Choosing the right dental handpiece for your practice
Choosing the best dental handpiece for your practice is crucial for safe and efficient care for your patients. Lower-quality generic or rebranded handpieces exhibit an array of deficiencies that can lead to longer procedure times, lower quality work, and increased risk of injury to you or your patients. Then when issues arise, they can often leave you frustrated by dismal customer service.
Investing in the right handpiece can improve the overall quality and success of dental procedures in your practice. In this article, we will list some of the advantages and disadvantages of different types of dental handpieces, specifically air-driven vs. electric and high-speed vs. slow-speed. Then we will discuss factors to consider and steps to follow in choosing the right instrument for your dental practice.
Types of dental handpieces
The types of handpieces dental practitioners use vary by specialty and the kinds of procedures they perform. Visit our guide to the most common types of dental handpieces to learn more about products for general dentistry compared with products for specialty practices. Here, we describe pros and cons for different handpiece types.
In the U.S., while electric handpiece systems are becoming more prevalent, especially as more dental schools begin to use them, air-driven handpieces still dominate the market. For a summary of the past, present, and future of dental handpiece development—including Star’s many contributions to the field—and a comparison of air-driven and electric handpieces, see our previously published article about how dental handpieces work.
Advantages of air-driven handpieces:
- Speed: High rotational speed (400,000 rpm) results in faster, less painful removal of hard tooth tissue.
- Weight: Lighter weight reduces hand fatigue and enables better tactile control and anatomy-driven clinical feedback.
- Size: Smaller head allows better access to the oral cavity.
- Affordability: Lower upfront and maintenance costs compared with electric. Star’s in-office turbine replacement and LubeFree technology make maintenance even easier.
- Autoclavability: Their relatively simpler design makes them easier to clean and sterilize.
Disadvantages of air-driven handpieces:
- Lack of torque: Higher speed typically results in lower torque when the cutting bur makes contact, a disadvantage when cutting through harder materials such as those used in crowns.
- Noise and vibration: Can emit a high-pitched noise and can sometimes vibrate excessively, causing discomfort to both the dentist and the patient. This can be mitigated with a design that uses ceramic bearings instead of stainless steel.
- Excessive aerosols: Especially since the COVID-19 pandemic, the level of aerosol created by high-speed air-driven handpieces has become far less acceptable.
Electric handpiece systems are growing in popularity, and there are practice leaders who believe electric handpieces represent the future of dentistry. Here are some pros and cons of this type of dental equipment.
Advantages of electric handpieces:
- Consistent torque: Electric power produces higher torque, making them ideal for procedures like removing crowns or cutting into harder materials like zirconia and noble metals.
- Smooth Operation: Internal gear design operates attachments smoothly and quietly, providing greater comfort for both patients and dentists.
- Variable speed control: Most have a controller with settings that allow dentists to adjust speed and torque without a foot pedal to power different attachments, such as endodontic, high-speed, and low-speed.
- Versatile: Easy to go from a high-speed attachment for tooth preparation to a low-speed attachment for finishing and polishing.
Disadvantages of electric handpieces:
- Weight: They are heavier than air-driven handpieces, which can cause hand fatigue during longer procedures.
- Size: Relatively large head size can make access to the oral cavity more difficult.
- Excessive heat: Poorly maintained handpieces that start to fail can generate excessive heat in the head that can burn patients.
- Cost: Cost of purchasing controller, motor, and attachments is currently about three times the cost of air-driven handpieces. Also, many moving parts make handpiece repair more difficult and expensive.
- Maintenance: Electric handpieces require more maintenance than air-driven handpieces, including regular lubrication and cleaning of the motor and transmission. Since motors are generally not autoclavable, maintenance is an arduous process.
Both air-driven and electric handpieces can accommodate high-speed and low-speed (or slow-speed) procedures. Here, we compare some of the pros and cons of these two handpiece types.
Advantages of high-speed handpieces:
- Efficient: High-speed handpieces are efficient, allowing dentists to remove tooth tissue quickly, which makes for a more efficient practice and calmer patients.
- Precise: Light weight and small head size provide precise control, making them ideal for procedures that require detailed work.
- Versatile: Can be used for a variety of restorative procedures, including cutting, drilling, and shaping.
Disadvantages of high-speed handpieces:
- Limited torque: Limited torque when pressure is applied to the bur makes them less effective for procedures that require more power, such as crown removal.
- Noise and vibration: High-speed handpieces emit a shrill sound that bothers some patients. They can vibrate excessively, causing cracking of enamel and jagged margins.
- Excessive aerosols: Compared with slower-speed handpieces, the level of aerosol created by high-speed air-driven handpieces can be problematic.
- Shorter lifespan: Wear and tear caused by constant high-speed operation means high-speed handpieces must be replaced more frequently than low-speed handpieces, usually every six to twelve months.
Low-speed (or slow-speed) handpieces
Advantages of low-speed handpieces:
- Versatile: Used for many types of procedures, including soft decay removal, polishing, finishing, adjusting crowns and bridges, and endodontic and implant work.
- Powerful: Can generate more torque than high-speed handpieces, making them effective for procedures that require greater control, such as root canals.
- Cooler: Create less heat than high-speed handpieces, reducing the risk of thermal damage to the tooth.
- Quieter: Produce less noise and vibration than high-speed handpieces, making them more comfortable for both the dentist and the patient.
Disadvantages of low-speed handpieces:
- Weight: Generally larger and heavier than high-speed handpieces, which can cause hand fatigue during longer procedures.
- Inefficient: For procedures that require lots of cutting, their slower speed makes them less efficient than their high-speed counterparts.
- Higher maintenance: Both air-driven and electric slow-speed handpieces require more maintenance than high-speed handpieces. If maintenance protocols aren’t followed adequately, they can operate sluggishly or even fail.
Factors to consider when choosing handpiece products
Now that we’ve discussed the pros and cons of various types of dental handpieces, how do you sift through what’s important for you and your practice? These are the main factors you should keep in mind when choosing your equipment.
Speed and torque
Finding the ideal balance between speed and torque is key for most dentists. The kinds of procedures you perform will be the most important determinant of what combination of these you will need your handpieces to deliver.
Star handpieces operate at the following speeds:
- Star ETorque electric handpiece system: 40,000 rpm
(with attachments for speeds from 100-200,000 rpm)
- Aeras 500 Elite: 408,000 rpm
- Aeras 400 Flex: 436,000 rpm
- 430 Torque: 430,000 rpm
- 430 Series: 430,000 rpm
- Titan low-speed motors: 5,000 or 20,000 rpm
(with attachments for speed ranges of 100-5,000 rpm or 110-20,000 rpm, respectively)
Weight and ergonomics
Another important consideration is weight, which affects how you hold your instrument. Air-driven and electric handpieces are designed to be gripped differently in order to achieve the best weight balance. Generally, air-driven handpieces are lighter and have swivel back ends to allow more freedom of movement. Electric handpieces are heavier and not as ergonomic, but their tubing is smaller and more flexible.
Star handpieces weigh as follows:
- Star ETorque electric handpiece motor: 62 grams
- Star 500 Elite: 48 grams
- Star 400 Flex: 63 grams
- 430 Torque: 47-60 grams
- 430 Series: 47-52 grams
Because excessive noise generated by dental handpieces can both make patients anxious and harm dental professionals’ hearing over time, you should consider what level of noise you are willing to accept. Of course, electric handpieces offer a huge advantage here, operating at around 20 decibels (dBA) less than air-driven handpieces. Compare the noise level of our Star electric and high-speed handpieces:
- Star ETorque: <40 dBA
- Star 500 Elite: 65.7 dBA
- 430 Torque: 67.7 dBA
- 430 SWL: 66 dBA
Maintenance and sterilization requirements
Maintenance and sterilization requirements may not be top-of-mind when choosing dental handpieces, but you should investigate what parts of different handpieces are autoclavable and which parts are not, to avoid downtime for preventable repairs. You should always follow manufacturer instructions for proper sterilization. For information on maintaining Star handpieces, refer to our guide to dental handpiece maintenance.
Electric handpiece systems cost more upfront than air-driven handpieces because of their complex internal design as well as the motor and control unit needed to operate them. This complexity makes repairs more expensive as well; however, since they tend to require repairs less often (assuming they are properly maintained) overall repair costs end up being about the same. Annual maintenance costs are also comparable to those of air-driven models.
Conclusion: Steps to choose a dental handpiece
After considering the many factors that can influence a dentist’s satisfaction with their handpieces, now it’s time to act:
- Determine what’s working and what’s not in your practice. Where are your pain points? Are your turbines breaking down? Do you wish you had more swivel for freedom of movement? Do you have too much or not enough water flowing through your instrument? Make a list of the things you want to keep and the things you want to change.
- Research options online. Look at tutorials and testimonials. Talk to your colleagues.
- Reach out to your dealer representative to discuss the options you’ve discovered during your research. If you are buying for a special market’s organization, such as a dental school, governmental provider, DSO, or community health organization, you should reach out directly to dental equipment manufacturers, who are equipped to handle large orders.
- Based on your discussions, narrow down your options to about two or three brands.
- Ask your salesperson(s) to provide you with models to try out for an agreed time period.
Trying out a handpiece before purchasing is important for several reasons. Overall, it allows you to form a realistic expectation of what the product can do. It’s a test drive, like with a car:
- It lets dentists assess the weight, grip, and balance of the handpiece to determine if it’s comfortable to hold and use for extended periods.
- It provides an opportunity to test the handpiece's performance and features, such as speed and torque, to ensure it is suitable for the intended procedures.
- It allows the dentist to evaluate the noise and vibration levels to determine if they are acceptable for the practice environment.
With more than 100 years of experience providing products to the dental industry, DENTALEZ is a trusted partner to supply your practice with handpieces that give you unmatched value for your money. We would love to show you how our future-ready and award-winning dental handpieces compare with other brands. Contact us to schedule a call!