Three safety concerns regarding use of the air polisher appear in the dental literature including that of the patient, the operator, and others in the treatment room. Patient concerns include systemic problems from absorption of the sodium bicarbonate polishing powder, respiratory difficulties from inhaling aerosols that contain oral microorganisms( intraoral camera usb ), stinging of the lips from the concentrated spray, and eye problems from the spray entering the patient’s eyes, especially if contact lenses are worn. Some of these problems could be addressed by coating a patient’s lips with a protective lubricant, using the appropriate technique, removing contact lenses, wearing safety glasses, and placing a protective drape over the patient’s nose and eyes.
Due to the possible absorption of sodium bicarbonate powder through the oral mucosa, use of the air polisher generally has been contraindicated when the patient’s medical history lists: a low sodium diet, hypertension, respiratory illness, infectious disease, renal insufficiency, Addison’s disease, Cushing’s disease, metabolic alkalosis, or certain medications, such as mineralocorticoid steroids, antidiuretics, or potassium supplements.
Despite these warnings, limited information has been published on the systemic effects of sodium bicarbonate absorption from air polishing powder. Air polishing for five minutes can cause a slight disruption of the acid/base balance, but serum ph does not remain at a dangerous level if the body’s buffering system functions properly. Only one subject’s venous blood was evaluated in this uncontrolled pilot inquiry and hyperventilation was the cause of the alkalosis, not the air solemnities.
In addition, no statistical analysis was done to rule out changes occurring solely by chance. Conflicting findings were reported in a later study. Following a five-minute exposure with an air polisher, no significant changes in the arterial blood supply of ten mongrel dogs was found for sodium, bicarbonate, ph, and other electrolytes. Potassium levels showed a change that was not clinically significant. In addition, arterial blood was thought to be more suitable for examining electrolyte changes than the venous blood used in the previous study. More research regarding the air polisher’s safety is recommended.
A very specific balance between acids and bases is important to maintain, usually by means of a complex system of controls within the body. Some individuals cannot readily adjust to disturbances to this balance. It is for this reason, due to the potential absorption of sodium bicarbonate by the oral mucosa, that air polisher manufacturers caution against their use with such patients. Clearly, more research with human subjects is needed to resolve this absorption issue.
An aerosol-reduction device (Safety Suction, Periogene, Ft. Collins, Colorado) has been shown to be effective in reducing aerosols produced by dental ultrasonic scalers. Another device is now available for use with air-polishing systems, and in-vitro and in-vivo studies currently are investigating its ability to reduce aerosols.