Air- polishing devices Flashcards
Describe air powder polishing
- Uses air, water and abrasive powder (E.g. sodium bicarbonate, aluminum trihydroxide, calcium sodium phosphosilicate, calcium carbonate, glycine)
- It has a handpiece nozzle that delivers a controlled spray of the powder-water slurry to mechanically remove extrinsic stain and biofilm
List the types of powders available
Sodium bicarbonate
Aluminium trihydroxide
Calcium sodium phosphosilicate
Calcium carbonate
Glycine
Describe sodium bicarbonate in terms of Mohs hardness and particle size
• Mohs hardness number of 2.5 with particle size of 75 µm
Describe aluminium trihydroxide in terms of Mohs hardness and particle size
- Alternative for those who are sodium bicarbonate intolerant
- Mohs number of 4 with particle size from 80 to 325 µm
Describe calcium sodium phosphosilicate in terms of Mohs hardness and particle size
• Bioactive glass with Mohs number of 6 with particle size from 25 to 120 µm
Describe calcium carbonate in terms of Mohs hardness
• Naturally occurring substance with Mohs number of 3
Describe glycine in terms of Mohs hardness
- Is an amino acid
- Mohs number of 2 with particle size of 20 µm
- Only one that can be used supragingivally
Describe erythritol in terms of
- Grain size
- Ingredients
- Indications
- Grain size ~14 µm
- Impact per particle is extremely low
- Contains 0.3% Chlorhexidine
- Polyol: natural sugar substitute that occurs naturally in some fruits and fermented food
- Suitable for patients on low salt diet (no salt)
- Used supra and subgingivally
State the indications for the use of air-powder polishing
- Effective removal of stain and biofilm on natural teeth, around orthodontic brackets and dental implants
- Removal of heavy and/or tenacious tobacco or chlorhexidine stain
- Prior to fissure sealant placement or other bonding procedures
- Root detoxification for open surgical periodontal surgery
Discuss the advantages of air-powder polishing
- Requires less time
- Generates no heat
- Improved ergonomics for clinician
- Less abrasive than traditional prophylaxis pastes
- Useful for removal of heavy extrinsic stain
- More effective around orthodontic appliances
- Useful in removal of deposits and debris prior to bonding techniques
Discuss the disadvantages of air-powder polishing
- Production of aerosols
- Use of mirror for indirect vision
- Spray may be uncomfortable for patient and inconvenient for clinician
- Contraindicated for some patients
Discuss the contraindications of air-powder polishing
- Patients with respiratory diseases/conditions that limit breathing and swallowing (E.g. asthma, bronchitis, emphysema, cystic fibrosis, cold, etc)
- Patients with end-stage renal disease, Addison’s or Cushing’s disease
- Patients with communicable infections
- Patients who are immunocompromised
- Diabetes
- Haemophilia
- Predisposed patients with sensitivity to powder (potential allergy)
- Patients taking potassium, anti-diuretics or steroids
- Patients with sodium-restricted diet (Low salt diet)
- Certain restorative materials (composite resins, cements, porcelain, gold, etc)
- Soft, spongy gingiva
Discuss the precautions of air-powder polishing
- AirFlow First, BEFORE scaling
- This is to reduce the risk of embolisms (little bubbles) in the gingiva
- That’s because when you scale, you may great microabrasions. Then, when you use the air flow, the air and water will go into the gingiva and cause “bubbles”
- It’s not painful and will see resolve, but it’s unpleasant for the patient
Explain the protective procedures for the patient and the clinician prior to air-powder polishing
Patient
• Explain air powder polishing procedure
• Pre-procedural anti-microbial mouthrinse
• Safety glasses and facial towel or cover
• High volume evacuator or saliva ejector (suction)
Clinician
• PPE (glasses, mask/face shield, protective gown, head cover)
• Set-up air powder polisher
Explain the supra and subgingival polishing technqiue
Supra (4mm pocket to extrinsic staining):
• Direct the nozzle 3 to 5mm away from tooth and at an angle of 30 - 60 degrees (incorrect angulation may impact effectiveness, cause excess aerosol production or soft tissue damage)
• Make constant small horizontal or circular motions (never stay in one place for more than 5 seconds)
Sub (5-10 mm pockets and implants)
• Insert nozzle into the periodontal pocket and press foot pedal for maximum of 5 seconds using short vertical motions of the nozzle
• Do not force nozzle into pocket
