I suppose nothing is more closely associated with dentistry than the sound of the drill. Actually, in the dental field, a drill is called a handpiece. When my great uncle graduated from dental school back in 1926, modern handpieces had not yet been invented. When I was in dental school, he gave me the drill he used back in the '20's to display as a relic of the past. It has an electric motor and some metal arms with wheels and a long flexible belt. Uncle Fred told me it was not uncommon in those days for this very drill to be in contact with a tooth for over a half hour. It cut the tooth dry so often there was a burning smell when the tooth was being treated. He also told me sometimes the patient and the dentist became so weary when a tooth was being readied for a filling that both the dentist and the patient would go outside for a smoke and resume treatment afterwards. These belt driven drills were slow and not very powerful.
The air driven handpiece was introduced in 1958. Air driven handpieces were a major advancement in comfort and efficiency for everyone. This is the drill most people these days associate with dentistry. It makes a loud high pitched whine because it turns at around 500,000 rpm. Although the rpm is high, the torque is not high. Later, water and a lighted tip on the drill were added. The air driven handpiece is still the most common drill in North American dental offices today. Time to treat a tooth is reduced in a dramatic way using an air driven handpiece when compared to a belt driven handpiece.
The current state of the art generation of drill runs on electricity. Electric handpieces are a major advancement over air driven handpieces. In Europe, they are very common. They are becoming more common over here. An electric handpiece has an electric motor and a step up gearing attachment that increases its rpm. Their rpm at the tip is lower than an air driven handpiece, but the torque available is tremendously improved when compared to an air driven unit. Many dentists have not made the change to electric handpieces because the cost is high. My first electric handpieces were ten times the cost of my air driven handpieces (over $7000 for each handpiece). Their cost is coming down, but they are still significantly more costly than air driven handpieces and I have found that they break down way more often than their air driven cousins.
The future likely will bring us lasers for cutting teeth. This is possible today, but the cost is very high and instead of being faster, laser cutting of teeth today is much slower than electric or air driven handpieces. As well, today's lasers for cutting teeth cannot remove old metal fillings or crowns. This technology is evolving and may change things for the better in our field later.
Dentists often are "gadget guys", so if you have a question about equipment, make sure you ask your dentist.
This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)