Risk of electromagnetic interference induced by dental equipment on cardiac implantable electrical devices

Abstract

Patients with cardiac implantable electrical devices should take special precautions when exposed to electromagnetic fields. Proximity to equipment used in clinical dentistry may cause interference. This study evaluated in vitro the risks associated with different types/makes of cardiac devices and types of dental equipment. Six electronic dental tools were tested on three implantable cardioverter defibrillators and three pacemakers made by different manufacturers. Overall, the risk of interference with the pacemakers was 37% lower than with the implantable cardioverter defibrillators. Regarding the types/makes of cardiac devices analysed, that from Boston Scientific had a five-fold greater risk of interference than did that from Biotronik [prevalence ratio (PR) = 5.58]; there was no difference between that from Biotronik and that from Medtronic. Among the dental equipment, the electric pulp tester had the greatest risk of inducing interference and therefore this device was used as the benchmark. The electronic apex locator (PR = 0.29), Periotest M (PR = 0.47), and the ultrasonic dental scaler (PR = 0.59) were less likely to induce interference than the electric pulp tester. The risk was lowest with the electronic apex locator. Pacemakers presented a lower risk of light to moderate interference (PR = 0.63). However, the risk of severe electromagnetic interference was 3.5 times higher with pacemakers than with implantable cardioverter defibrillators (PR = 3.47).

Electromagnetic interference effect of dental equipment on cardiac implantable electrical devices: A systematic review

“…Among these 18 selected studies, 12 were in vitro and six were in vivo studies. Table 1 summarizes the details and results of the in vitro studies, 7,10–20 while the main characteristics of the in vivo studies are shown in Table 2 21–26 …”

“…This literature summarized 12 in vitro studies conducted from 2000 to 2020 and found that most dental equipment did not interfere with CIED function at the clinical application distance (20 cm). Several in vitro studies have reported that EMI affects CIED function by using EALs, 7,13 ultrasonic instruments, 10,11 battery‐operated composite curing lights, 11 diathermy, 16 electrosurgery units, 18,20 and gutta‐percha heat carriers 15 . However, in these in vitro studies, severe EMI with CIED functional changes was usually at an extremely close distance to the electrode tip or CIED generator or at the maximum sensitivity level.…”

In‐vivo compatibility between pacemakers and dental equipment

“…Miranda ‐ Rius et al . also came to the conclusion that this was the dental tool most likely to interfere with CIEDs. In the light of these findings, we decided to include the electric pulp tester in the present study.…”

“…In 2016, Miranda ‐ Rius et al . evaluated the in‐vitro risk of interference of six electronic dental tools and reported that the electronic apex locator has the lowest risk of producing EMIs with CIEDs.…”

Highly Conductive PDMS Composite Mechanically Enhanced with 3D-Graphene Network for High-Performance EMI Shielding Application

“…With the booming of electronic devices and equipment over past decades, severe electromagnetic interference (EMI) and radiation pollution are brought out [1][2][3], which can easily interfere with electronic devices and also be harmful to human health [4,5]. Generally, metals with high electrical conductivity, such as copper, nickel, silver and aluminum, show good shielding performance because of the reflection of energy caused by impedance mismatch of the material and the free space [6][7][8][9].…”