Like many dentist equipment in dentistry, air polishing has changed since the late 1970s. There are several new air polisher designs and new abrasive powders, and we now have the ability to use air polishers subgingivally. Sodium bicarbonate was the original abrasive powder used, but newer abrasive powders include glycine, calcium carbonate, calcium sodium phosphosilicate, aluminum trihydroxide, and erythritol. These additional powders give us more choices for our patients' individual needs.
Patients must be selected carefully, as there are some contraindications for use. Typically, individuals with communicable disease, upper respiratory disease, compromised immune systems, sodium-restricted diets, polishing powder ingredient allergies, and contact lenses are not candidates for air polishing. However, sodium restriction is less of an issue now that there are powders without sodium.
Indications for use of an air polisher have typically included extrinsic stain removal, cleaning around orthodontic appliances, and to clean occlusal surfaces before placing a sealant. Now there are indications for use on exposed, hypersensitive dentin and periodontal pockets.
Dental hygienists have a wide variety of experiences with and opinions about air polishing-everything from loving it to hating it. Patients likely have similar opinions depending on the type of device used, the powders used, and the expertise of the clinician providing the air polishing. New advancements in this technology have some pleasant benefits for you and your patients.
With the advent of air polishing devices designed for use with low-abrasive powders, dentists and dental hygienists can obliterate supra- and subgingival biofilm from enamel, exposed root surfaces, and restorative materials efficiently and comfortably.
The benefits of air polishing for the dental professional include less operator fatigue, less time involved than the traditional polishing technique, and improved access to difficult-to-reach areas. Benefits to the patient include less time in the chair, less "scraping," excellent stain removal, reduced dentin hypersensitivity, and improved periodontal status.
Training regarding indications, contraindications, advantages and disadvantages is imperative for use of the air polisher. When used by a properly trained clinician, the clinical benefits as well as patient safety increase. But today, as an educator, I consider dental hygiene curriculum and wonder why not much has changed in regard to training students to use air polishers. The air polishers themselves have evolved, the list of uses has increased, and yet, in many schools, our students are lucky if they learn how to use one.