Oral health care professionals have a responsibility to patients to engage in life-long learning in order to provide the most contemporary clinical care. This review of air polishing should enable clinicians to make sound decisions regarding the most appropriate treatment for each patient. Air polishing has been studied extensively and, when used appropriately, provides a safe, efficient and contemporary approach to achieving a variety of treatment goals.
Use of the air polisher for stain removal involves three steps: patient selection and preparation, clinician preparation, and the actual clinical technique. Air polishing should follow a careful review of the patient’s medical and dental history, and a thorough examination of the oral hard and soft tissues. Indications and contraindications, effects on hard tissues, restorations, safety, and alternative uses should be reviewed prior to treatment planning the use of the air polisher.
Preparation of the patient should include an explanation of the procedure, removal of contact lenses, an anti-microbial rinse, application of a lubricant to the lips, placement of safety glasses or a drape over the nose and eyes, and placement of a plastic or disposable drape over the patient’s clothing. Operators should use universal precautions, including protective apparel, a face shield or safety glasses with side shields, gloves, and a well-fitting mask with high-filtration capabilities.
The actual air polishing technique includes proper patient and operator positioning for adequate access and direct vision, use of high-speed suction if an assistant is available, or use of the saliva ejector and aerosol-reduction device when working alone. The suction orifice of the saliva ejector should be as close as possible to the tip.
It also may enhance patient comfort if a moistened 2×2 gauze square is placed over the tongue or lip in the area being polished. Rapid, sweeping strokes are recommended, with the tip directed at a 60° angle to the tooth for anterior teeth, 80° for posterior teeth, and a 90° for occlusals. Cupping the lip with the forefinger and thumb allows the water to pool in the vestibule for easier evacuation and minimal aerosol dispersion. Polishing two to three teeth at a time by fully depressing the foot pedal, then rinsing the teeth and tongue by pressing the foot pedal half way increases efficiency and minimizes the saline taste. A systematic approach to polishing all teeth will increase efficiency. Polishing for five seconds or less per tooth is usually adequate to remove most stains.
Dental Hand Instruments; air polishers; sonic, piezo, and ultrasonic scalers; and rubber cup polishers on all tooth surfaces. In addition, these studies should attempt to control the variables of quantity of stain, abrasiveness of polishing pastes, and amount of pressure applied to each surface.