Do air-polishing devices have any contraindications?

PD Dr. Kristina Bertl, PhD MSc MBA

The use of air-polishing devices for the treatment of periodontal and peri-implant diseases is now part of daily routine at the dental surgery. When used for the right indications, they are regarded as safe and effective. In addition, patients often find them more pleasant than traditional methods.

However, there are certain local and systemic factors that should be taken into account before using air-polishing devices and when selecting the powder. The local factors (e.g. lack of attached gingiva/mucosa, extremely inflamed tissue, mouth floor at the height of the marginal gingival/mucosal margin) and their associated risks have already been discussed in a previous article.

But what about systemic factors? In general, caution should be exercised with patients who have severe and/or unstable infections and diseases of the upper and lower airways and, in the event of doubt, a different treatment option should be chosen. There is no direct contraindication to supragingival cleaning with air-polishing devices in pregnant women; however, depending on the patient’s inflammation and the severity of their periodontal and/or peri-implant disease and associated risk of local complications (e.g. emphysema), the use of air-polishing devices for subgingival cleaning should be assessed on a case-by-case basis, and the treating dentist should be consulted. A similar ‘restriction’ can also be discussed in relation to patients on bisphosphonate therapy. Again, however, this can primarily be decided on a case-by-case basis in consultation with the treating dentist.

The choice of powder can be affected by allergies or illnesses that ought to involve a low-sodium dietary treatment (e.g. high blood pressure). For example, a sodium bicarbonate-based power should not be used for patients following a low-sodium diet. In addition, any possible allergies to flavourings, chlorhexidine and/or glycine should always be taken into consideration.

Reference

1. Graumann SJ, Sensat ML, Stoltenberg JL. Air polishing: a review of current literature. J Dent Hyg. 2013 Aug;87(4):173-80.