While most laypeople tend to associate the high-pitched whine of a dentist's drill (or handpiece, as it is more properly known) with their sense of discomfort at being in the dentist's chair, the practitioner knows that among all his or her dental supplies, the handpiece is perhaps his or her most essential tool, and that its effectiveness is wholly dependent upon the design, material, and quality of the dental bur, the tiny cutting bit that spins in the drill body and actually does the work of removing material from a diseased or damaged tooth.
In order to work effectively, the dental bur must be of a shape that the practitioner finds most comfortable and that is best suited for the specific material to be removed. A good dental bur will remove material quickly enough to help the practitioner be as efficient as possible, yet not remove it so rapidly as to compromise the dentist's control. Beyond the shape of the dental bur, the material from which it is fabricated is also important. Materials used in dental bur manufacture include hardened stainless tool steel with a hard tungsten carbide coating, solid tungsten carbide, and stainless tool steel with a diamond coating. Each has its unique advantages and disadvantages.
The carbide-coated tool steel burs are typically the least expensive, and also have the shortest useful life, since the thin coating wears rather rapidly, and the bur cannot be effectively resharpened. These items are typically discarded after a single use, eliminating the need for sterilization. Solid carbides are markedly more expensive, but have a significantly longer useful life, as they can be resharpened at least a time or two before their contour is noticeably changed. While they must naturally be sterilized before being used on another patient, the carbide burs end up being the most economical type in the long run. Finally, diamond-coated burs offer aggressive yet controllable cutting, combined with good durability and long life. Although diamond dental burs, like carbide coated versions, cannot be resharpened, they still provide a relatively cost-effective alternative to clinicians who prefer not to be bothered with resharpening their tools.
Beyond the precision, controllability, and durability factors that must be considered when selecting the right tools to include in a clinic's inventory of dental supplies, the integrity of a dental bur's construction has a direct impact upon patient safety. Consider that a modern dental handpiece is capable of spinning the attached dental bur at a speed of 400,000 to 800,000 revolutions per minute (RPM). This is roughly one to two hundred times faster than a modern automobile engine is turning in a car traveling over one hundred miles per hour! The slightest weakness in the bur's construction could result in it coming apart, with pieces flying at the speed of a bullet inside a patient's mouth. One needn't stretch the imagination to realize the potential for tragedy in such a situation. Put within this perspective, those inexpensive dental burs begin to lose their appeal rather quickly. The prudent practitioner insists upon specifying quality, FDA- dental burs when placing a dental supplies order, because patients deserve no less.
