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NSK has re-engineered the turbine.
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And in doing so, they've got their hand pieces,
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the 990 and 890 up to 44 and 41 watts respectively,
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which provides a ton of torque.
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In a hand piece that's quite light and quite small.
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And that's a huge benefit.
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So suddenly I've got my new hand pieces.
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It's cutting it as about as efficient as an electric.
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It's smaller in size.
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It's lightweight, but the best benefit of this new hand piece
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is actually I can repair it on site.
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I take one little driver, unscrew the head,
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take the turbine, invert it, drop it out,
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drop a new turbine in, screw back on the top,
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and I'm back in business.
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So what's amazing about that is I used to have to send
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my old hand pieces out for repair.
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Three, four weeks, pay for shipping in each direction.
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Now with the 990 and 890, I can order a turbine,
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replace that instantly.
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Actually have a stock of them on hand, just in case.
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In four years of using the 990,
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I've replaced one turbine on about six hand pieces.
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Wow.
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So, God, guess what?
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It was up and running that day.
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Yeah.
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My goodness, this is failing.
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So that's really neat.
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The other thing they've done in the engineering on this,
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and you don't think about this, but an air-driven hand piece
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is nothing more than like a jet plane engine.
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When they turn off the engine,
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the turbine has to wind down and slow down.
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What's going on, everybody?
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I'm your host, John Stamper.
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Welcome to another episode here
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on the Beyond the Operatory Podcast,
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brought to you by the awesome team at Dental City.
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And as I may have shared with many of you,
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this podcast is all things dentistry.
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Some of our early episodes,
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we wanted to bring on individuals in the space
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that can help you in the dental practice
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with leadership and business.
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And where are we in the scope of hygiene and staffing
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and all those things?
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But we also know that in dentistry,
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which is really cool, is that products and services
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and technologies are a big part of what a dental practice
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uses in an effort to be able to take care of their patients.
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And so, Dental City has a lot of great relationships
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with companies.
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Today's episode is brought to you by the team at NSK.
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And I'm very excited to be with Dr. Mark Geisberger,
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who is a practicing dentist in Northern California.
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And Mark, there's not too many podcasts out there
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that actually talk about dental hand pieces,
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but we're going to dig into it.
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So I'm looking forward to it.
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And first of all, thanks so much for making the time to come on.
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Oh, John, I'm thrilled to be here.
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This is going to be exciting.
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I know hand pieces may sound mundane,
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but there's some kind of cool things
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that are going on in the hand piece world
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that I'm not sure every practitioner realizes.
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Yeah, well, I love that.
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And as you and I were speaking,
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I mean, I've been in dentistry for 21 years.
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I actually started selling the dental hand pieces.
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NSK actually was the brand that I worked in.
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And it really did, Mark, because I was a little bit unique,
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like a lot of reps, as you know,
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come into your practice, they're in and out,
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they take an order on the hand piece side.
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I got to spend a lot of time with the doctors in the team,
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especially if we had to install the electric hand pieces.
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And so to your point, I know and understand
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that it's what you use every day
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to do the work that you do.
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So it's an important piece of equipment in the practice.
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Absolutely.
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If my hand piece wasn't functioning,
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I'm not working that day.
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So that's the reality of the practice of dentistry, you know?
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It's got to be functioning and it's got to be spot on.
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I love it.
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So let's, I want to maybe kind of go in two different directions.
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I want to talk, when you as a clinician make a decision
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to look for the type of hand piece that you're going to use,
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what are some of the things that, you know,
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over the years have been important to you
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when it comes to that?
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So, you know, one of the most important things to me,
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honestly, in a hand piece selection
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from a clinical side is, of course, cutting efficiency,
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weight and really reliability.
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That's it.
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It boils down to, do I have a hand piece that cuts effectively?
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Is it reliable?
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And is it not so heavy that I get strained by the end of the day?
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That's especially true after practicing 35 years.
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To start to notice body parts responding
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to what goes on on a daily basis.
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So for me, those are really critical.
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Yeah, and then how about for your team?
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So for my team is easy setup, easy breakdown,
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easy sterilization process, easy maintenance.
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Some of these hand pieces require a lot of steps
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in lubricating and preparing them.
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And if they're not done properly, you have breakdown.
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You have repairs, premature repairs.
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So ease of use is a huge thing on the team side
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to manage hand pieces.
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All right, so the next direction I wanted to go
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is I want to talk a little bit about the difference
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between air driven and electric.
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Right, air driven is what we've known for so many years.
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Of course, before that was belt driven, right?
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A different generation from you and I,
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but the standard issue air driven hand piece,
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obviously like a staple in a dental practice.
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So we'll start there and then I want to get into electric.
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But what is it about the air driven hand piece
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that you still like to have?
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I mean, I know that there are practices
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that may go exclusively electric for a host of different reasons,
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but I don't know what your practice makeup is,
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but do you have both?
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And on the air driven side, like what do you like
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and how do you like to use an air driven hand piece?
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So I intend to answer your question, I have both.
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And there's a reason I have both.
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Electrics and we'll get to those, have their benefit.
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Air driven, however, are light, they're efficient.
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The head size tends to be smaller.
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So in all honesty, there are cases, clinical cases,
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say on a second molar with a patient
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that has limited opening, where it is literally impossible
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to get an electric hand piece in there.
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Need a small hand piece that will fit into the operating area.
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The other thing about an air driven hand piece
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is for me, it allows me to control my refinement skills
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a little better than electric hand piece.
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So there have been some new advances in air driven hand pieces
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that now really make them a player again in a marketplace
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that's really been kind of moving towards electric.
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A lot of Dell schools have transitioned to electrics,
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but now they're saying, hey, maybe keeping some air driven hand pieces
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for limited situations is a good idea.
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One of the issues with air driven hand pieces, of course,
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is turbine issues where turbines go out
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and they require repair and maintenance.
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But NSK has got a solution to that
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and they're new 990L hand piece
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and we can talk a little bit about that.
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Yeah, let's do it.
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So one of the interesting things
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with some of the modern hand pieces is,
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they've been re-engineered, NSK has re-engineered the turbine.
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And in doing so, they've got their hand pieces,
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the 990 and 890 up to 44 and 41 watts respectively,
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which provides a ton of torque in a hand piece
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that's quite light and quite small.
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That's a huge benefit.
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So suddenly I've got my new hand pieces,
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it's cutting it as about as efficient as an electric.
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It's smaller in size, it's lightweight,
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but the best benefit of this new hand piece
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is actually I can repair it on site.
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I take one little driver, unscrew the head,
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take the turbine, invert it, drop it out,
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drop a new turbine in, screw back on the top
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and I'm back in business.
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So what's amazing about that is I used to have to send
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my old hand pieces out for repair.
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Three, four weeks, pay for shipping in each direction.
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Now with the 990 and 890, I can order a turbine,
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replace that instantly,
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actually have a stock of them on hand just in case.
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In four years of using the 990,
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I've replaced one turbine on about six hand pieces.
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Wow.
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So, bud, guess what?
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It was up and running that day.
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Yeah.
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My goodness, this is failing.
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So that's really neat.
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The other thing they've done in the engineering on this,
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and you don't think about this,
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but an air-driven hand piece
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is nothing more than like a jet-clean engine.
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When they turn off the engine,
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the turbine has to wind down and slow down.
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So, a clinician still realizes,
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as soon as they release the rear step,
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that burr continues to spin until it winds down.
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What NSK has engineered in the 990 series
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is a quick stop or anti-rotation quick stop valve.
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So basically, as soon as you release your foot
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from the rear step, the hand piece stops instantly.
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And that is a huge, huge benefit.
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So there are some really neat innovations
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with the newest air-driven hand pieces
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that really make you question your decision
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to move towards electrics.
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It's really true.
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I like lightweight, I like small hand pieces,
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I like accessible, I like the high torque,
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and I love the fact that I can refine my preps
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like I've done in the past.
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So there are just some really cool innovations
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still in air-driven.
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When the market said maybe they're done,
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I don't think so.
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They're not going anywhere.
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Yeah, that's pretty cool.
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And especially as you know,
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that switch from air-driven to electric
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is you're working on some of the newer materials.
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You're doing some more difficult restorations.
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The material is harder.
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And as you mentioned, it was like natural inclination
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to go to my electric hand piece.
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But I know in the conversations that I had with dentists
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over the years when I'd be in the practice
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talking about hand pieces,
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they shared exactly what you shared,
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which is if there was an ideal situation
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where I could have an air-driven hand piece
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where I felt like was good in my hand,
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it was lightweight, especially for some of the pieces
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that don't open up wide, back in the posterior,
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but then not lose out on the torque.
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That's a big piece of it.
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Of course, being able to change out those turbines is big.
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I'm curious how you were able to get those hand pieces
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don't have to change out that turbine so many times
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in prior years.
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That's pretty good.
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Yeah, it is really good.
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Okay, so here's one thing I've noticed about dentists
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in general, training so many dentists in my career.
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Dentists are sometimes pennywise and pound foolish.
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And what I mean by that is they'll use a burr
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until that last diamond particle is toast.
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And they'll sit there and spend a lot of time prepping teeth
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rather than switching on a burr.
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Now, I get it, burrs are expensive, a $10 a piece.
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With that said, the repair of a hand piece
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is far more expensive.
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What old burrs do is they wear down the turbine very quickly,
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because what you have to do to get old nasty burrs
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and been autoclaved a hundred times to cut,
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is you have to lean on the tooth.
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You put a lot of torque on the hand piece itself
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by just pushing harder on that burr.
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What that does is tax the turbine
260
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and you have premature turbine failure
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by not really managing your burr system well.
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So dentists would be wiser to switch out their burrs
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more frequently as I do,
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because what that leads to
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is far less turbine failure in the long run.
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So it's just a strategy that dentists don't think about
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what most institutions have done VAs and dental schools.
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For instance, they've gone to single use diamonds,
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single use carbides.
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And what they find is although that may be
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a little more expensive on the front end,
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it saves them money on the back end
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because they're not replacing turbines as frequently.
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So that's just a tip for the listeners to realize,
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sometimes you're just, you're shooting yourself in the foot.
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There's Johnny as an old figure.
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Well, and the other thing that I learned,
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which I'd love to get your thoughts on this,
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when you speak about making a little bit of an investment
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up front, is that I know that some of the sterilizers
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now are today's are probably better than they were
282
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20 years ago when I was out there.
283
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However, I did learn that that heat can tend to wear
284
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on those turbines much quicker.
285
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And so I used to speak with offices,
286
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and I love to get your thoughts on this,
287
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is that if you were only running two hand pieces
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through those autoclaves all day long,
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instead of maybe investing in a couple of more hand pieces
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so that they weren't having to run through the cycle
291
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as frequently, that was also something
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over the years that I had heard.
293
00:13:22.840 --> 00:13:25.160
So I don't know what your experience or thoughts
294
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have been on that.
295
00:13:26.000 --> 00:13:27.400
And that's just another example, like you mentioned,
296
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of maybe making a little bit of investment on the front end
297
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in an effort to extend the life of those turbines.
298
00:13:33.040 --> 00:13:34.840
Yeah, I think that's a great call.
299
00:13:34.840 --> 00:13:38.680
And you know what happens so much in the marketplace
300
00:13:38.680 --> 00:13:41.600
is companies, whether it's NSK or another hand piece
301
00:13:41.600 --> 00:13:45.120
will run specials, I too get one free.
302
00:13:45.120 --> 00:13:46.640
And as well, I just need one hand piece.
303
00:13:46.640 --> 00:13:49.360
Well, I really think what people should do
304
00:13:49.360 --> 00:13:53.640
is have a fairly large stock.
305
00:13:53.640 --> 00:13:58.640
I have eight hand eight NSK 990s that serve me in two
306
00:13:59.640 --> 00:14:01.200
operatories.
307
00:14:01.200 --> 00:14:03.160
And probably the reason I've only replaced one turbine
308
00:14:03.160 --> 00:14:06.200
with four years is because of exactly what you're talking about.
309
00:14:06.200 --> 00:14:07.520
Yes, it's a little more expensive,
310
00:14:07.520 --> 00:14:12.400
but I utilized promotions and say, okay, I'm going to purchase this.
311
00:14:12.400 --> 00:14:13.960
It's a wise time to move.
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00:14:13.960 --> 00:14:17.000
They're going to give me a two for or three for two
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or whatever this special they're running is
314
00:14:18.880 --> 00:14:20.680
and just be wise about it.
315
00:14:20.680 --> 00:14:21.920
Yeah, absolutely.
316
00:14:21.920 --> 00:14:24.800
All right, so literally our most important instrument
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we have are hand piece.
318
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Completely, right?
319
00:14:27.520 --> 00:14:30.200
I mean, that's what, you know, you can,
320
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that's what pays the bills in so many cases.
321
00:14:32.960 --> 00:14:34.520
I totally agree.
322
00:14:34.520 --> 00:14:36.760
All right, so let's move to electric then.
323
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Let's talk about what it is you love about electric.
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00:14:40.480 --> 00:14:41.880
Maybe a little bit about, you know,
325
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some of the features of the NSK electric hand pieces
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is providing you.
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00:14:46.880 --> 00:14:50.560
Again, I, you know, I was always very proud to represent that brand
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because it was a hand piece that I felt like when I would go back
329
00:14:53.360 --> 00:14:56.520
and talk to my doctors that built it into their practice,
330
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like they were getting great results.
331
00:14:58.480 --> 00:15:00.240
Love to get your thoughts on how you've used it
332
00:15:00.240 --> 00:15:01.680
and maybe some ideas for a doctor
333
00:15:01.720 --> 00:15:03.080
that has not moved to electric
334
00:15:03.080 --> 00:15:04.600
and where you see the benefit.
335
00:15:04.600 --> 00:15:06.760
Yeah, so as, as I mentioned earlier,
336
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I utilize both and when any procedure is going on,
337
00:15:10.040 --> 00:15:12.360
I have both a high speed air driven
338
00:15:12.360 --> 00:15:15.840
and high speed electric on the chair setup,
339
00:15:15.840 --> 00:15:17.720
which allows me to jump back and forth.
340
00:15:17.720 --> 00:15:22.720
But where I find myself really utilizing the electric systems
341
00:15:22.720 --> 00:15:26.120
is for things like cutting off circonia crowns,
342
00:15:26.120 --> 00:15:30.720
cutting off old PFMs, rough preparations,
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00:15:30.720 --> 00:15:34.440
getting things kind of started with that high torque.
344
00:15:34.440 --> 00:15:35.760
That's a huge benefit.
345
00:15:35.760 --> 00:15:39.160
If I have to section a tooth for an extraction,
346
00:15:39.160 --> 00:15:42.720
I'll use an electric hand piece to do that.
347
00:15:42.720 --> 00:15:46.720
Now, the trade off with electrics is yes, you get high torque,
348
00:15:46.720 --> 00:15:51.720
but all systems are heavier than their air-driven counterparts.
349
00:15:52.600 --> 00:15:54.920
That's just the nature of the beast.
350
00:15:54.920 --> 00:15:58.440
One of the benefits with NSK's electric
351
00:15:58.440 --> 00:16:03.440
is their motor itself is literally the smallest on the market.
352
00:16:04.880 --> 00:16:07.840
In addition to that, their electric hand pieces
353
00:16:07.840 --> 00:16:10.680
are the lightest on the market.
354
00:16:10.680 --> 00:16:13.280
So you look at 57 grams for their motor
355
00:16:14.160 --> 00:16:16.520
and that is a huge benefit.
356
00:16:16.520 --> 00:16:19.960
So I like their hand pieces because yes,
357
00:16:19.960 --> 00:16:21.920
they provide me with that high torque,
358
00:16:21.920 --> 00:16:24.280
but they're the lightest on the market.
359
00:16:24.280 --> 00:16:25.680
With their Japanese engineering,
360
00:16:25.680 --> 00:16:27.520
they simply don't fail on me.
361
00:16:27.560 --> 00:16:30.760
So there's lots of times like if I'm doing something
362
00:16:30.760 --> 00:16:34.120
as mundane as adjusting a partial denture framework,
363
00:16:34.120 --> 00:16:36.440
I want something with high torque.
364
00:16:36.440 --> 00:16:37.520
I'll go to the electric.
365
00:16:37.520 --> 00:16:40.720
I'm not gonna sit there with an air-driven hand piece
366
00:16:40.720 --> 00:16:43.880
because it's not gonna get the job done as efficiently.
367
00:16:43.880 --> 00:16:48.880
So I think there's a place in a general practice for both.
368
00:16:49.600 --> 00:16:50.960
Not one or the other.
369
00:16:50.960 --> 00:16:53.400
I've never thought that was a smart strategy.
370
00:16:53.920 --> 00:16:57.600
And doctors figure out when they use one or the other.
371
00:16:57.600 --> 00:16:59.200
I've had situations where I'm like,
372
00:16:59.200 --> 00:17:01.360
oh, I'm trying to cut off a crown on a second molar.
373
00:17:01.360 --> 00:17:03.840
And again, the electric doesn't fit.
374
00:17:03.840 --> 00:17:05.480
The patient can't open that wide
375
00:17:05.480 --> 00:17:09.840
and when you look at the size comparison of electric hand pieces
376
00:17:09.840 --> 00:17:12.600
to say an air-driven, that can be a problem.
377
00:17:12.600 --> 00:17:14.240
Now, NSK saw that.
378
00:17:14.240 --> 00:17:17.840
They've got the smallest lightest electrics on the market.
379
00:17:17.840 --> 00:17:22.560
So they're a great option when looking at electrics
380
00:17:22.560 --> 00:17:26.520
from an ergonomic standpoint and a functional standpoint.
381
00:17:26.520 --> 00:17:30.800
So with that said, though, the truth is,
382
00:17:30.800 --> 00:17:34.240
all electrics are larger than air-driven hand pieces.
383
00:17:34.240 --> 00:17:35.640
Yeah.
384
00:17:35.640 --> 00:17:38.640
Any other hand pieces that you use in the practice
385
00:17:38.640 --> 00:17:40.680
other than air-driven and electric
386
00:17:40.680 --> 00:17:43.000
or using slow-speed hand pieces
387
00:17:43.000 --> 00:17:45.440
or using the electric for some of your slow-speed cases
388
00:17:45.440 --> 00:17:47.240
or any other ancillaries that you use.
389
00:17:47.240 --> 00:17:52.240
So I've got my NSK lab motor in my lab.
390
00:17:52.760 --> 00:17:54.640
And that's generally a straight nose cone.
391
00:17:54.640 --> 00:17:56.680
That's where I take things in the lab
392
00:17:56.680 --> 00:17:58.120
and do my adjustments.
393
00:17:58.120 --> 00:18:00.480
It might be a partial dendro adjustment.
394
00:18:00.480 --> 00:18:04.400
It could be an implant adjustment, temporary contouring,
395
00:18:04.400 --> 00:18:08.440
all that is done in the lab with the NSK's lab motor
396
00:18:08.440 --> 00:18:10.800
with a straight nose cone attachment.
397
00:18:11.920 --> 00:18:15.520
In addition to that, I'm using their low-speed latch locks
398
00:18:15.520 --> 00:18:17.280
and straight nose cone,
399
00:18:17.280 --> 00:18:19.560
share side to do things like
400
00:18:19.560 --> 00:18:24.040
share side dendro adjustments or polishing restorations,
401
00:18:24.040 --> 00:18:27.520
those things, a restoration adjustment with, say,
402
00:18:27.520 --> 00:18:30.200
brasslers, dial light system,
403
00:18:30.200 --> 00:18:32.800
in a straight nose cone to adjust crowns.
404
00:18:32.800 --> 00:18:35.600
So I utilize a lot of their,
405
00:18:35.600 --> 00:18:40.120
their armamentarium in my practice.
406
00:18:40.120 --> 00:18:42.680
I, you know, honestly, I used to be with Cabo,
407
00:18:42.680 --> 00:18:44.920
which is a great hand piece company.
408
00:18:44.920 --> 00:18:47.440
I had a lot of repairs, a lot of repairs,
409
00:18:47.440 --> 00:18:48.840
a lot of downtime.
410
00:18:48.840 --> 00:18:50.200
And I really wanted a product
411
00:18:50.200 --> 00:18:52.440
that wasn't going to leave me high and dry.
412
00:18:52.440 --> 00:18:54.400
And that's kind of when I made the transition
413
00:18:54.400 --> 00:18:56.240
about five years ago.
414
00:18:56.240 --> 00:18:57.560
Yep, love it.
415
00:18:58.880 --> 00:19:00.880
Do you do endodontics or no?
416
00:19:00.880 --> 00:19:01.720
I don't.
417
00:19:01.720 --> 00:19:02.560
You don't, okay.
418
00:19:02.560 --> 00:19:03.400
No, okay. Yep.
419
00:19:03.400 --> 00:19:05.400
And then 35 years, not going to start now.
420
00:19:07.400 --> 00:19:09.720
My endodontist loves me because I send him everything.
421
00:19:09.720 --> 00:19:12.000
Hey, yeah, good for you, man.
422
00:19:12.000 --> 00:19:14.000
Yeah, well, I know I was going to ask,
423
00:19:14.000 --> 00:19:15.560
because obviously I know that they've got
424
00:19:15.560 --> 00:19:17.720
an endodontic hand piece for some of that as well,
425
00:19:17.720 --> 00:19:21.000
but we'll, we'll talk, we'll get an endodontist down
426
00:19:21.000 --> 00:19:21.840
to talk about it.
427
00:19:21.840 --> 00:19:22.680
There you go.
428
00:19:22.680 --> 00:19:23.520
That's the way to do it.
429
00:19:23.520 --> 00:19:25.040
Even though I know, I know a lot of them still like
430
00:19:25.040 --> 00:19:26.640
to use those hand files, which I totally get.
431
00:19:26.640 --> 00:19:27.480
Thank you.
432
00:19:27.480 --> 00:19:28.320
Right.
433
00:19:28.320 --> 00:19:29.160
So, yeah, love it.
434
00:19:29.160 --> 00:19:29.840
This has been great.
435
00:19:29.840 --> 00:19:31.200
Yeah, like I said, I really appreciate it.
436
00:19:31.200 --> 00:19:32.520
I mean, like, you know, like you mentioned,
437
00:19:32.520 --> 00:19:34.320
you know, the hand piece part is something
438
00:19:34.320 --> 00:19:37.480
that every practice has, but it's a big investment.
439
00:19:37.480 --> 00:19:40.280
It can be, but I love the fact that you brought up.
440
00:19:40.280 --> 00:19:41.520
It's what you guys use.
441
00:19:41.520 --> 00:19:42.520
It's your, it's your tool.
442
00:19:42.520 --> 00:19:43.520
You have to have it every day.
443
00:19:43.520 --> 00:19:46.080
So any, any final thoughts?
444
00:19:46.120 --> 00:19:47.280
No, not really.
445
00:19:47.280 --> 00:19:49.960
I mean, just tell the, tell your audience,
446
00:19:49.960 --> 00:19:50.840
look at NSK.
447
00:19:50.840 --> 00:19:52.400
It's a great option.
448
00:19:52.400 --> 00:19:53.400
Yeah, awesome.
449
00:19:53.400 --> 00:19:54.560
Mark, thanks so much.
450
00:19:54.560 --> 00:19:55.520
Hey, thanks, John.
451
00:19:55.520 --> 00:19:56.360
Yeah, you got it.
452
00:19:56.360 --> 00:19:57.440
35 years of dentistry.
453
00:19:57.440 --> 00:19:58.440
Keep it going, man.
454
00:19:58.440 --> 00:20:00.520
And we'll talk to you soon.
455
00:20:00.520 --> 00:20:01.720
All right, talk to you later.
456
00:20:01.720 --> 00:20:02.560
See you there.
457
00:20:02.560 --> 00:20:03.400
Bye.
1
00:00:00.000 --> 00:00:02.480
NSK has re-engineered the turbine.
2
00:00:02.480 --> 00:00:06.120
And in doing so, they've got their hand pieces,
3
00:00:06.120 --> 00:00:11.120
the 990 and 890 up to 44 and 41 watts respectively,
4
00:00:12.280 --> 00:00:15.400
which provides a ton of torque.
5
00:00:15.400 --> 00:00:18.960
In a hand piece that's quite light and quite small.
6
00:00:18.960 --> 00:00:20.000
And that's a huge benefit.
7
00:00:20.000 --> 00:00:21.760
So suddenly I've got my new hand pieces.
8
00:00:21.760 --> 00:00:25.600
It's cutting it as about as efficient as an electric.
9
00:00:25.600 --> 00:00:28.000
It's smaller in size.
10
00:00:28.040 --> 00:00:32.960
It's lightweight, but the best benefit of this new hand piece
11
00:00:32.960 --> 00:00:36.320
is actually I can repair it on site.
12
00:00:36.320 --> 00:00:40.560
I take one little driver, unscrew the head,
13
00:00:40.560 --> 00:00:44.040
take the turbine, invert it, drop it out,
14
00:00:44.040 --> 00:00:48.200
drop a new turbine in, screw back on the top,
15
00:00:48.200 --> 00:00:50.000
and I'm back in business.
16
00:00:50.000 --> 00:00:53.000
So what's amazing about that is I used to have to send
17
00:00:53.000 --> 00:00:55.360
my old hand pieces out for repair.
18
00:00:55.360 --> 00:00:58.640
Three, four weeks, pay for shipping in each direction.
19
00:00:58.640 --> 00:01:03.440
Now with the 990 and 890, I can order a turbine,
20
00:01:03.440 --> 00:01:05.280
replace that instantly.
21
00:01:05.280 --> 00:01:08.720
Actually have a stock of them on hand, just in case.
22
00:01:08.720 --> 00:01:12.000
In four years of using the 990,
23
00:01:12.000 --> 00:01:15.080
I've replaced one turbine on about six hand pieces.
24
00:01:15.080 --> 00:01:15.920
Wow.
25
00:01:15.920 --> 00:01:17.440
So, God, guess what?
26
00:01:17.440 --> 00:01:19.320
It was up and running that day.
27
00:01:19.320 --> 00:01:20.160
Yeah.
28
00:01:20.160 --> 00:01:21.840
My goodness, this is failing.
29
00:01:21.840 --> 00:01:22.680
So that's really neat.
30
00:01:22.680 --> 00:01:25.520
The other thing they've done in the engineering on this,
31
00:01:25.520 --> 00:01:28.840
and you don't think about this, but an air-driven hand piece
32
00:01:28.840 --> 00:01:32.400
is nothing more than like a jet plane engine.
33
00:01:32.400 --> 00:01:34.160
When they turn off the engine,
34
00:01:34.160 --> 00:01:37.480
the turbine has to wind down and slow down.
35
00:01:42.480 --> 00:01:43.680
What's going on, everybody?
36
00:01:43.680 --> 00:01:44.880
I'm your host, John Stamper.
37
00:01:44.880 --> 00:01:46.960
Welcome to another episode here
38
00:01:46.960 --> 00:01:49.280
on the Beyond the Operatory Podcast,
39
00:01:49.280 --> 00:01:51.920
brought to you by the awesome team at Dental City.
40
00:01:51.920 --> 00:01:54.520
And as I may have shared with many of you,
41
00:01:54.520 --> 00:01:57.840
this podcast is all things dentistry.
42
00:01:57.840 --> 00:01:59.160
Some of our early episodes,
43
00:01:59.160 --> 00:02:01.160
we wanted to bring on individuals in the space
44
00:02:01.160 --> 00:02:02.960
that can help you in the dental practice
45
00:02:02.960 --> 00:02:04.440
with leadership and business.
46
00:02:04.440 --> 00:02:08.120
And where are we in the scope of hygiene and staffing
47
00:02:08.120 --> 00:02:09.240
and all those things?
48
00:02:09.240 --> 00:02:10.840
But we also know that in dentistry,
49
00:02:10.840 --> 00:02:13.280
which is really cool, is that products and services
50
00:02:13.280 --> 00:02:16.280
and technologies are a big part of what a dental practice
51
00:02:16.280 --> 00:02:19.160
uses in an effort to be able to take care of their patients.
52
00:02:19.160 --> 00:02:21.280
And so, Dental City has a lot of great relationships
53
00:02:21.320 --> 00:02:22.440
with companies.
54
00:02:22.440 --> 00:02:27.440
Today's episode is brought to you by the team at NSK.
55
00:02:28.080 --> 00:02:30.800
And I'm very excited to be with Dr. Mark Geisberger,
56
00:02:30.800 --> 00:02:33.840
who is a practicing dentist in Northern California.
57
00:02:33.840 --> 00:02:36.120
And Mark, there's not too many podcasts out there
58
00:02:36.120 --> 00:02:37.760
that actually talk about dental hand pieces,
59
00:02:37.760 --> 00:02:39.680
but we're going to dig into it.
60
00:02:39.680 --> 00:02:40.720
So I'm looking forward to it.
61
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And first of all, thanks so much for making the time to come on.
62
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Oh, John, I'm thrilled to be here.
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This is going to be exciting.
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I know hand pieces may sound mundane,
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but there's some kind of cool things
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that are going on in the hand piece world
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that I'm not sure every practitioner realizes.
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Yeah, well, I love that.
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And as you and I were speaking,
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I mean, I've been in dentistry for 21 years.
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I actually started selling the dental hand pieces.
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NSK actually was the brand that I worked in.
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And it really did, Mark, because I was a little bit unique,
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like a lot of reps, as you know,
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come into your practice, they're in and out,
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they take an order on the hand piece side.
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I got to spend a lot of time with the doctors in the team,
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especially if we had to install the electric hand pieces.
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And so to your point, I know and understand
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that it's what you use every day
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to do the work that you do.
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So it's an important piece of equipment in the practice.
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Absolutely.
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If my hand piece wasn't functioning,
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I'm not working that day.
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So that's the reality of the practice of dentistry, you know?
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It's got to be functioning and it's got to be spot on.
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I love it.
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So let's, I want to maybe kind of go in two different directions.
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I want to talk, when you as a clinician make a decision
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to look for the type of hand piece that you're going to use,
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what are some of the things that, you know,
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over the years have been important to you
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when it comes to that?
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So, you know, one of the most important things to me,
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honestly, in a hand piece selection
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from a clinical side is, of course, cutting efficiency,
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weight and really reliability.
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That's it.
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It boils down to, do I have a hand piece that cuts effectively?
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Is it reliable?
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And is it not so heavy that I get strained by the end of the day?
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That's especially true after practicing 35 years.
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To start to notice body parts responding
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to what goes on on a daily basis.
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So for me, those are really critical.
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Yeah, and then how about for your team?
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So for my team is easy setup, easy breakdown,
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easy sterilization process, easy maintenance.
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Some of these hand pieces require a lot of steps
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in lubricating and preparing them.
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And if they're not done properly, you have breakdown.
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You have repairs, premature repairs.
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So ease of use is a huge thing on the team side
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to manage hand pieces.
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All right, so the next direction I wanted to go
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is I want to talk a little bit about the difference
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between air driven and electric.
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Right, air driven is what we've known for so many years.
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Of course, before that was belt driven, right?
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A different generation from you and I,
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but the standard issue air driven hand piece,
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obviously like a staple in a dental practice.
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So we'll start there and then I want to get into electric.
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But what is it about the air driven hand piece
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that you still like to have?
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I mean, I know that there are practices
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that may go exclusively electric for a host of different reasons,
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but I don't know what your practice makeup is,
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but do you have both?
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And on the air driven side, like what do you like
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and how do you like to use an air driven hand piece?
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So I intend to answer your question, I have both.
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And there's a reason I have both.
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Electrics and we'll get to those, have their benefit.
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Air driven, however, are light, they're efficient.
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The head size tends to be smaller.
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So in all honesty, there are cases, clinical cases,
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say on a second molar with a patient
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that has limited opening, where it is literally impossible
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to get an electric hand piece in there.
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Need a small hand piece that will fit into the operating area.
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The other thing about an air driven hand piece
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is for me, it allows me to control my refinement skills
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a little better than electric hand piece.
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So there have been some new advances in air driven hand pieces
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that now really make them a player again in a marketplace
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that's really been kind of moving towards electric.
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A lot of Dell schools have transitioned to electrics,
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but now they're saying, hey, maybe keeping some air driven hand pieces
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for limited situations is a good idea.
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One of the issues with air driven hand pieces, of course,
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is turbine issues where turbines go out
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and they require repair and maintenance.
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But NSK has got a solution to that
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and they're new 990L hand piece
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and we can talk a little bit about that.
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Yeah, let's do it.
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So one of the interesting things
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with some of the modern hand pieces is,
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they've been re-engineered, NSK has re-engineered the turbine.
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And in doing so, they've got their hand pieces,
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the 990 and 890 up to 44 and 41 watts respectively,
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which provides a ton of torque in a hand piece
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that's quite light and quite small.
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That's a huge benefit.
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So suddenly I've got my new hand pieces,
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it's cutting it as about as efficient as an electric.
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It's smaller in size, it's lightweight,
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but the best benefit of this new hand piece
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is actually I can repair it on site.
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I take one little driver, unscrew the head,
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take the turbine, invert it, drop it out,
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drop a new turbine in, screw back on the top
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and I'm back in business.
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So what's amazing about that is I used to have to send
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my old hand pieces out for repair.
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Three, four weeks, pay for shipping in each direction.
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Now with the 990 and 890, I can order a turbine,
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replace that instantly,
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actually have a stock of them on hand just in case.
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In four years of using the 990,
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I've replaced one turbine on about six hand pieces.
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Wow.
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So, bud, guess what?
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It was up and running that day.
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Yeah.
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My goodness, this is failing.
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So that's really neat.
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The other thing they've done in the engineering on this,
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and you don't think about this,
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but an air-driven hand piece
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is nothing more than like a jet-clean engine.
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When they turn off the engine,
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the turbine has to wind down and slow down.
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So, a clinician still realizes,
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as soon as they release the rear step,
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that burr continues to spin until it winds down.
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What NSK has engineered in the 990 series
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is a quick stop or anti-rotation quick stop valve.
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So basically, as soon as you release your foot
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from the rear step, the hand piece stops instantly.
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And that is a huge, huge benefit.
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So there are some really neat innovations
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with the newest air-driven hand pieces
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that really make you question your decision
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to move towards electrics.
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It's really true.
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I like lightweight, I like small hand pieces,
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I like accessible, I like the high torque,
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and I love the fact that I can refine my preps
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like I've done in the past.
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So there are just some really cool innovations
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still in air-driven.
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When the market said maybe they're done,
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I don't think so.
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They're not going anywhere.
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Yeah, that's pretty cool.
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And especially as you know,
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that switch from air-driven to electric
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is you're working on some of the newer materials.
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You're doing some more difficult restorations.
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The material is harder.
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And as you mentioned, it was like natural inclination
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to go to my electric hand piece.
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But I know in the conversations that I had with dentists
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over the years when I'd be in the practice
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talking about hand pieces,
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they shared exactly what you shared,
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which is if there was an ideal situation
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where I could have an air-driven hand piece
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where I felt like was good in my hand,
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it was lightweight, especially for some of the pieces
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that don't open up wide, back in the posterior,
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but then not lose out on the torque.
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That's a big piece of it.
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Of course, being able to change out those turbines is big.
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I'm curious how you were able to get those hand pieces
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don't have to change out that turbine so many times
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in prior years.
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That's pretty good.
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Yeah, it is really good.
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Okay, so here's one thing I've noticed about dentists
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in general, training so many dentists in my career.
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Dentists are sometimes pennywise and pound foolish.
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And what I mean by that is they'll use a burr
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until that last diamond particle is toast.
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And they'll sit there and spend a lot of time prepping teeth
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rather than switching on a burr.
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Now, I get it, burrs are expensive, a $10 a piece.
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With that said, the repair of a hand piece
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is far more expensive.
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What old burrs do is they wear down the turbine very quickly,
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because what you have to do to get old nasty burrs
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and been autoclaved a hundred times to cut,
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is you have to lean on the tooth.
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You put a lot of torque on the hand piece itself
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by just pushing harder on that burr.
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What that does is tax the turbine
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and you have premature turbine failure
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by not really managing your burr system well.
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So dentists would be wiser to switch out their burrs
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more frequently as I do,
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because what that leads to
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is far less turbine failure in the long run.
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So it's just a strategy that dentists don't think about
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what most institutions have done VAs and dental schools.
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For instance, they've gone to single use diamonds,
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single use carbides.
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And what they find is although that may be
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a little more expensive on the front end,
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it saves them money on the back end
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because they're not replacing turbines as frequently.
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So that's just a tip for the listeners to realize,
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sometimes you're just, you're shooting yourself in the foot.
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There's Johnny as an old figure.
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Well, and the other thing that I learned,
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which I'd love to get your thoughts on this,
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when you speak about making a little bit of an investment
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up front, is that I know that some of the sterilizers
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now are today's are probably better than they were
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20 years ago when I was out there.
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However, I did learn that that heat can tend to wear
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on those turbines much quicker.
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And so I used to speak with offices,
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and I love to get your thoughts on this,
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is that if you were only running two hand pieces
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through those autoclaves all day long,
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instead of maybe investing in a couple of more hand pieces
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so that they weren't having to run through the cycle
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as frequently, that was also something
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over the years that I had heard.
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So I don't know what your experience or thoughts
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have been on that.
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And that's just another example, like you mentioned,
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of maybe making a little bit of investment on the front end
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in an effort to extend the life of those turbines.
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Yeah, I think that's a great call.
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And you know what happens so much in the marketplace
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is companies, whether it's NSK or another hand piece
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will run specials, I too get one free.
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And as well, I just need one hand piece.
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Well, I really think what people should do
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is have a fairly large stock.
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I have eight hand eight NSK 990s that serve me in two
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operatories.
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00:14:01.200 --> 00:14:03.160
And probably the reason I've only replaced one turbine
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with four years is because of exactly what you're talking about.
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Yes, it's a little more expensive,
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but I utilized promotions and say, okay, I'm going to purchase this.
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It's a wise time to move.
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They're going to give me a two for or three for two
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or whatever this special they're running is
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and just be wise about it.
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Yeah, absolutely.
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All right, so literally our most important instrument
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we have are hand piece.
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Completely, right?
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00:14:27.520 --> 00:14:30.200
I mean, that's what, you know, you can,
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that's what pays the bills in so many cases.
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I totally agree.
322
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All right, so let's move to electric then.
323
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Let's talk about what it is you love about electric.
324
00:14:40.480 --> 00:14:41.880
Maybe a little bit about, you know,
325
00:14:41.880 --> 00:14:44.680
some of the features of the NSK electric hand pieces
326
00:14:44.680 --> 00:14:46.880
is providing you.
327
00:14:46.880 --> 00:14:50.560
Again, I, you know, I was always very proud to represent that brand
328
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because it was a hand piece that I felt like when I would go back
329
00:14:53.360 --> 00:14:56.520
and talk to my doctors that built it into their practice,
330
00:14:56.520 --> 00:14:58.480
like they were getting great results.
331
00:14:58.480 --> 00:15:00.240
Love to get your thoughts on how you've used it
332
00:15:00.240 --> 00:15:01.680
and maybe some ideas for a doctor
333
00:15:01.720 --> 00:15:03.080
that has not moved to electric
334
00:15:03.080 --> 00:15:04.600
and where you see the benefit.
335
00:15:04.600 --> 00:15:06.760
Yeah, so as, as I mentioned earlier,
336
00:15:06.760 --> 00:15:10.040
I utilize both and when any procedure is going on,
337
00:15:10.040 --> 00:15:12.360
I have both a high speed air driven
338
00:15:12.360 --> 00:15:15.840
and high speed electric on the chair setup,
339
00:15:15.840 --> 00:15:17.720
which allows me to jump back and forth.
340
00:15:17.720 --> 00:15:22.720
But where I find myself really utilizing the electric systems
341
00:15:22.720 --> 00:15:26.120
is for things like cutting off circonia crowns,
342
00:15:26.120 --> 00:15:30.720
cutting off old PFMs, rough preparations,
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00:15:30.720 --> 00:15:34.440
getting things kind of started with that high torque.
344
00:15:34.440 --> 00:15:35.760
That's a huge benefit.
345
00:15:35.760 --> 00:15:39.160
If I have to section a tooth for an extraction,
346
00:15:39.160 --> 00:15:42.720
I'll use an electric hand piece to do that.
347
00:15:42.720 --> 00:15:46.720
Now, the trade off with electrics is yes, you get high torque,
348
00:15:46.720 --> 00:15:51.720
but all systems are heavier than their air-driven counterparts.
349
00:15:52.600 --> 00:15:54.920
That's just the nature of the beast.
350
00:15:54.920 --> 00:15:58.440
One of the benefits with NSK's electric
351
00:15:58.440 --> 00:16:03.440
is their motor itself is literally the smallest on the market.
352
00:16:04.880 --> 00:16:07.840
In addition to that, their electric hand pieces
353
00:16:07.840 --> 00:16:10.680
are the lightest on the market.
354
00:16:10.680 --> 00:16:13.280
So you look at 57 grams for their motor
355
00:16:14.160 --> 00:16:16.520
and that is a huge benefit.
356
00:16:16.520 --> 00:16:19.960
So I like their hand pieces because yes,
357
00:16:19.960 --> 00:16:21.920
they provide me with that high torque,
358
00:16:21.920 --> 00:16:24.280
but they're the lightest on the market.
359
00:16:24.280 --> 00:16:25.680
With their Japanese engineering,
360
00:16:25.680 --> 00:16:27.520
they simply don't fail on me.
361
00:16:27.560 --> 00:16:30.760
So there's lots of times like if I'm doing something
362
00:16:30.760 --> 00:16:34.120
as mundane as adjusting a partial denture framework,
363
00:16:34.120 --> 00:16:36.440
I want something with high torque.
364
00:16:36.440 --> 00:16:37.520
I'll go to the electric.
365
00:16:37.520 --> 00:16:40.720
I'm not gonna sit there with an air-driven hand piece
366
00:16:40.720 --> 00:16:43.880
because it's not gonna get the job done as efficiently.
367
00:16:43.880 --> 00:16:48.880
So I think there's a place in a general practice for both.
368
00:16:49.600 --> 00:16:50.960
Not one or the other.
369
00:16:50.960 --> 00:16:53.400
I've never thought that was a smart strategy.
370
00:16:53.920 --> 00:16:57.600
And doctors figure out when they use one or the other.
371
00:16:57.600 --> 00:16:59.200
I've had situations where I'm like,
372
00:16:59.200 --> 00:17:01.360
oh, I'm trying to cut off a crown on a second molar.
373
00:17:01.360 --> 00:17:03.840
And again, the electric doesn't fit.
374
00:17:03.840 --> 00:17:05.480
The patient can't open that wide
375
00:17:05.480 --> 00:17:09.840
and when you look at the size comparison of electric hand pieces
376
00:17:09.840 --> 00:17:12.600
to say an air-driven, that can be a problem.
377
00:17:12.600 --> 00:17:14.240
Now, NSK saw that.
378
00:17:14.240 --> 00:17:17.840
They've got the smallest lightest electrics on the market.
379
00:17:17.840 --> 00:17:22.560
So they're a great option when looking at electrics
380
00:17:22.560 --> 00:17:26.520
from an ergonomic standpoint and a functional standpoint.
381
00:17:26.520 --> 00:17:30.800
So with that said, though, the truth is,
382
00:17:30.800 --> 00:17:34.240
all electrics are larger than air-driven hand pieces.
383
00:17:34.240 --> 00:17:35.640
Yeah.
384
00:17:35.640 --> 00:17:38.640
Any other hand pieces that you use in the practice
385
00:17:38.640 --> 00:17:40.680
other than air-driven and electric
386
00:17:40.680 --> 00:17:43.000
or using slow-speed hand pieces
387
00:17:43.000 --> 00:17:45.440
or using the electric for some of your slow-speed cases
388
00:17:45.440 --> 00:17:47.240
or any other ancillaries that you use.
389
00:17:47.240 --> 00:17:52.240
So I've got my NSK lab motor in my lab.
390
00:17:52.760 --> 00:17:54.640
And that's generally a straight nose cone.
391
00:17:54.640 --> 00:17:56.680
That's where I take things in the lab
392
00:17:56.680 --> 00:17:58.120
and do my adjustments.
393
00:17:58.120 --> 00:18:00.480
It might be a partial dendro adjustment.
394
00:18:00.480 --> 00:18:04.400
It could be an implant adjustment, temporary contouring,
395
00:18:04.400 --> 00:18:08.440
all that is done in the lab with the NSK's lab motor
396
00:18:08.440 --> 00:18:10.800
with a straight nose cone attachment.
397
00:18:11.920 --> 00:18:15.520
In addition to that, I'm using their low-speed latch locks
398
00:18:15.520 --> 00:18:17.280
and straight nose cone,
399
00:18:17.280 --> 00:18:19.560
share side to do things like
400
00:18:19.560 --> 00:18:24.040
share side dendro adjustments or polishing restorations,
401
00:18:24.040 --> 00:18:27.520
those things, a restoration adjustment with, say,
402
00:18:27.520 --> 00:18:30.200
brasslers, dial light system,
403
00:18:30.200 --> 00:18:32.800
in a straight nose cone to adjust crowns.
404
00:18:32.800 --> 00:18:35.600
So I utilize a lot of their,
405
00:18:35.600 --> 00:18:40.120
their armamentarium in my practice.
406
00:18:40.120 --> 00:18:42.680
I, you know, honestly, I used to be with Cabo,
407
00:18:42.680 --> 00:18:44.920
which is a great hand piece company.
408
00:18:44.920 --> 00:18:47.440
I had a lot of repairs, a lot of repairs,
409
00:18:47.440 --> 00:18:48.840
a lot of downtime.
410
00:18:48.840 --> 00:18:50.200
And I really wanted a product
411
00:18:50.200 --> 00:18:52.440
that wasn't going to leave me high and dry.
412
00:18:52.440 --> 00:18:54.400
And that's kind of when I made the transition
413
00:18:54.400 --> 00:18:56.240
about five years ago.
414
00:18:56.240 --> 00:18:57.560
Yep, love it.
415
00:18:58.880 --> 00:19:00.880
Do you do endodontics or no?
416
00:19:00.880 --> 00:19:01.720
I don't.
417
00:19:01.720 --> 00:19:02.560
You don't, okay.
418
00:19:02.560 --> 00:19:03.400
No, okay. Yep.
419
00:19:03.400 --> 00:19:05.400
And then 35 years, not going to start now.
420
00:19:07.400 --> 00:19:09.720
My endodontist loves me because I send him everything.
421
00:19:09.720 --> 00:19:12.000
Hey, yeah, good for you, man.
422
00:19:12.000 --> 00:19:14.000
Yeah, well, I know I was going to ask,
423
00:19:14.000 --> 00:19:15.560
because obviously I know that they've got
424
00:19:15.560 --> 00:19:17.720
an endodontic hand piece for some of that as well,
425
00:19:17.720 --> 00:19:21.000
but we'll, we'll talk, we'll get an endodontist down
426
00:19:21.000 --> 00:19:21.840
to talk about it.
427
00:19:21.840 --> 00:19:22.680
There you go.
428
00:19:22.680 --> 00:19:23.520
That's the way to do it.
429
00:19:23.520 --> 00:19:25.040
Even though I know, I know a lot of them still like
430
00:19:25.040 --> 00:19:26.640
to use those hand files, which I totally get.
431
00:19:26.640 --> 00:19:27.480
Thank you.
432
00:19:27.480 --> 00:19:28.320
Right.
433
00:19:28.320 --> 00:19:29.160
So, yeah, love it.
434
00:19:29.160 --> 00:19:29.840
This has been great.
435
00:19:29.840 --> 00:19:31.200
Yeah, like I said, I really appreciate it.
436
00:19:31.200 --> 00:19:32.520
I mean, like, you know, like you mentioned,
437
00:19:32.520 --> 00:19:34.320
you know, the hand piece part is something
438
00:19:34.320 --> 00:19:37.480
that every practice has, but it's a big investment.
439
00:19:37.480 --> 00:19:40.280
It can be, but I love the fact that you brought up.
440
00:19:40.280 --> 00:19:41.520
It's what you guys use.
441
00:19:41.520 --> 00:19:42.520
It's your, it's your tool.
442
00:19:42.520 --> 00:19:43.520
You have to have it every day.
443
00:19:43.520 --> 00:19:46.080
So any, any final thoughts?
444
00:19:46.120 --> 00:19:47.280
No, not really.
445
00:19:47.280 --> 00:19:49.960
I mean, just tell the, tell your audience,
446
00:19:49.960 --> 00:19:50.840
look at NSK.
447
00:19:50.840 --> 00:19:52.400
It's a great option.
448
00:19:52.400 --> 00:19:53.400
Yeah, awesome.
449
00:19:53.400 --> 00:19:54.560
Mark, thanks so much.
450
00:19:54.560 --> 00:19:55.520
Hey, thanks, John.
451
00:19:55.520 --> 00:19:56.360
Yeah, you got it.
452
00:19:56.360 --> 00:19:57.440
35 years of dentistry.
453
00:19:57.440 --> 00:19:58.440
Keep it going, man.
454
00:19:58.440 --> 00:20:00.520
And we'll talk to you soon.
455
00:20:00.520 --> 00:20:01.720
All right, talk to you later.
456
00:20:01.720 --> 00:20:02.560
See you there.
457
00:20:02.560 --> 00:20:03.400
Bye.
