Air Polishing for Stain and Biofilm Removal
Air polishing cleans teeth with a jet of air, water and fine powder that can remove surface stain and biofilm, the soft bacterial film on teeth. This page covers how it works, what plaque disclosure is, comfort, who should avoid some powders, and cost. Air polishing removes stain from the tooth surface. It does not whiten teeth, and it does not remove tartar.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, the practice's principal dentist, reviewed this page. He is a General Dental Practitioner registered with the General Dental Council, number 301711, and his qualifications are BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry and PG Cert Restorative and Aesthetic Dentistry.
What is air polishing?
Air polishing is a way of cleaning teeth that sprays compressed air, water and fine powder particles onto the tooth surface.
A 2013 review in the Journal of Dental Hygiene describes air polishing as an alternative way of removing extrinsic stain, stain on the outside of the teeth, above the gum line. It says the device's mix of pressurised air, powder and water removes plaque biofilm as well as stain.
Air polishing powders include sodium bicarbonate, glycine and erythritol. Sodium bicarbonate was the first, and glycine, a naturally occurring amino acid, is among newer powders that manufacturers say are less abrasive, the 2013 review explains.
Why is plaque sometimes dyed before air polishing?
Dyeing plaque, called disclosure, makes the biofilm easier to see, so it can be targeted during cleaning and checked afterwards.
In general, a disclosing agent is a dye that stains plaque so it is easier to see, a Leeds Teaching Hospitals NHS Trust leaflet on gum disease explains. The hospital uses one to calculate the percentage of tooth surfaces free from plaque, so plaque is measured as well as seen.
A 2020 randomised trial of 32 healthy patients gave everyone air polishing followed by ultrasonic cleaning, with or without a disclosing agent applied beforehand as a visual guide. Less plaque was left in the dye group: 6.1% against 12.0% of the surface near the gums, and 3.5% against 9.0% on the crown. The authors concluded that disclosure seems to lead to better biofilm removal, though this was one small trial.
Is air polishing more comfortable than scaling?
In gum disease treatment, studies report equal or lower discomfort with glycine or erythritol air polishing than with scaling the root surfaces.
A 2016 systematic review of nine studies of non-surgical gum disease treatment found reported discomfort consistently equal or lower with glycine or erythritol powders than with hand or ultrasonic instruments on the root surfaces. It concluded that glycine air polishing seems to be associated with less discomfort. Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance describes air polishers as, in most situations, acceptable to patients.
One trial compared air polishing with rubber cup polishing instead. In a 2021 trial of 60 people, glycine air polishing caused significantly more gum trauma immediately afterwards than rubber cup polishing, and patient acceptance was 75% for the rubber cup against 25% for air polishing. In general, gum soreness or bleeding that does not settle after a clean is worth showing to a dentist.
Can air polishing be used below the gum line?
Air polishing with glycine powder has been studied above the gum line and below it, in gum pockets under 5 mm deep. Scottish SDCEP guidance says that in most situations air polishers have been shown to remove biofilm, particularly above the gum line, and that they do not remove tartar (calculus).
Scottish SDCEP guidance says there is some evidence that air polishers remove soft plaque biofilm as effectively as hand or powered instruments, mostly from studies of supportive care after gum treatment rather than active treatment. In most situations, it says, they have been shown to remove biofilm, particularly above the gum line. As the devices do not remove calculus, hand or powered instruments are also needed where calculus is present, so SDCEP concludes that air polishers are more applicable at the maintenance step of gum disease therapy (Step 4) and where calculus removal is not needed.
Treating periodontitis below the gum line is a different job from a routine clean, and our page on root surface debridement explains it. Our guide to plaque and calculus explains why tartar cannot be brushed away.
How much stain can air polishing remove?
Studies find air polishing can remove surface stain, though the type of evidence differs from powder to powder.
A 2013 review reports earlier studies finding sodium bicarbonate air polishing more effective and quicker at removing stain above the gum line than rubber cup polishing. In a 2017 randomised trial of 35 people with moderate to heavy staining, sodium bicarbonate air polishing removed all the stain from selected upper teeth on one side of the mouth in about four and a half minutes on average, with wide variation between people.
In a 2021 trial of 60 people, glycine air polishing and rubber cup polishing with glycine powder both reduced stain, with no significant difference between them. The authors concluded that both were equally beneficial for plaque and stain removal, but that rubber cup polishing had an advantage, being significantly less traumatic to the gums and better accepted by patients.
Erythritol's stain result here comes from a laboratory study. In a 2025 study on extracted teeth stained with cigarette smoke, erythritol air polishing removed the staining as effectively as sodium bicarbonate air polishing and pumice polishing, without changing the roughness of the tooth surface. None of the three methods restored the teeth's original colour.
Questions about this treatment? Book online or call the practice.
Does air polishing whiten teeth?
No. Air polishing removes stain from the tooth surface, while NHS guidance describes teeth whitening as lightening the colour of natural teeth.
Abrasive cleaning can take stain off the tooth surface, a 2019 review explains, but can remove stain within the enamel only by removing part of the enamel as well.
Why stain forms on or inside teeth is explained in our guide to intrinsic and extrinsic staining. Lightening the natural colour of teeth is a separate treatment with a dentist, described on our page about professionally whitening your teeth.
Is air polishing safe for enamel, bonding and veneers?
Studies of sodium bicarbonate powder have generally found air polishing safe on enamel, but advised caution on root surfaces. They advised caution or complete avoidance on composites and porcelain veneers, and studies of newer powders on these restorations are limited.
A 2013 review reports studies of sodium bicarbonate generally finding air polishing safe on enamel, with no significant enamel loss, but advising caution on root surfaces and recommending it be limited to enamel. One study it cites concluded that sodium bicarbonate may not be safe on exposed roots. A 2016 systematic review of 17 studies done outside the mouth found sodium bicarbonate caused significantly larger root surface defects than glycine, and concluded that glycine air polishing may be safely applied to root surfaces and gums.
A 2021 clinical trial of 60 people, though, found significantly more gum trauma immediately after glycine air polishing than after rubber cup polishing. Gum soreness or bleeding that does not settle is worth showing to a dentist. A 2025 laboratory study found no significant change in enamel or dentine roughness after repeated erythritol air polishing.
For composite and porcelain, the 2013 review says the limited studies of newer powders have indicated a small but noticeable loss of material from both, with glycine leaving smaller surface defects on composite than sodium bicarbonate. If you have composite bonding, our guide to composite staining covers how it is looked after.
Who should avoid air polishing or a particular powder?
Sodium bicarbonate powder is not suitable for people whose conditions are affected by sodium intake or by aerosols, a 2013 review concludes.
The 2013 review summarises an earlier review's list of contraindications to air polishing:
- a sodium-restricted diet
- high blood pressure (hypertension)
- respiratory illness
- infectious disease
- kidney problems (renal insufficiency)
- Addison's disease
- Cushing's disease
- metabolic alkalosis
- medicines such as mineralocorticoid steroids, antidiuretics or potassium supplements
Powders without sodium, glycine among them, are not contraindicated for a sodium-restricted diet, high blood pressure or kidney problems, and high-volume suction reduces the risk for people with respiratory disease, the 2013 review says. That review does not cover erythritol powder.
Very rare complications from the aerosol, such as air emphysema, have also been reported: the 2013 review cites 9 air emphysema and 3 air embolism incidents reported to a device alert system between 1977 and 2001, and 6 later articles describing similar incidents.
When should you speak to a dentist?
Speak to a dentist about stain that does not brush away, a tooth that has darkened, or tartar that has built up.
Tartar (calculus) cannot be removed by brushing, a Leeds Teaching Hospitals leaflet notes, and needs removing by the dental team. In general, a dentist can also check whether stain sits on a tooth's surface or inside it.
Air polishing at Deepcar Dental Care
Deepcar Dental Care's air polishing unit is made by Woodpecker, and the powders used are glycine, erythritol and sodium bicarbonate, chosen to suit the patient.
How do you find out about the cost of air polishing?
Prices at Deepcar Dental Care are set out on the practice's current fee list, and questions about cost can be asked on 0114 288 2121.
Frequently asked questions
Is air polishing the same as a scale and polish?
No. NHS guidance describes a scale and polish as carefully removing the plaque and tartar that build up on teeth, while air polishing removes biofilm and surface stain. Scottish SDCEP guidance says air polishers do not remove calculus, so hand or powered instruments are also needed where it is present.
Does air polishing leave a salty taste?
It can, depending on the powder. A 2013 review notes that studies in earlier reviews found a salty taste and some gum bleeding could follow air polishing, with no significant gum trauma a week or two later. It describes glycine as water-soluble with a non-salty taste. Gum bleeding that does not settle is worth showing to a dentist.
Can air polishing be used around braces?
It can, but the powder matters. A 2013 review reports an earlier finding that air polishing cleaned stain and plaque around braces most efficiently. One study concluded sodium bicarbonate, which raised friction, should not be used in metal or ceramic bracket slots. In another, glycine and sodium bicarbonate slightly changed metal brackets and wires; only sodium bicarbonate roughened plastic ones.
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You can contact Deepcar Dental Care online, on 0114 288 2121 or on WhatsApp on +44 7438 552581. Our patient reviews describe visits to the practice, and related hygiene and gum treatment guides are among the options in this section.
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