Marty Jablow, DMD, is a clinician, speaker, and authority in dental technology. In his presentation titled “The Dental Handpiece & Its Role in Daily Practice,” Dr. Jablow discusses the history of handpieces and the differences between air-driven, electric, and hybrid electric handpieces. Read below as THE NEXTDDS talks to Dr. Jablow for his insights on using handpieces to access difficult areas, proper hand treatment after procedures, and his daily maintenance routine for dental handpieces.
What’s your approach when using a high-speed electric handpiece to cut through a zirconia crown?
Dr. Jablow: First: I would knock down the rpms from 200,000 to 100,000. I do not bond every crown in because I don’t think it’s necessary if you have good resistance and retention form. What you would do is slice into this; cut through it on the buccal at about a 1/3 or 1/2 way across the occlusal and, if I can get an instrument in there, I can crack the crown into two pieces and it comes out fairly clean. It’s much easier using this than an air-driven handpiece.
Share some insight on how you access difficult areas like mandibular lingual, maxillary molars, etc.
Dr. Jablow: There are huge advantages to isolation. Do I put a rubber dam on every patient? The answer is “No.” What we use in my office to make things easier are isolation systems. My system of choice includes mouthpieces that retract the tongue and the cheek and provides vacuum suction and illumination. It’s also important to use thing like cotton rolls, retractors, and other hand-held instruments; those make your access much easier.
How should dental students build up their hand skills with their handpieces as they think about making their way into the clinical environment?
Dr. Jablow: It’s just about cutting and taking the time to do it. You are going to go through a whole bunch of things. I believe teeth are not contiguous enamel and dentin; they do not cut the same. Some enamel in the teeth is harder. With practice, practice, and more practice, you will eventually develop the skills. The main thing is the frustration. Let it go, it’s not always easy, just keep practicing. There is no magic to this.
You also talked about your daily upkeep of your handpieces. How long does your maintenance routine take and who’s responsible for that in your practice?
Dr. Jablow: After you use the handpiece, run the water through it for 30 seconds or so; this procedure is done every day in the morning. We also flush the lines and place the oil. This is the manual way of doing it. There are also handpiece cleaners/centers where you can actually put the handpiece on the attachments and they will lubricate and blow the air through it.
Sounds very effective. What do you to help with your hands before a long procedure?
Dr. Jablow: Take a break. Give yourself enough time. If you going to do a long procedure, make sure the patient has break time and you have break time. Sometime I simply flex my hands and stretch them out. If you’re having hand issues, you should speak with an orthopedic surgeon or hand surgeon.
Any tips for the new dentist on handpiece positions? For example, if you’re preparing tooth #2 or #15 distobuccally for a crown?
Dr. Jablow: First thing: use magnification. I know in many dental school students are required to buy loupes but not everyone is wearing them. That’s a big deal; if you can see it well, you can do it well. This is very important for preparation. Obviously, isolation is a little harder back there. If you’re concerned about lacerating cheeks, absorbent pads and dry shields will help prevent that. You may even have to get out of the chair and do those non-ergonomic things for an effective procedure.
Thank you very much for your time Dr. Jablow! We greatly appreciate you taking the time to share your knowledge with THE NEXTDDS user community!