Traditionally, a rubber cup and fluoridated prophy paste method has been used for plaque and stain removal. However, this technique has obvious limitations in areas of crowding, around orthodontic fixed appliance and of course, in areas of limited access such as under and around fixed multiple unit restorations.
 
Air polishing is introduced to the dental community as a mechanism to quickly and easily remove extrinsic stain and soft deposits from tooth surfaces. 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.

In most currently available units, the water stream emits through a separate nozzle that may be concentric to that of the powderladen air stream nozzle. The resulting buildup of crystalline anhydrous sodium bicarbonate deposits in the lumen of the air/powder nozzle results in clogging. Several attempts have been made to overcome this, including the introduction of a ‘bleed air stream’ that flowed constantly through the air/powder nozzle and changes in the chemical composition or physical nature of the powder

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.