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.

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.

Effects of air polishing on gold foil, gold castings, porcelain, amalgam, and glass ionomers have been studied. Air polishing of amalgam alloys and other metal restorations has produced a variety of effects, including matte finishes, surface roughness, morphological changes, and structural alterations.

One study found no detrimental changes to the marginal integrity of amalgams. Surface roughness, staining, pitting, and loss of marginal integrity were seen on porcelain surfaces. One study reported only minimal changes in porcelain and gold alloys. Hand instrumentation at the gingival margins and caution were recommended when working around these restorations. The surface roughness of glass ionomers increased following either air polishing or rubber-cup polishing. Until research findings on air polishing's effect on these restorative materials are unequivocal, clinicians should follow manufacturer recommendations to "avoid prolonged or excessive use on restorative dental materials.