How Air-Flow technology simplifies biofilm management

As a dental hygienist for over 40 years, I like to think I have seen a lot of improvement with products that I use. Of course, I learned the basics of instrumentation and got the opportunity to use an ultrasonic scaler only once, maybe twice while in school. 

One of the products that wasn’t around when I was in school was the air polisher. After graduating, I just happened to work in an office that had one. That was exciting, but no one seemed to know exactly how it worked or why anyone wanted to use it. The first time I used it, it was a disaster and I found there was definitely a learning curve. Quite a few patients learned to hate it (or me) based on the “sandblasting” they got from my inability to control the spray. Maybe some of you have had similar experiences. Even when I got somewhat familiar with the use, my patients complained: “my gums are sore,” “it takes my make-up off,” “it’s just too messy.” Long story short, I only used it on those who requested it. It took time to clean up, and my busy schedule did not allow for any extra time for cleaning up the salty, powdery residue that seemed to settle everywhere. 

Fast forward to 2015. I was invited to learn about, observe and use the new Air-Flow^® technology by Hu-Friedy. I was skeptical about seeing a product I thought Iwould never use. Well, I was wrong because it was amazing! I’ve always supported the premise that biofilm was the root of all evil, and this air polisher removes it, both supra- and subgingivally. It polishes the teeth, removes stain, can be used effectively for implant maintenance, restorative materials, and orthodontics, all with little trauma to the patient or clinician. The air/water pressure/powder stream is controlled and is delivered in a warm spray. Instead of sodium bicarbonate, the powder is glycine. As you might know, glycine is a non-essential, biocompatible amino acid and much smaller in particle size than sodium bicarbonate. This system was designed for comfort. When I was introduced to the Air-Flow, I was both clinician and patient. As the clinician, it was exceptionally user friendly, and as the patient, it was so gentle and the powder was fine and even slightly sweet. I even got my tongue cleaned and it was painless. Your patients will love it: it’s cleaner, gentler and faster. Efficient biofilm management with air polishing is time saved, which gives the clinician freedom to treat the patient in a comprehensive manner. 

Now, you will need to make a decision and choose the option best suited to your practice. There are several choices. You can choose the handheld portable, the Air-Flow handy 3.0 Premium, which is small, lightweight and connects to your unit. It is easy to hold and fairly balanced. You can use two attachments: one for supragingival plaque removal and one for biofilm removal in the sulcus. If you are one who doesn’t want to be constrained in my dental hygiene treatment, I would definitely go for this unit. 

Beyond the portable choices, there are also the stand alone models: Air-Flow S1 or the Air-Flow S2. Both units have supragingival biofilm and stain removal, while the S2 is a combination unit also featuring Piezon technology. My personal preference is the Air-Flow Master or the Air-Flow Master Piezon^®. The Master is equipped with two handpieces and powder chambers that offers the ability to easily switch from Classic to Perio powders, allowing you to be prepared for any patient in your chair. For those patients that perhaps require additional scaling, the Master Piezon^® may be your best option.

The numbers back me up. 200 periodontal pockets were treated with the Air-Flow and there was a 1.22 mm reduction in pocket depth in a short time of four-to-six months. Hand instrumentation to remove subgingival biofilm takes anywhere from 30 seconds to one minute per pocket. The air polisher with glycine takes five seconds of exposure to disrupt and remove the biofilm.^1,2 You don’t have to be a mathematician to figure out the time savings.

In its position paper,* the ADHA highlights a study by Galloway and Pashley (1986) that demonstrated the air polisher can cause clinically significant loss of tooth structure when used excessively and should therefore not be used on exposed cementum or dentin.³ In addition, ADHA cites Woodall’s 1993 textbook recommendation that states “air polishers should be avoided around most types of restorative materials due to the possibility of scratching, eroding, pitting or margin leakage.”^1,2 This, however, would not be true for the glycine powder.

So, if you are looking for an efficient and time-saving alternative, superior biofilm management, increased comfort, a higher level of care and a state-of-the-art alternative technology, I personally recommend these Air-Flow^® products.   

References

1. Wenstrom JL, Dahlen G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. Journal of Clinical Periodontology 2011; 38:820-827.

2. Moene R, Decaillet F, Andersen E, Mombelli A. Subgingival plaque removal using a new air polishing device. Journal of Periodontology 2010; 81:79-88.

From http://www.hu-friedy.com/magicalminutes

3. Galloway, S., & Pashley, D. (1987). Rate of removal of root structure by the use of the Prophy-Jet device. Journal Of Periodontology, 58(7), 464-469.

4. Woodall, IR. Comprehensive dental hygiene care, (2ed.) Mosby.

5. Bednarsh HS, Eklund KJ, and Mills S. Reprinted from Access Vol. 10, No.9, copyright  ©1997 by the American Dental Hygienists’ Association, http://www.osap.org/?page=Issues_DUWL_7&hhSearchTerms=polish.

6. https://www.hu-friedy.com/products/mastercontrol/index/file/id/325 

* The American Dental Hygienists’ Association 2010 Position on Polishing Procedures lists the following as contraindications for air polishing procedures using sodium bicarbonate:

Patients with restricted sodium diets, respiratory, renal, or metabolic disease, with infectious disease, children, diuretics or long-term steroid therapy, and with titanium implants.