Key points in brief
- Evidence suggests that properly performed air polishing does not damage healthy enamel. Veneers and bonding can be air-polished too, if the powder and technique suit the material.
- Bonding, white fillings made of tooth-coloured composite, exposed roots and veneer edges call for caution. On these, a powder chosen for the surface, gentle technique and polishing matter.
- Before air polishing, point out where you have veneers, bonding, crowns and white fillings, and mention any receding gums or white spots on your teeth.
- Before the procedure, also mention asthma, other lung diseases, a sodium-restricted diet and allergies. They affect the choice of powder, and with lung disease, whether air polishing is possible.
Consult your case with an expert and get your treatment plan
Is air polishing bad for teeth, and how do the powders differ?
Evidence suggests that air polishing does not damage healthy enamel if it is done properly. Enamel is the hardest tissue in the body, and the particles of the powders used to clean teeth are softer than enamel. The root of a tooth and composite are softer than enamel and wear more easily. White fillings are made of composite. It is also used for bonding, a layer applied at the practice to the front surface of a tooth. Enamel weakened by acids, as in enamel erosion, or demineralised in white spots also calls for caution.
Air polishing cleans teeth with a jet of water, air and powder that removes soft plaque and stains from coffee, tea and tobacco. What the jet does to the surface of a tooth or a filling depends mainly on the powder. The classic powder has coarse particles and is most often bicarbonate of soda, that is sodium bicarbonate. It removes stains well, but it is meant for enamel above the gum line.
Fine-grained powders are less abrasive. One of them is finely ground bicarbonate. The others, known as gentle powders, contain glycine, erythritol or trehalose, that is an amino acid, a sweetener or a type of sugar. It is these gentle powders that were developed for use below the gum line.
A gentle powder does not necessarily clean less well. In a laboratory study, tobacco smoke stains came off enamel after erythritol about as well as after bicarbonate. How much a powder wears away also depends on technique: the angle at which the jet hits the tooth, how far the tip is from the tooth and how long the jet stays on one spot.
Air polishing is one of the stages of a dental hygiene appointment. The difference between scaling and air polishing is that the powder jet does not remove hard tartar, so air polishing does not replace scaling, that is the removal of tartar. If you are worried about pain, see what professional teeth cleaning involves and how it feels: for most patients air polishing is painless, and over an exposed root it can be slightly unpleasant.
What to tell the hygienist before air polishing
Before the procedure, tell the hygienist or dentist about any veneers, bonding, crowns and white fillings, including those placed at another practice. A composite veneer or a well-matched white filling can sometimes be hard to tell apart from a natural tooth. You can also ask:
- Do my veneers and bonding need a different powder?
- My gums have receded. Does that change how you clean near the gum line?
- I have white spots or enamel weakened by acids. Do they need more careful cleaning?
- I have asthma or I am on a sodium-restricted diet. Do you need to choose a different powder or a different way of cleaning?
- Is there anything worrying at the edge of any of my veneers or crowns?
Also point out anything that has changed recently: a dark line at the edge of a veneer, a step you can feel, or a chip. The hygienist will then treat those areas more carefully and show them to the dentist.
How powder affects enamel, roots, composite and ceramics
The same powders act differently on different surfaces. Almost everything known about this comes from laboratory studies on extracted teeth and material samples.
| Surface: what studies show | What is seen at the appointment | What this means for powder and polishing |
|---|---|---|
| Enamel. Several consecutive treatments with a gentle powder or bicarbonate did not noticeably change its smoothness. Whether enamel in the mouth changes after many years of such treatments is not known. | Usually no changes visible to the naked eye. | For healthy enamel, the usual choice of powder is enough. Enamel with white spots or weakened by acids needs a more careful technique. |
| Exposed root. After a single treatment with a fine powder, including fine bicarbonate, so little root was lost that it was hard to measure. The result applies to roots of extracted teeth, with no gum or saliva. | The root is matt and yellowish. Right after cleaning it can be rough, and polishing may partly smooth it. | On the root, fine powder only, used briefly and without stopping in one place. Classic coarse-grained powder is not aimed at the root. |
| Composite in bonding and fillings. Every powder tested leaves composite slightly rough. After bicarbonate, including fine bicarbonate, the roughness is more marked than after glycine and erythritol. The studies used smooth composite samples, not fillings in the mouth. | Older composite is sometimes matt and rough, with stained edges. | For composite, a gentle powder such as glycine or erythritol is usually chosen. The composite is polished at the end. |
| Ceramic veneers and crowns. The surface of veneers made of modern ceramics did not change after a gentle powder. Less is known about other powders and other types of ceramics. | The ceramic surface usually looks the same as before the procedure. | A gentle powder is suitable for the ceramic surface. Its edge is what calls for caution. |
| Veneer edge and cement. Luting cement, that is the material used to attach a veneer to the tooth, was slightly worn away at the edge after a gentle powder and temperature changes. It is not known how often this leads to a stained edge in the mouth. | Over time, a dark line or a step you can feel may appear at the edge of a veneer. | Over time, a dark line or a step you can feel may appear at the edge of a veneer. |
Fine bicarbonate left the root smoother than glycine did, but left composite rougher than glycine did, so no single powder is the gentlest for everything. Laboratory results also cannot be transferred directly to teeth in the mouth, where saliva and gums are present. That is why, with veneers, bonding or an exposed root, the hygienist chooses the powder and technique for each surface separately.
Can veneers and bonding be air-polished?
Yes, veneers and bonding can be air-polished if the powder is matched to the material and the jet is not aimed directly at the edge. A ceramic surface tolerates a gentle powder well. Bonding loses its shine more easily, so it is cleaned with a gentle powder, for example glycine or erythritol, and polished at the end of the appointment. A ceramic veneer is attached with luting cement, so its edge, where it meets the tooth, is cleaned most carefully.
Air polishing and bonding or composite fillings
Even after gentle powders, composite becomes slightly rough, and in one study it lost most of its shine after bicarbonate. A rough surface holds on to bacterial plaque more easily, and dulled composite stands out from the neighbouring teeth.
Polishing bonding is a normal part of professional cleaning, and if bonding loses its shine, the dentist can also polish it between cleaning appointments. A composite veneer is made of the same material as bonding, so the same rules apply to it. If you are only planning veneers or bonding, the timing of the procedure depends on the state of your gums after teeth cleaning before veneers.
Ceramic veneers and the cement at their edge
Ceramics are harder than composite, so the weaker point of a ceramic veneer is its edge, where a thin strip of luting cement is exposed. In the laboratory, a little cement was lost at the edge of ceramic veneers after cleaning with a gentle powder and many temperature changes.
Cement was also lost around ceramic crowns. In a simulation of 5 years of regular appointments, a little more disappeared with each gentle-powder treatment when the jet was also aimed directly into the gap between the crown and the tooth. No veneer or crown came off in these studies, but it is not yet known what effect such loss has in the mouth. Polishing will not rebuild the cement, so the dentist assesses changes at the edge at a check-up.
The root at the gum line: why it wears more easily than enamel
The root has no enamel, so where the gum has receded the jet hits the cementum - a thin layer of tissue covering the root - and the dentine beneath it. Both tissues are softer than enamel, and the cementum near the neck of the tooth can be very thin. For this reason, exposed tooth necks need to be air-polished differently from enamel. The root is not skipped during cleaning, though. Plaque on it encourages decay, so it has to be removed, just more gently than from enamel.
Classic coarse-grained powders can wear away a fair amount of tissue from the root, so they are reserved for enamel above the gum line. In a study on roots of extracted teeth, a single treatment with glycine, erythritol, trehalose or fine bicarbonate removed so little tissue that it was hard to measure. The same root is cleaned at every appointment, however, so the jet is moved over it briefly, without stopping in one place.
Polishing and fluoride after air polishing with bonding, veneers and exposed roots
At the end, the hygienist polishes the teeth and fillings to smooth them after scaling and air polishing. This is done with rubber cups, soft brushes and polishing paste. Paste is also abrasive, though, so a finer paste is chosen for fillings, veneers and exposed roots than for enamel.
During fluoride treatment, a high-fluoride product, most often a varnish or foam, is applied to the cleaned teeth. It is meant to strengthen enamel and reduce sensitivity after the procedure. On an exposed root, fluoride has one more job - it helps protect the root from decay.
How to prepare for your next professional cleaning
Do not put off professional cleaning for fear that air polishing will damage your enamel. Evidence suggests that a properly performed procedure does not harm healthy enamel. With veneers, bonding and exposed roots, what matters is a powder suited to each of these surfaces, careful technique at the edges and polishing at the end of the appointment. The hygienist will be able to choose the powder and technique if, before the procedure, you mention your veneers, bonding, crowns, white fillings, receding gums and white spots.
Frequently asked questions
Can air polishing be used around dental implants?
Yes, air polishing is one of the methods used to clean implants. Specialists in gum treatment consider gentle powders with glycine or erythritol safe for implants. The type of powder and tip is still chosen to suit the crown or bridge on the implant and the condition of the gum around it. Between appointments, daily implant hygiene at home is just as important.
What are the contraindications to air polishing?
The powder jet is not aimed at fresh ulcers in the mouth. Bicarbonate powder is not used in people on a sodium-restricted diet, for example because of high blood pressure or kidney disease. The hygienist then chooses a sodium-free powder. Before the appointment, also mention asthma and other lung diseases. The jet of air and powder may then make breathing difficult, so air polishing is sometimes left out. Also mention any allergies, including allergies to antiseptics.
Can air polishing irritate or damage the gum?
The jet can irritate the gum. This probably happens especially when it hits the gum at a slant. For a day or two the gum may be tender and may bleed slightly when you brush. Contact the practice if bleeding has not eased after 2 days or is getting worse, or if you have pain, swelling of the gum or cheek, or a fever.
Does air polishing remove stains from fine cracks in the enamel?
Air polishing removes stain from the surface of the enamel, but stain that has seeped into a fine crack, known as a craze line, usually stays. Craze lines in enamel are common, do not hurt and usually need no treatment. If a dark line on a front tooth bothers you, the dentist will assess what might lighten it.
Does air polishing wear away enamel if it is repeated for years?
In the laboratory, the smoothness of healthy enamel did not change noticeably after several consecutive treatments. It is not known, however, how enamel in the mouth copes with many years of regular appointments. Luting cement, on the other hand, was lost with each treatment when the jet was also aimed directly into the gap between the crown and the tooth, which is why such areas are cleaned especially carefully.
Do composite and veneers stain more easily in the first hours after air polishing?
It is not known whether composite stains more easily in the first hours, so for about a day after the procedure, cut down on coffee, tea and red wine, as in the aftercare advice after professional cleaning. In the laboratory, composite did not darken from smoke any faster when air polishing was repeated in the following weeks. A ceramic veneer resists staining, and only the cement at its edge can be more vulnerable.
Can teeth feel rough near the gum in the first days after air polishing?
Yes, for the first few days your tongue may feel a different surface near the gum than before. Where tartar sat before it was removed during scaling, the root may now be visible. It is matt and feels different from enamel. Polishing at the end of the appointment may partly smooth out minor unevenness left by cleaning. Show the dentist any clear step or groove near the gum that does not go away.
Read more:
- Dental Hygiene and Whitening in Warsaw
- Scaling or air polishing — which procedure is done for which problem
- Implant hygiene — how to clean dental implants step by step
- How long do veneers last? Durability of porcelain and composite in the light of studies
- Dental bonding — a quick smile makeover. What does it involve?
Content and liability disclaimer
This article is informational and educational in nature and does not constitute medical advice, a diagnosis or a therapeutic recommendation — it does not replace a consultation with a specialist. If you are experiencing symptoms, have doubts or are facing a decision about treatment, consult a dentist. The methods described and the data cited are general in nature. The results of scientific studies relate to populations, not to an individual patient. The course and outcome of therapy depend on the individual clinical situation and may vary between patients. No information contained in this article constitutes a guarantee of result. The content has been prepared with due care, based on publicly available medical knowledge and the scientific publications indicated in the Sources section. We do not advise taking or refraining from any health-related action solely on the basis of the content of this article, without prior consultation with a doctor.
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