tips on drilling

[pickaychu]

hi!
i’m on week 5 of D1 and we have been drilling for awhile now. at first, with the easier preps i have done fine, but we’re doing a bit more complicated ones now and i’m noticing myself falling behind.

every time i do my preps (specifically on molars) i find myself going a tad too deep, not being able to get my walls to converge/diverge, and everything is super rough and sloppy looking. my school has us primarily using a 330 bur but i feel like every time i go to fix something, i take off a chunk or go far too deep.

does anyone have tips for drilling? i’m trying to not be too self critical because i’m so new to it but i hate feeling like i’m falling behind my peers.

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[DMD12345]

I am by no means a pro, but I sympathize with you completely. I had the exact same problems as you and now I'm a lot better and pretty comfortable with pre-clinic preps. I was using the 330 but when I switched to the 330Diamond it fixed a lot of the problems. It's straight up and down so it doesn't leave the side walls rough (I feel like since the 330 is flared out to create convergent walls, when you drill deeper than the height of the burr it leaves horizontal lines and roughness), but we're allowed to have our prep walls convergent *or* at 90 degrees so the 330D bur is acceptable for us.

Going too deep: some people like depth cuts, some just draw back and fourth. I like the latter. Find which you prefer. Pay attention to the depth your bur has gone in and frequently check with your perio probe in the beginning to really get a sense of the depth. It's hard because if you go to the correct depth, then when you're making the prep wider you'll probably accidentally deepen it too in the beginning. Then if you make it the right width and then go for depth, you'll likely widen it. Try making the depth short of your target then make the width just short of your target so you have a little room for error on both ends, then go cut them a bit more if you haven't already accidentally done so. Also turn your RPM down. I brought mine down to 80k and it helped a lot until I got more proficient. I was in awe at how profs could just come over and drill at 200K with such ease and they weren't going too deep or too wide, but now a year later I've realized I've gained a lot of hand control and that's probably what it is. It develops over time. So keep this mindset in mind; while you're drilling, focus on precisely *controlling* your hand and your bur and *putting it where you want*, don't have the mindset of pushing your burr around. That's probly my best piece of advice.

The small hatchet is my favorite tool, especially in the beginning when my hand control wasn't great with the handpiece. So you can use that to more controllably adjust things, though it doesn't always leave things perfectly smooth like burs.

As with anything, but this especially, it just takes a lot of practice. You'll get a lot better over time, especially once you find burs and techniques/strategies that you like. Oh another thing is keeping your handpiece parallel to the long axis of the tooth. In the beginning this was hard to do but you get a lot better at it and once you do it helps make the prep look *a lot* better.

 

[Lemillion]

My two cents: ask the faculty which 2nd year was one of the “good” ones with hand skills and did well with the operative course.

Approach that student and ask for pointers. I did that and it jump started me as he had great tips that reduced my learning curve versus figuring stuff out on my own.

 

[schmoob]

Don’t hold the handpiece too tight and see if a finger rest helps. Fresh burs and sharp hand instruments. Use the the cutting surface of the 330 as a guide to how deep you should go.

Like all things it takes lots of practice. Imagine what your 2nd grade handwriting looked compared to now. You’ve been a dental student for only a month so don’t be too hard on yourself. I hope that it will give you reassurance that when I work on real teeth I absolutely never use hand instruments. A decayed tooth cuts very differently from plastic and no one cares how deep or converged your walls are as long as you get the decay and fill the tooth properly. Keep practicing and you will get it.

 

[pickaychu]

I am by no means a pro, but I sympathize with you completely. I had the exact same problems as you and now I'm a lot better and pretty comfortable with pre-clinic preps. I was using the 330 but when I switched to the 330Diamond it fixed a lot of the problems. It's straight up and down so it doesn't leave the side walls rough (I feel like since the 330 is flared out to create convergent walls, when you drill deeper than the height of the burr it leaves horizontal lines and roughness), but we're allowed to have our prep walls convergent *or* at 90 degrees so the 330D bur is acceptable for us.

Going too deep: some people like depth cuts, some just draw back and fourth. I like the latter. Find which you prefer. Pay attention to the depth your bur has gone in and frequently check with your perio probe in the beginning to really get a sense of the depth. It's hard because if you go to the correct depth, then when you're making the prep wider you'll probably accidentally deepen it too in the beginning. Then if you make it the right width and then go for depth, you'll likely widen it. Try making the depth short of your target then make the width just short of your target so you have a little room for error on both ends, then go cut them a bit more if you haven't already accidentally done so. Also turn your RPM down. I brought mine down to 80k and it helped a lot until I got more proficient. I was in awe at how profs could just come over and drill at 200K with such ease and they weren't going too deep or too wide, but now a year later I've realized I've gained a lot of hand control and that's probably what it is. It develops over time. So keep this mindset in mind; while you're drilling, focus on precisely *controlling* your hand and your bur and *putting it where you want*, don't have the mindset of pushing your burr around. That's probly my best piece of advice.

The small hatchet is my favorite tool, especially in the beginning when my hand control wasn't great with the handpiece. So you can use that to more controllably adjust things, though it doesn't always leave things perfectly smooth like burs.

As with anything, but this especially, it just takes a lot of practice. You'll get a lot better over time, especially once you find burs and techniques/strategies that you like. Oh another thing is keeping your handpiece parallel to the long axis of the tooth. In the beginning this was hard to do but you get a lot better at it and once you do it helps make the prep look *a lot* better.

this was beyond helpful thank you so much. i’ve asked around and most others have encouraged me to try the 330D. i’ll try that next week. thanks again!!

 

[pickaychu]

Don’t hold the handpiece too tight and see if a finger rest helps. Fresh burs and sharp hand instruments. Use the the cutting surface of the 330 as a guide to how deep you should go.

Like all things it takes lots of practice. Imagine what your 2nd grade handwriting looked compared to now. You’ve been a dental student for only a month so don’t be too hard on yourself. I hope that it will give you reassurance that when I work on real teeth I absolutely never use hand instruments. A decayed tooth cuts very differently from plastic and no one cares how deep or converged your walls are as long as you get the decay and fill the tooth properly. Keep practicing and you will get it.

thank you! i’ll try and give myself a bit more leniency. it’s just hard when everyone learns at a different pace.

 

[DMD12345]

this was beyond helpful thank you so much. i’ve asked around and most others have encouraged me to try the 330D. i’ll try that next week. thanks again!!

Let us know how things go later on down the road👌🏻

 

[Faefly]

to avoid mistakes, you have to be conservative and slow and have a good finger rest. One hand on the *handpiece*, the other hand is resting and stablizing the typodont. Always use a pencil to mark where your prep starts and ends. Use the small condensing instrument that is 1.5 mm in length to measure your depth, once you reached 1.5 mm, use a slow speed with friction grip to smooth the edges and go * about 0.3* mm more deeper.

I am saying slow, but eventually you'll be faster.
Every saturday/sunday, go to school, practice on 6 teeth, time yourself, evaluate your prep, then show it to others.

So your hw for tomorrow (sunday)
Drill 3DO on #3 or #14 and 3 MO
Drill 3 MOD on #19 or #30
Time for each prep is 45 min for now, then make it shorter for the last prep of the day (35 min)

*Sorry I found typos, I corrected them now (one hand on hand piece not the bur, and after you switch to slow speed, you go 0.3 or 0.2 mm deeper not 1 mm lol*