Airflow Teeth Cleaning (Guided Biofilm Therapy)

What is Airflow dental cleaning?

Airflow dental cleaning is a professional oral hygiene method that removes bacterial plaque (biofilm), pigment stains, and early-stage deposits from tooth surfaces using a controlled spray of heated water, pressurized air, and ultrafine erythritol powder. It replaces the traditional polishing step with brush and polishing paste with a non-contact, controlled flow technique. The powder particles are 14 microns in size, making them minimally abrasive on enamel, dentin, and root surfaces. At Doredent, we perform this treatment using a Swiss-made EMS device and the manufacturer's eight-step GBT (Guided Biofilm Therapy) protocol.

The core principle of GBT is simple: invisible debris cannot be thoroughly cleaned. Biofilm on tooth surfaces is not visible to the naked eye, so before cleaning begins, a special disclosing agent makes the layer visible. The treatment continues on these areas until no dye remains. The procedure is most commonly indicated for tartar and plaque buildup complaints. It is also one of the most effective methods for regular biofilm control in patients with bleeding gums, bad breath, gingivitis, and periodontitis.

The procedure begins with an oral examination and gum pocket measurement; cleaning does not proceed without this assessment. After disclosing, the Airflow tip cleans biofilm and surface stains from tea, coffee, and smoking up to four millimeters below the gumline. The tongue and palate surfaces are also cleaned during this step. For gum pockets deeper than four millimeters and peri-implant areas, a fine, flexible nozzle (Perioflow) is used; anesthesia is usually not required at this stage. If hardened tartar remains, it is removed with a fine ultrasonic tip. Because surfaces are already smooth after Airflow, no additional polishing is performed. The treatment is completed with a protective fluoride application and typically takes 30 to 60 minutes.

Airflow does not replace dental scaling, it encompasses and expands it. The traditional method targets hardened deposits, while the GBT protocol addresses biofilm at its source and below the gumline. For this reason, it is especially preferred for patients with implants, those undergoing braces or clear aligner treatment, those with a history of gum disease, and patients who avoid traditional cleaning due to sensitivity. When surfaces are completely cleaned, early cavities, filling margins, and white spot lesions can be evaluated much more accurately, making it a valuable preparatory step before teeth whitening, fillings, and prosthetic procedures. The frequency of repeat visits is determined by the patient's cavity and gum disease risk; intervals of 6 to 12 months are recommended for healthy gums, and shorter intervals for patients with gum problems.

Applications

Airflow is a method that can be applied to almost any hard or soft tissue in the mouth, not just a single surface. Thanks to the fine powder particles and the tip not touching the tooth, it can be safely used on surfaces where conventional brushes and polishing paste pose a risk. Below you can find the most common application areas.

🦷 Natural Teeth and Baby Teeth

It can be applied on enamel, dentin, and root surfaces (cementum). Exposed root surfaces due to gum recession are cleaned with a significantly less abrasive surface compared to conventional polishing paste. On baby teeth, the device is operated at a low setting, which is why it is preferred in pediatric dentistry applications.

• Can be applied on baby teeth and permanent teeth.
• Has low abrasive effect on exposed root surfaces.
• Cleans accumulation in pits and fissures.
• Settings are lowered for children and sensitive patients.

🔩 Implants and Surrounding Tissues

Implant surfaces carry a risk of scratching when cleaned with metal hand instruments and conventional tips. Airflow works without leaving changes on the implant surface. In peri-implant pockets deeper than four millimeters, a thin and flexible nozzle is used. Peri-implantitis is one of the most common causes of implant loss, and the most effective way to prevent it is regular biofilm control.

• Safely applied on implant surfaces and necks.
• Can clean peri-implant sulcus and deep pockets.
• Used regularly in monitoring mucositis and peri-implantitis.
• Maintenance interval is determined based on the condition of peri-implant tissue.

👑 Crowns, Fillings, and Prostheses

Zirconia and laminate crowns, composite fillings, bridges, and removable prostheses can be treated. Restoration margins are the areas where plaque accumulation is most intense, and keeping these areas clean directly affects the longevity of the restoration.

• Does not cause loss of shine on crown and laminate surfaces.
• Cleans accumulation at filling and restoration margins.
• Can be applied on fixed bridges and removable prostheses.
• Removes staining at restoration margins.

🔧 Patients Undergoing Orthodontic Treatment

In patients using braces, the area around brackets and wires is the hardest place for a brush to reach. In these areas, the risk of white spot lesions and gum inflammation increases significantly. Airflow can reach around brackets, under wires, and around clear aligner attachments. In patients with a retainer wire, the accumulation on the back surface of the wire is cleaned in the same way.

• Cleans biofilm around brackets and wires.
• Safely applied around clear aligner attachments.
• Reaches accumulation behind retainer wires.
• Helps reduce the risk of white spot lesions.

👅 Gums, Tongue, and Palate

Biofilm does not only accumulate on tooth surfaces. The back of the tongue and palate are also important bacterial reservoirs and are common sources of bad breath. Airflow can also be applied on these soft tissues. It can work up to four millimeters below the gum line, and up to nine millimeters in deep pockets with a special nozzle.

• Can clean the back of the tongue and palate surface.
• Can be applied in subgingival areas.
• Used in monitoring gingivitis and periodontitis.
• Does not cause pain or sensitivity on soft tissue.

✨ Preparation Before Other Treatments

When biofilm and stains are removed, the tooth surface becomes a clean base both visually and for the material to be applied. For this reason, Airflow is planned as the first step of many treatments.

• Before cavity diagnosis: initial lesions are more clearly visible on a clean and dry surface.
• Before teeth whitening: color lightening is more even when surface stains are removed.
• Before fillings, crowns, and prostheses: bonding surface is prepared.
• Before fluoride application: enamel surface absorbs fluoride better.

Treatment Process

How Airflow Differs from Other Cleaning Methods

Airflow is not a replacement for other methods used in oral care. It is often planned as a stage together with them. Which method is necessary depends on the amount of biofilm, presence of hardened tartar, gum pocket depth, and the patient's risk level. Below you can find the differences between Airflow and the most commonly confused methods.

Difference from Traditional Tartar Cleaning (Scaling)

Tartar cleaning aims to break up hardened deposits with ultrasonic vibration. Afterward, the surface is polished with a brush and polishing paste. Airflow, however, targets not the hardened tartar but the bacterial layer that has not yet hardened and pigment stains. It also reaches below the gumline, the tongue, and the palate.

The two are not competitors. In the GBT protocol, biofilm and stains are first removed with Airflow. If any hard tartar remains, it is cleaned with an ultrasonic tip. Because biofilm is removed first, tartar becomes much more visible and the ultrasonic stage is shortened. In patients with heavy hardened tartar buildup, both methods are used in the same session.

• Traditional scaling focuses on hardened tartar, Airflow focuses on biofilm.
• Airflow is also applied below the gumline, to the tongue, and palate.
• If hard tartar is present, ultrasonic cleaning is still necessary.
• After Airflow, no additional polishing with brush and paste is performed.

Difference from Polishing with Brush and Paste

Polishing pastes used in the final stage of traditional cleaning contain abrasive particles and are applied by rubbing them onto the tooth surface with a rubber brush. The erythritol powder used in Airflow is 14 microns and the tip does not touch the tooth surface. Therefore, no additional polishing is needed after the procedure.

• The tip does not touch the tooth surface, no friction occurs.
• The particle size of the powder used is much smaller than polishing pastes.
• It is safer on exposed root surfaces and restorations.
• Procedure time is shorter because there is no additional polishing stage.

Difference from Curettage (Deep Cleaning)

Curettage is a procedure to clean inflamed tissue inside the gum pocket and hardened deposits on the root surface in advanced gum disease. It is usually performed under local anesthesia and over multiple sessions. Airflow cleans the biofilm inside the pocket but does not remove hardened tartar on the root surface.

For this reason, in advanced periodontitis cases, Airflow does not replace curettage. However, in the maintenance phase after curettage is completed, it is used regularly to prevent the pockets from refilling with bacteria.

• Curettage targets hardened root surface deposits, Airflow targets biofilm.
• Curettage usually requires anesthesia, Airflow does not in most cases.
• In advanced gum disease, Airflow alone is not sufficient.
• It is often preferred in maintenance care after periodontal treatment.

Difference from Teeth Whitening

Airflow is not a whitening procedure. Because it removes surface stains from tea, coffee, smoking, and similar sources, teeth appear lighter and brighter after the procedure. However, this is the tooth's natural color being revealed, not a change in its tone. Teeth whitening chemically lightens the tooth's own color. If a whiter smile is the goal, the correct sequence is cleaning first, then whitening.

Does Not Replace Home Oral Care

No procedure performed in a clinic replaces daily care. Biofilm begins to reform within hours after it is cleaned. Lasting results are achieved with regular brushing and interdental cleaning. This is why the staining stage in the GBT protocol is shown to the patient: it concretely reveals which areas are being neglected at home.

Important Considerations

Airflow is a minimally invasive procedure with a low complication rate. Most patients require no additional precautions. However, as with any dental procedure that uses pressurized air and powder, certain conditions should be evaluated beforehand. The sections below explain what you should share with your dentist before treatment and what temporary effects are considered normal.

What to Expect During and After the Procedure

During the procedure, you'll hear a gentle spray sound and feel water flow and a slightly salty taste from the powder. In the first few hours after treatment, you may notice temporary sensitivity or minimal bleeding in your gums. This is a normal part of the healing process for inflamed gum tissue and typically resolves within a few days.

• The powder's slightly salty taste may be noticeable throughout the procedure.
• Patients with heavy buildup may experience temporary hot and cold sensitivity after cleaning.
• Staining solution may temporarily remain on your lips and tongue.
• If tartar was also removed, you may feel spaces between your teeth. This is simply because the existing buildup has been cleared away.

What You Must Tell Your Dentist Before Treatment

Because of the powder, staining solution, and rinse ingredients used, certain allergies and sensitivities need to be known in advance. Additionally, systemic conditions and regular medications directly affect how your treatment is planned.

• Sensitivity to iodine, chlorhexidine (CHX), or cetylpyridinium chloride (CPC).
• Known allergies to flavorings such as mint, cherry, or lemon.
• Sensitivity to sugar alcohols such as erythritol and xylitol.
• Use of blood thinning (anticoagulant) medications.
• Treatment for bone resorption (bisphosphonates, denosumab).
• Medical risk conditions such as diabetes or heart disease.
• Pregnancy and breastfeeding.
• Respiratory conditions and contagious infections.

None of these conditions alone is an absolute contraindication. Your dentist will determine the scope and settings of the procedure based on your individual situation, and if necessary, will seek approval from your treating physician.

When Deep Pocket Treatment Is Postponed

The fine nozzle used for pockets deeper than four millimeters is not applied when the soft tissue is not in suitable condition. In these cases, supragingival cleaning is performed, and the deep pocket phase is planned after the tissues have healed.

• Presence of an abscess or active inflammation in the area.
• Excessive bleeding and discharge (suppuration) during probing.
• Insufficient keratinized tissue around the gums.
• Proximity to an area where a tooth was recently extracted or has not yet healed.
• Suspected vertical root fracture.
• Anatomically low sinus floor.

Emphysema Risk

Subcutaneous emphysema is a rare complication that can occur when pressurized air escapes into tissue spaces. It has been documented for all dental procedures that use pressurized air. To minimize risk, the nozzle is not pushed into the pocket, limited time is spent in each area, and application is avoided in areas where soft tissue integrity is compromised. If you notice sudden swelling, tightness, or a crackling sensation when pressed in your face, neck, or around your eyes during or after the procedure, contact the clinic immediately.

Pacemakers and Implantable Devices

Active implantable medical devices such as pacemakers, defibrillators, insulin pumps, and hearing aids are a consideration for the ultrasonic scaling phase of treatment. The procedure can be performed in these patients, but a safe distance is maintained between the device and the oral cavity, and approval from the patient's own physician is obtained if deemed necessary. Removable devices such as insulin pumps and hearing aids should be turned off or removed during the procedure.

When Should You Contact the Clinic?

• If gum bleeding does not subside within a few days or is increasing.
• If sensitivity lasts longer than a week or is getting worse.
• If swelling, pain, or fever develops in your face or neck area.
• If you notice a sore in your mouth that does not heal after the procedure.

When Is It Recommended?

Airflow is not a treatment for a specific complaint. It is a routine procedure to maintain oral health. However, it provides noticeably greater benefit for certain patient groups and conditions. Below you will find the situations where it is most commonly used.

🩸 Bleeding and Inflamed Gums

Bleeding while brushing or flossing is the most common sign of gum inflammation. The source of inflammation is the bacterial plaque that accumulates on and below the gum line. Airflow removes this plaque both on the tooth surface and up to four millimeters below the gum line. In gingivitis cases, inflammation typically subsides within a few weeks once the buildup is removed.

• Bleeding signals inflammation. If neglected, it can progress to bone loss.
• Biofilm below the gum line cannot be reached with a regular toothbrush and toothpaste.
• The procedure typically does not cause pain in inflamed gums.
• Maintaining regular home care is essential for lasting results.

🦠 Patients Who Have Undergone Periodontal Treatment (Maintenance Care)

The period after periodontitis treatment is as important as the treatment itself in preventing recurrence. Bacterial colonies remaining in deep pockets can multiply again in a short time. Airflow is one of the core tools for this maintenance phase, as it can work with a fine nozzle in pockets deeper than four millimeters.

• Biofilm inside the pocket can be cleaned without requiring anesthesia.
• It does not cause changes or wear on the root surface.
• It is planned as part of the maintenance protocol after curettage.
• The follow-up interval is determined based on pocket depth and bleeding findings.

💨 Bad Breath Complaints

The most common source of chronic bad breath is bacterial activity in the mouth. The tongue surface is an often overlooked part of this problem. Since Airflow can clean not only tooth surfaces but also the tongue and palate, it makes a noticeable difference in cases where the source of odor is inside the mouth.

• The bacterial coating on the tongue surface is included in the procedure.
• Bacterial load in gum pockets is reduced.
• Most patients notice the difference immediately after the procedure.
• If the odor persists, cavities, prosthetic fit, or systemic causes should be investigated.

😖 Patients Who Avoid Cleaning Due to Sensitivity

A significant number of patients who postpone dental cleaning do so because of the scraping sensation and vibration from past experiences. With Airflow, the tip does not touch the tooth and the water is warmed. These two features significantly increase comfort for sensitive patients. Additionally, the device settings can be adjusted based on the level of sensitivity.

• The scraping and friction sensation is largely eliminated.
• Since the water is warmed, there is no cold shock.
• It is easier to work in areas with gum recession.
• Settings can be gradually reduced according to the patient.

☕ Patients with Tea, Coffee, and Tobacco Stains

Surface discolorations come not from the tooth's natural color but from pigments that settle on the enamel. Airflow removes these pigments even in areas that are difficult for a toothbrush to reach, such as between teeth and along the gum line. The result is not whitening but revealing the tooth's natural color.

• Stains between teeth and along the gum line are cleaned.
• Discoloration at the edges of restorations and crowns is removed.
• Because buildup accumulates faster in smokers, the interval may be shortened.
• If teeth whitening is planned, applying Airflow beforehand improves the outcome.

🧒 Children and Young Patients

The procedure is performed at low settings on baby teeth and newly erupted permanent teeth. The absence of a scraping sensation is also important in preventing dental fear in children. In our pediatric dentistry department, the procedure is planned according to the child's age and cooperation.

• It is safely applied to baby teeth at low settings.
• Buildup in pit and fissure areas is cleaned.
• It provides surface preparation before dental sealants and fluoride treatment.
• Fluoride protective foam is not used in children under seven years old.

How Often Should It Be Done?

The interval is not fixed for everyone. It is determined individually based on cavity risk, gum condition, and findings around implants if present. The general framework is as follows:

• If gums are healthy: Every 6 to 12 months.
• If gum inflammation is present: Every 6 months.
• If there is a history of periodontitis: Every 1 to 3 months.
• If the area around implants is healthy: Every 6 months.
• If there is inflammation around implants (mucositis): Every 3 to 6 months.
• If peri-implantitis is present: Monthly follow-up intervals may be planned.

The interval is not a permanent decision. As gum health improves, the interval is extended. If risk increases, it is shortened again.

After Treatment

Airflow is a procedure that requires no recovery period and is typically completed in a single session. Since no anesthesia is used, you can return to your daily routine immediately after the procedure. However, there are a few things you should know to ensure lasting results and avoid any unexpected issues in the first few days.

The First Few Hours After Treatment

• You can eat right away: There is no waiting period. Since no anesthesia is used, there is no numbness in your lips or tongue.
• If protective foam was applied: To allow the fluoride foam to take full effect, we recommend avoiding eating and drinking for approximately 30 minutes after the procedure.
• Avoid colored foods and drinks: In the first few hours, your tooth surfaces are more susceptible to pigments until saliva rebuilds its protective layer. Staying away from tea, coffee, red wine, concentrated fruit juices, and cigarettes during this time helps preserve your results longer.
• Temporary sensitivity: Patients who have not had a cleaning in a long time may experience hot or cold sensitivity. This sensation, which occurs when the surface previously covered by buildup is exposed, typically resolves on its own within a few days.
• Dye residue: A slight color may remain on your lips, tongue, or gums from the dye used to make biofilm visible. This disappears on its own shortly after.

The First Week: Gum Healing

• Bleeding decreases: Gums that bled during brushing before the procedure typically stop bleeding noticeably within 1-2 weeks after the buildup is removed.
• Gum color returns to normal: Tissue that was red and swollen during inflammation begins to regain its pink, firm structure.
• Do not skip brushing: Avoiding brushing due to sensitivity or slight bleeding delays healing. You should continue gentle brushing with a soft-bristled brush.
• Start interdental cleaning: Dental floss or interdental brushes target the areas where biofilm reforms most quickly. Pay special attention to the problem areas identified during your procedure.

Daily Care to Maintain Results

Biofilm begins to reform within hours after cleaning. The clinical procedure resets this cycle, but your home care determines how slowly the cycle progresses.

• Brush twice a day for two minutes each time: Use a soft-bristled brush and fluoride toothpaste. Hard brushes or pressing too hard can cause gum recession.
• Clean between teeth daily: Your toothbrush cannot reach about one third of tooth surfaces. Dental floss or interdental brushes fill this gap.
• Choosing interdental brushes: The right thickness for your tooth spaces is determined together during your procedure. The wrong size is both ineffective and can strain your gums.
• If you have orthodontic appliances: For those wearing braces, the area around brackets is critical. For clear aligner users, brushing before inserting aligners is essential.
• If you have implants: The area around implants, unlike natural teeth, is more vulnerable to inflammation. Daily cleaning of these areas must not be neglected.
• Smoking: Smoking both accelerates buildup and masks gum bleeding, delaying detection of problems.

Follow-Up Appointment

Your next appointment is planned based on the gum health and cavity risk assessment performed during your procedure. While this interval can extend to 6-12 months with healthy gums, it is kept much shorter for patients with a history of periodontitis or peri-implant inflammation. The interval is not a fixed rule. As your gum health improves, the time between appointments can be extended.

If Something Unexpected Occurs

Contact our clinic if any of the following occur:

• Gum bleeding does not decrease within a few days or is getting worse.
• Sensitivity lasts longer than a week or is intensifying.
• Swelling, tightness, or fever develops in your face, neck, or around your eyes.
• You notice a sore that is not healing or an unexpected color change in your mouth.

Treatment Costs

Frequently Asked Questions