Air Abrasion in Dentistry

According to Wikipedia, air abrasion is an alternative to the traditional dental drill. It is a miniature sand blaster.

The technique requires a special machine and handpiece that sprays out aluminum oxide particles that are 27-50 micrometers in diameter. It usually has 40-120 psi of pressure. This allows the tooth structure to be cut. Also the size of tip plus the size of the hole in the tip plus its angulation can modify how the particles leave the handpiece.

Why is it used less today?

I had an expensive machine in the 90’s, made by a company no longer in business and was supposed to be one of the top manufacturers of this machine at that time. I found several problems with the entire process:

  1. It’s slow.
  2. It’s messy. The particles go everywhere. There is a suction that goes with it but the aluminum oxide still made a mess.
  3. Patients frequently felt it even though we were expecting they wouldn’t.
  4. If the decay went deeper than expected, which happened frequently, I’d have to go back and anesthetize, and the patient wouldn’t be happy about that even when warned about this possibility.
  5. It has a limited usage: usually for pit and fissure sealants or small cavities in the grooves. I’ve heard of doing some small interproximal (between the teeth) fillings with this…I was not comfortable with this in my hands.
  6. Maintenance of the machine was very expensive.

I’ve read excerpts from articles from dental opinion leaders like Gordon Christensen who recommend revisiting this. There are now smaller less expensive models available at 1/10th of the cost. With the above host of shortcomings, it’s just not worth it.

If you are of the mindset that aluminum might be bad for you, this provides a mouthful for you that has to be cleaned up. The dental community at large says this is OK for you for just one procedure, but I think the aluminum oxide issue causes another area for concern.