Air Polishing Lecture

Definition: Air polishing is a specialized dental hygiene technique that utilizes a pressurized stream composed of air, water, and fine powder.
Primary Function: The procedure is designed to effectively remove plaque and extrinsic stains from the tooth surfaces.
Clinical Role: It is frequently employed as either a direct alternative to or a supplemental procedure for traditional prophylaxis methods, such as scaling and standard rubber-cup polishing.
Substance Composition: The process employs a "slurry," which is a specific mixture of air, water, and various types of abrasive powders.
Targeted Debris: The technology is particularly adept at removing biofilm and stubborn extrinsic stains caused by the consumption of coffee, tea, and red wine, as well as the use of tobacco products.

Introduction: The technique was first introduced to the dental field in the 1970s.
Evolution of Materials: Historically, Sodium Bicarbonate was the primary powder used in air polishing systems. In recent years, several new powder types have been developed and introduced to expand the clinical scope of the procedure.
Professional Trend: There is a documented increase in the adoption of air polishing techniques within the dental hygiene profession.

System Components: The typical air polishing unit consists of several critical parts:
- Handpiece: The tool used by the clinician to direct the stream.
- Powder Chamber: The reservoir where the polishing powder is stored before being mixed into the stream.
- Air/Water Source: The supply lines that provide the necessary pressure and fluid for the slurry.
Mechanism of Action: The equipment functions via a pressurized stream that physically disrupts the attachment of the biofilm and stains from the tooth's surface.

Sodium Bicarbonate:
- Main Use: Primary stain removal.
- Characteristics: Coarse texture with high abrasiveness.
Glycine:
- Main Use: Specifically utilized for subgingival cleaning.
- Characteristics: Gentle on the soft oral tissues.
Erythritol:
- Main Use: Optimized for biofilm disruption.
- Characteristics: Very fine particle size and characterized by a lower abrasive profile.
Calcium Carbonate:
- Main Use: General polishing procedures.
- Characteristics: Features a medium level of abrasiveness.

Extrinsic Staining: Used for patients presenting with heavy exterior stains that are difficult to remove with traditional methods.
Biofilm Management: Effective for the thorough removal of bacterial biofilm.
Orthodontic Care: Specifically indicated for orthodontic patients, as the spray can easily navigate around brackets and wires.
Implant Maintenance: Used for cleaning dental implants and their associated components during routine maintenance visits.

Respiratory Concerns: Use is contraindicated for patients with chronic respiratory diseases, including asthma and Chronic Obstructive Pulmonary Disease (COPD).
Dietary Restrictions: Patients on sodium-restricted diets should not be treated with sodium bicarbonate powder.
Condition Transmission: Contraindicated for patients with known infectious diseases due to aerosol production.
Oral Lesions: The procedure should be avoided if there are open wounds or ulcerations present within the oral cavity.

Efficiency: The procedure is generally faster than traditional rubber-cup polishing.
Enamel Preservation: It is considered less abrasive on the tooth enamel compared to some traditional polishing pastes.
Accessibility: Provides superior access to hard-to-reach areas of the mouth that are often inaccessible to mechanical polishing cups.
Patient Comfort: Generally reported as a more comfortable experience for the patient.

Aerosol Generation: A major concern regarding infection control, as the pressurized spray creates a significant amount of airborne particles.
Iatrogenic Injury: There is a risk of soft tissue irritation or damage if the handpiece is misused or directed improperly.
Patient Specificity: The procedure is not universally suitable for every patient type.

Personal Protective Equipment (PPE): Comprehensive PPE must be worn by both the clinician and the patient to protect against aerosols and splatter.
High-Volume Suction: The use of high-volume evacuation (HVE) is mandatory to capture aerosols at the source.
Pre-procedural Rinse: Patients should perform a pre-procedural rinse to reduce the microbial load of the oral cavity before the generation of aerosols.