Air Polishing Has Changed—So Why Hasn't The Dental Hygiene Curriculum?

Since air polishing was introduced in the 1970s, air polishers and abrasive powders have changed, and more indications for air polishing exist. So why isn't it more of a focus in the dental hygiene curriculum?

I recall having a brief overview of air polishing and getting to use it in the clinic—just one time—when I was a student of dental hygiene back in 1993. At the time, I had mixed thoughts: "Wow! That stain came off like magic," "what a mess," and finally, "it's not worth the effort to assemble the unit, only to have my patient complain about how horrible it tastes."

In my 23 years as a hygienist working for countless dentists in Washington State and California, I've learned that only a small percentage of offices seem to have air polishing devices. I've given this very little thought over the years. When I did think about it, it was when patients with horrific stain landed in my chair. However, after attending a continuing education course earlier this year, taught by Karen Davis, RDH, BSDH, I started to give air polishing more thought.

Changes in air polishing

Air polishing was introduced in the late 1970s as an alternative to a rubber cup filled with pumice. (1) Using a slurry of water, abrasive powder, and pressurized air, the air polisher effectively removes extrinsic stain, plaque biofilm, and prepares occlusal surfaces of teeth for sealant placement. (1) Originally, air polishers were only intended for use on supragingival surfaces since the abrasive powder could potentially harm the softer tissues, such as the cementum, dentin, and gingival epithelium. (1)

Like many things 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.