Dental Burs and Files: Clean, Sterilise or Throw Away?
Burs are small, sharp and textured, which makes them hard to clean and easy to lose track of. When single use is the better answer, how reusable burs are cleaned and sterilised in a bur block, why carbon-steel burs rust in steam, and when a bur has done its last job.
Single-use or reusable
Single-use burs and files
Anything marked with the “do not reuse” symbol — a 2 inside a crossed-out circle — is used on one patient and goes into the sharps container. Many clinics choose single-use diamonds and burs for surgical work and for any bur too clogged to clean.
Reusable burs
Tungsten carbide, diamond and steel burs sold as reusable can be reprocessed only as their maker’s instructions for use describe. If a bur has no validated reprocessing instructions, treat it as single-use.
Endodontic files and reamers
Since 2007 the UK Department of Health has advised that endodontic files and reamers be used once only: studies found they are hard to clean reliably, and prion proteins bind to steel. Many file makers now label their files single-use. Follow the labelling and your clinic’s infection-control policy.
Why burs are hard to clean
- Diamond grit and carbide flutes trap blood, dentine and filling material.
- Debris dries quickly on a hot bur sitting in a bur stand.
- A bur is small enough to be put back in the stand without anyone noticing it was used.
- Repeated reprocessing dulls cutting edges, so a reused bur can cut more slowly and heat the tooth more.
- Worn burs can fracture or shed their diamond coating during treatment.
Reprocessing a reusable bur
| Step | What to do |
|---|---|
| Straight after use | Remove the bur from the handpiece with a bur remover or forceps, not fingers, and place it in a bur block or holding solution so debris does not dry on |
| Pre-clean | Remove visible debris with a bur brush or cleaning sponge, holding the bur in forceps |
| Ultrasonic clean | Run it in a bur block or fine-mesh basket in an ultrasonic cleaner, with a detergent made for rotary instruments (ideally with corrosion protection), for the time on the label |
| Rinse and dry | Rinse thoroughly and dry completely — water left on a bur is what rusts it |
| Inspect | Check under magnification for debris, blunt or chipped edges, missing diamond grit, bends and rust; reclean or discard |
| Pack and sterilise | Sterilise in the bur block or a pouch on a Class B cycle, at a temperature the bur maker allows |
Read next Ultrasonic cleaners for instrumentsCleaning before sterilisation
Bur blocks and holders
What a bur block is
A stainless-steel or aluminium holder with a lid and numbered holes. Burs stay upright and apart through cleaning, sterilisation and storage, and the set for one procedure goes to the chair together.
Why they help
Burs stop knocking against each other, small burs cannot slip through an ultrasonic basket, and it is clear which burs have been used.
Cautions
Burs packed tightly in a closed block are a harder load for steam. Use a block with enough openings, sterilise it on a Class B cycle as its maker describes, and keep aluminium blocks away from strongly alkaline detergents, which attack aluminium.
Carbon-steel burs and corrosion
Carbon-steel burs rust in steam, especially when they are packed wet or the autoclave water is poor. That is why some makers specify dry heat for them or label them single-use, and why many clinics use carbide or diamond burs instead. Carbide burs have a steel shank that can also corrode if it is left wet.
- Never leave burs soaking overnight.
- Dry burs completely before packing them.
- Run the autoclave on distilled or deionised water.
- Discard any bur with rust spots or pitting.
When to throw a bur away
- It is labelled single-use.
- Debris will not come off after cleaning.
- It is blunt, chipped, worn or bent, or diamond grit is missing.
- It shows rust or pitting.
- The shank is worn or damaged and no longer sits firmly in the chuck.
- It has reached the number of uses its maker states, if one is given.
- Your policy for patients with known or suspected prion disease applies.
Read next Dental handpiece sterilisation
Related guides
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Frequently asked questions
Can dental burs be autoclaved?
How do you clean burs in an ultrasonic cleaner?
Are endodontic files single-use?
Why are my burs rusting after autoclaving?
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