What is air polishing and how much does it cost?

Over time, bacteria-containing plaque can build up on teeth. This can lead to gum disease (gingivitis), calculus (tartar) build up, and can cause stains to develop on your teeth.

Traditionally a scale and polish has been used to remove these problems, but air polishing is an increasingly more popular alternative to the traditional cleaning.

In this article I will explain:

What is Air Polishing Dental Treatment?

Air polishing dental treatment is the use of a powerful combination of water and powder directed at the teeth to help remove plaque and staining.

AirFlow® is a trade name and is produced by EMS Dental and is the market leader in this technology at present. 

The main purpose of AirFlow® is to remove plaque and staining from the teeth and just underneath the gums.

By removing plaque (and the bacteria it contains) the main cause of tooth decay, gingivitis, and periodontitis is removed. EMS Dental explain that AirFlow® is used for:

  • Removing plaque from teeth and underneath the gums, to increase gum health.
  • Removing stains from teeth to enhance their appearance.
  • Removing calculus from teeth to promote gum health and make cleaning easier at home.
Patient undergoing AirFlow® air polishing dental treatment
A patient undergoing AirFlow® air polishing dental treatment — Image Source: EMS Dental

What is plaque?

Plaque is a sticky substance on the teeth that contains bacteria. 

It is completely normal that plaque builds up over the course of the day. 

However whilst some bacteria in plaque are harmless, some are harmful to your tooth and gum health. This is why not removing plaque causes gingivitis (gum disease) and dental decay.

Over time, if the teeth and gums are not properly cleaned, the plaque is not removed. The plaque builds up and the bacteria in it produce acids which irritates your gums. This can lead to redness with bleeding, swelling and tenderness.

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Teeth stained with plaque disclosing solution -- Image Source: Electric Teeth

This is the early stages of a condition called gingivitis, or as it is more commonly known, gum disease.

The bacteria in plaque produce acids that can also soften the outermost surface of your tooth, eventually leading to holes in your teeth – dental decay.

Safely removing plaque from teeth will prevent gingivitis and dental decay developing, and air polishing is a professional cleaning service you may want to use in addition to good cleaning at home.

How do stains form?

Staining on teeth is a common occurrence. Extrinsic stains are those which develop on the outside of the tooth as a result of what we put in our mouths.

This sort of staining will often develop at the edges of your teeth where they meet the gums, or in between teeth where cleaning is more difficult.

It is possible to stain your teeth for example with:

  • Tea and coffee
  • Curry 
  • Red wine
  • Chlorhexidine mouthwash (such as Corsodyl)
  • Tobacco/smoking

As we have already said, if you have a build up of calculus, this can stain more easily than your teeth.

Our yellow teeth article talks a lot about staining and what causes it, and you can also find out about how food and drink stain your teeth here.

AirFlow® demonstration video

AirFlow® is demonstrated in the video below, but to find out more about the procedure, read on…

GBT Step 04: Stains, biofilm and young calculus removal with AIRFLOW® and PLUS powder

How does AirFlow® teeth cleaning compare to a regular scale and polish? 

AirFlow® uses a special handpiece to direct water and powder towards the teeth. This differs from traditional scaling using an ultrasonic or even handpieces, and traditional polishing which uses a rubber cup or brush with a special paste.

Abrasive teeth cleaning method vs AIRFLOW method

More effective cleaning

Air polishing is specialised, because it uses a stream of water and powder to clean the tooth surfaces. This allows the user to reach into difficult to reach areas such as:

  • Interdental spaces
    • These are the tight gaps where the teeth meet, which makes it difficult to reach with a traditional polishing cup, especially between crowded teeth. These areas are missed if you don’t regularly use floss or interdental brushes, or if your technique has room for improvement.
  • Pits and fissures
    • These are the natural dips and cracks in your teeth, some of which can be very fine. It is easy to leave small amounts of plaque and food in these very hard to reach gaps.
  • Around braces (orthodontic brackets) on teeth
    • The metal or white coloured bit stuck to the tooth that holds the wires for braces can be very difficult to clean around.

The water-powder combination can reach just below the gum surface, so can safely remove the bacteria which cause early gum disease, gingivitis. In the long term this can enhance your cleaning at home and prevent the disease progressing to more serious periodontitis.

Overall you get a more thorough and effective clean as bacteria can be removed from more surfaces.

Use of a powder to help cleaning

Different AirFlow® powders work on different types of surfaces. 

Sodium bicarbonate based powders are excellent for removing very tough stains, but can cause some damage such as tooth wear, especially if used too often.

However, glycerine based powders can be used safely on fillings, crowns, implants and teeth as well, results which were confirmed by Bühler et al in their systematic review on the effects of air polishing. It is also completely safe on the soft tissues in the mouth such as gums and cheeks.

The powders have actually been found to be better for teeth when compared to traditional polishing pastes. This is because generally they do not remove the very outer layer of the enamel in the same way that the pastes do.

There are only a limited number of safe powders available at present, and there are also fewer choices in flavour when compared to the variety of traditional pastes that are used. 

Because a specific texture is needed for the powder, it is also possible that fewer beneficial ingredients can be added. Some traditional powders can have anti-sensitivity ingredients added like Novamin, as outlined by  Sawei et al in their research.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555792/

More comfortable

Air polishing uses water which prevents the mouth drying out, a common side effect when using traditional polishing cups and pastes. This makes the experience more comfortable for the patient.

Patients also often find the vibrations, or simply the thought of a drill-like instrument going into the mouth, can be very nerve wracking or uncomfortable with traditional techniques. 

Using and air polishing device such as AirFlow® avoids these problems, putting patients at ease during the procedure.

Faster

AirFlow® is very effective at removing stains because of the powder that is used in the mix. 

Studies have shown that less time is needed to remove the same amount of plaque and stains.

This means that the procedure can be quicker than traditional scaling and polishing.

AIRFLOW® VS Rubber cups

Is AirFlow® cleaning good for stain removal? 

Air polishing aims to remove the plaque that has built up on your teeth and underneath your gums, and is also very good at removing stains on your teeth.

The effective mixture of water and powder under high pressure gently removes almost all staining with very minimal, if any, damage or side effects.

Are there any side effects to air polishing?

As with any dental procedure, there are some possible side effects when undergoing air polishing. 

There is potential for damage to the gums, to existing dental work. 

On top of the potential for damage it may be possible that you don’t get the desired effect as not all cleaning is completed in one appointment.

Damage to gums

Air polishing can have some side effects. Most commonly, it can cause some temporary damage to the gums, in the form of very small cuts on the surface. Research has shown this to be at a lower level that the damage done by traditional cleaning, and the damage is fully healed within two weeks.

Damage to fillings and other dental work

There are a number of different powders available, and if a high abrasive powder is used on crowns and fillings it can cause scratches and stains.

Are there any other negatives when using AirFlow®?

Cannot remove tough calculus

AirFlow® is able to remove young calculus. This means that calculus that has been present for a long time and which is well and truly stuck to the teeth will need removing with traditional ultrasonic or hand scaling instruments before AirFlow® can be used for fining cleaning.

People who cannot have air polishing

There are a small number of medical conditions that mean someone should not have air polishing.

Some powders, ie. those containing sodium bicarbonate, cannot be used on people on a sodium–restricted diet, those with hypertension or people with kidney disease. Newer sodium-free powders however are safe.

Air polishing should be avoided for people who have respiratory illnesses such as asthma, as well as infectious disease because of the bleeding risk.

There is also some question about the safety of air polishing in people with Addison’s disease, Cushing’s disease, metabolic alkalosis or medications such as mineral corticoid steroids, antidiuretics or potassium supplements.

What happens in the appointment

An appointment will normally last about half an hour.

Any large amounts of calculus may be removed with traditional methods first.

The AirFlow® is used to direct the water and powder towards your teeth. This is not painful, but you may get a little wet!

After cleaning you can return to your normal daily activities.

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AirFlow® equipment used for air polishing -- Image Source: EMS Dental

How long do the effects last?

This all depends on your normal lifestyle.

If you clean your teeth well at home -- using an electric toothbrush for two minutes twice a day, and cleaning between your teeth with floss or interdental brushes every day -- the effects will last longer.

Smoking, red wine, tea, coffee, curry and chlorhexidine containing mouthwashes (e.g. Corsodyl) will re-stain the teeth. If you have more of these in your lifestyle than the effects of AirFlow® will not last as long.

People who clean well and have few staining effects in their life may only need a clean once a year. The more risk factors you have, the greater the chance that you will need to return before that, perhaps as often as every 3 months.

How much does air polishing treatment cost? 

Dental practices generally have two different options for air polishing. The option available to you will depend on the condition of your teeth and gums before starting treatment,

The first option is two have a normal scaling procedure (with ultrasonic or hand scalers), which may be required if you have a lot of old calculus. Air polishing is then used for stain removal and finer cleaning at the end. This will mean that you pay for a regular hygiene appointment plus an airflow appointment. On average you can expect to pay between £50 and £100 for this sort of treatment.

If you have relatively minor staining and little calculus you could have air polishing alone. You can expect to pay between £30 and £75 for this, depending on the length of appointment offered.

Can you get AirFlow® cleaning on the NHS? 

In a short answer, no. You are unlikely to receive any for of air polishing treatment on the NHS.

Air polishing is a new technology and it’s primary use is for the removal of staining on teeth. This means air polishing is an aesthetic procedure which is not supported by the NHS.

NHS UK states:

“The NHS will provide any clinically necessary treatment needed to keep your mouth, teeth and gums healthy and free of pain.”

As explained above, an NHS dentist only needs to provide treatment that is clinically necessary, and the removal of staining using AirFlow® is an aesthetic procedure which is not normally deemed clinically necessary. 

Although air polishing can be used for plaque and calculus removal in a similar way to a routine scale and polish, this is unlikely to be offered instead of treatment with an ultrasonic or hand scalers due to availability. In practice, the rules also mean that you are unlikely to be entitled to an NHS routine scale and polish as part of your regular NHS check up because of the lack of evidence supporting the routine scale and polish for treatment of gingivitis.

If you like the feel of the cleaning and still want it, you will need to pay privately for this, as the NHS UK site explains “If your dentist says a scale and polish is not clinically necessary but you want one anyway, you will have to pay for it privately.”

At present air polishing is not supported for the treatment of periodontitis, for which you would be entitled to NHS treatment. The current guidelines for the treatment of periodontitis include the use of ultrasonic or hand instruments.

Can AirFlow® treatment be used for teeth whitening? 

AirFlow® is excellent at removing stains on your teeth, for example those caused by tea, coffee, red wine, curry, tobacco, and chlorhexidine (found in Corsodyl Mouthwash).

Whilst this may cause teeth to appear lighter, AirFlow® will not whiten your teeth.

If you want to lighten the overall colour of your teeth, the only option is professional tooth whitening.

To find out about tooth whitening, we have put together the ultimate guide to teeth whitening.

FAQ

What is AirFlow® cleaning?

AirFlow® cleaning is a type of air polishing. Air polishing uses a mixture of water and powder, delivered under pressure and directed at the teeth to remove plaque, calculus, and staining.

Does AirFlow® hurt?

No, AirFlow® or any other type of air polishing does not hurt.

How long does AirFlow® last?

The effects of stain removal could last up to 12 months. This time is reduced if you consume food and drinks that cause staining, if you use a chlorhexidine mouthwash, or if you are a smoker.

What are the alternative treatments to AirFlow®?

Scaling using an ultrasonic or hand scalers, and polishing with a rubber cup and paste will also remove plaque, calculus and staining. Professional tooth whitening will lighten the colour of your teeth.

About Dr. Gemma Wheeler

Gemma qualified from Cardiff University School of Dentistry in 2015. She went on to complete her Foundation Training and a further two years in the Armed Forces, primarily based around Wiltshire. She now works in mixed NHS and Private practice in South Wales.

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