All About Dental Burs: Types, Use, And More

By Dr. Fadi Swaida

 

Dental burs are a vital tool required for almost every dental treatment and procedure. They are necessary for cutting, grinding, and removing hard and soft tissue and are designed to attach to the rotary dental handpiece for fast and efficient dental work.
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 Types of Dental Burs and Their Use

The two most common types of dental burs are tungsten carbide burs and diamond burs. Within those general categories, there are sub-types of burs that come in different shapes, blade configurations, and head angles to suit a variety of procedures.

  • Tungsten Carbide Burs

Carbide burs are made from tungsten carbide and three times more robust than steel. Due to the hardness of the metal, they are ideally suited to cutting work such as preparing cavities, cutting through metal fillings, and shaping bone during dental implant surgery. They are also often used for crown removal during endodontic procedures.

Unlike diamond burs, they don’t grind the enamel, leaving a smoother surface and reducing the amount of vibration on the handpiece.

  • Diamond Burs

Diamond burs are composed of a stainless-steel frame coated in diamond powder available in various grits. The level of the grit determines the type of procedure the burs can be used for.

Diamond burs are typically used for precision shaping and polishing, but as diamond is one of the hardest known materials, they are often used to cut through zirconia or grind porcelain during the preparation and placement of veneers and crowns.

The Benefits of Single Patient Use Burs and Instruments

Single-patient-use burs and instruments such as probes, mirrors, or procedural kits, are designed to be used and immediately discarded instead of sterilized for the next patient. They have recently gained popularity due to the dramatic reduction in patient and staff infections, and the decreased cost of replacement which can help dental practices to save money.

  • Better Hygiene

Even if your practice uses exceptional cleaning and sterilization techniques, a small number of bacteria can withstand the extreme temperature and pressure of an autoclave. Single-patient-use burs and instruments improve your infection control by minimizing the patient-to-patient transfer of oral microorganisms.

While most patients with strong immune systems can withstand mildly contaminated burs and instruments, immunocompromised patients or patients with a significant co-morbidity are at a high risk of infection. Single-patient-use burs and instruments eliminate this risk, especially during the current COVID-19 pandemic.

  • Patient-friendly

All types of burs become clogged with enamel and dentin throughout a procedure, which can reduce the cutting efficiency. Clogged burs require additional pressure to achieve the same cutting intensity, which can not only irritate the patient but also damage expensive handpieces and result in longer chair times.

Using a new single-patient-use bur for each procedure keeps chair time to a minimum to reduce fatigue, keeps handpiece bearings in good condition, and provides a more comfortable experience for patients.

  • Cost-efficient

Cleaning and sterilizing instruments and burs can increase your overhead costs due to utilities, additional staff, and extra rental space needed to store autoclaves and sterilizing equipment.

Single patient use instruments are a cost-efficient solution to patient care that significantly reduces your overheads and enables you to focus on providing outstanding service to your patients. Despite their low-cost, single-patient-use burs offer the same strength and grinding and cutting ability as their reusable counterparts.

Final Thoughts

The right bur is critical to a successful dental treatment with different sizes, shapes, grits serving different purposes. Single-patient-use burs are now preferred over reusable burs as they offer greater infection control and provide a better patient experience.

 

 

 

About the author

Dr. Fadi Swaida first graduated from the University of Western Ontario with an Honors BSc in Biology before graduating from the University of Manitoba’s Faculty of Dentistry. He is an active member of his church and enjoys football and being by the water! His outgoing personality and fun-loving character will ensure you always feel welcome at Dentist North York.

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Aesthetics… A Natural Career Step for Dentists?

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While many dentists and dental assistants love what they do and have a true passion for helping patients to care for their health and wellbeing, job satisfaction across the industry isn’t as high as it could be. 

Research by the American Dental Association (ADA) and the Health Policy Institute (HPI) found that, amongst those working in dentist owned and operated practices (DOO), only 69% were happy with their working hours, and just 55% were satisfied with their salary. At a time of change throughout ours and many other industries, it is understandable that many trained dentists would be interested in learning more about the different career pathways available to them, or about diversification activities that could help them to expand their practices. 

Introducing Aesthetics

One of the most rapidly emerging diversification activities for dentists is aesthetics, primarily due to the almost unprecedented growth of this alternative healthcare industry. In North America, the facial injectables market was worth a total of $2.1 billion in 2015, and is anticipated to rise to $5.8 billion by 2024. Among these minimally invasive procedures, the American Society of Plastic Surgeons reports that Botox and dermal fillers are the two most widely requested procedures from American audiences. 

Botox? Really?

It’s not as crazy as it seems! As dentists are able to prescribe, are accustomed to working with patients on a day-to-day basis, have mastered their own injecting technique, and boast a comprehensive understanding of the maxillofacial and oral areas of the face, much of the necessary training in facial injectables has solid roots in core dental processes. Even dental hygienists and dental therapists with prescribing rights make excellent candidates due to their extensive training in intricacies of the face and mouth. 

Believe it or not, aesthetic medicine is becoming more heavily incorporated into many dental practices all across the country, and it’s actually pretty easy to see why. Not only are patients becoming more and more savvy and looking for professionals in whom they can fully place their trust to carry out their procedures, but aesthetics is one of the most lucrative areas of diversification for dentists. 

Of course, it’s not just about money. It’s about achieving greater levels of success as a dentist. Cosmetic dentistry procedures have long been used to improve patient satisfaction, and the use of facial fillers can have a significant effect on appearance and even the success rate of necessary dental treatments. 

Career Options for Dentists


Not all dentists will be interested in aesthetics, and that’s OK! We’ve used aesthetics as an example to really highlight the massive diversity in the range of careers that can be enjoyed with dental qualifications. Along with aesthetics and orthodontics, there are also plenty of non-clinical options to consider. The ADA actually reports that clinic ownership in the United States is declining, with an increasing number of trained professionals moving into training and teaching roles, research and technician jobs, and the dental products industry. There’s more to being a dentist than being a dentist!

 

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4 Ways to Help Children Feel Comfortable at Their First Appointment

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In the US, parents are widely encouraged to bring their little ones in for their first dentist appointment within six months of the first tooth breaking through. With central incisors typically appearing anywhere from 6 - 12 months of age, closely followed by lateral incisors and first molars, children are usually very young the first time they meet their dentists. So how can we ensure our littlest patients feel comfortable?

The Rise of Dentophobia

Unfortunately, making young patients feel at ease in the chair isn’t always easy, and dentophobia — a fear of dentists — is on the rise. According to a report titled ‘Children’s Perceptions of Their Dentists’, published in the European Journal of Dentistry, around 11% of children surveyed said they don’t like dentist appointments, and an additional 12% claimed to be afraid. Overall, it appears that as much as 16% of the school age population have a fear of dentists, so what can we do to help them handle these necessary appointments better?

Below are 4 ways that dentists can help children feel comfortable at their first appointment:

1. Do a Practice Run

A popular method  used by specialist pediatric dentists is to keep a small doll, teddy, or action figure nearby to use as a ‘practice run’ model. Before asking a child to take a seat in the chair, get them settled with mom and dad (or whoever has brought them to the appointment) and place the doll in the chair. Explain to the child that you’re going to do a practice run with the doll so that they can better understand what will happen during their appointment. This can help to settle nerves and create calm.

2. Show, Don’t Tell

The European Journal of Dentistry report found that the appearance of some common dental tools and equipment, including dental burs, can enhance anxiety in young patients. This is because children can see them, but don’t understand what they do. Some children may even make up uses for the tools in their head, and we all know how logical children are. A dentist can become a torturer in seconds! In order to help children feel at ease, it’s a good idea to briefly go through the tools that you’ll use, showing kids how they are used (and letting them hear any sounds), rather than telling them. 

3. Be Professional

Did you know that your own appearance can make a big difference in how children feel during their appointment? Remarkably, 90% of the children surveyed in the European Journal of Dentistry study said they would prefer their dentist to wear a white coat; an item of clothing that children will have come to associate with helping and healing throughout pediatric doctor appointments. So, while it’s important to be friendly and welcoming to young patients, it’s also important to remain professional at all times. 

4. Give Mom & Dad Homework

Perhaps one of the most important aspects of a child’s first dentist appointment is making sure they don’t feel alone, and they know they have support in maintaining a happy, healthy mouth. A great tip to ensure that children know this is to give mom and dad (or their guardian) homework — a small guide on helping their child to brush their teeth that they should read up on back home. Getting adults involved is essential, and adult help and supervision when brushing should be in place until children are around 7.

Don’t Sweat It

The truth is that it’s not just dentists who are responsible for helping children feel comfortable at their appointments; a significant portion of the work lies with the parents, and it’s not always easy for moms and dads to settle these nerves in their little ones. If you find that you have a patient who isn’t quite comfortable, don’t sweat it. The most important thing at first appointments is simply getting children accustomed to visiting the dentist… thorough checks and treatments can come along a little later.

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Oral odors - is it more than just bad breath?

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As dentists, we all know just how prevalent halitosis is across the United States, and it’s something we see in our patients each and every day. Reports suggest that as much as 65% of the population have bad breath, but fortunately halitosis is rarely more than a sign that patients have been brushing properly. 

But what if it is bad brushing?

Oral Causes of Halitosis

Most cases of halitosis are simply caused by a failure to maintain good oral hygiene, and can be effectively treated at home through interdental cleaning, tongue cleaning, and the use of mouth rinses both morning and evening. Sometimes, there can be a little more to it, with bad breath being caused by conditions such as gingivitis or periodontal disease, but again these are all oral causes that we’re trained to both identify and treat at the practice. In total, it’s estimated that between 65 and 85% of halitosis cases are the result of problems arising on the tongue or in the parodontium area of the mouth. 

Non-Oral Halitosis

The remaining 15 - 35% of halitosis cases can be a little more tricky to manage. While it is statistically most likely that non-oral causes are minor, it can’t be overlooked that bad breath can indicate very serious localized or systemic conditions. Diabetes, liver failure, and lung diseases such as respiratory infections and cystic fibrosis can all present with bad breath as one of the most prominent symptoms. 

Perhaps even more incredibly, MIT reports that bad breath can also signal lung cancer. It has been found that, in some cases of lung cancer and some forms of lung infection, bad breath can present as the first noticeable symptom. This occurs long before fever, cough, or chest pain are experienced by the patient. 

Knowing What to Look For

While we are not trained to diagnose or treat these types of conditions, as dentists it is essential that we understand that oral symptoms are not always indicative of oral health or oral conditions. Knowing what’s normal — and what’s not normal — in the presentation of halitosis really could save a life. 

Here are two of the most common indicators that halitosis has a non-oral cause:

  • Acetone / Nail Polish Remover

If a patient’s breath smells like nail polish remover, it should be recommended that the patient makes an appointment with their physician to have their blood sugar levels checked. In cases of diabetes, diabetic ketoacidosis occurs when there are very high levels of ketones in the blood, resulting in a greater odor. Ketones have a strong smell which is most commonly associated with nail polish remover. That’s because many nail polish removers contain acetone, a form of ketone that’s often used for cleaning purposes. 

  • Sweet / Musty / Perfume

If a patient’s breath smells somewhat perfumey, with a definite sweet and musty aroma, it may be that the cause isn’t due to ketones, but to limonene. Studies have found that those suffering from liver disease have more of the chemical compound limonene in the body than healthy individuals. The link is so strong that limonene is on track to be used as an official biomarker for early stage liver disease. With symptoms rarely presenting in early stages, bad breath could be key to more timely diagnostics. 

Share, Don’t Scare

The most important aspect to keep in mind is that different odors smell different to different people, so even if you do identify an unusual smell on your patient’s breath it does not always mean there is cause for alarm. If there is uncertainty as to the cause of bad breath, or halitosis is not responding as expected to common forms of treatment, advise your patients to visit their physician for further examination.

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Is Your Dental Practice Ready for Halloween?

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Is Your Dental Practice Ready For Halloween?

Halloween is right around the corner, and for dentists it can definitely be one of the most frightening times of the year! According to IHS Global Insights, Halloween candy sales now exceed $3.8 billion, and a whopping 94% of American children go trick-or-treating based on figures published by the American Dental Association (ADA). Yet the ADA also reports that less than half of kids brush twice a day. Yuck. 

So it’s really not that surprising to learn that emergency dental appointment rise by 80% on Halloween, with more people requesting appointments on the 31st than any other day in October. That’s according to Sikka Software, who analyzed appointment bookings for 13000 practices in the US...

Spooky stuff indeed! 

Preparing for Halloween

Of course, Halloween poses a bit of a dilemma for dentists. On the one hand, we’re trained to advise against sugary snacks. On the other hand, it’s important to keep our patient base — particularly the little ones — satisfied with their visits. Because of this, around 60% of all dentists in the United States will hand out candy to their patients. Dental insurance firm Delta Dental estimates that 5% hand out toothbrushes, and 25% don’t give anything at all, which isn’t particularly festive of them!

Getting into the spirit of the celebration is important for many practices, but what’s surprising is that around 13% of dentists are giving out hard candies and lollipops… not exactly the best choice in terms of oral hygiene. Fortunately, the majority give out chocolate, which clears more quickly from the mouth to minimize the risk of decay. Other good snacks to hand out, according to research by the Forsyth Dental Center, include certain ‘sticky’ foods, such as caramels, which clear quicker than dried fruits and chips and far quicker than the aformentioned hard candy offenders. 

Think it’s just children that you need to keep an eye on over the spooky season? Think again! The National Confectioners Association confirms that three quarters of adults buy Halloween candies for their households (happily eating what they don’t give away), and 72% tuck into their children's swag. 

The Silver Lining

Halloween is rarely a dentist’s favorite time in the holiday calendar, but there is a bright side to this traditionally candy-fuelled occasion. Halloween is an excellent time to educate your patients not only about caring for their teeth, but also about disease prevention and about making healthy choices.

Here are some great tips to make the most of a tricky holiday:

  • Show kids — and their parents — that good oral hygiene isn’t about avoiding sweet treats at Halloween, but about choosing better options (like chocolate) and brushing well afterwards. 

  • Don’t be afraid to ‘scare’ your younger patients with a few dental-related Halloween horror stories. Nothing too frightening, of course, but this is a holiday based on ghouls and goblins!

  • Do hand out some Halloween treats, but remember that there are non-candy alternatives that kids will love, such as themed coloring sheets and even spooky stickers. 

  • And finally, use the holiday as an excuse to reinforce good behaviors and ensure that all your patients understand the best ways to care for their teeth at home and reduce the risk of damage. There are learning moments everywhere at this time of year!

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