Air-Powder Polishing

1What & why

A pressure-washer for stain.

The air-powder polisher (air abrasion polishing, "Prophy-Jet") sprays a pressurized slurry of air, water, and fine sodium bicarbonate powder to blast away stain and plaque — fast, effective on heavy stain, and able to reach grooves a cup can't.

Its power is also its problem: an aerosol-heavy spray with a salty payload, which creates a specific — and heavily tested — contraindication list.

2Who should NOT get it

Salt + aerosol = the list.

The patientWhy not

Sodium-restricted dietPatients limiting salt for hypertension, kidney or heart disease.

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The powder is sodium bicarbonatethe classic contraindication — they swallow salt spray

Hypertension, kidney disease

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Sodium loadsame salt logic, named diseases

🚬Respiratory diseaseAsthma, COPD, other conditions compromising breathing.

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The aerosol cloudfine powder aerosol is inhaled — dangerous for compromised lungs

Tooth showing exposed root surface below the gumline

Exposed cementum/dentin, restoration margins

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Abrades soft surfacesthe spray pits root surfaces and can damage margins & soft restorative materials

😷Communicable infection

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Aerosols spread itaerosol production multiplies exposure risk

3Technique notes

Angle away from the gums, HVE running.

When it is used: the nozzle is kept slightly away from the tooth (a few millimeters), angled toward the enamel surface, away from the gingiva, in constant sweeping motion — with high-volume evacuation (HVE) managing the aerosol cloud. Patient wears eyewear; a protective coating (like petroleum jelly) can shield the lips.

An air-powder polishing nozzle held a few millimetres off a molar, spray angled at the enamel and away from the gum, with a high-volume evacuation tip capturing the aerosol. An inset names the spray as air, water and sodium bicarbonate powder. A side panel lists contraindications: sodium-restricted diet, respiratory disease, and exposed root surfaces. — **Salt or spray.** Tip held just off the enamel and angled **away from the gingiva**, kept moving, with HVE managing the cloud. Every contraindication sorts into one of two buckets — the **salt** (sodium-restricted, hypertensive, renal) or the **spray** (respiratory disease, communicable infection, soft surfaces in the blast path).

4Make it stick

Think salt spray: who can’t have salt, who can’t have spray?

Every air-polishing contraindication is one of the two: the salt (sodium-restricted, hypertension, kidney disease) or the spray (respiratory disease, infections, delicate surfaces in the blast path). Sort the answer options into those buckets and the question solves itself.

5Beat the exam

"Air polishing powder is usually…"→sodium bicarbonate (in an air-water slurry)

"Which patient should NOT receive air polishing?"→sodium-restricted / hypertensive / renal / respiratory patients

"Nozzle direction"→angled at the enamel, away from the gingiva, kept moving

"Managing the aerosol"→HVE (high-volume evacuation) + patient eyewear

6Check yourself

Air-powder polishing is contraindicated for a patient with:

A sodium-restricted diet. The powder is sodium bicarbonate — the patient inevitably swallows some of the salt spray. Heavy stain and groove stain are exactly what air polishing is FOR.

6Check yourself

During air polishing, the spray should be directed:

At the enamel, away from the gingiva — and always moving. Aiming at the sulcus or parking on one spot traumatizes tissue; root surfaces are too soft for the spray.

Recap

The whole thing in 4 lines.

✓Air polishing = pressurized air + water + sodium bicarbonate.
✓Great for heavy stain and grooves — but aerosol-heavy.
✓Contraindications: salt (sodium-restricted, hypertension, renal) + spray (respiratory, infection, soft surfaces).
✓Technique: angle at enamel away from gingiva, keep moving, run the HVE.