1. The most common powder used for conventional air polishing is:
Conventional air polishing utilizes sodium bicarbonate. It is intended for stain removal from the enamel tooth surface. Air polishing with sodium bicarbonate is intended for supragingival use only.
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
2. Conventional air polishing with sodium bicarbonate powder has been available as an alternative to rubber cup polishing since the late 1970s.
Air polishing was first introduced to dental hygienists in the late 1970s. However, the technology was invented by Dr. Robert Black in 1945; his original idea was to use compressed air, water, and a highly abrasive powder to eliminate pain during cavity preparation. Though the idea was flawed and did not pan out, it was determined to be a useful tool in the area of dental hygiene and, more recently, in the control of biofilm.
Graumann, S.J., Sensat, M.L., Stoltenberg, J.L. Air polishing: a review of current literature. J Dent Hyg. 2013; 87(4): 173-180.
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
3. Deep subgingival biofilm (> 4mm in depth) removal can be achieved using the air polisher with which of the following?
Sodium bicarbonate should never be used subgingivally. The metal standard nozzle with glycine powder is effective for pockets up to 4 mm in depth, while the flexible plastic tip with glycine powder is effective in pockets greater than 4 mm. In the U.S., the FDA has approved the use of plastic perio tip for use in pockets up to 5 mm in depth. Health Canada has approved the use of the plastic perio tip in pockets up to 10 mm in depth.
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
4. Both sodium bicarbonate and glycine powder can be used for the removal of biofilm. Both may also be used on restorative materials.
Both sodium bicarbonate and glycine powder can be used for the removal of plaque biofilm; however, sodium bicarbonate is contraindicated for use on restorative materials. Glycine powder is less effective when compared to sodium bicarbonate for removal of extrinsic stain and cleaning of fissures prior to sealants. In addition to the contraindication of use on restorative materials, sodium bicarbonate is also contraindicated for use on cementum, dentin, within a sulcus or periodontal pocket, and cleaning implant surfaces.
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
5. Patients that present with which of the following medical conditions are contraindicated for the use of air polishing with sodium bicarbonate?
Contraindication for the use of air polishing with sodium bicarbonate include all of the following:
- Patients on restrictive sodium diets
- Patients with respiratory problems (asthma, bronchitis, COPD)
- Patients who are immunocompromised (diabetes, hemophilia, neutropenia, agranulocytosis, etc.)
- Patients that are pregnant or breastfeeding
- Patients undergoing radiotherapy or chemotherapy
- Patients with a communicable infection
- Patients with a history of allergies
- Patients with Addison disease, Cushing disease, or metabolic alkalosis
- Patient taking certain medications (potassium supplements, antidiuretics, or corticoid steroids)
- Patients with certain restorative materials (hybrid, micro-hybrid, micro-filled composite, glass ionomers)
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
6. Iatrogenic facial emphysema is a rare condition that results from the accidental introduction and collection of air in the soft tissues of the face from the use of pressurized air in dental procedures. Air emphysema is reported in the literature more frequently associated with the use of high-speed dental drills rather than air polishing devices.
Facial emphysema has been reported after the use of air polishers, high-speed dental handpieces as well as air/water syringes, and even taking impressions. Three cases of air embolism have been reported in the literature associated with air polishing devices from 1977 to 2001. Facial air emphysema is reported more frequently in association with high-speed dental drills rather than air polishing devices.
Symptoms of facial air emphysema include facial swelling, a crackling feeling of the face and neck, tenderness, and pain. Emergency healthcare providers may not be familiar with facial emphysema and misdiagnose it as an allergic reaction; therefore, it is imperative that dental professionals are able to detect the symptoms quickly.
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
7. During treatment with an air polisher, it is strongly recommended that both the clinician and patient wear eye protection. If the patient wears contact lenses, there is no indication they should be removed prior to treatment.
During treatment with air polishing devices, it is strongly recommended that both the patient and the clinician wear safety glasses. Additionally, if the patient wears contact lenses, it is recommended that the patient remove their contact lenses prior to treatment. Powder accidentally spraying into the eyes could cause severe eye injury. Additionally, nonpetroleum-based lip protection should be provided to prevent irritation or chapping of the lips.
Gehrig, J. (Ed.). (2019). Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation (Enhanced 8th edition, 717–742). Jones & Bartlett Learning.
