Air flow…but not as you know it!
BSDHT Publications Team member, and practising Dental Hygienist, Ali Lowe shares her personal experience of air polishing.
Air polishing was first introduced over 40 years ago as an alternative to traditional polishing with a rubber cup and pumice. Using a slurry of water, abrasive powder and pressurised air the air polisher was found to effectively remove extrinsic stain and plaque biofilm. Fast forward to 2020 and not only has air polishing evolved but the list of uses has also increased. Indeed, there are several air polishers and powders available now and most can even be used subgingivally. Despite this, I have still not really embraced the concept, mainly because I thought the powder tasted horrible and I have found them to be messy, difficult to maintain and not worth the effort to assemble; furthermore, the patient usually complains about the taste!
However, I have been more than pleasantly surprised. I was given the opportunity to trial Durr’s Lunos powder jet handpiece over the last month and have been very impressed. I have numerous patients that I thought would benefit from its use although initially I thought it would just be for stain removal. I have found it can be used on both stain and plaque biofilm supra and sub-gingivally in routine maintenance patients with pockets less than 4mm. The tip can then be easily changed for biofilm disruption/removal in patients with deeper pockets. This has allowed me to reduce the bacterial load at every appointment and remove stain from dentine and hard to reach places, quickly and effectively with very little mess, making it a much nicer experience for both the patient and for me. I have also found the device to work well prior to teeth whitening as it definitely adds value to the appointment and enhances the treatment. I have also used it on orthodontic patients for cleaning effectively and quickly around appliances and allowing more time to focus on all important oral hygiene instruction and prevention. In short, it has benefitted most of my patients.
The handpiece attaches to the turbine connection of all dental units with the appropriate adaptor (this is clearly explained, but if in doubt simply send a picture of your adaptor to Durr and they will advise you) and simply becomes an additional handpiece on the cart. The ergonomic design is fantastic sitting comfortably in my hand and its exchangeable chamber principle means the powder container can be replaced quickly and easily, avoiding the inconvenience of having to refill in the middle of treatment. Also, I can prepare enough powder containers for the whole day; this is really helpful because the list of things to do in between patients is ever increasing! A word of warning though - do not operate the handpiece outside of the mouth as the fine mist will leave a fine film of powder on all nearby surfaces! High volume suction is also essential; suction adaptors are available for use if you are working without a nurse.
Although patients often complain their teeth are sensitive (usually to the ultrasonic) virtually none of my patients complained about sensitivity with this. Indeed, they have loved the superior stain removal, and having to spend less time in the chair having their teeth ‘scraped’.
Powders have definitely evolved, now it is all about patient comfort, ease of use, aesthetics, taste, health and feeling good, not to mention removal of biofilm. Lunos works with various prophylaxis powders selected according to our patients' individual needs and patients no longer experience the unpleasant grittiness or salty taste typically associated with this type of treatment.
I would recommend you try it!
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