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Air polishing overview 2012

May 7, 2012
Tracey Linnemann, RDH, provides an overview of air polishing protocols and materials.

By Tracey Lennemann RDH, BA

Many questions are asked about the different air polishing powders, how they work, and for what situations are they used. Below is a brief overview of the powders to assist in choosing which powder to use for which patient.

Scientists have shown us that plaque is actually biofilm,1,2 a complex living environment of various species of bacteria existing in a harmonious world. We know that biofilm is located everywhere in our mouths and is difficult to remove in areas such as under restorative margins, around implant interfaces, and deep in periodontal pockets.

Studies continue to support the connection between oral bacteria and systemic complications.3 The mouth is the door to the body; therefore, it is vital that the oral cavity be kept as healthy as possible not only for teeth but for overall general health.

Today’s treatment protocols begin with general debridement of hard deposits (tartar/calculus) and biofilm removal.

  • Assessment of disease and diagnosis
  • Ultrasonic removal of subgingival calculus
  • Hand instrumentation (scaling and curettage)
  • Polishing (air + manual)
  • Homecare instructions and optimization
  • Individual maintenance intervals
Once hard deposits are eliminated, our focus is to remove the soft plaque and biofilm from all surfaces. Which system and product should be used is individually assessed according to each patient’s needs. For fast and effective stain and Biofilm removal, air polishing is the procedure of choice.4,5Today, there are five different air polishing powders on the market each having a different effect on tooth and root surfaces, restorative materials and biofilm.6,7,8,9,10The first air polishing equipment was introduced in the late 1970s using sodium bicarbonate as the most common air polishing powder.4 Around early 2000, other powders entered the market proving to be more effective, less damaging, easier to use, and more suitable for most patients.Understanding air polishing is key to a successful treatment. Refer to the charts at this link and this link for specific information on each powder. Both charts offer detailed information about current air polishing powders.
Tracey Lennemann RDH, BA, is an international professional speaker and trainer living in Europe. She has been a practicing clinical periodontal dental hygienist since 1986. Tracey is an honorary lecturer at Warwick University, UK and is CEO of in2motion Ltd. In 1995, Tracey developed a series of continuing education workshops, lectures and seminars for dental teams. These motivational and educational programs have provided a unique integration of sales, communication and customer service tools designed to help the Dental professional promote prophylaxis and periodontal concepts to their patients. She can be contacted at [email protected] for more information.References
  1. J. Li, E.J. Helmerhorst. Identification of early microbial colonizers in human dental biofilm. Journal of Applied Microbiology Volume 97, Issue 6, pages 1311–1318, December 2004.
  2. Chen C, Rich S. Biofilm basics. Dimen Dent Hyg 2003; 1(1):22-25.
  3. Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology 2006; 94(1):10-21.
  4. Gutmann ME. Air Polishing: A comprehensive review of the literature. J Dent Hyg 1998; 72(3): 47-56.
  5. Weaks LM, Lescher NB, Barnes CM, Holroyd SV: Clinical evaluation of the prophy-jet as an instrument for routine removal of tooth stain and plaque. J Periodontol 1984; 55: 486-488.
  6. Christensen R: Oral prophylaxis: Prophy-jet. Clin Res Assoc Newsletter 1981; 5: 1.
  7. Berkstein S, Reiff RL, McKenney JF, Kilroy WJ: Supragingival root surface removal during maintenance procedures utilizing an air-powder abrasive system or hand scaling; J Periodontol 1987; 58; 327-330.
  8. Flemmig TF, Hetzel M, Topoll H, Gerss J, Haeberlein I, Petersilka G.Subgingival debridement efficacy of glycine powder air polishing. J Periodontol. 2007;78:1002-1010.
  9. Banerjee A, Hajatdoost-Sani M, Farrell S, Thompson I. A clinical evaluation and comparison of bioactive glass and sodium bicarbonate air polishing powders. J Dent 2010; 38: 475 – 479.
  10. The Effects of a Commercial Aluminum Airpolishing Powder on Dental Restorative Materials. W. Johnson, C. M. Barnes, D.A. Covey, Journal of Prosthodontics 13:3 (September 2004), pp. 166–172.