There are several new dental air polisher designs and new abrasive powders, and we now have the ability to use air polishers subgingivally. These devices incorporate an abrasive powder with a stream of compressed air and water to clean and polish a surface. Air Polishers are mostly used by the dental hygienist to remove stain, plaque, and polish the enamel above the gum line.

When moderate to heavy stain is present on root surfaces, dental hygienists are often faced with the problem of removing it with the least alteration of cementum. One choice is to leave the stain and explain to the patient that stain is not associated with oral disease and will not harm the teeth or gingiva since it is only a cosmetic concern. To many patients, this is not a viable choice since appearance is considered so important in today's society.

Other choices include removing the stain with a rubber cup polisher and prophylaxis paste; sonic, ultrasonic scalers; Dental Hand Instruments or the air polisher. However, in one in-vitro study, air polishing was shown to remove less root structure than a curet in simulated three-month recalls for three years. Since less root structure is removed, decreased root-surface sensitivity also may be a benefit.

Air polishing has been compared to scaling and rubber-cup polishing for efficiency and effectiveness of stain and plaque removal. The use of the 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.

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. The surface roughness of glass ionomers increased following either air polishing or rubber-cup polishing.  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.