immersing the handpiece, placing it in an ultrasonic bath, using aggressive chemicals or allowing liquid to enter couplings, unless the IFU specifically permits it. Water quality also matters; use the quality specified by the manufacturer rather than assuming tap water is suitable.
Internal cleaning and channel care
Use the validated manual or automated method specified for that instrument. The correct adaptors and connections are important because air, water and drive channels must actually be reached by the process.
Inspection and function checks
Under good lighting, check cleanliness, damage, corrosion, spray output, chuck operation, O-rings and any other points stated in the IFU. A handpiece that remains visibly soiled should go back through cleaning. A damaged or unreliable handpiece should be removed from use.
Lubrication and chuck care
Apply the correct oil, in the correct amount and at the correct point in the sequence. Some instruments must not be lubricated and some require separate chuck care. Purge excess lubricant only as directed, using a system that contains aerosols and does not re-contaminate the instrument.
Packaging, sterilisation and storage
Package instruments when required by their intended use and local policy, then select a steriliser and cycle validated for the load. Wrapped hollow handpieces will commonly require a type B vacuum cycle. A type S cycle is only suitable where the steriliser manufacturer has specified and validated that particular load, and type N cycles are not intended for hollow or wrapped loads.
Complete the required cycle records, release checks and storage controls.
Manual cleaning and oiling
Manual care can work well when the handpiece IFU permits it, but it relies heavily on staff training and consistency. Make sure that you:
- Use the recommended cleaner and lubricant rather than assuming any spray oil will do the job
- Shake the can if the product instructions require it
- Fit the exact nozzle or adaptor for the handpiece and connection
- Keep nozzles clean, undamaged and effective
- Run the approved quantity and duration through the correct channel
- Use a clean tissue/non-linting cloth to check what is being expelled
- Carry out separate chuck care when required
- Record training and review the process if handpieces sound rough, run hot, lose spray or show bur movement.
Chuck lubrication is one of the most common areas that is overlooked in general practice, however it is extremely important and can heavily affect the performance of the handpieces when not carried out.
Common signs of the chucks not being lubricated are grinding noises on run down, wobbly burs and buttons sticking. Always consult the manufacturer’s instructions as to the frequency that this should be carried out.
Listen to what the handpiece is telling you
Does the handpiece sound rough as it runs down? Is the spray pattern changing? Is it becoming hot, losing power or failing to hold the bur securely? These are warning signs, not little annoyances to work around.
Stop using the instrument, check the IFU and arrange inspection or repair through an appropriate service provider. Follow the manufacturer’s service intervals rather than relying on a blanket annual rule for every model.
Good handpiece care is about patient safety, reliable clinical performance and protecting a significant practice investment.
Keep the four stages clear, train the team to follow the same validated process every time, document what needs to be documented, and never let an oiling unit – manual or automated – be mistaken for a complete decontamination cycle.
Catch up on previous Decon Pete columns:
- Recommissioning new or existing equipment
- Closing your practice for Christmas: what to remember
- DUWLs and the risks associated with biofilm
- It’s the final countdown to the NSC 2021
- Are you ready for the NSC 2021 implementation?
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