GBT/Air Polishing

Air Polishing in Gum Disease and Mucositis

What is it?
Air polishing is a technique that uses a jet of compressed air, water, and a low-abrasive powder to gently remove biofilm, plaque, and soft deposits from teeth, restorations, and implants.

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Powder Types:

• Glycine (20–25 μm): Very gentle, suitable for subgingival use.

• Erythritol (14 μm): Even finer, with added antibacterial properties, ideal for subgingival and implant care

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Clinical Applications:​

1. Gingivitis & Early Periodontitis:

   • Removes supragingival and subgingival biofilm with minimal damage to root surfaces or gingival tissues.

   • Reduces bleeding on probing and inflammation.

2. Peri-Implant Mucositis:

   • Safely cleans around implants without scratching titanium surfaces.

   • Reduces microbial load and prevents progression to peri-implantitis.

3. Maintenance Therapy:

   • Ideal for supportive periodontal therapy (SPT) and implant maintenance.

   • Comfortable and quick, improving patient compliance.

Larkin Protocol Sequence

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Developed by Dr Tom Larkin, a comprehensive protocol that combines diagnostics, disclosure, and air polishing in an 8-step process focused on biofilm removal with precision and respect for tissues.

The 8 Steps of Larkin Protocol Air Polishing

1. TEST: Microbial sample using phase contrast microscopy

2. Disclose: Use plaque-disclosing agents to visualize biofilm (increases patient awareness and ensures thorough removal).

3. TEACH the patient about the microbial findings and EDUCATE the patient on personalized oral hygiene strategies.

4. TREAT:  Air polishing: Use air polishing (with erythritol/glycine) to remove supragingival and subgingival biofilm.

5. TREAT:  Ultrasonics: ultrasonic scalers for calculus removal (only where necessary).

6. TREAT:  Diode Laser: Laser pocket disinfection, especially for deeper pockets.

7. Check:  Reassess tissue response and remove residual deposits.

8. PEPEAT: Establish an individualized maintenance schedule.

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Benefits of Air Polishing 

Feature                    Air Polishing

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Focus                      Biofilm removal​

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Abrasiveness           Minimal (glycine.erythritol powders) 

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Comfort                    Very high

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Tissue Protection      Excellent                   

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Educational Value     Very High  (when used in combination with phase contrast microscopy)     

Clinical Takeaway

• Air polishing, especially with glycine or erythritol powders, is an effective and gentle way to remove biofilm in patients with gingivitis, periodontitis, or implant mucositis.

• By using air polishing in a structured, diagnostic-driven workflow that enhances both patient understanding and clinical outcomes.

• Both approaches prioritize early intervention, minimally invasive care, and long-term maintenance, making them ideal for preventive and supportive periodontal therapy.

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These technologies represent a shift from traditional scaling-based approaches to biofilm-focused, tissue-respecting care, perfectly aligned with the modern understanding of periodontal and peri-implant diseases as biofilm-induced inflammatory conditions.

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