Airflow Teeth Cleaning: What Air-Polishing Can and Cannot Do

What air-polishing is

Air-polishing devices spray a mixture of water, compressed air and a fine powder at the tooth surface. The powder wipes off soft plaque and surface stain. Air-polishing with fine, low-abrasive powders is also used inside the gum pockets that form in gum disease; that is the use most of the research below tested.

"Airflow" and "Guided Biofilm Therapy" are one manufacturer's trade names for its equipment and cleaning routine; the general term for the method, and the one the research uses, is air-polishing. This article is about the method, not a brand. Powders include sodium bicarbonate and finer powders such as glycine and erythritol. The studies below mainly used the finer powders; they do not show that one powder is better than another.

What the studies compared

The trials in the reviews we use were done almost entirely in people already treated for periodontitis, the gum disease that destroys the bone around teeth, during their regular maintenance care, with a few during active treatment or on implants. They compared air-polishing of the gum pockets with cleaning by hand instruments and ultrasonic scalers.

• Gum pockets and attachment. A 2022 review of 6 randomised trials pooled 3 maintenance trials at six months and found no statistically significant difference¹ in pocket depth or attachment between air-polishing and conventional instruments. Four of the 6 trials had a high risk of bias, and one maintenance trial found the conventional instruments did better. In the two trials on implants the results pointed in opposite directions.
• Erythritol powder. Another review of 8 trials found improvements in pocket depth and bleeding comparable to hand or ultrasonic cleaning² during maintenance. Used in addition to standard deep cleaning in active treatment, it gave a very small extra gain, 0.16 mm, in how firmly the gum is attached to the tooth.
• UK guidance calls the evidence on air-polishing below the gum, compared with ultrasonic cleaning, still limited and inconclusive³.

So "no clear difference" is the honest summary. It does not mean air-polishing works as well in every case, and it certainly does not show it works better. None of these trials looked at a routine clean in people with healthy gums, at stain removal or at whitening.

Comfort and risks

Comfort is the consistent advantage. In the maintenance trials, patients reported lower pain scores and higher acceptance¹ with air-polishing. A review of 9 studies found discomfort with glycine or erythritol powders equal to or lower than⁴ hand or ultrasonic root cleaning, and the erythritol review reports the same.

Air under the skin. Occasionally, air is forced into the soft tissues of the face or neck during dental treatment (emphysema), causing sudden swelling that can crackle when pressed. A 2026 scoping review describes it as an infrequently reported complication⁵ of dental care. It collected 129 patients described in 109 published reports after many kinds of procedures and groups dental cleaning and air-polishing together, so no figure for air-polishing alone exists. It advises that sudden swelling with crackling after dental treatment should be assessed immediately.

We do not give a list of who should not have air-polishing, because we could not confirm one from the research we use. Before any cleaning, tell your dentist about your health conditions, including breathing problems, any allergies, and the medicines you take.

What it has not been shown to do

• Remove tartar. Tartar is hardened plaque that the American Dental Association says can only be removed through cleaning performed by a dental professional⁶, and in practice that means hand or ultrasonic instruments. Two of the maintenance trials only treated sites without detectable tartar below the gum¹. No study we use shows air-polishing alone removing established tartar.
• Whiten teeth. It is used to clean off surface stain, but it does not bleach the tooth, and none of the trials we use measured tooth colour. Claims that it lightens teeth by a set number of shades have no study behind them that we could find.
• Replace home care. Plaque starts to form again straight after any cleaning. Daily brushing and cleaning between the teeth do the lasting work.

Where it fits in a professional clean

Air-polishing is one tool within a cleaning, not a treatment of its own. A dentist or hygienist removes tartar with hand instruments or an ultrasonic scaler and may use air-polishing for plaque and stain, or in gum pockets during maintenance care. Whether it is used depends on your gums, what needs removing, and the equipment available.

How often you need a professional clean is a separate question. In a Cochrane review of adults without severe gum disease who saw their dentist regularly, a routine scale and polish every 6 or 12 months made little or no difference to gum inflammation⁷ over two to three years compared with no scheduled scale and polish, while slightly reducing tartar. Your dentist sets your interval from the state of your own gums. Treatment for gum disease is explained on the gum disease treatment page.

When to see a dentist

See a dentist if your gums bleed when you brush⁸ or are sore or swollen, if you have bad breath that does not go away, or if you can see tartar. Ask for an urgent appointment if your teeth feel loose or your gums are very sore and swollen.

After a cleaning, contact the dental practice straight away if your face, cheek or neck swells suddenly, especially with a crackling feeling under the skin.

Emergencies. Call 112 or go to the nearest emergency department if you:

• find it hard to breathe, speak or swallow⁹
• have a swollen or painful eye, sudden problems with your eyesight, or swelling in your neck¹⁰
• have a lot of swelling inside your mouth
• find it hard to open your mouth

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