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. A systematic review found that reported discomfort during non-surgical periodontal therapy was consistently equal or lower when glycine or erythritol powders were used compared with hand instruments or ultrasonic devices, with glycine appearing to be associated with less discomfort ^[1]. In a randomized controlled trial comparing air polishing followed by ultrasonic calculus removal versus conventional ultrasonic scaling and rubber cup polishing, superior patient comfort was reported for the air polishing protocol ^[2]. Similarly, in a split-mouth RCT evaluating subgingival air polishing with a conical-shaped tip during supportive periodontal therapy, pain perception was significantly lower for the air polishing group compared to sonic scaling (mean VAS 12.56 vs. 28.8, p = 0.006) ^[3]. The majority of patients in several studies also rated subgingival air polishing as more comfortable compared to hand instruments or sonic scaling ^[3]. These findings apply across both supragingival and subgingival applications, and across different low-abrasiveness powders such as erythritol, glycine, and trehalose ^[1][2][3].