Using ultrasonics around pacemakers

Aug. 26, 2005
Question concerns the safety of ultrasonic scalers with patients who have pacemakers.

Dear RDH eVillage:

Just a quick question regarding using ultrasonic handpieces — piezo or magnetostrictive: Can these units be used on or near a patient with a pacemaker? I graduated from dental hygiene school in 1998 and was taught that the use of these devices were safe, provided the pacemaker was shielded. I was also under the impression that all pacemakers now placed were shielded. Please share your thoughts regarding this important matter.

Jeannie Gendron, RDH

Dear Jeannie:

This is a great question that comes up all of the time!

The information that you learned in 1998 is correct, but let me clarify one point. The concern about using power driven scalers on patients who have cardiac pacemakers is limited only to magnetostrictive devices. In other words, sonic scalers and piezo electric scalers create tip vibrations from either vibrating metal plates (sonic) or activated ceramic discs (piezo).

Magnetostrictive scalers, which are the most widely used power scalers in North America, create vibration when energy is applied to a series of magnetic strips (the stack). This process creates a weak magnetic field, which in theory could cause pacemaker disruption in an unshielded unit.

In reality it would be very unlikely for a patient in 2005 to have an unshielded device; however, it is prudent to contact the cardiologist to get clearance to use a magnetostrictive device.

Anne N. Guignon, RDH, MPH
2004 Mentor of the Year
Philips Oral Heath Care - RDH magazine