Injuries with a drill?

[LeagueofLigTies]

So this might be a stupid question.. I’m a D1 and haven’t started operative/sim lab yet- I don’t know much about drilling. Out of nowhere I’ve just developed this fear of my hand slipping when using something like learn a prep, hitting my fingers for example, and injuring myself or a would-be future patient. I know the drill runs at an insanely high RPM. Can anyone weigh in on this? Am I just being irrational or could a drill do some serious harm? (We start operative towards the end of this year)

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[Ivy.ch]

Yes, damage can be done. You need a finger rest - usually your 4th and 5th digits - to stabilize the drill, so if a patient moves, the drill moves with them.
To alleviate your fear a bit, although the drills have high speeds, they have poor torque. If your foot isn’t on the pedal, and the bur contacts something, it quickly decelerates.

 

[Big Time Hoosier]

Yes, damage can be done.

Especially watch the floor of the mouth.

Big Hoss

 

[oralcare123]

Damage can result from stupidity of operator or stupidity of the patient. With operator it is easy - fulcrum, or finger rest either on teeth or facial bones or something else if in the lab. Patients. They are the cause of heart attacks. Some just fall asleep on you and close their mouth on working handpiece. Please use mouth prop, use floss to secure it - some manage to swallow mouth prop. Yeah, fun

 

[dPseh]

They can do damage and oralcare123 is correct in that operator error can easily be remedied, but patients are hard to control. Here are a couple personal anecdotes:

1) had a young man come in for some anterior fillings. He fell asleep with a bite block in his mouth, so no big deal, right? Except in his slumber, he suddenly jerked his head and the bur cut his upper lip - maybe about a 2-3mm laceration. Gauze and pressure, finished the fillings and sent him off.

2) had a #17 crown prep without an assistant (the office had only one and she ran off to lunch). Guy had a huge tongue, and while I was struggling to prep, he swallowed, and whoops, bur cut a huge hole in the tissue posterior to #17 and bleeding ensued. That was a nightmare.

3) slow speeds can do damage too! Was polishing a filling on a lower molar with a pogo/enhance polisher, patient swallowed yet again and whoops, cut a little bit of the floor of mouth. Polishing discs can also cause major damage.

So the take aways are:
1) fulcrum/finger rest
2) always work with an assistant on lower posteriors. And if you’re an associate at an office that doesn’t have enough assistants, then gtfo.
3) polishing burs and discs on the slow speed can do lots of damage if you’re not careful.

 

[TanMan]

For some reason, I've never damaged the floor the the mouth. Usually, what gets me is the lateral border of the tongue or cheek. Sometimes, the upper lip from polishing discs too. As long as the soft tissue damage is not visible, they aren't prone to scarring, and bleeding is controllable, you should be fine. Most soft tissue lacerations and injuries heal well. Most patients also think that they bit themselves and it's their fault.

 

[LeagueofLigTies]

Thanks everyone!

 

[DrJeff]

For some reason, I've never damaged the floor the the mouth. Usually, what gets me is the lateral border of the tongue or cheek. Sometimes, the upper lip from polishing discs too. As long as the soft tissue damage is not visible, they aren't prone to scarring, and bleeding is controllable, you should be fine. Most soft tissue lacerations and injuries heal well. Most patients also think that they bit themselves and it's their fault.

Agree with this 100% and has been my experience as well