Numerous studies over the last decade have reported high rates of shoulder and wrist injuries among dental health-care workers.1-6 Females and dental hygienists are particularly susceptible to musculoskeletal injuries in these areas of the body.1–6 Working long hours or using an instrument that is the wrong size also contributes to increased risk.5–6
It’s been 21 years since the first cordless polisher was introduced.7 Devices have come and gone, but over time, more and more clinicians are appreciating the value of a lightweight, balanced handpiece with no tightly coiled, hose-end connection.8
Six different cordless polishing handpieces are available on the market today. Designs vary, but the devices all use rotating prophy cups and brushes to remove stain, disrupt supragingival biofilm, and apply paste-based desensitizing medicaments. It is important to understand the design nuances to determine if a specific polisher will meet individual clinical requirements. Figure 1 summarizes the details for all current polishers.
Trust what your hands tell you
Many office treatment rooms feature a one-size-fits-all layout, with every treatment room a carbon copy of the one down the hall. Typically, these designs favor right-handed clinicians. Cordless devices eliminate one more challenge for lefties, who make up 10% of the population, and reduce hand, finger, wrist, and elbow strain.8,9 The ability to be untethered to a hose of any weight is even more important for a leftie.
The gripping details
Polishers come in different sizes, shapes, and diameters. Getting the right polisher is all about what works for you! A cordless device that fits someone with a very petite hand is not the best option for a clinician who wears an XL glove. Each tool’s exact weight, diameter, and length is detailed in the chart. Adding a disposable prophy angle increases overall length.
Balance is critical. This is the point where the device sits comfortably in the area between your thumb and your palm. A balanced device feels natural and allows the lightest grasp possible. A device with a fingertip swivel makes it easy to reposition the cup without changing wrist position.
Handpiece surface texture is very important. After all, it’s hard to hold on to a smooth surface in a moist environment. Texture equals traction, and this can be accomplished in a variety of ways: silicone grips, metal surface projections, cross-hatching, or a finely textured surface. The goal is to decrease the clinician’s pinch grip without sacrificing control.
Power controls and RPMs
Some feel cordless polishers are not powerful enough. Simply pressing down harder creates more hand strain without enhancing stain removal. The goal of polishing is not to remove industrial strength stains that have been around for years. It is easier to break up heavy stain with a power scaler and remove remaining bits and pieces with a polisher.
All cordless polishers use an on/off switch on the handpiece to initially activate the device, but this is where the similarity ends. The lowest RPM level on all polishers is 500, but the highest level is product dependent and ranges from 2,500 to 4,000 RPM.
Speeds are designed to be either discrete and incremental or continuously variable. Two of the cordless units feature both gradient and continuous variable speed options. The speed on one unit increases when more pressure is applied on the teeth.
Powering up, indicator lights, going to sleep
Cordless polishers use rechargeable lithium-ion batteries, and charging time varies per product from 90 minutes to two hours for a full charge. One unit has close to three and a half hours of polishing time. The remaining products report 60 minutes of operating time. Actual charging processes vary and include a cable plugged directly into the device, a charging stand or cradle that uses induction charging, and a direct-contact charging stand. Several units have a short 15–20-minute recharge feature—a huge benefit when the handpiece needs a quick boost.
Every device has its own color-coded indicator light system. Systems vary but can show the unit is charging, charge level, low power, polishing RPMs, and rheostat battery. Some lights are stationary and others blink.
Handpieces can have a sleep or standby mode that kicks in after a short period of inactivity to help prolong battery life. Some start back up at the last setting, while others default to the lowest RPM.
All rechargeable batteries have a finite lifespan. Contact the dealer if the battery quits working during the warranty period. Most units can have a replacement battery installed at the factory or an authorized repair center once the unit is past the initial warranty.
Details, details
It is critical to read the fine print. The warranty and instruction manual spell out the details. The longest product warranty is three years for both the handpiece and the battery, while the shortest is 12 months for the handpiece or sheath, and two years for the battery.
Most disposable prophy angles will work with all brands but one. There are pluses and minuses to each approach. The proprietary angle is specifically designed to operate with the device. To maximize performance, it is wise to use a high- quality, disposable angle on all other handpieces.
Several tools come with handpiece cradles or support stands. This provides a secure parking place when not in use, and is particularly useful in a busy practice or a crowded treatment room. Nothing is worse than the sound of an expensive piece of equipment hitting the floor.
Barriers and sterilization
Cordless polishers are sophisticated electronic devices. Moisture is an enemy. All recommend using a single-use disposable barrier that covers the entire motor or handpiece. Failing to do so increases the risk for a handpiece malfunction. Most systems also have an autoclavable sheath or nose cone that secures the barrier and provides a second layer of protection.
It is important to follow the manufacturer’s directions regarding barriers, surface disinfection, and which parts can be steam autoclaved. There are specific guidelines regarding surface disinfectants with step-by-step instructions for the exact process. Most manufacturers recommend alcohol-based, hospital-grade products. Some devices are autoclavable, others should be cleaned with the recommended surface disinfectant.
What is the final answer?
While it is important to get feedback from your colleagues, what works for one clinician may not be optimal for the next. Good luck in selecting your ideal cordless polisher. The most important thing is what feels right in your hand.
Click on the tool name below for a link to the product manual:
References
- Booyens SJ, van Wyk PJ, Postma TC. Musculoskeletal disorders amongst practising South African oral hygienists. SADJ. 2009;64(9):400-403.
- Hayes MJ, Smith DR, Cockrell D. Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students. Int J Dent Hyg. 2009;7(3):176-181. doi:10.1111/j.1601-5037.2009.00370.x
- Hayes M, Cockrell D, Smith DR. A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg. 2009;7(3):159-165. doi:10.1111/j.1601-5037.2009.00395.x
- Gandolfi MG, Zamparini F, Spinelli A, Risi A, Prati C. Musculoskeletal disorders among Italian dentists and dental hygienists. Int J Environ Res Public Health. 2021;18(5):2705. doi:10.3390/ijerph18052705
- Al-Mohrej OA, AlShaalan NS, Al-Bani WM, Masuadi EM, Almodaimegh HS. Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study. BMJ Open. 2016;6(6):e011100. doi:10.1136/bmjopen-2016-011100
- Feng B, Liang Q, Wang Y, Andersen LL, Szeto G. Prevalence of work-related musculoskeletal symptoms of the neck and upper extremity among dentists in China. BMJ Open. 2014;4(12):e006451. doi:10.1136/bmjopen-2014-006451
- Guignon AN. Putting a spin on polishing. RDH. September 2000. Accessed August 1, 2021. https://www.rdhmag.com/patient-care/in-office-preventive/article/16407282/putting-a-spin-on-polishing
- McCombs G, Russell DM. Comparison of corded and cordless handpieces on forearm muscle activity, procedure time and ease of use during simulated tooth polishing. J Dent Hyg. 2014;88(6):386-393.
- de Kovel CGF, Carrión-Castillo A, Francks C. A large-scale population study of early life factors influencing left-handedness. Sci Rep. 2019;9(1):584. doi:10.1038/s41598-018-37423-8
