Air polishing units typically generate a stream of pressurized air, carrying specially graded particles of a mild soluble abrasive, such as sodium bicarbonate. The abrasive is directed, in the presence of a stream of water, at a tooth surface to be cleaned. The mixture of water and powderladed stream occurs on the tooth surface and forms a “slurry” that is responsible for the cleaning action.

More recent technology produces a slurry by introducing the water stream into the powder-laden air stream, within the spray head at a critical moment, to produce a fully homogeneous stream that is emitted from a single nozzle. This stream technology configuration has not only been shown to prevent nozzle clogging by preventing the buildup of deposits, but also results in a much more efficient cleaning action because the slurry is formed prior to emission.

Air polishing devices were originally designed to be standalone tabletop units. They have been considered to be the equipment of choice for the hygiene department, sometimes being combined with ultrasonic scaler. They offer a large powder chamber holding enough powder for multiple treatments, along with the convenience of a lightweight, fully autoclavable handpiece design. They are activated by a dedicated foot control that can select either a polishing or rinse mode and they require connections to water, air and electrical outlets. As such, they are normally allocated to a particular treatment room. 

Air polishing has been compared to scaling and rubber-cup polishing for efficiency and effectiveness of stain and plaque removal. The literature overwhelmingly supports the use of the dental air polisher as an efficient and effective means of removing extrinsic stain and plaque from tooth surfaces. Air polishing requires less time than traditional polishing methods and removes stain three times as fast as scaling with comers. In addition, less fatigue to the operator has been mentioned as an important benefit of air polishing.

 Because polishing with a rubber cup and prophylaxis paste has been shown to remove the fluoride rich layer of enamel and cause marked loss of cementum and dentin over time, this method of stain removal has been challenged Rubber cup polishing with prophylaxis pastes, therefore, may not be a suitable method for moderate-to-heavy stain removal on enamel, cementum, or dentin. One study, however, contradicted these findings and suggested that rubber cup polishing with chalk is equally effective in decreasing root-surface roughness caused by sonic scaling. Chalk is not a common polishing agent and no comparison of the abrasiveness was made between it and the sodium bicarbonate used in air polishing powder.

Gingival bleeding and abrasion are the most common effects of air polishing. These effects are temporary; healing occurs quickly and effects are not clinically significant. No complications were seen with healing at extraction sites following air polishing of teeth prior to extraction. To avoid tissue trauma, the manufacturer recommends pointing the tip of the air polisher at the facial, lingual, or occlusal surfaces, thus avoiding the gingival margins.