Air Abrasion

Air abrasion is a minimally invasive cavity preparation technique that uses a focused stream of fine abrasive particles, typically aluminum oxide with a particle size of 27 to 50 microns, propelled by compressed air through a small handpiece nozzle directed at the tooth surface. The kinetic energy of the particles removes decayed tooth structure and prepares the surface for bonded restorations without generating the heat, vibration, or pressure associated with conventional rotary handpieces. The technique is particularly effective for small to moderate Class I and Class V lesions, removal of superficial staining, and surface preparation prior to sealant placement or composite bonding procedures.

Air abrasion gained clinical acceptance as part of the broader movement toward minimally invasive dentistry, which prioritizes preservation of healthy tooth structure. Because the technique does not produce the noise and sensation of a traditional drill, many patients, particularly pediatric and anxious patients, tolerate the procedure more readily. In many cases, air abrasion preparations do not require local anesthesia, which reduces procedure time and eliminates the recovery period associated with soft tissue numbness. However, air abrasion has limitations in that it is less effective for removing large volumes of decay, accessing deep interproximal lesions, or working on hard materials such as amalgam or porcelain. Rubber dam isolation or high-volume suction is typically recommended to manage the particle spray and protect adjacent tissues.

In billing workflows, restorations completed using air abrasion preparation are coded identically to those prepared with conventional rotary instruments, using the standard CDT codes for composite or amalgam restorations based on tooth type and surface count. The preparation method itself does not warrant a separate or modified procedure code. Practices that market air abrasion as a patient comfort advantage should ensure their fee schedules reflect the same restoration codes regardless of preparation technique. Documentation should note the use of air abrasion in the clinical narrative, which can be useful during audits to explain the conservative preparation design.