Air Polishing in Professional Dental Prophylaxis

How air polishing technology works, why new-generation glycine- and erythritol-based powders have expanded clinical indications all the way to implants and periodontal pockets, and when to prefer it over — or pair it with — ultrasonic scaling.

Air polishing uses a controlled jet of compressed air, water and extremely fine abrasive powder to remove bacterial biofilm, surface stains and recently-formed calculus from dental and subgingival surfaces. The mechanical principle is simple: the kinetic energy of the powder particles, accelerated by the compressed air flow, dissipates almost completely on impact with the tooth surface, producing an effective yet gentle cleaning action, complemented by a water jet that simultaneously rinses away residue.

First-generation powders, based on sodium bicarbonate, had relatively coarse particle size and an abrasive profile that made them unsuitable for use on exposed dentin, root cementum or aesthetic restorative materials, effectively limiting their use to supragingival enamel surfaces only. The introduction of new-generation powders — glycine and erythritol, with particle size roughly between 14 and 25 microns, considerably finer — has substantially changed the clinical indication landscape: these powders are minimally invasive even on root surfaces exposed by gingival recession, on mucosa and on implants, opening the way to what is now called perio-polishing — the use of air polishing directly for decontaminating periodontal pockets.

Between the two latest-generation powders, erythritol (particle size around 14 microns) has a further advantage documented in the literature: beyond its mechanical action, it exerts a direct biochemical effect that inhibits biofilm development and specific cariogenic bacteria such as Streptococcus mutans, effectively making it the current gold standard for prophylaxis with this technology. The fine particle size of both powders allows safely reaching gingival sulci and pockets several millimeters deep, areas traditionally reserved for manual or ultrasonic instrumentation alone.

In day-to-day clinical practice, air polishing doesn't necessarily replace ultrasonic scaling but complements it: it can follow it as a final surface finish, or precede it to immediately remove biofilm, stains and recently-formed calculus, thereby reducing use of the scaler — an instrument a non-negligible share of patients find unpleasant or anxiety-inducing. On prosthetic restorations in particular, air polishing with fine powders offers a specific advantage: manual instruments can scratch or chip surfaces, while the controlled jet of fine powder removes biofilm from crown margins without compromising marginal seal.

On Oralzon you'll find air polishing systems and professional glycine- and erythritol-based powders, suited both for routine supragingival prophylaxis and for perio-polishing in periodontal pockets.