Introduction to Professional Podiatry Bits
Bit shapes and materials exist in a range of combinations. While there is always an appropriate tool for the job, most jobs are properly completed with more than just one type or size of bur; oftentimes you'll use three or more.
It's important that when you're learning foot care sanding, that you try all available tools to learn which ones ideally suit your goal. Practice using a range of tools in order to become comfortable with a wider set.
Lamella Saw Carbide Bit:#W
This bur is highly specialized, great for advanced treatments on patients with very thick, tall nails. In the past, trimming these types of nails was very time-consuming because it required sanding to first reduce the height of the nail; or extensive clipping, which is both awkward for the foot care specialist as well as uncomfortable for the patient. Using the saw bit eliminates movement and stress, providing a pleasant and stress-free foot care experience for everyone involved. With this tool, you can actually saw through thick nails, greatly reducing the amount of time your patient has to sit for you.
This bit is too coarse to be skin friendly, so it cannot be used for precision work or on corns or calluses.
Rosebud Carbide Ball Bit: #H
When enlarged, it's quite obvious how many sharp edges this tool has, however, this bur is extremely small. This tool is perfect for nucleated corns and calluses that lead to lesions, caused by mechanical stresses from faulty footwear or abnormal gait or foot mechanics. Because it's difficult but essential to remove these pressure points, learning how to appropriately use the rosebud ball bit is critical.
This bur is used above 30,000 RPMs, making it a quick and effective solution - ideal for patients who report pain and cannot sit through long treatments. Because it is carbide, it does generate quite a bit of heat, so it's important to apply it to the skin for only very short periods of time.
This touch-and-lift method is also best practice as it allows you to assess the depth to which you've sanding, ensuring the safety of the patient.
If your patient is reporting pressure pain, but you're not able to identify any obvious keratotic lesions, use an alcohol swab or antibacterial hand gel to reveal the sore spot.
Diamond Pear Bit:#F
This bur creates a pear-type shape, where the bit becomes slightly more narrow as it moves away from the neck. These burs are available in a variety of materials, and have a range of podiatry uses. Pear bits are great for smoothing rough edges, thinning, rounding and semi-precision work, such as getting around the corner of the nail in order to thin it in preparation for clipping or further sanding.
Medium Barrel Diamond Bit: #Q
These bits have diamond dust around the barrel as well as on the top or bottom, so it can be used on all three sides. This bit is great for shortening, smoothing and removing lateral or distal edges that are prone to catching socks and other materials.
Barrel bits are ideal for thick nails, allowing you to create a smooth distal edge easily and without compromising the integrity of the nail or any surrounding skin.
Barrel diamond burs are available in three different grits: fine, medium and coarse.
Barrel bits can also be used to thin the corner of the nail, accomplishing the same task a cone bit would but using a slightly different approach. Moving back and forth between the medial and lateral edges when using a diamond bur will help to prevent heat buildup. This can of course be mitigated by using a titanium aluminum nitrate, however, practicing consistent sanding techniques helps to significantly reduce discomfort for your patients.
Narrow TiAIN Cone Bit:#Z
A narrow cone bit, whether titanium aluminum nitrate or another material, is designed for tighter spaces, such as the corners or the nail. It's important to sand edges properly so that patients don't catch their nails on socks or bedding, and in order to keep nails properly trimmed for longer. It prevents ingrown toenails and greatly reduces uncomfortable and dangerous pressure points when wearing shoes.
When sanding, remember to let the bur do the work; this is easier on both you as well as the nail. Although it's almost always quicker to clip the nail at the sides rather than sanding it, sanding will allow you to trim away the nail that's attached to the skin without causing pain or bleeding. Using an appropriately shaped bur when sanding doesn't create trauma and accomplishes the goal of relieving pressure.
Large TiAIN Cone Bit: #AA
TiAIN burs are used the same way that other disks or burs are used for sanding. Please review the basics of sanding for additional information here.
This cone shaped bit is available in a range of other materials, all of which can be used on skin as well as nails. However, titanium aluminum nitrate bits contain a special coating that allows you to sand for longer and at higher speeds without building up heat the way other burs do. This is particularly advantageous when sanding high-risk foot care patients with poor vascular supply who are especially sensitive, such as diabetics. Whereas disks should be used at 7 or 8,000 rpm, the TiAIN cone bur can be used up to 25,000 rpm.
This bur's cone shape offers universal functionality, from thinning to smoothing. Using the broad edge will allow you to cover more area, while sanding only with the tip allows for precise smoothing and shaping where needed.
Hurricane Diamond Bit:#V
This versatile bit is unique because it contains holes. This design is intended to remove more nail particle dust.
These bits are great for quick nail thinning, particularly for very thick nails.
In addition to sanding thick nails down with this bur, you'll find that it's also great for thick calluses, heels and the sole of the foot.
This bit can be used very safely and effectively up to 25,000 rpm, making it an absolute workhorse. Although this bit may look a bit intimidating, it is perfectly safe even for people with venous insufficiencies, who have skin that's more prone to injury. Although this probably wouldn't be your first choice for smaller nails, it does work fine when proper care is taken.
Long Taper Point Bit: #M
This bit is much thinner than the narrow cone bur, allowing it to go into very narrow spaces. You'll get the most our of this bur by using a touch-and-lift technique, and at 20 to 30,000 rpm, allowing you to safely thin the edges of the nail all the way down to skin level to relieve pressure in the sulcus.
A long taper point bit is not appropriate for nail thinning on a larger scale.
Learn how to use all of these tools and more effectively in an intimate hands-on environment. Dr. Julia Overstreet teaches affordable classes throughout the year. Both the WOCN & AFCNA accept this class toward prerequisites for certification. You will receive a certificate for 10 Hours of proctored hands-on training for each day that you attend.