I recently gave a webinar on ‘Osseointegration – maintaining the balance', where I discussed in-depth the crucial role maintenance and monitoring has in maintaining peri-implant health. There were many questions at the end of the presentation around use of air polishers, and I highlighted the European Federation of Periodontology (EFP) position on the use of air polishers, in particular the excellent EFP infographics which provide an evidence-based approach to their use.1

On reading the British Dental Journal the next day I found the publication by Mordi et al.2 an extremely useful case study, which in my opinion makes essential reading for clinicians using air polishers, or those considering their use. The article explained the mechanism as to how a pneumomediastinum could result whilst using an air polisher. On a number of occasions the authors mentioned the need to develop protocols to ensure the safe use of air polishers and if iatrogenic events did unfortunately occur, appropriate protocols to manage these events.

Having found this an interesting and informative read, on scanning through the BDJ I noticed an advertisement for an air polisher with the strapline ‘Free yourself from protocol'. Whilst the effective use of air polishers for supragingival plaque, stain, and calculus removal may be more time effective than traditional hand instrumentation (freeing clinicians from current hand instrumentation protocol), the article by Mordi et al. highlighted the need for other protocols for safe and effective use. As always prevention is better than cure, and protocols for safe and appropriate use will go some way to mitigate against untoward events, as highlighted by this case.