Evidence answers on dental prophylaxis

47 clinical questions · answered from peer-reviewed studies and guidelines · updated 2026-10-20

Short, cited answers to the questions hygienists and dentists ask most about air polishing, powders, periodontal and peri-implant maintenance, instrumentation and home care. Each answer is drawn only from our indexed literature and links to every source. Cannot find your question? Ask the evidence.

Air polishing

• Is air polishing safe for enamel and dentine?Air polishing safety differs between enamel and dentine, and depends heavily on the powder used.
• Does air polishing damage composite restorations or ceramic surfaces?Air polishing can adversely affect both composite restorations and ceramic surfaces, though the degree of damage varies by material and powder type.
• Does air polishing produce more aerosol than ultrasonic scaling?The indexed literature does not directly compare aerosol production between air polishing and ultrasonic scaling in a head-to-head manner.
• How can aerosols be reduced during air polishing and ultrasonic scaling?Based on the indexed literature, several complementary strategies can reduce aerosol and droplet contamination during ultrasonic scaling (evidence on air…
• Can air polishing cause subcutaneous emphysema or gingival damage?Yes, air polishing carries risks for both subcutaneous emphysema and gingival damage, though the magnitude of risk varies by powder type.
• Is air polishing more comfortable for patients than conventional instrumentation?Yes, the evidence consistently supports that air polishing is more comfortable for patients than conventional instrumentation.
• Does air polishing reduce treatment time compared with conventional prophylaxis?Yes, the evidence consistently supports that air polishing reduces treatment time compared with conventional prophylaxis methods.
• Does air polishing remove extrinsic stain better than rubber cup polishing?The indexed literature I have available does not directly compare air polishing versus rubber cup polishing specifically for extrinsic stain removal as a…

Powders

• How do erythritol and glycine air polishing powders compare?Based on this systematic review and network meta-analysis of nine RCTs involving 462 patients, erythritol and glycine showed no statistically significant…
• Is sodium bicarbonate powder safe for subgingival use?Sodium bicarbonate is not among the powders evaluated for subgingival use in the indexed literature.
• Is trehalose powder effective for air polishing?Based on the indexed literature, trehalose is an effective subgingival air-polishing powder, though with some nuances worth noting.
• Does erythritol powder have an antimicrobial effect on oral biofilm?Yes, erythritol powder demonstrates antimicrobial properties relevant to oral biofilm management.
• Which air polishing powders are recommended around dental implants?Based on the indexed literature, erythritol and glycine are the two powders most investigated and discussed for use around dental implants.

Periodontal therapy

• Is subgingival air polishing effective in periodontal pockets?Subgingival air polishing (SubGAP) appears to be clinically effective in periodontal pockets, with outcomes comparable to conventional hand or ultrasonic…
• Can subgingival air polishing replace ultrasonic debridement in supportive periodontal therapy?Based on the indexed literature, subgingival air polishing (SubAP) can serve as an effective alternative to ultrasonic debridement in supportive…
• Does adjunctive air polishing improve the outcomes of non-surgical periodontal therapy?Based on the indexed literature, the evidence is nuanced and depends on pocket depth and context.
• How deep into a periodontal pocket can subgingival air polishing reach?The indexed literature does not provide a precise, universally agreed millimetre depth of penetration for subgingival air polishing across all tip…
• Does air polishing reduce bleeding on probing in periodontal maintenance?In patients undergoing supportive periodontal therapy (SPT), air polishing devices (APDs) produce reductions in bleeding on probing (BOP) that are…
• How often should supportive periodontal therapy visits be scheduled?The evidence does not support a single fixed interval for all patients; instead, risk-based scheduling is more appropriate.
• What happens to residual pockets during supportive periodontal therapy?During supportive periodontal care (SPC), residual pockets represent a persistent clinical challenge and a recognised risk factor for periodontitis…
• Does local antimicrobial therapy improve outcomes in residual periodontal pockets?Yes, local antimicrobial therapy does provide statistically significant, though modest, improvements in residual periodontal pockets during supportive…
• Do lasers improve the outcomes of non-surgical periodontal therapy?Based on the indexed literature, adjunctive laser therapy generally provides some clinical benefit over scaling and root planing (SRP) alone, though the…
• Are probiotics effective as an adjunct to periodontal therapy?The evidence suggests probiotics offer modest but inconsistent clinical benefits as an adjunct to non-surgical periodontal therapy (NSPT).

Implants

• How should peri-implant mucositis be treated?Peri-implant mucositis should be treated primarily with nonsurgical mechanical debridement, which alone produces meaningful reductions in bleeding on…
• Is air polishing effective for treating peri-implantitis?Air polishing for peri-implantitis shows modest and inconsistent clinical benefits compared to conventional mechanical debridement.
• Does air polishing damage titanium implant surfaces?Air polishing with certain powders can cause surface changes to titanium implants, but the degree of damage depends heavily on the powder used.
• How often should implant patients have professional maintenance?Based on the indexed literature, a definitive universal frequency cannot be stated, but several findings help guide clinical decisions.
• Which instruments are safe for cleaning dental implant surfaces?Based on the indexed literature, several instrument categories have been evaluated for implant surface safety.
• Does supportive peri-implant therapy reduce the risk of peri-implantitis?Yes, supportive peri-implant therapy (SPIT/SPT) consistently reduces the risk of peri-implantitis across multiple systematic reviews and meta-analyses.

Protocols and instrumentation

• What is Guided Biofilm Therapy?Guided Biofilm Therapy (GBT) is a treatment protocol that combines a disclosing agent to visualise biofilm with air-abrasive powder (erythritol)…
• Is Guided Biofilm Therapy more effective than scaling and root planing?Based on the available evidence, GBT does not consistently outperform conventional scaling and root planing (SRP) or scaling and root debridement (SRD)…
• Does biofilm disclosing improve plaque removal during prophylaxis?Based on the indexed literature, the evidence is mixed and context-dependent.
• Is ultrasonic scaling as effective as hand instrumentation?Based on the indexed literature, ultrasonic and manual scaling produce broadly similar clinical outcomes, though some nuances exist depending on pocket…
• Are there clinical differences between piezoelectric and magnetostrictive ultrasonic scalers?Based on the indexed literature, there are meaningful clinical and in vitro differences between the two scaler types, though each has distinct advantages.
• Does full-mouth disinfection give better results than quadrant-wise scaling?The evidence comparing full-mouth disinfection (FMD) and quadrant-wise scaling and root planing (Q-SRP) is mixed, and any advantages of FMD appear modest.
• Is coronal polishing after scaling necessary?Based on the indexed literature, coronal polishing after scaling is not considered a routine necessity for all patients.

Patient groups

• How should professional prophylaxis be adapted for patients with fixed orthodontic appliances?The evidence consistently shows that fixed appliances promote generalised plaque accumulation and gingivitis, making periodontal monitoring at every…
• Is professional dental prophylaxis safe during pregnancy?Based on the indexed literature, professional dental prophylaxis and nonsurgical periodontal therapy are considered safe during pregnancy.
• How does diabetes affect periodontal treatment and maintenance?Diabetes increases the risk of periodontitis onset and progression by approximately 86% compared to non-diabetic individuals, driven primarily by the…
• Does smoking reduce the response to periodontal therapy?Yes, smoking consistently and significantly reduces the response to periodontal therapy across multiple study designs and treatment modalities.
• How can pain and anxiety during periodontal instrumentation be reduced?Several complementary strategies can reduce pain and anxiety during periodontal instrumentation.

Home care and adjuncts

• Is chlorhexidine mouthwash effective as an adjunct to scaling and root planing?Chlorhexidine (CHX) mouthwash as an adjunct to scaling and root planing (SRP) does produce measurable benefits, though the clinical magnitude is modest.
• Are interdental brushes more effective than dental floss?The evidence suggests interdental brushes (IDBs) may have an edge over dental floss for reducing gingivitis, though overall certainty is low.
• Do powered toothbrushes remove more plaque than manual toothbrushes?Yes, the overall evidence consistently supports that powered toothbrushes remove more plaque than manual toothbrushes, though the magnitude varies by…
• Does professional fluoride varnish application reduce caries in adults?Professional fluoride varnish application does appear to reduce caries in adults, though the evidence is nuanced.
• Does dentine hypersensitivity increase after scaling, and how is it managed?Dentin hypersensitivity (DH) is a recognised consequence of non-surgical periodontal therapy, including scaling and root planing (SRP), which exposes…
• Does motivational interviewing or oral hygiene instruction improve plaque control?Both motivational interviewing (MI) and traditional oral hygiene instruction (OHI) appear capable of improving plaque control, though the evidence on…

Machine-readable version for AI agents: /evidence/index.json. Live answers through the API: see for agents.