Cardiac Pacemaker — ORE Part 1 MCQ
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Correct answer: E — Magnetostrictive ultrasonic scaler
**A. Magnetostrictive ultrasonic scaler** is the best answer. This type of scaler has historically been associated with electromagnetic interference with pacemakers and should be avoided where an alternative is available, particularly a hand scaler or piezoelectric unit used cautiously. The decisive feature is the **magnetostrictive** mechanism, rather than ultrasonic scaling as a whole. A high-speed air turbine is pneumatically powered, and a rubber dam clamp and mirror are non-electrical instruments. An LED composite curing light is not contraindicated: a prospective human study found no clinically significant interference with pacing or sensing from commonly used dental electrical devices, including battery-operated curing lights. Similarly, contemporary in-vivo evidence does not justify treating all ultrasonic scalers as absolutely contraindicated; the question is made discriminating by specifying the magnetostrictive type.
Reference: Elayi CS et al. “Interference between dental electrical devices and pacemakers or defibrillators: results from a prospective clinical study.” Journal of the American Dental Association, 2015. https://pubmed.ncbi.nlm.nih.gov/25637210/