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High Speed Handpiece Connections: All About Couplers & Chucks

High Speed Handpiece Connections


As a dental practitioner, your high speed handpiece is arguably the most important piece of dental equipment in your operatory.  


But the connective components that complete your high speed handpiece ‒ couplers and chucks ‒ are as important to your practice as the handpiece itself.  


There is a wide variety of high speed handpiece coupler and chuck configurations on the market, and knowing the differences is key for a smooth and efficient practice.  


Here’s what you need to know about high speed handpiece couplers and chucks.


1. What is a Dental Handpiece Coupler? 

2. Types of High Speed Handpiece Couplers 

  • ISO-A or Borden Connection 
  • ISO-B or Midwest Connection 
  • ISO-C or New Style Coupler 
  • Quick Disconnect Coupler 

3. What is a Dental Handpiece Chuck? 

4. Types of Dental Handpiece Chucks 

  • Manual Chuck 
  • Auto Chuck 

5. Choose Your Connections Carefully


1. What is a Dental Handpiece Coupler?


A coupler (also known as a coupling) is an attachment for high speed handpieces that connects it to the dental unit in order to supply air, water, and (optionally) light to the handpiece.  


High speed handpiece couplers do not contain moving parts ‒ they simply connect the handpiece to the dental unit. Couplers do not come into direct contact with a patient at any point during a procedure.  


High speed handpiece couplers are available with different tubing connection configurations. Knowing what back end and coupler your high speed handpiece uses is very important, as this determines whether it will fit the dental unit you currently have.  


We’ll explain more about the types of dental handpiece couplers next.


2. Types of High Speed Handpiece Couplers


The International Organization for Standardization (ISO), which issues medical, industrial, and commercial standards worldwide, has established specific standards for three types of high speed handpiece coupler configurations:

  1. ISO-A or Borden Connection 
  2. ISO-B or Midwest Connection 
  3. ISO-C or New Style Connection

Most dental handpieces have a fixed back end that uses one of these three standardized couplers, but there are important exceptions you should know.  


The following sections will cover ISO standardized couplers and quick disconnect couplers.


a) ISO-A or Borden-Type Connection


ISO-A couplers, better known as Borden Connection, come in 2 or 3-hole configurations that connect the high speed handpiece and dental unit. There is a large hole for air intake to drive the turbine and a smaller hole for water to cool the bur. The third smaller hole is for water atomizing.


ISO-A couplers


Handpieces with a Borden connection do not have an air exhaust port, so the air blows directly out of the handpiece, which makes the handpiece much louder than other types. 


Borden connections are most widely used in Latin America and Europe. These handpieces are not commonly used by Canadians or Americans in dentistry today.


b) ISO-B or Midwest Connection


ISO-B connection, better known as Midwest connection, come in 4 or 5-hole configurations. In most cases, Midwest couplers have at least 4 holes, which are used for:

  1. Air intake to drive the turbine 
  2. Air exhaust, which reduces noise from the handpiece  
  3. Water spray to cool the bur 
  4. Chip air, which mixes with the water spray to create a “mist”

ISO-B connection


A fiber optic lighting connection can be made through the optional fifth hole. In order to meet ISO standards, 4-hole Midwest couplers include a "dimple" in place of the 5th hole. 


Midwest connection are the most popular of the three types of dental handpiece couplers used by dental practitioners in the United States and Canada.


c) ISO-C or New Style Coupler


ISO-C couplers, often referred to as “new style” couplers, function similarly to ISO-B or Midwest couplers. Like the Midwest models, ISO-C couplers have holes for:

  1. Air intake 
  2. Air exhaust 
  3. Water spray 
  4. Chip air 
  5. Fiber optics (optional)

ISO-C couplers


However, new style couplers include a 6-pin handpiece or lamp module connection set in the same position as the 5th hole on an ISO-B or Midwest coupler.  


ISO-C is the newest standard for handpiece couplers and most new dental units comply with it. While ISO-B couplers still remain the most popular, more and more manufacturers are starting to use six pins in their dental handpieces. It is also possible to attach an ISO-C coupler to an older 4-hole ISO-B handpiece.


d) Quick Disconnect Coupler (like KaVo MultiFLEX)


Today, many handpieces feature a quick disconnect back end instead of a fixed one.  


Handpieces with quick disconnects allow for quick and easy removal from the dental unit to boost your efficiency, such as KaVo’s MultiFLEX and Sable Industries’ Highspeed handpieces.


Quick Disconnect Coupler


However, quick disconnect back ends are not ISO standardized. Since most manufacturers use proprietary back ends, you can generally only use a quick disconnect handpiece with a quick disconnect coupler from the same manufacturer.  


Sable Industries is one of few Canadian dental suppliers to offer KaVo MultiFLEX compatible 4, 5, and 6-hole replacement couplers.


3. What is a Dental Handpiece Chuck?


The chucking mechanism, also called a chuck or collet, is the component at the head of the handpiece that holds its bur in place. The bur is the cutting tool that spins with the turbine to cut or carve teeth.


4. Types of Dental Handpiece Chucks


There are two basic types of chucking mechanisms: manual chucks (also called standard or wrench chucks) and auto chucks (also called push button chucks).


Manual Chuck 

A manual chuck or wrench chuck opens and closes as you push it back and forth. The bur is threaded into place and tightened with a specialized bur wrench, which is also used to loosen and remove the bur.  


Manual chucks are generally less expensive and easier to repair than auto chucks, but changing burs is more time consuming and difficult than it is with an auto chuck.


Auto or Push Button Chuck 


An auto chuck or push button chuck is spring-loaded, opening and closing at ease with the push of a small button. With proper use and maintenance, high-quality auto chucks hold the bur just as securely and reliably as a manual chuck. 


Auto chucks are more convenient and thus much more popular than manual chucks. However, repairing the auto chuck is difficult and usually requires replacing the chuck and spindle entirely. Be sure that your repair technician uses only FDA and Health Canada approved dental handpiece repair parts.


Choose Your High Speed Handpiece Connections Wisely


The coupler and chuck are two connective components that complete your high speed handpiece. Consider their features and compatibility carefully before you make your next order from your Canadian dental supplier. 


Our team is always happy to answer any questions you may have about our high speed handpieces or dental handpiece replacement parts. Feel free to contact us and we will get back to you as soon as possible.

Generic Administrator at 5:33 AM
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What is a High Speed Handpiece? How it Works, Speed & More

High speed dental handpieces are highly versatile instruments used in a wide range of procedures across all branches of dentistry. They are, without a doubt, one of the single most important tools in a practitioner's proverbial toolkit. 


As a dental professional, it is essential that you understand the different types and functions of various high speed handpieces. 


So we’ve prepared an introductory guide to everything you need to know about high speed handpieces: what they are, how they work, how fast they spin, and more.


  1. What is a High Speed Handpiece?  
  2. How Does a High Speed Handpiece Work? 
  3. What is a High Speed Handpiece Used For? 
  4. High Speed vs. Slow Speed Handpieces 
  5. How Fast Does a High Speed Handpiece Run? 
  6. How Long Will a High Speed Handpiece Last? 
  7. Maintenance of High Speed Handpieces 
  8. What to Know Before Buying a High Speed Handpiece Online

1. What is a High Speed Handpiece?



A dental handpiece, or dental drill, uses a rotating bur to precisely remove tissue in the mouth. ‘High speed’ describes any handpiece that runs at speeds of between 300,000 and 450,000 RPM.  


Most high speed handpieces are powered by air, but electric high speeds are also available. About 76% of dentists use air turbine handpieces, 16% use electric, and 8% use both. This article will focus on air driven high speeds. 


All high speed handpieces have two main parts: the body or shell and the turbine. High quality handpieces have a stainless steel or titanium body.  


Lower-quality handpieces are made of brass, which is lighter and cheaper to manufacture. Brass is weaker, more susceptible to wear, and unable to withstand repeated sterilization cycles than stainless steel or titanium.  


Dental high speed handpieces come in a variety of designs, but all run between 300,000 and 450,000 rotations per minute. Different models can be distinguished by its attachment type, head size, light source, weight, and motor noise.


2. How Does a High Speed Handpiece Work?


Most high speed handpieces are air driven. Air flow is activated by a chair unit foot control, moving up the airline attached to the back end of the handpiece, and into the handpiece head where it is forced over the turbine's impeller. This rotates the cutting bur.  


Exhaust air is then expelled through the handpiece's back end. 


Note that a handpiece's maximum speed is not related to its power or torque; a handpiece with a larger head and a larger turbine operates at a slower speed, but delivers greater torque and power than a handpiece with a smaller head. 


Because the bur rotates so fast, high-speed handpieces generate a lot of heat. To counter this heat, high speed handpieces feature cooling water sprays. However, the water spray also makes it harder to see; so many high speed handpieces feature fiber optics to improve visibility.


3. What is a High Speed Handpiece Used For?



High speed handpieces remove tooth tissue precisely and easily, making them ideal for a wide range of applications. 


These instruments are commonly used to remove enamel, dentin, and filling materials efficiently, and polish restorations effectively. 


4. High Speed vs. Slow Speed Handpieces


Slow speed handpieces are precision tools with an important clinical purpose, just as their high speed counterparts. But in contrast to high speeds, slow speed handpieces perform heavier duties at slower speeds. 


Slow speed handpieces run between 5,000 and 40,000 RPM and are used to remove cavities and prepare teeth for restorative work, along with other orthodontic procedures. 


High speed handpieces, on the other hand, run between 300,000 and 450,000 RPM and are used to cut tooth enamel, dentin, and filling materials.  


To learn more, check out our article on the differences between high speed and slow speed handpieces.


5. How Fast Does a High Speed Handpiece Run?


High speed handpieces operate at speeds between 300,000 and 450,000 RPM. 


The turbine's speed varies depending on air pressure and the diameter and configuration of its components (bearings, impeller, etc.) 


For example, at 40.5 PSI, an average sized turbine (such as the Sable Access Pro-KL) should spin at approximately 350,000 RPM. 


High speed handpieces differ in their cutting speed (or Active Speed) and rotational speed (or Free Speed). There is usually a 30% difference between the slower cutting speed and the faster rotating speed.


6. How Long Will a High Speed Handpiece Last?



High speed handpieces contain many components with various lifespans. In a high quality handpiece, each of these individual components is designed to be easily replaced to extend the life of the handpiece.  


According to one recent study, a typical high speed handpiece will last approximately 500 sterilizations, or one year of clinical use, before it requires some repair work. 


It is important to use only high quality replacement parts when repairing your handpiece. In a perfect world, all parts would be high-quality. Unfortunately this is not the case, which is why you need to do your research before making any purchase. 

Replacement parts are not always the same quality as the original parts. It is important to know that some replacement parts are inferior in quality and can cause you to replace them sooner than they should be replaced.


7. Maintenance of High Speed Handpieces


Because dental handpieces are not cheap, you will want to extend their life as much as possible. Having a consistent dental handpiece maintenance program is a surefire way to make sure these instruments perform at their best. 


You don't need to be a rocket scientist to maintain your high speed handpiece, but it does require diligence and effort. 


You could write entire books about all the ins and outs of high speed handpiece maintenance, but there are a few key points that apply to virtually every one: 

  1. Don’t increase the air pressure beyond what the manufacturer recommends 
  2. Use only manufacturer-approved, premium quality handpiece repair parts 
  3. Avoid using strong chemicals to clean your handpiece 
  4. Apply handpiece lubricating oil generously 
  5. Run the handpiece for 30 seconds or do an air flush after lubricating 
  6. Remove the bur before lubricating and purging your handpiece 
  7. Keep lubricant out of the air drive hole 
  8. Clean fiber optics 
  9. Remove the bur and release chuck levers before sterilizing your handpiece 
  10. Check, clean, and lubricate the chuck separately

Handpieces are used so frequently that their accuracy and efficiency have a great impact on practice overhead. A malfunctioning, worn, or outdated handpiece can negatively impact production, efficiency, and accuracy of procedures. Learn more about keeping your high speed running smoothly in our 10-point checklist for dental handpiece maintenance.


8. What to Know Before Buying a High Speed Handpiece Online



Not all high speed dental handpieces are created equal so there are some things you should consider before making a purchase. Using these tips, you can choose reliable products that won't fail you (or your patients):


  1. Verify FDA Approval: Before becoming an FDA-listed Class 1 medical device, dental tools, such as handpieces, must undergo a rigorous 510(k) FDA clearance process. This is the #1 indicator that a manufacturer and its dental products are credible and reliable. In Canada, handpiece manufacturers must also contain Health Canada Establishment License and medical device licenses.
  2. Buy from Reputable Sources: The number of counterfeit dental products being sold over the internet is at an all-time high. Price gaps are a red flag: if something is sold for $200 on one platform and $1,500 on another, that's a warning sign. Buying from overseas discount sites or eBay is never a good idea. Only buy from trusted dealers and distributors.  
  3. Don’t Be Fooled by Savvy Marketing Campaigns: Instead of focusing on marketing hype, focus on specifications (e.g., torque power, bur concentricity, noise, warranty length, and price).

If the above fundamentals aren’t there, then it’s buyer beware! Keep these in mind and make an honest appraisal of what types of procedures you actually perform in your practice before investing in any new high speed handpiece.


Still Have Questions About High Speed Handpieces?


Today’s dentists have access to a wider array of efficient, easy-to-use, and precise handpieces than ever before! If you’d like to learn more, our team is always happy to answer any questions you may have about our high speed handpieces. Contact us now and we’ll get back to you as soon as possible.

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